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Many Doctors Weigh in: Hydroxychloroquine (HCQ), Zinc and Azithromycin Should be Greenlighted for COVID-19

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From this article:

It’s important to note that HCQ, zinc, and azithromycin are very well understood drugs with clear safety profiles; they are widely available, generic, inexpensive, and can be scaled rapidly, including to the developing world…

Our primary strategic objective must be to prevent ICU overwhelm, which on our current course is imminent in most states. It is an axiom of infectious diseases that treatment in earlier stages is more effective than treating advanced stages. Early COVID-19 treatment is more likely to prevent disease progression to critical status, radically lowering hospitalizations and CFR than inaction.

Current clinical drug trials are mostly focused on treating late stages of disease, when immunologic damage is a dominant threat. We believe that trials should focus on earlier stage infection to prevent progression to advanced disease.

Some health authorities have given the typical caution against early treatment until large, peer-reviewed, randomized controlled trials (RCTs) provide conclusive data. We fully support the continued effort to investigate existing and novel pharmaceuticals to determine the best intervention through blinded and controlled trials. Weighing the urgency of this unprecedented situation combined with the effects of inaction, plus the relative safety of the drugs, and the preponderance of data showing effective early treatment significantly decreases the percentage of cases that progress to needing hospitalization, we believe that the proposed recommendation is not only adequately founded but ethically obligate[d]…

Early clinical reports suggest it’s best to treat within 5 days of symptom onset. Waiting until a patient is hospitalized or critically ill is unwarranted and unwise.

