Doctor Ivette Lozano from Dallas, Texas on treating patients with HCQ Cocktails

_{kairosfocus
May 18, 2020

Defending our Civilization, Medicine, News Highlights, rhetoric, Sci-Tech watch

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Inimitable:

https://youtu.be/coyfWpwxedQ

Food for thought.

U/D: When it reaches the pharmacy . . .

U/D May 19, another Lozano interview:

And, oh yes, breaking 1: Mr Trump is praising — yes, I am NOT using, “touting” — a promising vaccination. Announcement by the firm, here.

Breaking, no 2, courtesy Daily Mail as usual:

Of course, the now standard, it’s risky is in the subheads.

U/D: Video:

Compare our Texas Doctor’s remarks. And then, there is the latest from Dr Raoult:

Whose report do you believe, why? END

Comments

EG, did you note that my purpose in commenting as I did in was "that our thought space needs to open up"? That is why I was openly speculative. You will also find Jerry's remark at 196 perhaps helpful:
Why were they in the hospital? They were not outpatients. From what I understand they were far along in the virus and had serious symptoms. Tests were performed after they entered hospital. Which means they were late stage. The drug is to prevent hospitalization.
So, let us be open to all of the valid evidence, in interests of a sound inference to the best explanation. And, the question of equating control designs to placebo designs is clearly material to how "control" is being used. KF PS: I clip from Jerry's linked:
[Dr. Jean-Jacques Rajter] and his wife, who is also a pulmonologist, are pioneering the use of an anti-parasitic drug called Ivermectin to fight the novel coronavirus. “If we get to these people early, and what I mean by that is if their oxygen requirements are less than 50%, I’ve had nearly a 100% response rate, they all improve, if they’re on more oxygen than that, then it becomes a little more varied, some people, they don’t respond anymore because they are too far advanced,” explained Dr. Rajter. Two weeks ago, Dr. Rajter started adding Ivermectin to the cocktail of drugs currently used to treat COVID-19: hydroxychloraquine, azithromycin, and zinc sulfate. [--> shows where a lot of clinicians are] Since then he’s treated dozens of people with this combination, with results so encouraging, he calls them remarkable. Dr. Rajter is in the process of publishing a scientific paper, which could take weeks to publicize the findings. “But if I wait, every day that goes by is another day when lots and lots of people get very sick, go to ICU, many of them die and that could theoretically even be preventable and that’s why I thought it was so critically important to get this information out there,” Dr. Rajter said. He credits his wife, Dr. Juliana Cepelowicz-Rajter, with the idea of using Ivermectin for this purpose. She came across Australian research which showed Ivermectin destroys the virus in the lab, in vitro, but it has not been studied for this purpose in people. “More studies need to be conducted,” Dr. Cepelowicz-Rajter said. “We haven’t had any ill effects from it and it’s readily available, we have some patients who are pretty advanced, not yet intubated, and even those, in 12 hours, they showed a significant improvement.”
Notice, how he speaks:
It is not a cure. That’s the first thing Dr. Jean-Jacques Rajter wants everyone to know about the treatment he’s using on his COVID-19 patients at Broward Health Medical Center. “Ideally, the sooner you get to them, the better off they are,” said Dr. Rajter, a pulmonologist.
The key principle, clearly is, a stitch in time saves nine.kairosfocus_{May 23, 2020
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The lancet study only included patients who received treatment within 48 hrs of diagnosis, well within the timeframe that you claim it is effective
Why were they in the hospital? They were not outpatients. From what I understand they were far along in the virus and had serious symptoms. Tests were performed after they entered hospital. Which means they were late stage. The drug is to prevent hospitalization. Another doctor with success stories using HCQ plus. Adding Ivermectin to zinc and azithromycin https://www.nbcmiami.com/news/local/local-doctor-tries-new-coronavirus-drug-treatment/2219465/jerry_{May 23, 2020
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EG, evasion again. KFkairosfocus_{May 23, 2020
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KF
EG, you are conflating control group with placebo control group.
The red herring must be shoaling off your little island. I am comparing two non-controlled retrospective studies, the one you keep shilling for like the My Pillow guy, and the much larger, more comprehensive, one published in the lancet. Why you keep bringing up the ethics of placebos is beyond me given that neither study involved these. The fact that you refuse to address the merits (or flaws) of the Lancet paper speaks volumes, and not in your favour. Have you even read it, or have you already decided that you are right and reading anything that might contradict your opinion would be a waste of time?Ed George_{May 23, 2020
