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The Frontline Doctors put some “plausible” mechanisms for Hydroxychloroquine on the table

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In their July 28 seminar, the Frontline Doctors Group led by Dr Simone Gold, have put some plausible mechanisms for HCQ based cocktails on the table. These were noted on in an augmentation to an earlier post, but deserve headlining in their own right:

Dr Frieden OP: >>I have found at Bit Chute, a July 28 Frontline Doctors seminar which describes several mechanisms of action. Accordingly, I take liberty to annotate a screenshot, summarising several mechanisms of action described by these Doctors [cf. here for their references], but which are hard to find because of now almost pervasive censorship:

I add, that the above suggests a fairly similar viral attack process to the West Nile Virus (which is also an RNA virus), e.g.:

U/D, Mon Aug 16: I further add, a “DrBeen” — Dr Mobeen Syed — educational video, just found — this is the presenter summarised above:

I note, this first answers a puzzle on the mode of action, shape-shift of ACE2: the shift is INTERNAL to the cell by hindering “glycation” of the final AA (thus prior to exposure to buffering of blood etc), altering the shape enough to hamper S-protein reception. This reduces fusion with bilipid layer and RNA injection.

Other direct mechanisms as noted, reduce intracellular acidity thus action of organelles. They highlight stalling of assembly of new viri in the Golgi bodies, with implication of blocking export of fresh viri, thus hampering the multiplication chain. The by now well known indirect activity is that as a lipophilic molecule, HCQ enters the cell bilipid layer membrane, acting as a Zn ionophore, i.e. it “shoots” Zn into the cell. Zn in turn hinders a key viral enzyme, RdRP.

Thus, we see a plausible picture of causal action, involving multiple, synergistic effects. This lends credibility to the use of HCQ-based cosctails in treating the early viral phases of CV19.>>

Unfortunately, WP for UD is not set up to embed BitChute videos.

An odd bit of support for this, is that HCQ/CQ have been used as fish tank cleaner for about 40 years. The complex animals (the fish) live, but the crud from several kingdoms, dies. That points to attack modes that hit core cell processes, such as we may summarise:

That seems to be what is now on the table, through the effects of pH shifting, as proposed. In short, we have reasonable mechanisms to go with the reports of doctors who are treating CV 19 in the early, viral phase, with vulnerable group patients:

From this, we can freely say that it is going to be a challenge to refute the framework of issues and implicit model being presented in the open letter to Dr Fauci:

>>There is currently no recommended pharmacologic early outpatient treatment for individuals in the flu stage of the illness, correct?

It is true that COVID-19 is much more lethal than the flu for high-risk individuals such as older patients and those with significant comorbidities, correct?

Individuals with signs of early COVID-19 infection typically have a runny nose, fever, cough, shortness of breath, loss of smell, etc., and physicians send them home to rest, eat chicken soup etc., but offer no specific, targeted medications, correct?

These high-risk individuals are at high risk of death, on the order of 15% or higher, correct?

So just so we are clear—the current standard of care now is to send clinically stable symptomatic patients home, “with a wait and see” approach?

Are you aware that physicians are successfully using Hydroxychloroquine combined with Zinc and Azithromycin as a “cocktail” for early outpatient treatment of symptomatic, high-risk, individuals?

Have you heard of the “Zelenko Protocol,” for treating high-risk patients with COVID 19 as an outpatient?

Have you read Dr. Risch’s article in the American Journal of Epidemiology of the early outpatient treatment of COVID-19?

Are you aware that physicians using the medication combination or “cocktail” recommend use within the first 5 to 7 days of the onset of symptoms, before the illness impacts the lungs, or cytokine storm evolves?

Again, to be clear, your recommendation is no pharmacologic treatment as an outpatient for the flu—like symptoms in patients that are stable, regardless of their risk factors, correct?

Would you advocate for early pharmacologic outpatient treatment of symptomatic COVID-19 patients if you were confident that it was beneficial?

Are you aware that there are hundreds of physicians in the United States and thousands across the globe who have had dramatic success treating high-risk individuals as outpatients with this “cocktail?”

Are you aware that there are at least 10 studies demonstrating the efficacy of early outpatient treatment with the Hydroxychloroquine cocktail for high-risk patients — so this is beyond anecdotal, correct?

If one of your loved ones had diabetes or asthma, or any potentially complicating comorbidity, and tested positive for COVID-19, would you recommend “wait and see how they do” and go to the hospital if symptoms progress?

Even with multiple studies documenting remarkable outpatient efficacy and safety of the Hydroxychloroquine “cocktail,” you believe the risks of the medication combination outweigh the benefits?

Is it true that with regard to Hydroxychloroquine and treatment of COVID-19 infection, you have said repeatedly that “The Overwhelming Evidence of Properly Conducted Randomized Clinical Trials Indicate No Therapeutic Efficacy of Hydroxychloroquine (HCQ)?”

But NONE of the randomized controlled trials to which you refer were done in the first 5 to 7 days after the onset of symptoms- correct?

All of the randomized controlled trials to which you refer were done on hospitalized patients, correct?

Hospitalized patients are typically sicker that outpatients, correct?

None of the randomized controlled trials to which you refer used the full cocktail consisting of Hydroxychloroquine, Zinc, and Azithromycin, correct?

While the University of Minnesota study is referred to as disproving the cocktail, the meds were not given within the first 5 to 7 days of illness, the test group was not high risk (death rates were 3%), and no zinc was given, correct?