Comments
No mention of zinc by the IDS. They can't be that dense.ET
April 14, 2020
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Jerry
You failed to point out that the study was not similar to other studies and not comparable.
None of the studies is comparable. That is the problem.Ed George
April 14, 2020
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the Infectious Diseases Society of America could not recommend hydroxychloroquine with or without azithromycin or any other experimental therapy for COVID-19 outside of a clinical trial.
What treatment did they recommend? Was this treatment they recommended deemed effective? If there is no other treatment is this tantamount to sentencing some people to death? If not, why not?jerry
April 14, 2020
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All I did was provide a link to a study that had different results than some others
You failed to point out that the study was not similar to other studies and not comparable. It is something you should have done so that people would know it didn't represent what else was being done. RHampton did the same thing.
If you want to assign some nefarious motivation to my comment and link, that is your problem, not mine.
I didn't assign any motivation to what you did. I just pointed out you misrepresented what you said. I have no idea why you posted the original link and why then misrepresented what you had posted.jerry
April 14, 2020
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After scrutinizing all of the evidence, the Infectious Diseases Society of America could not recommend hydroxychloroquine with or without azithromycin or any other experimental therapy for COVID-19 outside of a clinical trial. The reason: The data are just not there that the drugs are safe and effective alternatives to supportive care. In the case of hydroxychloroquine and azithromycin, the panel was concerned about the potential effects on the heart. The combination can cause QT prolongation, and patients must be monitored, which can be difficult especially in an outpatient setting, Dr. Bhimraj explained. The panel made seven recommendations for consideration among hospitalized patients with COVID-19: 1. Recommends hydroxychloroquine/chloroquine in the context of a clinical trial. 2. Recommends hydroxychloroquine/chloroquine plus azithromycin in the context of a clinical trial. 3. Recommends the HIV combination lopinavir-ritonavir in the context of a clinical trial. 4. Suggests against the use of corticosteroids for people with COVID-19 pneumonia (low body of evidence). 5. Recommends using corticosteroids for people with acute respiratory distress syndrome due to COVID-19. 6. Recommends the rheumatology drug tocilizumab (Actemra, Genentech), only in the context of a clinical trial. 7. Recommends convalescent plasma in the context of a clinical trial.rhampton7
April 14, 2020
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I wonder if the FAA assessed pilots ability to fly while in the grip of covid-19? I would think the FAA would want the pilots to be A) alive and B) healthy, regardless of how that came to be. Heart disturbances at doses no one is recommending shouldn't even be discussed.ET
April 14, 2020
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“Chloroquine and hydroxychloroquine were both reviewed by the FAA Federal Air Surgeon when they entered the market and have long been considered generally incompatible for those performing safety related aviation duties,” the agency said in an emailed statement. Hydroxychloroquine can be taken by pilots in low doses for treatment of arthritis, according to the FAA. Generally, though, pilots who have taken the drugs aren’t permitted to fly within 48 hours. Because it’s currently impossible to know the doses needed to prevent infection -- a use of the drugs that’s not approved -- the FAA can’t perform a risk assessment. The known risks include heart disturbances and hypoglycemia, according to the agency.rhampton7
April 14, 2020
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Jerry
Yes, you did. You said it didn’t have the same success. You failed to cite relevant information on why it wasn’t successful.
Every study is different. All I did was provide a link to a study that had different results than some others. If you want to assign some nefarious motivation to my comment and link, that is your problem, not mine.Ed George
April 14, 2020
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Anyone using any form of chloroquine without zinc, is a moron. Any doctor unaware of what zinc can do to viruses, is ignorant and shouldn't be trying to help.ET
April 14, 2020
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Apparently the Brazilians are so dense they thought moar was betta.ET
April 14, 2020
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The President listened to his expert who said, on February 29, people should go on with their normal lives. And in March CNN's doctor said the flu is more to worry about than covid 19. But the tarded left will blame the President, even though his actions have saved lives. The left would never have banned travel to China. The left never would have banned travel to Europe. With the left at the helm the USA would be in the midst of the worst case model predictions. So again, seversky is either high or extremely stupidET
April 14, 2020
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7 I couldn’t possibly have dealt with the iceberg because I was being court-martialed for that other stuff I did.Jim Thibodeau
April 14, 2020
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Jim Thibodeau @ 9
You know how the right wingers have said the media is overhyping the pandemic? Trump has a new campaign ad that attacks the media for minimizing the risk. How long before we’ve always been at war with Eastasia?
[Donald Trump, Titanic captain] 1. There is no iceberg 2. We won’t hit the iceberg 3. We barely touched the iceberg 4. Nobody could’ve seen the iceberg 5. These deaths mean my plan worked 6. I’m the best captain ever
Seversky
April 14, 2020
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By the way the dose of chloroquine in the Brazilian study was 1200 mg per day for 10 days for the high group. This is about 6 times as much of the Hydroxychloroquine Dr. Zelenko gave his patients. He gave 400 mg for 5 days. I assume the mg dosage is equivalent but do not know this. Maybe someone knows. The latest I have seen from Zelenko is two deaths, 6 hospitalizations, 4 intubations all extubated and no side effects except nausea and diarrhea.jerry
April 14, 2020
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Small chloroquine study stopped after irregular heart beats detected in subjects
