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Dr Zelenko’s HCQ-based ALT-ernative to the near-Business As Usual (n-BAU) approach

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Jerry drew our attention last night to a radio interview by Dr Vladimir Zelenko. In this interview, he summarises his approach and rationale, giving results and making several announcements. (Unfortunately, the media cannot be embedded at UD as it is not YT. Kindly, go here; and make sure your browser has no active ad blocker.)

On listening last night, here are my first observations on highlight points:

Brazil and Israel are doing his early treatment, clinical diagnosis (backed up by nasal swab test), outpatient-oriented dosage for vulnerable patients protocol, ALT-1. He has treated 405 in that profile and sees 95% reduction on the expected death rate for the n-BAU baseline. He points out that the Raoult [by implication] protocol, which does not use Zn supplements is seeing 90% reduction relative to the same baseline, ALT-2 . . . which is consistent with implications of the tabulated numbers I discussed over the past few days. Several other countries are interested and other physicians are joining in in the US. He intends, with colleagues, to publish in it seems JAMA or NEJM shortly. Long Island has a control group double blind test in train, with results in perhaps 3 – 4 months [implying a smallish test I believe?].

To set context, here, again, is my BAU vs ALT, SWOT-driven, sustainability oriented strategic change decision-making framework:

This framework is relevant to the validity of a case based research framework, given that, naturally, there is a [near-] Business As Usual framework. In effect, treat the patients similarly to Flu patients, especially if complications arise. That has yielded a familiar pattern of outcomes for Covid-19, such as we saw in this graphic for China . . . and B & O, summary data with a source are just that, data:

We see here, that age is a critical vulnerability factor. As are several preconditions, especially heart disease.

We therefore have a baseline profile of likely outcomes of Covid-19, a troubling profile. This is n-BAU, with the typical treatments and drugs etc. The pattern of outcomes is as profiled.

In this context, we may now see that Dr Raoult et al [a whole institute in France] and Dr Zelenko et al [it seems, about sixty doctors are using his protocol in a network] are putting on the table two closely related alternatives. Given the suggested mechanism that Hydrochloroquine [HCQ] helps hold open pores that allow Zinc ions to enter the cell at a higher rate than normal, where this is said to help disrupt viral replication, the 5% difference may be significant, and it would be inexpensive to add Zn supplements.

Let us further observe the IHU results as they have moved on since April 18th when we last posted:

This is of course generally compatible with Dr Zelenko’s summary.

These are case study results, which fall afoul of a proposed “Gold Standard” pivoting on double blind, placebo controlled trials. However, they are obviously real observations made in the context of research and treatment in a 3500 bed hospital complex in a major city in France. Indeed, the city that is literally the title for the French national anthem. I can find no good reason to disregard such as no data or not valid tests for ALT-2, especially given the baseline nBAU provided by the hospital.

Where, we may again note, via Google Translate, the approval of protocol:

Research protocol approved by the ANSM [= “Agence Nationale de Sécurité du Médicament et des Produits de Santé (ANSM)”, i.e. National Agency for the Safety of Medicines and Health Products] and the Île-de-France CPP [= “COMITE DE PROTECTION DES PERSONNES ILE DE FRANCE,” i.e. ILE DE FRANCE PERSONAL PROTECTION COMMITTEE] in progress at the IHU Méditerranée Infection: Treatment of respiratory infections with Coronavirus SARS-Cov2 by hydroxychloroquine Acronym: SARS-CoV2quine.”

My follow-up thoughts were:

we have proxies [only] so far, really good numbers are going to require a lot of testing on antibodies and going back through statistical records then calibrating demographically. What we have is tracking the basic dynamics of sigmoids and related models well enough to guide decisions. We are seeing global peaking of wave 1, with China seeing minor onward waves, true Wave 2 is likely, come the next flu season.

Damaging economic and social impacts of the lockdown are leading to early signs, pointing to a need for a managed exit from n-BAU.

With the Raoult-Zelenko protocols allowing early targetted treatment of vulnerable groups on outpatient basis with 90 – 95% reduction in mortality relative to the n-BAU Flu with Complications & ventilators etc baseline, we have a reasonably plausible ALT1 and ALT2 to feed our scenario based planning exercise. The big weaknesses pivot on the polarisation of esp the US and its one-party media, which may cripple and delay moving to ALT-1 until a large wave of needless deaths shifts balance of power.

The use of decision theory and sustainability thinking to counter the threat and compensate for the weakness may help shift balance of power. In particular, the gold standard fallacy must be exposed and corrected. That is, decision theory and BAU vs ALT using the n-BAU protocol as baseline shows an inductively cogent, epistemologiically relevant, ethically responsible answer to required evidence to move forward in the face of polarisation and mischaracterisation.

Selective hyperskepticism has civilisation-level consequences and costs measured in blood and tears through pandemic and needless economic dislocation.

We need to shift back to prudence based responsible rationality.

