All of Sjcs's Comments + Replies

Hydroxychloroquine is pretty well tolerated from what I've seen (never seen chloroquine given we have a safer alternative). The most common side effect is nausea/vomiting/diarrhoea and this is the only thing I could find a rate on (~10%). There are also a collection of rare, severe side effects.

Some of my concerns are:

  • Most of our safety data would be targeted at use in relatively well patients with rheumatological or dermatological disease, not acutely unwell infective patients (I have no idea about its safety profile in malaria other than it's not reall
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TL;DR We don't know, it's variable case to case, and could be longer than 25 days from symptom onset if you get sick

In patients admitted to hospital with COVID-19, there are cases (Korea, Singapore) of viral RNA detectable up to 25 days after symptom onset. This is not the same as still being infective, so we don't really know.

In people exposed to SARS-CoV-2, 14 days is an estimation that the vast majority will have developed symptoms by this time (here). However, this doesn't take into account cases that remain asymptomatic throughout their infection (may

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I think this is unsafe advice, specifically using chloroquine and hydroxychloroquine without medical supervision.

These are not benign drugs (chloroquine being worse) and you are advising people use it while unwell with an emerging and poorly understood disease that could potentially alter its safety and pharmacokinetic/dynamic profile, and without any consideration for potential other health issues people have or medications people are taking (eg many antidepressants and anyone with diabetes).

If you have chloroquine/hydroxychloroquine, you should go see yo

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4Wei Dai4y
I've added some information about possible side effects to my comment. Obviously "with medical supervision" would be preferable, so sure talk to your doctor on the phone about it first if you can. (I think visiting a doctor's office is too risky at this point.) But if your doctor can't or won't talk to you about taking chloroquine/hydroxychloroquine, and you don't have preexisting conditions that make chloroquine/hydroxychloroquine more dangerous for you, it seems to me safer to take it than not. Unfortunately I'm unable to find quantitative information about the risk of side effects (UpToDate says "Frequency not defined" under "Adverse Reactions"), so it's hard to make a really informed decision about this. Perhaps to be safer, one could take chloroquine/hydroxychloroquine at home at a lower dosage than is recommended for severely sick hospitalized patients? Would you agree with that, or do you think "young and healthy" should refrain from taking any dosage, absent medical supervision? If so, what is that based on? (E.g., are you a doctor with first-hand experience or some other source of information about chloroquine side-effects?)

1000-2000IU on average per day for an adult, depending on your size. You add this up and take it instead every 2-3 days likely without any issues (e.g. I take 3000-4000IU every 2-3days)

If you have lighter toned skin and get regular sun exposure you may not need any supplementation

Normal blood oxygen saturation is 95% and above; without a history of fairly significant lung disease I'd be surprised if you were persistently under this level - note that an oximeter can give very variable readings due to artefact from all sorts of things including movement, ambient light, temperature (probably a significant one in the context of an infection if you are having a fever/rigoring/very cold fingers), and the number it spits out is the average over the last 3-12s.

If you are short of breath with coronavirus it is worth talking to a healthcare

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2Jay Molstad4y
Personally my oxygen saturation always reads 91-93%. I'm 47 years old with no known lung problems who never smoked. People vary. I'm an unusually large man, so it may be a square-cube law effect or a finger-thickness effect. It may be some other confounder. Under normal circumstances I would agree with the rest. In the very near future healthcare providers are expected to be absolutely swamped with coronavirus cases; apparently corpses have been piling up in Italy. I think my thresholds for action are stricter than yours because I'm trying to minimize strain on the system. But at 90% your plan is to go to the hospital and my plan is to call a doctor to find out if I should go to the hospital. That's not a huge difference. Related: the mayor of Baltimore has requested his citizens avoid senseless gun violence for similar reasons. Things are getting weird out there.

Most potential at-home oxygen supplementation methods will aerosolize the virus and increase contagiousness nearby, and are not allowed in a healthcare setting as a result. Default to assuming this applies.