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EG, you are conflating control group with placebo control group. I have pointed to the ethical issue of giving deliberately mislabelled sugar pills to those facing a fast acting, significantly fatal disease and the alternative that business as usual vs a credible, promising possibility is thus a more valid design in such cases, per do no harm. This is the issue discussed in the article you are still evading. As for the various oh see proof it does not work claims, there is first the pattern of in vitro/chemical action results, plausible mechanisms and known ability to go into tissue in effective concentrations. The relevant biochemistry would suggest at this point, at minimum, some promise, with also particular expectation of some anti-inflammatory action . . . common to even malaria action.Thus, in that context, the presence of a significant body of findings of success that align with that pattern has to be reckoned with seriously. This body includes reports of rapid clearing action by patients and by doctors. At the most, other studies need to be assessed as to why they diverge (apart from simply denigrating and dismissing what is tossed). And, you are far too well educated not to grasp these points. KF PS: Let me add a few thoughts. There is some discussion of a wide range of patterns of infection, from asymptomatic to mild to rapidly lethal and aggressive. Where, this is an RNA virus, suggestive of rapid mutations. In that context, could we be seeing early signs of fairly divergent strains and possible presence of some drug resistance? Suppose, effectiveness is fairly marginal, dependent on cumulative or even chained action of mechanisms. If resistance develops somewhat to one aspect that can break the margin. Where, if such is at work it may mean that vaccinations will be a challenge. Such is a speculation, obviously, but it is evident to me that our thought space needs to open up.kairosfocus_{May 23, 2020
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JVL- Hopeful: Summary of Wuhan #Coronavirus Therapies and Potential Cures:
The mechanism of chloroquine action on RA has long been well known. It increases a cell’s lysosomal pH. (Lysosomes are membrane bound cellular organelles [think tiny balloons inside the cell floating at a lower pH in the higher pH cytosol] containing about 50 enzymes, discovered and named in 1955.) This in turn changes their ‘leaked’ enzyme balance into the cytosol, which then inhibits the cell’s RA tissue antigen signaling, which in turn reduces the immune system’s attack on the RA tissue, slowing (but usually not stopping) progression of RA tissue damage. The reason the Chinese and then the French thought to use chloroquine against Wuhan coronavirus is this same mechanism of action, albeit with different sequelae. The viral S protein binds to the epithelial cell wall’s angiotensin-converting enzyme 2 (ACE2) receptor. Raising lysosomal pH changes (via indirect enzymatic action) the ‘shape’ of ACE2 enough that the S protein cannot bind to it, thus preventing cell infection. Chloroquine changes the cell ‘lock’ so the viral ‘key’ doesn’t work. Does not undo damage from infected cells, nor prevent an infected person from shedding existing viable virus, but does stop the spread in an infected person’s body—a promising therapeutic for those testing positive.
That's from March 20, 2020ET_{May 23, 2020
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Jerry
The Lancet study is irrelevant to the issues being debated. It is an analysis of a time in the progression of the disease when HCQ will be less effective so any report of late stage use of HCQ is meaningless in the fighting of the virus. The issue is will administering of HCQ at early stages, within 12 days of initial infection affect the suppression of the virus.
The lancet study only included patients who received treatment within 48 hrs of diagnosis, well within the timeframe that you claim it is effective.
Patients who received one of the treatments of interest within 48 h of diagnosis were included in one of four treatment groups (chloroquine alone, chloroquine with a macrolide, hydroxychloroquine alone, or hydroxychloroquine with a macrolide), and patients who received none of these treatments formed the control group. Patients for whom one of the treatments of interest was initiated more than 48 h after diagnosis or while they were on mechanical ventilation, as well as patients who received remdesivir, were excluded.
Ed George_{May 23, 2020
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The public is already aware that established superspreaders of the virus can include “hospitals, nursing homes, large dormitories, food processing plants and food markets.
Could all be treated with HCQ and zinc? The cost is 47 cents a day per person.
As of Friday, COVID-19 had killed more than 95,000 people in the US in just four months.
Probably the great majority could have been saved if the medical community listened to Trump and Zelenko. Who is responsible for people not listening? Youtube takes down Zelenko videos in the name go community standards. They took down one of MedCram's videos on the effectiveness of zinc. (WHO the World Health Organization is also responsible for people not listening.) One lost of life or victim is a tragedy. Several thousands victims are just statistics or just dots from a distance. How many in our society are just like Harry Lime and only see dots. https://bit.ly/3aMWiC4jerry_{May 23, 2020