A small Brazilian study on the effects of the anti-malaria drug chloroquine, which is similar to the drug that President Trump has touted as a possible "game changer" in treating the coronavirus, was abruptly halted because some patients taking high doses developed irregular heart rates generating "safety hazards." The findings were revealed in a study funded by the Brazilian state of Amazonas and published on Saturday in medRxiv, an online server for medical articles, The New York Times first reported. Chloroquine is similar to hydroxychloroquine, the drug Trump has repeatedly touted. Health experts have insisted that not enough is known about either drug to determine its efficacy in combating COVID-19. The Brazilian study included 81 hospitalized patients, with about half being given a 450 milligram dose of chloroquine twice on the first day of the study followed by one daily 450 milligram dose for four more days. The other participants were prescribed a dose of 600 milligrams twice daily for 10 days. Patients taking higher doses experienced heart arrhythmias, or improper beating of the heart, within three days, according to the study. Eleven patients died by the sixth day of treatment and caused the research on high-dosages to end. "Preliminary findings suggest that the higher CQ dosage (10-day regimen) should not be recommended for COVID-19 treatment because of its potential safety hazards," the study's abstract said. "Such results forced us to prematurely halt patient recruitment to this arm."
We still need to be cautious and wait for stronger data.Seversky
April 14, 2020
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UAB infectious disease doctor and recovering COVID-19 patient Dr. Michael Saag said Monday that the authors of the French study had to retract some of their initial conclusions, and only six patients took both drugs in the original study, making it hard to draw any conclusions about effectiveness. Worse, new concerns have emerged about potentially fatal side effects with the drug combination, side effects Saag said he did not know to watch for when taking the drugs. “In retrospect, now that I’ve survived and I’m doing better, I’m a little bit unhappy with myself only because we’ve now learned that that combination of hydroxychloroquine and azithromycin can lead to EKG abnormalities that can lead to fatal arrhythmia, and I wasn’t being monitored, so I was being a little cavalier and I think what we should do is do this under controlled studies.”rhampton7
April 14, 2020
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In Bridgeport Hospital, virtually every patient in the intensive care unit has been given hydroxychloroquine, which is normally used to treat lupus, an auto-immune disease, as well as arthritis and malaria, said Dr. Zane Saul, chief of infectious disease there. “We’re collecting data, so we don’t have any clear data,” Saul said. “I don’t think anyone does. We’ll know later in the year when all the data comes in. For the most part people are able to tolerate it. It does cause nausea and diarrhea.” Saul said that, sometimes, patients can remain on the drug for only limited amounts of time. “This is by no means a benign drug, but we felt good enough to give it to people who are a little sicker,” Saul said. “Everybody in the ICU is on it because they are the sickest of the sick.” Patients with histories of heart problems are kept away from it.rhampton7
April 14, 2020
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Folks, i/l/o the map by Raoult et al, kindly examine here. KFkairosfocus
April 14, 2020
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I didn’t cite anything other than the article.
Yes, you did. You said it didn't have the same success. You failed to cite relevant information on why it wasn't successful.jerry
April 14, 2020
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Here is a Twitter link to a medical study at McGill university. There are about 20 references to the value of quercetin for virus protection and medication. There is also information on zinc. Hard to make out how valid this. thread is but there are lots of references to medical studies and medical sites. Open up the thread in case it is not fully opened. https://twitter.com/HighPeaks77/status/1249505664398954497jerry
April 14, 2020
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Jerry, I didn't cite anything other than the article.Ed George
April 14, 2020
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This is also now showing up in US hospital data reported to the CDC: Many of the sickest Covid-19 patients also have underlying medical conditions. Seventy-eight percent of all people put into intensive care for Covid-19 in the US have had an underlying condition like diabetes or heart disease: 32 percent had diabetes, 29 percent had heart disease, 21 percent had chronic lung disease, and 9 percent had compromised immune systems.rhampton7
April 14, 2020
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Cardiovascular complications should be considered when hydroxychloroquine and azithromycin are used to treat patients with coronavirus disease 2019 (COVID-19), according to new guidance jointly published by the American Heart Association (AHA), the American College of Cardiology (ACC) and the Heart Rhythm Society (HRS). The full guidance, titled “Considerations for Drug Interactions on QTc in Exploratory COVID-19 (Coronavirus Disease 2019) Treatment” can be found here. https://www.ahajournals.org/doi/pdf/10.1161/CIRCULATIONAHA.120.047521rhampton7
April 14, 2020
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The Brazilians need to watch medcram update #34ET
April 14, 2020
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A study from Brazil didn’t see the same success
You failed to cite that it was. those receiving extremely high doses that died.jerry
April 14, 2020
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Why were they given a high dose? What is the dosage the rest of the world is using and why isn't that good enough for Brazil?ET
April 14, 2020
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Did the Brazilians pair it with zinc? If not then they did it wrong.ET
April 14, 2020
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In March CNN's Anderson Cooper and their resident Dr. Gupta downplayed the virus. So yes, the media did downplay the risk. Now the media is in overhype.ET
April 14, 2020
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Trump has a new campaign ad that attacks the media
Did you look at or read the link you gave? It says the opposite of what your comment said. You are making the case for Trump with this link.jerry
April 14, 2020
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You know how the right wingers have said the media is overhyping the pandemic? Trump has a new campaign ad that attacks the media for minimizing the risk. How long before we’ve always been at war with Eastasia? https://www.motherjones.com/kevin-drum/2020/04/trump-blasts-fox-news-in-new-video-1/Jim Thibodeau
April 14, 2020
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