Again, for clarity, the trials upon which you base your opinion regarding the efficacy of Hydroxychloroquine, assessed neither the full cocktail (to include Zinc + Azithromycin or doxycycline) nor administered treatment within the first 5 to 7 days of symptoms, nor focused on the high-risk group, correct?

Therefore, you have no basis to conclude that the Hydroxychloroquine cocktail when used early in the outpatient setting, within the first 5 to 7 days of symptoms, in high risk patients, is not effective, correct?

It is thus false and misleading to say that the effective and safe use of Hydroxychloroquine, Zinc, and Azithromycin has been “debunked,” correct? How could it be “debunked” if there is not a single study that contradicts its use?

Should it not be an absolute priority for the NIH and CDC to look at ways to treat Americans with symptomatic COVID-19 infections early to prevent disease progression?

The SARS-CoV-2/COVID-19 virus is an RNA virus. It is well-established that Zinc interferes with RNA viral replication, correct?

Moreover, is it not true that hydroxychloroquine facilitates the entry of zinc into the cell, is a “ionophore,” correct?

Isn’t also it true that Azithromycin has established anti-viral properties?

Are you aware of the paper from Baylor by Dr. McCullough et. al. describing established mechanisms by which the components of the “HCQ cocktail” exert anti-viral effects?

So- the use of hydroxychloroquine, azithromycin (or doxycycline) and zinc, the “HCQ cocktail,” is based on science, correct?>>

Let us see how the “game” moves forward beyond this point. END

PS: As an extra, here is Dr Zelenko:

PPS: As a further extra, Aug 29, HT Jerry, Raoult et al on the pattern of cases and studies, involving 40,000+ cases:

360 Replies to “The Frontline Doctors put some “plausible” mechanisms for Hydroxychloroquine on the table

  1. 1
    kairosfocus says:

    HEADLINED: The Frontline Doctors put some “plausible” mechanisms for Hydroxychloroquine on the table

  2. 2
    Seversky says:

    I don’t know why Dr Gold was fired by her hospital but if it was because she expressed controversial opinions rather than for any professional incompetence then she should be reinstated. Whatever her views, we need every doctor we can get.

    I don’t approve of censorship. It is far better to have contentious arguments, views or opinions out there in the open where they can be examined by anyone. If they are right then we learn something new and if they are wrong then we still learn something by discovering how they are wrong.

    That said, it is clear that there are many plausible mechanisms for how drugs or cocktails of drugs might work but that does not mean that one or even any of them is how they actually work. So the question is how do you decide reliably between them?. That it is not best achieved by forming advocacy groups but by conducting research. If Dr Gold and her colleagues have data that HCL alone or in combination with other agents demonstrates measurable efficacy against the SARS-CoV-2 virus then by all means put them on the table so that we can all look at them.

  3. 3
    kairosfocus says:

    Sev, she was fired in 24 hours of her involvement with the conference and protest at the US Supreme Court building. That timing speaks for itself and its message is not just “cancel culture” but whistleblower retaliation. That, sadly, is where we are. As for data you claim to look for, it has long been on the table now. Above is a bit of it, on causal mechanisms summarised from literature and presented in a seminar.I should note that proof is not in the gift of inductive logic and empirical investigation, we are looking at best, empirically warranted inference. However, much of what is being said is hard to dispute. KF

    PS: Just for starters, Dr Risch’s summary:

    Every randomized controlled trial to date that has looked at early outpatient treatment has involved low-risk patients, patients who are not generally treated. In these studies, so few untreated control patients have required hospitalization that significant differences were not found. There has been only one exception: In a study done in Spain with low-risk patients, a small number of high-risk nursing home patients were included. For those patients, the medications cut the risk of a bad outcome in half.

    I reiterate: If doctors, including any of my Yale colleagues, tell you that scientific data show that hydroxychloroquine does not work in outpatients, they are revealing that they can’t tell the difference between low-risk patients who are not generally treated and high-risk patients who need to be treated as quickly as possible. Doctors who do not understand this difference should not be treating COVID-19 patients.

    What about medication safety? On July 1, the FDA posted a “black-letter warning” cautioning against using hydroxychloroquine “outside of the hospital setting,” meaning in outpatients. But on its website just below this warning, the FDA stated that the warning was based on data from hospitalized patients. To generalize and compare severely ill patients with COVID-induced pneumonia and possibly heart problems to outpatients is entirely improper.

    In fact, the FDA has no information about adverse events in early outpatient use of hydroxychloroquine. The only available systematic information about adverse events among outpatients is discussed in my article in the American Journal of Epidemiology, where I show that hydroxychloroquine has been extremely safe in more than a million users.

    It is a serious and unconscionable mistake that the FDA has used inpatient data to block emergency use petitions for outpatient use. Further, already back in March, the FDA approved the emergency use of hydroxychloroquine for hospitalized patients, for whom it is demonstrably less effective than for outpatients. If hydroxychloroquine satisfied the FDA criteria for emergency inpatient use in March, it should more than satisfy those criteria now for outpatient use, where the evidence is much stronger.

  4. 4
    Seversky says:

    Kairosfocus @ 4

    Sev, she was fired in 24 hours of her involvement with the conference and protest at the US Supreme Court building. That timing speaks for itself and its message is not just “cancel culture” but whistleblower retaliation.