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Eight countries have death rates higher than 10%: Belgium, France, Italy, Mexico, the Netherlands, Spain, Sweden, and the UK, according to a Johns Hopkins University database. Other places like Singapore, which has a robust testing program, have reported rates as low as 0.1%. A number of factors can drive death rates up. Sweden, for example, never issued a mandatory lockdown, instead asking its citizens to voluntarily maintain social distance. Experts warned early on that this strategy could lead to more death. The virus might also be reaching more elderly people there, who are more susceptible to severe illness. High death rates could also be the result of limited testing capacity. Countries with scarce testing resources tend to prioritize the most severe cases for COVID-19 confirmation, leaving many people with mild or asymptomatic cases undetected, thus giving the appearance of an unusually high death rate. Sweden has only just expanded its testing to include those with mild symptoms. As of Friday, COVID-19 had killed more than 95,000 people in the US in just four months. https://www.businessinsider.com/coronavirus-death-rates-high-deadlier-than-flu-2020-5rhampton7_{May 23, 2020
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Some scientists now say “superspreader” events may be responsible for at least 80 percent of coronavirus infections. A report on the website of The Telegraph, a British newspaper, details some findings that “closely packed markets, vigorous dance classes, loud bars and choirs” may be the primary culprits in the spreading of the virus. The public is already aware that established superspreaders of the virus can include “hospitals, nursing homes, large dormitories, food processing plants and food markets.” https://www.voanews.com/covid-19-pandemic/superspreader-events-may-be-responsible-80-covid-infectionsrhampton7_{May 23, 2020
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The Lancet study is irrelevant to the issues being debated. It is an analysis of a time in the progression of the disease when HCQ will be less effective so any report of late stage use of HCQ is meaningless in the fighting of the virus. The issue is will administering of HCQ at early stages, within 12 days of initial infection affect the suppression of the virus. There is ample evidence that it does suppress the virus when administered early and almost no evidence that it is harmful. So studies like the one reported in Lancet are essentially fake news because they are irrelevant to the issue. The are late stage treatment studies. There is nothing wrong with trying to find a late stage treatment but using these studies to abrogate all uses of HCQ are fallacious. One has to wonder at why they are being used to do so. But for something relevant see https://bit.ly/3gj4mic
Background: Severe acute respiratory syndrome (SARS) is caused by a newly discovered coronavirus (SARS-CoV). No effective prophylactic or post-exposure therapy is currently available. Results: We report, however, that chloroquine has strong antiviral effects on SARS-CoV infection of primate cells. These inhibitory effects are observed when the cells are treated with the drug either before or after exposure to the virus, suggesting both prophylactic and therapeutic advantage. In addition to the well-known functions of chloroquine such as elevations of endosomal pH, the drug appears to interfere with terminal glycosylation of the cellular receptor, angiotensinconverting enzyme 2. This may negatively influence the virus-receptor binding and abrogate the infection, with further ramifications by the elevation of vesicular pH, resulting in the inhibition of infection and spread of SARS CoV at clinically admissible concentrations. Conclusion: Chloroquine is effective in preventing the spread of SARS CoV in cell culture. Favorable inhibition of virus spread was observed when the cells were either treated with chloroquine prior to or after SARS CoV infection. In addition, the indirect immunofluorescence assay described herein represents a simple and rapid method for screening SARS-CoV antiviral compounds
This is from 15 years ago. For the lighter side https://bit.ly/2AZbcJDjerry_{May 23, 2020
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Researchers will be testing whether Vitamin C and Zinc help reduce the likelihood of a newly diagnosed COVID-19 patient being hospitalized. Researchers also want to see if it can reduce the severity and duration of symptoms. “The goal is to start these medications within two days of your diagnosis,” McWilliams said. McWilliams said they will have a goal of enrolling 520 Cleveland Clinic patients in the trial within two days of their positive diagnosis. McWilliams said it is possible some of those trial participants could be patients on the Treasure Coast. “Vitamin C and Zinc have been around for a long time in the outpatient setting. There’s a lot of products out there. They’re all used for colds and flu,” McWilliams said. The soon-to-open Cleveland Clinic Florida Research and Innovations Center (FRIC) in Port St. Lucie, Florida, will be an essential part of research and treatment for COVID-19. https://www.wptv.com/news/coronavirus/cleveland-clinic-florida-spearheading-clinical-trials-to-test-success-of-vitamin-c-and-zinc-as-treatment-in-covid-19-patientsrhampton7_{May 23, 2020