My projection, currently, therefore is that:

decision theory will prevail over the gold standard evidence threshold fallacy. We will recognise that nBAU gives a baseline comparison with Flu and its treatment so there is no need to give people facing a disease that can kill in 10 days, doing organ damage along the way, sugar pills in order to construct an artificial baseline. We will see evidence being belittled, dismissed and suppressed that points to 90 – 95% reduction in mortality among vulnerable groups for two credible ALTs. We will see that a US$20, outpatient oriented treatment can take pressure off the system, allowing better care for serious cases. We will see that this then allows responsible re-opening of community life and economic activity, leading to a surge in investor and consumer confidence. The lockstep globalist progessivist elites and their media mouthpieces and amplifiers will take a deserved, decisive blow to their credibility and dominance of opinion. As a result, civilisation-level trends are going to shift dramatically, starting with digitalisation of work and education. That’s a Kondratiev, long wave level shift. This pandemic marks a break in history.

Post-pandemic, we are in a different world. END

5 Replies to “Dr Zelenko’s HCQ-based ALT-ernative to the near-Business As Usual (n-BAU) approach

  1. 1
    kairosfocus says:

    Dr Zelenko’s HCQ-based ALT-ernative to the near-Business As Usual (n-BAU) approach

  2. 2
    jerry says:

    An article from Science magazine on what the virus does. It can do a lot of things and over time it becomes more deadly. This article though it doesn’t say it, it a rationale for treating it early with an effective protocol (which may not work as well later or at all) and boosting the immune system in whatever ways possible.

    It seems to strike the elderly more intensely as youth seems to be spared. Is it their inadequate immune system? If so there are remedies that have been shown to increase the activity of the immune system.

    So first, preventive as best we can. And second, treat it early with what works best. Because near the end there may be much less available that will work.

    After reading this article, one can understand the New York doctor who said we don’t know what we are doing and we have never seen anything like this before.

    Nearly every thing in this article screams to treat it early as opposed to waiting for hospitalization to start serious treatments.

    We really don’t understand who is vulnerable, why some people are affected so severely, why it comes on so rapidly … and why it is so hard [for some] to recover.”

    This article is very extensive but omits treating it early as the most effective weapon. Thank God for people like Zelenko who are pushing very strongly for the early approach and seem to be getting attention of more and more with his results and those of others. Dr. Seheult at MedCram is another pushing for treatments prior to the hospitalization phase.

    It not only saves lots of lives, it save precious hospital resources for the very needy of this disease and other problems now being ignored.

  3. 3
    kairosfocus says:

    Jerry, thanks again. The dots are there to connect. KF

  4. 4
    jerry says:

    The dots are there to connect

    Don’t expect a lot of people to do that. As I said many times the human aspect of about how people respond to evidence and logic is the most interesting phenomena.

  5. 5
    kairosfocus says:

    Jerry, true enough. Which, doesn’t sit right with lives and the global economy [so, a lot more lives] in the balance. KF

    PS: I saw your comment in another thread:

    Dr. Zelenko went to twitter this morning to comment on studies supposedly showing HCQ has no effect. It is what we suspected. The studies are at best inappropriate.

    all the hydroxychloroquine trials published are designed to fail. They study the sickest hospital patients who have >50% of dying and then conclude that the drugs don’t work.

    Are we witnessing the baseness of human behavior in both the organization of the studies and the reporting? Probably ignorance on the former but it may be accurate for the reporting.

    PPS: See this on a China study, pub Mar 26:

    News recently came out that hydroxychloroquine—an anti-malaria drug highlighted by President Donald Trump as a promising coronavirus therapy—disappointed in a China clinical trial on mild COVID-19 patients. But a careful examination of the study reveals a more complicated situation.

    According to investigators, adding hydroxychloroquine (HCQ), a more tolerable form of chloroquine, on top of conventional therapy didn’t shorten the time to SARS-CoV-2 clearance in a 30-patient trial. No significant differences were observed across the two arms in terms of the time it took to bring body temperature to normal or the number of patients with disease progression as shown in CT scans.

    However, most patients in the study’s control group were actually treated with other antiviral therapies at the same time, including AbbVie’s HIV combo med Kaletra and flu drug Arbidol. Most, but not all, patients in the hydroxychloroquine group were also treated with Arbidol. All patients got interferon-alpha.

    Those meds had already been added to China National Health Commission’s COVID-19 treatment guidelines after showing some promise against the novel coronavirus. As a FiercePharma reader pointed out, “If that is the case, and even one of them has some effect on the virus, then one cannot tell if hydroxychloroquine worked or not.”

    The study, published in the Journal of Zhejiang University (Chinese), found that the median time from hospitalization to conversion to virus-negative status was four days in the HCQ group, “comparable to” the two days observed in the control group. After one week of treatment, 13 patients (86.7%) had turned negative in a throat swab test, while 14 (93.3%) in the control group could say that. Again, no significant difference.

    Something just a tad weird seems afoot.

    What I can make out from those fat cocktails, is that the cocktails seem to be doing something relative to n-BAU.

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