    I found the Fox News report claiming that she was fired but I can’t find any other sources to corroborate that she was ever a permanent employee of Provident Saint Joseph Medical Center or, if she was, that she was fired by them. If the Fox News report is inaccurate then this would not be an example of “cancel culture” or whistleblower retaliation.

    As for data you claim to look for, it has long been on the table now. Above is a bit of it, on causal mechanisms summarised from literature and presented in a seminar.I should note that proof is not in the gift of inductive logic and empirical investigation, we are looking at best, empirically warranted inference. However, much of what is being said is hard to dispute. KF

    I was wondering if this group had data from their own practices in addition to what is already on the table. If they don’t then they are just an advocacy group rather than a group conducting primary research whose data and analyses are being ignored by the public health establishment, which is what was implied.

  5. 5
    kairosfocus says:

    Sev, she was fired. Its timing is suspicious and reflects the climate of censorship and intimidation that now obtains. I append some questions from the open letter to Dr Fauci. KF

    PS: Questions:

    Are you aware that doctors who are publicly advocating for such a strategy with the early use of the HCQ cocktail are being silenced with removal of content on the internet and even censorship in the medical community?
    You are aware of the 20 or so physicians who came to the Supreme Court steps advocating for the early use of the hydroxychloroquine cocktail. In fact, you said these were “a bunch of people spouting out something that isn’t true.” Dr. Fauci, these are not just “people,” these are doctors who actually treat patients, unlike you, correct?
    Do you know that the video they made went viral with 17 million views in just a few hours, and was then removed from the internet?
    Are you aware that their website, American Frontline Doctors, was taken down the next day?
    Did you see the way that Nigerian immigrant physician, Dr. Stella Immanuel, was mocked in the media for her religious views and called a “witch doctor?”
    Are you aware that Dr. Simone Gold, the leader of the group, was fired from her job as an Emergency Room physician the following day?
    Are you aware that physicians advocating for this treatment that has by now probably saved millions of lives around the globe are harassed by local health departments, state agencies and medical boards, and even at their own hospitals? Are you aware of that?
    Don’t you think doctors should have the right to speak out on behalf of their patients without the threat of retribution?
    Are you aware that videos and other educational information are removed off the internet and labeled, in the words of Mark Zuckerberg, as “misinformation?”
    Is it not misinformation to characterize hydroxychloroquine, in the doses used for early outpatient treatment of COVID-19 infections, as a dangerous drug?
    Is it not misleading for you to repeatedly state to the American public that randomized clinical trials are the sole source of information to confirm the efficacy of a treatment?
    Was it not misinformation when on CNN you cited the Lancet study based on false data from Surgisphere as evidence of the lack of efficacy of hydroxychloroquine?
    Is it not misinformation as is repeated in the MSM as a result of your comments that a randomized clinical trial is required by the FDA for a drug approval?
    Don’t you realize how much damage this falsehood perpetuates?
    How is it not misinformation for you and the FDA to keep telling the American public that hydroxychloroquine is dangerous when you know that there is nothing more than anecdotal evidence of that?

    PPS: These are doctors on the front lines, their experience with up to hundreds of patients is as validly evidence as anything in a lab; especially as the effect in question seems quite strong, feeling “better” in 24 – 48 hours seems common, effective relief in the 5 – 7 day window of the prescription; that feeling better phase is of course notorious as the point many are tempted to discontinue medications, which has helped to build up drug resistant strains. Further to this, the summary I have outlined above comes from a summary of the literature. Watch the video and check their listed references. Advocacy is neither here nor there as regards truth or warrant in unfortunately controversial contexts, and the summary I clipped and annotated from is otherwise fairly hard to find; you are welcome to view the vid — I cannot embed, as it is Bit Chute (YT has suppressed video by this group after it went viral). Summary is often an important service. It is probably not irrelevant that the presenter of that summary is obviously an immigrant from India, a country quite familiar with HCQ given Malaria.

  6. 6
    kairosfocus says:

    U/D: I have found a Dr Been vid (the Dr who presented the summary for Frontline Doctors), and have embedded the lecture. KF

  7. 7
    Seversky says:

    Kairosfocus @ 5

    Sev, she was fired. Its timing is suspicious and reflects the climate of censorship and intimidation that now obtains

    The only evidence that she was fired that I can find so far is her claim on the Tucker Carlson show on Fox.

    I have found another report which indicates she works part-time at an emergency care facility:

    Gold, who featured prominently in the video at the U.S. Supreme Court and founded the America’s Frontline Doctors group, works in the emergency department at Adventist Health Bakersfield. The hospital said last week Gold is part of its medical staff through a contract the hospital has with physicians group Sound Physicians Emergency Medicine of Southern California, PC. Sound Physicians confirmed Gold has worked for the group as a part-time, independent contractor.

    Her name is still listed as a physician on the Sound Physicians Emergency Medicine of Southern California, PC site. This appears to be a different facility to the one cited in connection with the Fox News report.

    I find it concerning that it is so difficult to pin down where Dr Gold has and does work and in what capacity. If a doctor is not open and honest about his or her professional career and medical experience and practice then how can we trust their judgement on other medical matters?

  8. 8
    john_a_designer says:

    Why isn’t the Frontline Doctors seminar on YouTube? Why was Dr Gold censored on Twitter? Why was James Todaro’s paper (another speaker at the seminar) censored by Google?

    You can find a PDF copy of Todaro’s paper on his website.

    https://www.medicineuncensored.com/

    Take a look at it. What’s unscientific or dangerous about it?