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We started this thinking if you had COVID and you came to the ICU and you got put on a ventilator it was a death sentence,” Emory’s Dr. Craig Coopersmith said. “We've become significantly more aggressive in trying to prevent blood clots and treat blood clots,” Piedmont's Dr. Amy Hajari Case added. Proning, or placing the patients on their bellies for a few hours instead of their back, has helped reduce the amount of time a ventilator is in use. They're discovering it may even keep some people off of them. “We're finding for COVID it appears to be effective before anyone gets put on a breathing machine,” Coopersmith said. From quirks in how COVID-19 responds to fluids and changes in ventilator settings, doctors say they're learning so fast because they're learning from each other. “I start the day somewhere between 7, 7:30 in the morning with a text that says, good morning team COVID,” Coopersmith said. “Mulitple ICU's - multiple doctors - who never literally had met each other before are now texting each other saying, ‘I've seen this. Have you seen this?’” “I think that's led to a very rapid understanding of maybe unanticipated elements of their care,” Case said. https://www.11alive.com/article/news/health/coronavirus/coronavirus-treatments-evolution-georgia/85-17f20a8e-92b6-4355-aea8-b120971dd825rhampton7_{May 23, 2020
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KF
Non-controlled is of course the gold standard fallacy, and it is precisely why the clip you keep evading is highly relevant.
Please enlighten me. How is bringing up controlled studies relevant when all I am doing is comparing two non-controlled studies. Raising your misplaced ethical concerns about controlled studies is a rouge Clupea harengus.
A study of cases is evidence and this one compares the cocktail treatment with non treatment, through a major research centre in a significant hospital complex
And the paper I linked to is a study of cases comparing the cocktail treatment with HCQ treatment and non treatment in >96,000 patients from 671 hospitals on six continents.Ed George_{May 23, 2020
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RH7, HCQ is an old, generic, easily manufactured drug by today's standards. Any shortages that emerge will be quite temporary. The issue, further, is an emerging new market for it which would address a pandemic that is not only fast acting and fatal in many cases, but also one which has led to a global lockdown threatening to trigger deep recession or depression, which also have damaging and too often fatal consequences. Again, we see want of responsible balance in the sort of talking points that are used to shape the dominant narrative being pushed by various power interests. That sort of imbalance is always a sign that something is seriously wrong. KFkairosfocus_{May 23, 2020
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Lupus patients in the U.S. who rely on hydroxychloroquine are beginning to worry as the nation's supply of the drug dwindles in the midst of the coronavirus pandemic, calling the situation "survival of the fittest." According to USA Today, Jennifer McCollom, 48, of Thornton, Colo. has grappled with lupus for eight years, and couldn't get her medication for more than two weeks due to supply shortages of hydroxychloroquine. The Food and Drug Administration (FDA) added hydroxychloroquine to its list of drugs in shortage on March 31, following a surge of state and local governments stockpiling it throughout March. Data shared by Vizient, a group purchasing organization that serves nearly 3,000 medical facilities in the U.S., showed the demand for hydroxychloroquine surged almost 17 times higher in April compared to January. The report added that the available volume of the drug last month was only half of the total units ordered. "It shouldn't be hoarded away from people who are sick like us," said McCollum. "It feels to me like survival of the fittest right now." https://thehill.com/policy/healthcare/499293-as-nations-hydroxychloroquine-supply-runs-low-patients-who-rely-on-it-beginrhampton7_{May 23, 2020
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EG: >>a flawed>> -- projection: sez who, this indicates an attitude from the outset >> non-controlled retrospective study>> -- Non-controlled is of course the gold standard fallacy, and it is precisely why the clip you keep evading is highly relevant -- A study of cases is evidence and this one compares the cocktail treatment with non treatment, through a major research centre in a significant hospital complex -- the results are consistent with the known ability of HCQ et al to enter and spread across the body, its known impact on the virus [and others] in plausible in-tissue concentrations, the existence of several plausible mechanisms and more. -- it is also compatible with significant report of rapid effect from physicians and patients, so we see a growing body of mutually consistent evidence coming from reasonable custody >> to a much larger (orders of magnitude)>> -- beyond law of large numbers scale mere size is not all >> well designed, more comprehensive,>> -- sez who? -- recall, there is a pattern of converging lines of evidence to be addressed. >> non-controlled, retrospective study>> -- same basic issue. KF PS: Touting is a fighting word, drop it. Maybe the issue of converging lines of evidence does not impress you, it should. And clearly you disregard the ethical challenges faced by placebo based study designs. That's another reason to see just why what you evade is relevant.kairosfocus_{May 23, 2020