I don't think this is correct; (almost) all at-home devices will be oxygen concentrators providing supplemental oxygen at low flow rates (majority 1-6L/min) via (low flow) nasal prongs or masks (not the non-rebreather style mask mentioned later). Clinically significant aerosolization of respiratory droplets requires higher flow - like the high flow na

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1Spiracular4y
Ah. Then that is an error on my part because I had no prior knowledge on this topic, and assumed that rebreather oxygen masks were the default form of oxygen masks. Thanks for the correction! I've tried to update the relevant bullet-points towards what you described.
The thing is, I don’t mean “it’s okay” as something to think. I mean it more like an instruction, like “look up” in the cell phone parable. Trying to understand the meaning is analogous to Alex posting a photo of their phone and then scrolling above it in the text chat.
Another way I could try to say the “it’s okay” thing is something like, “The world is real in your immediate experience before you think about it. Set aside your interpretations and just look.” The trouble is, most people’s thinking system can grab statements like this and try to in
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This is one way to make your beliefs pay rent

...

Puns aside, great post!

0cousin_it7y
Thanks!

As a bit of a tangent to 2)

Certainly using visualisation as practice has some evidence (especially high-fidelity visualisation increasing performance at comparable rates to actual practice; one course I've been to advocated for the PETLEPP model in the context of medical procedures/simulation) - in this sense it may help achieving an endeavor but 1. It's got nothing (much) to do with positive visualisation and 2. It feels like its moving the goal-posts by interpreting the 'endeavor' as 'performing better'.

I've definitely also heard people discussing posit... (read more)

You could record the audio on a separate device at the same time placed much closer. I'd suggest recording the audio in a lossless format (I used wavpack but only because it was convenient), then converting to WAV format (lossless but no compression so large filesize). In WAV format the audio can be processed by CN Levelator to improve the quality. Then convert to whatever format you want (eg for podcast) or directly replace the video's audio with your improved recording using any video editing software. It's a annoying series of steps but may get you much... (read more)

I have taken the survey.

The only option i think was missing was in the final questions about quantities donated to charities, an option such as "I intend to donate more before the end of the financial year" or similar. (and while likely not feasible, following up on those people in the next survey to see if they actually donated would be interesting)

Off the top of my head, the most reliable way would be to ask another senior medical professional - senior as they would tend to have been in the same geographic area for a while and know their colleagues, plus have more direct contact with primary care physicians. Also, rather than asking "who should i see as my primary care physician", you could ask "who would you send your family to see?". This might help prevent them from just recommending a friend/someone with whom they have a financial relationship. I note that this would be relat... (read more)

paracetamol (tylenol) but with muchas caution as it is a liver killer, or ibuprofen (I would say if you have kids, don't even keep paracetamol/tylenol in the house, ibuprofen works just as well and is safer)

This is incorrect. Normal paracetamol dosing is less than half the toxic dose of paracetamol, and it is an incredibly safe drug at these levels. Ibuprofen however has rare but well know side effects of gastric irritation, ulceration and life-threatening haemorrhage

0[anonymous]9y
Yes, that is the point. It is incredibly easy to go over double the normal, if you are irritated with symptoms. I know people who take three aspirin pills at once because they really want to throw a nuke on that hangover. A typical coldrex pill is 4 pills a day. It is far too easy to not even read it (it is OTC so "safe" right???? they would make it prescription if it was dangerous right???? <- this is a common logic used) and pop a pill every hour.
0NancyLebovitz9y
Unfortunately, paracetamol is included in some multi-drug combinations, so it's relatively easy to overdose by accident.

Why does it being blatant mean it is no longer humorous? Sure, a subtle joke can be more humorous for its subtlety, but not being subtle doesn't necessarily preclude a joke's enjoyment.

There are many forms, and EY is probably trying catering to a range of people's sense of humour.

0Fivehundred9y
You did actually read the part where Hermione says: "What if Harry Potter behaved exactly like canon, Quidditch, Ron Weasley, etc! Ha ha ha!"

Preserving the image of Quirrell also helps in continuing to restore Slytherin, whereas outing him could damn the house to be forever ignoble or be removed completely

2Velorien9y
Howso? It is no revelation to anyone that Voldemort was a Slytherin.