    When freedom speech goes (which is more broadly the freedom of thought, conscience and belief) there goes democracy. So what do you prefer? Anarchy or tyranny? Those are your choices.

  9. 9
    kairosfocus says:

    Sev, you are of course on a side track. the reality is that many doctors work emergency on a part time basis. the dismissal is what is there and whether or not you like Fox News, it is real. Notice, the doctors writing to Dr Fauci, who have direct knowledge of circumstances, highlught it as one of several examples of what is going on. Meanwhile, we have some plausible mechanisms on the table with some circumstantial detail, now including a lecture. KF

  10. 10
    kairosfocus says:

    JAD, excellent questions. usually, anarchy is the repeller pole that snaps back into tyranny on excuse of restoring order. KF

  11. 11
    jerry says:

    Kf,

    The Been video is extremely informative. It just puts icing on the cake of what has been discussed here for over 4 months.

    But to reiterate about the virus:

    Everyone who dies of C19 passes through a window where the virus is just beginning to spread. Everyone! Most who get the virus will pass through it without much effect but there is a very vulnerable part of the population that won’t.

    This transition is believed to be about 1-7 days but maybe longer for some. It is during this transition that HCQ in combination with other ingredients seems to have the most effect. First on preventing the virus from entering the cells and secondly, enabling other ingredients to also enter the cell that would also inhibit the virus from replicating such as zinc. The video shows that HCQ also works inside the cell to inhibit virus replication. So HCQ works inside and outside the cell.

    It is during this time that the immune system starts to work to actually kill the virus cells.

    So common sense and it has always been good medical practice from treating other diseases is to treat early and boost the immune system. Here it is to introduce inhibitory drugs such as HCQ to prevent the virus from spreading. Other thing such as Vitamin C and Vitamin D seem to help boost the immune system. Other additives such as NAC inhibit negative processes from spreading after the virus attacks the ACE2 receptors.

    This is aside from later term use of HCQ to fight the virus when other medications and procedures are apparently much more effective. But in all cases the immune system should be enhanced because this will be the way the virus is ridden from the body.

    And by enhanced, the immune system should be prevented from over reacting and actually becoming a cause of damage to the body.

    But it is this window at the beginning that all pass through that HCQ and zinc seem best. It is also during this time that drugs like Ivermectin also seem effective.

    Also to reiterate, one of the main reasons I come here to discuss this issue is to learn and hone my understanding of the issues. The Been video has been a big addition.

  12. 12
    john_a_designer says:

    Seversky @ # 2,

    I don’t approve of censorship.

    So? How are your beliefs or opinions binding on anyone else? What about the people who approve of censorship like the powers that be at Google and Twitter? They’re not bothered by anyone else’s so-called rights. They have the power to censor anyone they want for any reason they wish. That’s all that they need. It’s an example of the ancient principle of might makes right. (Didn’t Plato use that phrase in one of his dialogues?)

    It is far better to have contentious arguments, views or opinions out there in the open where they can be examined by anyone. If they are right then we learn something new and if they are wrong then we still learn something by discovering how they are wrong.

    Where are you getting your standard of right, wrong or better from? Whose standard is it? Your standard? So any so called consensus is really just the result of the way you are able manipulate– perhaps by vilifying and demonizing– someone else’s opposing opinion because there is no overarching real standard of right or wrong. That sounds pretty disingenuous to me.

  13. 13
    jerry says:

    Just as an aside, the Been video shows the entry into the cell is through the ACE2 receptor on the cell wall. Something which we have known for quite awhile. This enzyme does not exist on all cell types so some cells will not see the virus get inside.

    The ACE2 receptor or enzyme has very specific properties in protecting the body from getting out of wack in terms of blood clotting. MedCram has spent several of their lectures on the effect on blood clotting and other functions that are inhibited or eliminated because the ACE2 receptors are taken out of action by the virus. In fact one of the ways the virus kills is to eliminate the processes normal set in motion because these enzymes are available. So when they are not available after the virus binds to the ACE2 enzymes, positive processes are no longer available in several parts of the body. Specifically cardiovascular processes and in the cell wall lining of blood vessels.

    Deterioration of the cell wall of blood vessels releases a protein that can cause havoc by increasing blood clots. (probably not expressed exactly so watch the MedCram videos on von Willebrand Factor – See MedCram 67 and 96)

  14. 14
    Mac McTavish says:

    Apparently Ben Carson and the My Pillow guy are pushing Trump to pressure FDA to approve oleander extract as a supplement and COVID-19 cure.

    https://www.axios.com/trump-covid-oleandrin-9896f570-6cd8-4919-af3a-65ebad113d41.html

  15. 15
    ET says:

    We should be looking at OTC supplements for a cure or to alleviate symptoms.

  16. 16
    ET says:

    Oregano oil has antiviral and anti-inflammatory properties.

  17. 17
    jerry says:

    Interesting, there is a chart on Dr. Gold’s site which displays which states are most restrictive on the use of HCQ. https://bit.ly/2PXnne0

    Some surprises. Most restrictive states usually have a Democratic governor except Arkansas and Utah are exceptions. Most lenient states have Republican governors including two very liberal states, Massachusetts and Maryland which is unusual.

    But Minnesota just reversed course and has allowed more lenient use of HCQ, https://bit.ly/3145Hnm

    It also has the countries where it is freely purchased vs those that have moderate restrictions and those who have severe restrictions such as the US.