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KF
EG, it seems we need yet another round of counsel from the Kennedy School that you have ducked since comment 56, noting that one half is a professor there, the other is a French PhD graduate from it. KF
I have no idea why you keep repeating this as it has no relevance when comparing a flawed non-controlled retrospective study to a much larger (orders of magnitude) well designed, more comprehensive, non-controlled, retrospective study. Given current information, your continued touting of HCQ for COVID-19 simply is not warranted.Ed George_{May 23, 2020
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EG, it seems we need yet another round of counsel from the Kennedy School that you have ducked since comment 56, noting that one half is a professor there, the other is a French PhD graduate from it. KF PS: Duly,
Observe:
Unleash the Data on COVID-19 By Maryaline Catillon and Richard Zeckhauser* Given the lethality of the COVID-19 pandemic, the urgent need is for actionable information directing care towards treatments offering higher probabilities of improving outcomes and preventing death. In normal times, randomized control trials (RCTs) would be the gold standard for determining whether innovative medical treatments are safe and effective. But with 1,500 Americans dying every day, these are hardly normal times. There is an urgent need for high quality studies based on real world experience, which has already accumulated for many thousands of patients. Dr. Anthony Fauci, the nation’s pandemic physician in chief, said that RCT results will not be available "for months". The disease will not wait. RCTs, which randomly assign patients to a treatment or a control group, are only ethically acceptable when the safety and performance of a treatment is unknown. When ample data exists, as now, that criterion is not met. Analyzing real world data on actual outcomes, when it exists in abundance, offers an alternative approach to learn almost immediately. Moreover, it avoids the ethical challenge of an RCT, given that available data could predict outcomes. Massive numbers of COVID-19 patients are currently being administered "unproven" drugs based on medical decisions made by doctors. Massive numbers are not receiving any such drugs. Thus, carefully designed case control studies could leverage differences between ongoing protocols at large hospital systems and detailed information from patients’ electronic medical records. That could determine whether widely employed hydroxychloroquine, with or without azithromycin, provides significant benefits, and at which stages to which patients, and could provide similar information on the risks it imposes. It could yield the same information about remdesivir, and about many other drug treatments currently in use. [--> sounds familiar? That's been a line of argument I have pointed to for weeks] For each patient, doctors strive to optimize treatment in the current, uncertain environment. These drug versus non-drug decisions constitute an ongoing large observational study, in which the allocation to treatment and control groups varies widely. The large numbers of patients treated eliminates concerns that random variation might lead to misleading results. Those large numbers also yield results by demographic, comorbidities, and stage of disease. Leveraging real world evidence is more acceptable ethically when extensive information is already available. As decision theorists who have studied the methodological quality of vast numbers of RCTs, we are enthusiasts for well-conducted RCTs. But delaying public health recommendations till RCTs are completed is not appropriate in the present circumstance. Imminent threats are enormous and widespread data is easily at hand. The outcomes of the thousands of individuals who have already received drug therapies on an ad hoc basis should inform practice now . . . . High quality case control studies based on thousands of cases, the silver standard we recommend, are immensely faster than RCTs. Recent articles in the world’s leading medical journals show that they consistently yield the same major findings. Experience with the recommendations of antiretroviral therapy (ART) for HIV provides an instructive warning. Even though 20 years of observational studies demonstrated its enormous benefits, the World Health Organization waited until 2015 and the publication of the first set of RCT results (which reached the same conclusions) to make a "treat all" recommendation. Many lives were lost as the world waited for its recommendation. COVID-19 presents its own example. Through late March, medical authorities recommended the general public not employ masks to protect against it. In early April, that all switched: masks became strongly recommended. No RCT supported this reversal; little evidence was mounted. Yet officials applauded, the public widely complied, and the world was better off.
Well conducted includes ethical criteria. Of course. But such is obviously at a discount today. And notice the by now familiar context: decision theory.