As my email is on my phone, I almost never proactively check my mail - instead I check it in a reactive manner. All my email addresses forward to a central email which is synced to my phone. Once email arrives, I check its contents and either:

  • archive it if I don't need to respond or need it for anything
  • mark it as read if I want to read it later or it requires a response
  • mark it as read and star it if it is really important (assuming I don't deal with it immediately)

Additionally, I have a pebble smartwatch which notifies me when mail arrives so I can k... (read more)

6tog9y
You can also do this with GMail - if your address is bob@gmail.com, bob+anystring@gmail.com and bob+anystring2@gmail.com will reach you (ie you can put anything after +).

Instead of using a nasal decongestant pill such as Sudafed, try using a decongestant nasal spray like Afrin or Anefrin.

It is worth noting that nasal sprays containing oxymetazoline (the active ingredient in Afrin and Anefrin) should not be used for extended period as they cause rebound congestion ie if you use it for more than 3-5 days, when you cease using it you may become congested for a number of days.

I agree that sinus rinses are good. I tend to mix salt with lukewarm water, as it is the least irritating. I have read you are not meant to use tap wa... (read more)

You could try changing your username. I am not sure whether it would change the username that appears on all your past comments, but I suspect it would. You could email and ask.

The book On Combat by Dave Grossman discusses some of these things. I haven't read it yet, but have read reviews and listened to a podcast by two people I consider highly evidence-based and reputable (here). In particular, the book discusses a method of physiologically lowering your heart rate he calls "Combat Breathing". This entails 4 phases, each for the durations of a count of 4 (no unit specified, I do approx 4 seconds):

  1. Breathe in

  2. Hold in

  3. Breathe out

  4. Hold out

It sounds very simple, but I have heard multiple recommendations of it from... (read more)

I unfortunately haven't developed a quirrellmort yet (the concept is on my to-do list though, along with a number of other personifications). I do have two loose internal models though, for very specific tasks.

The first is called "The Alien" or just "Alien". I created it in my mid-teens after reading the last samurai (not the movie), although my use of The Alien is not the same as the book's. The Alien is the voice in my head that says the pointlessly stupid or cruel things (generally about people) for no reason other than being able t... (read more)

This month, I finished medical school, which elicits a complex set of emotions difficult to describe. Maybe relief/fist pumpin' exuberance/trepidation/excitement/tiredness/nostalgia/determination/pride in variable amounts (results aren't out yet, and I guess that adds to some of those emotions). This isn't very LW-related, but is a big transition point and I'm quite proud it's complete.

Possibly my favourite thing about finishing is that I now have 3-or-so months with only a few commitments before I start work, which means I can get started on some of my pe... (read more)

Put another way, I've been trying to think of the various ways that people outside the memeplex see those inside it as weirdos.

The lurker, who may not be gaining as much utility as they would if they participated. However, they still receive the same (or a degree of) connotations from those outside the memeplex, due to their association with the group. These percepts from the outside may be either good or bad.

Took the survey a few days ago, and forgot to even comment! Thanks Yvain and looking forward to seeing what comes out of it

I have been an on-and-off lurker for ~15 months, and only recently created an account (not because of the survey though). I have participated in both 2013 and 2014's surveys.

Although I would consider myself as a supplement novice, I generally look into supplements based on other peoples recommendations whenever I stumble upon them, and then look them up on Wikipedia and Examine. I occassionally go looking (via google) specifically for peoples' negative reviews of the supplement to check for significant adverse effects that might not have been made clear.

I realise this is obvious, but if anyone were to experiment with supplements be very aware of placebo effect and confirmation bias.

I almost exclusively listen to medical podcasts (as I work in the medical field), but have been meaning to break into some non-medical podcasts; this looks like an interesting list to start with, thank you.

If anyone else is interested in medical podcasts, particularly from the emergency/intensive care/anaesthetics/retrieval sphere, there is a flourishing community of #FOAMed (Free Open Access Meducation) that strive to provide quality, evidence based teaching in medicine. It aims to reduce the knowledge translation time, as well as discuss cutting edge top... (read more)