    Now here is a study which should be the basis for approval in the US. All received a treatment with prospects. Ivermectin vs HCQ, each with an anti-biotic. https://bit.ly/3g8D3FQ

    Ivermectin did much better, faster clearance of virus, but the age was too young to be appropriate. But a good start. Should have been done months ago.

  18. 18
    daveS says:

    Mac McT,

    I wonder if the Pillow Guy has ever thought, “Hmm, I’m a former crackhead. Maybe I should leave medicine, in particular alleged Covid cures, to people with some knowledge of the subject”.

  19. 19
    kairosfocus says:

    Oleander is a notoriously poisonous ornamental. There is a weird-looking orange caterpillar with black spikes that eats it (just checked, polka dot wasp moth) — obvious poison warning colours, but that’s the only thing I see eating it. Goats avoid like the plague. (Look, there is a type of iguana that eats manchineel, something so bad rain drops from it are caustic.) Obviously, powerful stuff is in it I have heard it compared to snake venom. What is it they are claiming to find? And BTW, a plant extract novelty is light years away from a drug approved and in use 65 years with a wide range of effects for which plausible mechanisms are on the table and thousands of successful cases with high risk groups. Say 1 in 10^3 odds of by chance success once, after a thousand times that is not plausible anymore. Meanwhile the quinine family and aspirin both started as plant extract, penicillin as bread mould and much more. KF

    PS: I find the thesis and tone of the article really out of line.

  20. 20
    RHolt says:

    There is the often told tale of boy scouts or a vacationing family cooking hotdogs on oleander skewer and being found dead. It is an urban legend but the history behind such stories is pretty interesting reaching back into the early 1800’s. See the Snopes link below.

    https://www.snopes.com/fact-check/fatal-wienie-roast/

    there are reported instances of people being made ill and even dying after ingesting oleander, e.g., chewing leaves. Oleandrin and other cardiac glycosides in the oleander plant aren’t to be trifled with. If this is a proposed or existing supplement it likely contains no oleandrin and I’d venture a guess its offered as a homeopathic remedy……which of course must have nothing in it given how homeopathic nostrums are prepared.

  21. 21
    kairosfocus says:

    RHolt, you are talking about the front hedge (which is goat-proof). Guess who has to trim it? To make it more interesting, the next hedge is allamander, with just as ferocious a reputation to go with the yellow flowers. Let’s just say, a careful job. All that’s missing is poinsettias. KF

  22. 22
    ET says:

    Even oxygen is poisonous @ large concentrations. Most, if not all, vitamins are very bad for you if you take too much. Too much protein is also bad. For centuries local peoples and scientists have harnessed the medicinal powers of poisons, toxins and venomsThe Power of Poison: Poison as Medicine

  23. 23
    ET says:

    daves- that former crackhead is now a multimillionaire business owner and entrepreneur. It doesn’t hurt to hear what he has to say and then get the experts to check it out.

  24. 24
    kairosfocus says:

    ET, I have repeatedly noted the saying of the old pharmacology prof in my UNI: pharmacology is the study of poisons in small doses. KF

  25. 25
    jerry says:

    Could this be why certain commenters here are so ill informed?
    https://www.franklintempletonnordic.com/investor/article?contentPath=html/ftthinks/common/cio-views/on-my-mind-they-blinded-us-from-science.html

    ON MY MIND: THEY BLINDED US FROM SCIENCE

    Americans still misperceive the risks of death from COVID-19 for different age cohorts—to a shocking extent;

    The misperception is greater for those who identify as Democrats, and for those who rely more on social media for information; partisanship and misinformation, to misquote Thomas Dolby, are blinding us from science; and

    We find a sizable “safety premium” that could become a significant driver of inflation as the recovery gets underway.

    Scott Adams has a new name for this. It’s called “social media poisoning.”

  26. 26
    Mac McTavish says:

    Jerry, nobody questions the demographics. That data is available to everyone. The question is how to protect the most vulnerable. One way would be to put everyone in a high risk category into isolation until the virus runs its course. The other way is for everyone to do their part. I prefer the latter.

  27. 27
    jerry says:

    Two words striking fear in the C19 panic mongers? Sweden and Switzerland. From Australia.

    https://www.youtube.com/watch?v=IXmwt_8tdNY&feature=youtu.be

  28. 28
    jerry says:

    The other way is for everyone to do their part. I prefer the latter.

    That could mean anything. If you are against treating early then I would not be proud of that position.

    The best is to treat early and lead normal lives. Then provide for those at high risk If they want it.

    I know some elderly people 80+ who want to lead normal lives and understand the risk. It’s their choice if they know the risks. I live a mile from a continued care facility where all are locked in and can not leave and then come back. They feel they are in prison.

  29. 29
    JVL says:

    Jerry: Two words striking fear in the C19 panic mongers? Sweden and Switzerland. From Australia.

    Explain how Sweden has done so very well, comparing it to Denmark, Norway and Finland.

  30. 30
    jerry says:

    This report just reinforces what is suspected. Most of the C19 deaths in the US occur in a small number of large counties mainly in the Northeast (18 of top 25 counties). These counties make up 1.6% of the counties, 25% of the population and 53% of the deaths. https://herit.ag/3iRcQNU

    One major mistake is that Hidalgo county in Texas is left off. It should be #31 or 32 in the country but is not on the list.

    Along the lines of fake news reporting on C19 see https://bit.ly/2EcCmyf

    Two stories on exaggerated new levels of C19 deaths and a killer strain. Be careful what you read.