kairosfocus_{May 23, 2020
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BO'H: SE France is not particularly exceptional, save in the dominant narrative. I add, I suggest you listen to what Dr Lozano has to say. She is by no means an isolated individual. KFkairosfocus_{May 23, 2020
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KF
EG, what part of, Placebo controlled studies will take far too long in the teeth of a fast moving pandemic is so hard to understand?
What part of, accepting the greatly flawed conclusions of a non-controlled retrospective study while ignoring a far larger, more comprehensive, better designed retrospective study don’t you understand?Ed George_{May 23, 2020
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ET: This change may affect the vibration of the ACE2. When that happens covid-19 cannot bind to it. I've been trying to track down this idea, references?JVL_{May 23, 2020
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Again, HCQ alone just changes the Ph of the body. This change may affect the vibration of the ACE2. When that happens covid-19 cannot bind to it. HCQ with zinc puts more zinc into cells. This added zinc can then prevent the virus from replicating. The science is well known. So I don't understand why the evos here have against scienceET_{May 23, 2020
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kf @ 169 - so why is the south-east of France different to the rest of the world? And why are you ignoring results from the rest of the world? Especially as you've repeatedly linked to an essay arguing for precisely the sorts of studies that have been done (and NOT the sorts of studies Raoult is doing)?Bob O'H_{May 23, 2020
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PS: I note, the tier 2 approval is good enough more or less, releasing to physician-patient judgement. The issue now shifts to narrative dominance and implications of what we collectively create as dominating message.kairosfocus_{May 23, 2020
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JVL, in the face of pandemic, time is precisely what we do not have. KFkairosfocus_{May 23, 2020
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Kairosfocus: A far better answer is, there is a reason why FDA, within a day or two of Raoult’s tier 2 results on chemical action and effectiveness, with 80 patients, moved up the emergency off label approval. And after significant professional protest on the ferocious warnings on toxicity, it is far more plausible that they felt it wisest to revert to the balance in the second tier statement. Maybe. Hopefully time will tell, someday.JVL_{May 23, 2020
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JVL, the projection is telling. It is obvious that Mr Trump is a minority voice and the NIH/FDA people have made no bones to say things that cut across his discussion or at least moderate it. With talk of a second impeachment attempt on the table, that suggestion is utterly unlikely. A far better answer is, there is a reason why FDA, within a day or two of Raoult's tier 2 results on chemical action and effectiveness, with 80 patients, moved up the emergency off label approval. And after significant professional protest on the ferocious warnings on toxicity, it is far more plausible that they felt it wisest to revert to the balance in the second tier statement. KF PS: As there is no need, I am not on the cocktail, I have experimented with filter-level for cloth face masks towards sustainability. My initial conclusion is that a thin filter layer of meltblown felted fabric is less fatiguing than the thicker ~ 2 mm material (unless there is a breathe-out valve) in a filter pocket in a cotton fabric mask. I have concerns on rebreathing palpably warm air in the mask, indicating elevated CO2 levels and the sense of forcing to breathe. Where no, breathing in through nose and out and down through the lips does not work with close fitting masks. It might, with a bandana or the like. Some varieties of wet wipes are likely good enough for light duty use. Regular washing and sanitising of such masks is essential.kairosfocus_{May 23, 2020
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BO'H: kindly scroll up to the results excerpted in the OP, as of several days ago. One would expect on the BAU track a much higher death rate from IHU's treatments. The framework of cumulative evidence noted to RT suggests that we have in fact got an effective treatment and reports from too many sources and cases indicate far stronger, faster effects than one would pick up from the sort of things that are being headlined. My inference is, likely, breaking synergy and/or failing the stitch in time test. I particularly recall on this the Guardian report on a huge, placebo control test proposed for the UK. Where, as soon as I see placebo controls as gold standard without serious discussion of ethical issues, for cause my concern level goes up. Political polarisation is toxic and arguably dangerous. KFkairosfocus_{May 23, 2020
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Kairosfocus: Ask yourself, why are they backing away? Political pressure I'd guess 'cause normally they'd stick to a strict RCT policy of approval.JVL_{May 23, 2020
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