  31. 31
    john_a_designer says:

    Besides the usual party politics it appears that there is another factor behind the suppression, censorship and outright demonization of doctors trying to promote hydroxychloroquine based treatments– big pharma. It looks like there is a lot of money to be made as along as the treatment is anything but HCQ.

    Here are some disturbing points raised in an AAPS op-ed from this past May.

    At the Presidential Briefing on Apr 30, Dr. Anthony Fauci announced early results, prior to peer-review, of one clinical trial using remdesivir, an intravenous (IV) experimental antiviral medicine in patients hospitalized with COVID-19. At the “warp speed” currently in vogue for the Fauci-led push to a new vaccine, the very next day the FDA issued an Emergency Use Authorization (EAU) for remdesivir to be used in seriously ill hospitalized patients. To announce the emergency approval, President Trump met with the CEO of the drug’s manufacturer, Gilead Sciences, in the Oval Office.

    Such rapid authorization is quite unusual with the FDA. Unlike the experimental remdesivir with no prior FDA approval, hydroxychloroquine (HCQ) required two months from reports of successful use in China and South Korea to get the Mar 28 FDA EUA for use in hospitalized COVID-19 patients. HCQ was approved in 1955 for malaria, and later for lupus and rheumatoid arthritis. Over the last 65 years, hundreds of millions of prescriptions have been written for HCQ worldwide…

    Dr. Steven Nissen, Cleveland Clinic cardiologist who has conducted dozens of clinical trials, explained to The New York Times: “The disclosure of trial results in a political setting, before peer review or publication, is very unusual. Scientists will need to see figures on harms associated with the drug in order to assess its benefits…. This is too important to be handled in such a sloppy fashion…”

    Money appears to be trumping medical wisdom in the recent enthusiasm for remdesivir based on just one study with modest results… (emphasis added)

    HCQ has been off patent for decades, is available from a dozen U.S. generic manufacturers, and is also produced in China, India, Israel, and other countries. HCQ costs the patient on average less than $10 (range 37-63 cents per tablet), for the usual 5-7 day course of treatment. Remdesivir costs upwards of $1,000 per dose, plus the added costs of having to be hospitalized to receive it…

    Patients’ lives are being sacrificed on the altar of financial interests and elite D.C. powerbrokers instead of being entrusted to the judgment of patients’ own physicians.

    https://aapsonline.org/a-tale-of-two-drugs-money-vs-medical-wisdom/

    One of the Front Line Doctors also raised that same possibility. (Maybe that is the reason they are being censored.) From my own research I would have no problem taking HCQ (it’s safe and there is good evidence that it is effective) and we have been told that doctors still have the freedom to prescribe it with a patients consent for “off label use.” But I have been discovering that may not be as true as I have been led to believe. Recently my state (OH) came close to banning HCQ. That order been rescinded now but apparently only temporarily. How ironic. A few years ago Ohio legalized the medical use of cannabis (marijuana.) However, several municipalities have since voted to decriminalize it completely tacitly making it widely available for recreational use.

    Even though it’s not the most dangerous drug, I opposed its legalization because it is a gateway drug– it can lead to the use of more dangerous drugs. However, it’s not something I lose a lot of sleep over. So tell me, what’s the danger with HCQ if taken as directed by a physician? People are going to start using it recreationally?

  32. 32
    JVL says:

    The pandemic coronavirus has made its way onto two mink farms in Utah, leading to “unusually large numbers” of dead animals, according to a Tuesday announcement by the US Department of Agriculture.

    These are the first reported cases of the coronavirus, SARS-CoV-2, infecting mink in the country. For months, authorities in European countries, including the Netherlands, Denmark, and Spain, have reported outbreaks in mink pelt farms, leading to the culling of more than a million of the soft, furry mammals. From laboratory experiments, it’s also clear that ferrets, a relative of minks, are also readily infected with the novel coronavirus.

    https://arstechnica.com/science/2020/08/coronavirus-creeps-into-us-mink-farms-unusually-larger-numbers-dead/

  33. 33
    kairosfocus says:

    JVL, looks like animal models are possible. Mind you, this is quite late in the epidemic’s life cycle. KF

  34. 34
    kairosfocus says:

    Notice, how no one has been able to provide specific refutation of the suggested mechanisms of action (as opposed to dismissive remarks)? That should tell us something. With animal analogs on the table too, we have opportunities for close investigation. KF

  35. 35
    kairosfocus says:

    F/N: Supportive points from a letter by Peter A. Mc Cullough of Baylor on opening up outpatient (early) use of HCQ etc:

    >>Hydroxychloroquine (HCQ), chloroquine, and me?oquine are antimalarial drugs
    that impair endosomal transfer of virions within human cells. HCQ is also a zinc
    ionophore that conveys zinc intracellularly to block the SARS-CoV-2 RNA-dependent
    RNA polymerase which is the core enzyme of the virus replication.‘
    At the time of this
    writing, there are > 200 ‘clinical trials registered on clinica|trials.gov utilizing these agents
    in COVID-19. The currently completed retrospective studies and randomized trials
    have generally shown these findings: 1) when started late in the hospital course and
    for short durations of time, antimalarials appear to be ineffective, 2) when started earlier
    in the hospital course, for progressively longer durations and in outpatients,
    antimalarials may reduce the progression of disease, prevent hospitalization, and are
    associated with reduced mortality? 6 7 2 5 in a retrospective inpatient study of 2541
    patients hospitalized with COVID-19, therapy associated with an adjusted reduction in
    mortality was HCQ alone, HR=0.34 (95% Cl 0.25-0.46), p<0.001, and
    HCQ+azithromycin, HR=0.29, 95% Ci 0.22-0-40, p<0.001. HCQ was approved by the
    U.S. Food and Drug Administration in 1955, has been used by hundreds of millions of
    people worldwide since then, is sold over the counter in many countries and has a well
    characterized safety pro?le.“ FDA cautions about HCQ should not be applied to
    outpatient treatment in response to the evolving observations on HCQ administration to
    COVID-19 patients? State medical boards should rescind restrictions on HCQ use for
    COVID-19 patients in states where they have been put in place. While asymptomatic
    QT prolongation is a well-recognized and infrequent (LT 1%) complication of HCQ it is
    possible that in the setting of acute illness symptomatic arrhythmias could develop.
    Despite heightened scrutiny, data safety and monitoring boards have not declared
    safety concerns in any clinical trial published to date. Physicians should be allowed to
    assess the benefits and risks of HCQ as with any other therapy administered to patients
    at risk for arrhythmia or on one or more chronic QT prolonging medications. Rare
    patients with a personal or family history of prolonged QT syndrome, those on additional
    QT prolonging, contraindicated drugs (e.g. dofetiiide, sotalol), shouid be treated with
    caution and a plan to monitor the QTc in the ambulatory setting. >>

    Notice, this supports the mechanisms discussed in the OP.

    KF

  36. 36
    jerry says:

    Not as much hope as originally hoped for. But lots of money. A review of Remdesivir and Fauci’s fingerprints all over it.

    https://bit.ly/3iSs2ub

    Remdesivir for Covid-19: $1.6 Billion for a “Modestly Beneficial” Drug?

  37. 37
    john_a_designer says:

    Have you heard of LancetGate? I hadn’t till I read the following article. It reports some things that has the fingerprints of corporate greed and corruption written all over it:

    May 22: The Fake Lancet Report on Hydroxychloroquine (HCQ)

    It is worth noting that the full report of the NIH-NIAID) entitled Remdesivir for the Treatment of Covid-19 — Preliminary Report was released on May 22, 2020 in the NEJM, on the same day as the controversial Lancet report on Hydroxychloroquine.

    Immediately folllowing its publication, the media went into high gear, smearing the HCQ cure, while applauding the NIH-NIASD report released on the same day.

    Remdesivir, the only drug cleared to treat Covid-19, sped the recovery time of patients with the disease, … “It’s a very safe and effective drug,” said Eric Topol, founder and director of the Scripps Research Translational Institute. “We now have a definite first efficacious drug for Covid-19, which is a major step forward and will be built upon with other drugs, [and drug] combinations.”

    When the Lancet HCQ article by Bingham-Harvard was retracted on June 5, it was too late, it received minimal media coverage. Despite the Retraction, the HCQ cure “had been killed”. (emphasis added)

    June 29: Fauci Greenlight. The $1.6 Billion Remdesivir Contract with Gilead Sciences Inc

    Dr. Anthony Fauci granted the “Greenlight” to Gilead Sciences Inc. on June 29, 2020.

    The semi-official US government NIH-NIAID sponsored report (May 22) entitled Remdesivir for the Treatment of Covid-19 — Preliminary Report (NEJM) was used to justify a major agreement with Gilead Sciences Inc.

    The Report was largely funded by the National Institute of Allergy and Infectious Diseases (NIAID) headed by Dr. Anthony Fauci and the National Institutes of Health (NIH).

    https://www.globalresearch.ca/scientific-corona-lies-and-big-pharma-corruption-hydroxychloroquine-versus-gileads-remdesivir/5717718?utm_campaign=magnet&utm_source=article_page&utm_medium=related_articles

    The mainstream media needs to take a closer look at this. Do you think they will?

  38. 38
    jerry says:

    The mainstream media needs to take a closer look at this. Do you think they will?

    It was covered in detail here starting about two months ago. The press did not cover and will not cover except in passing. It’s against their religion and financial interests to report anything positive on HCQ.

    The finding was that HCQ was dangerous and this was thought would be its Achilles heel and thus kill it. But the study was bogus and even though supported by high level medical researchers associated with a prestigious hospital in Boston, they will suffer no harm.

    When it was proven bogus, the press and medical establishment forgot the Lancet study and went into over drive to show that HCQ was ineffective since they no longer could say it wasn’t safe. They are essentially corrupt, the medical establishment and the press.

    As an example, Fauci constantly lies. It will be interesting to see what Atlas starts saying. He is for HCQ.

  39. 39
    kairosfocus says:

    Jerry, I wish I could simply dismiss such thoughts as ill founded conspiracism. I cannot, as essentially the whole medical establishment is tainted with the enabling of the worst — ongoing — holocaust in history [which has killed far more this year than CV19, about 20 millions of our living posterity on the womb so far), and with enabling sexual identity confusion and more. That is, I cannot rely on them to be sensitive to the do no harm premise, so I am forced to be open to possibilities of grave and even institutionalised moral breakdowns. In that context, I have had to note on the gold standard fallacy and how it is used to dismiss epistemologically valid evidence, specifically regarding right use of HCQ-based cocktails. This thread is about some such evidence, on causal mechanisms. So, I can see cultivation of ill founded bias towards such. For sure, we saw a well-timed media kill shot pattern and we have seen few signs of retracting the second claim in the face of evidence. It is time to return to first duties of responsible reason. KF

    PS: On said duties:

    We can readily identify at least seven inescapable first duties of reason. Inescapable, as they are so antecedent to reasoning that even the objector implicitly appeals to them; i.e. they are self-evident. Duties, to truth, to right reason, to prudence, to sound conscience, to neighbour, so also to fairness and justice etc. Such built in law is not invented by parliaments or courts, nor can these principles and duties be abolished by such. (Cf. Cicero in De Legibus, c. 50 BC.) Indeed, it is on this framework that we can set out to soundly understand and duly balance rights, freedoms and duties; which is justice. The legitimate main task of government, then, is to uphold and defend the civil peace of justice through sound community order reflecting the built in, intelligible law of our nature. Where, as my right implies your duty a true right is a binding moral claim to be respected in life, liberty, honestly aquired property, innocent reputation etc. To so justly claim a right, one must therefore demonstrably be in the right. Thus, too, we may compose sound civil law informed by that built-in law of our responsibly, rationally free morally governed nature; from such, we may identify what is unsound or false thus to be reformed or replaced even though enacted under the colour and solemn ceremonies of law. These duties, also, are a framework for understanding and articulating the corpus of built-in law of our morally governed nature, antecedent to civil laws and manifesting our roots in the Supreme Law-giver, the inherently good, utterly wise and just creator-God.

  40. 40
    rhampton7 says:

    China has advised against the use of hydroxychloroquine in treating coronavirus patients, a controversial malaria treatment touted by US President Donald Trump as a wonder drug for Covid-19. However, it has recommended the use of a similar malaria drug called chloroquine. The recommendations are part of new Covid-19 treatment guidelines released on Wednesday and updated for the first time since March 3. “Some drugs may demonstrate a certain degree of efficacy for treatment in clinical observation studies but there are no effective antiviral drugs confirmed by double-blind, placebo-controlled clinical trials,” the National Health Commission said in version eight of the diagnosis and treatment guidelines.

    “The use of hydroxychloroquine, or the combined use of it with azithromycin, is not recommended.” But the same guidelines said chloroquine can continue to be used.

    https://www.scmp.com/news/china/society/article/3098021/coronavirus-conflicting-treatment-message-china-rejects-trump

  41. 41
    kairosfocus says:

    F/N: It seems we have been here before:

    http://sitn.hms.harvard.edu/fl.....-epidemic/

    >>On April 22, 1721, a British ship arrived in Boston Harbor. On board, one of the sailors had begun to exhibit symptoms of smallpox. He was quickly quarantined, but several more members of the crew soon fell ill with the disease. An outbreak of the disease spread quickly through the city [1]. As the epidemic worsened, Cotton Mather reached out to the medical community of Boston, imploring them to use the inoculation method. One physician, Zabdiel Boylston, heeded his call, but most other doctors were hostile to the idea. At the forefront of the anti-inoculation contingency was one of Boston’s only physicians who actually held a medical degree, Dr. William Douglass. The arguments against inoculation were varied, ranging from disagreement on religious grounds to scientific uncertainty. While many argued that inoculation violated divine law, by either inflicting harm on innocent people or by attempting to counter God’s specific will, the main argument that Douglass made was that inoculation was untested and seemingly based on folklore. Douglas feared that unchecked use of inoculation would only quicken the spread of disease throughout the city [8].

    By modern standards, this argument seems highly sensible. The use of a poorly researched medical technique, particularly one as potentially hazardous as intentionally exposing healthy people – including children – to smallpox, would be highly unethical today. To many professional Boston physicians, inoculation must have appeared as unscientific as other contemporary treatments such as bleeding and purging, which were still common practice during the early 18th century.

    But as the epidemic began to diminish in early 1722, Mather and Boylston had collected surprisingly thorough data that made a clear argument for the effectiveness of inoculation (Figure 1). Boylston, who had personally inoculated some 287 people, recorded that of those inoculated only 2% had died. In comparison, the mortality rate of the naturally occurring disease during that year was 14.8% [1].

    Although inoculations were themselves a risky practice and carried a not-insignificant health risk, this data demonstrates that inoculations were significantly less fatal than the naturally occurring virus. Ultimately, this helped to disprove the opposition’s fear that such a technique would only facilitate the spread of disease. Mather and Boylston’s advocacy and observations resulted in what was actually one of the earliest clinical trials on record, and the use of both experimental and control groups to demonstrate the effectiveness of inoculation significantly aided the adoption of the practice [1,9].>>

    There is need to rethink.

    Of course, c 1796, Jenner pioneered cross-immunity where another virus confers significant immunity in a relatively safe way. Which started with milk maids and cowpox.

    KF

  42. 42
    john_a_designer says:

    Here is an article from July 30 about Ohio’s then pending plan to ban HCQ.

    The State of Ohio Board of Pharmacy has changed course on its ban of hydroxychloroquine and chloroquine as coronavirus treatments following the governor’s urging to do so.

    Beginning Thursday, pharmacies, clinics and other medical institutions were to be prohibited from dispensing or selling the drugs to treat COVID-19, according to regulations issued by the State of Ohio Board of Pharmacy…

    The board’s shift came after… Gov. Mike DeWine asked the state pharmacy board… to rescind its plan…

    DeWine said the decision of how to treat COVID-19 should instead be between patients and their doctors.

    https://www.usatoday.com/story/news/health/2020/07/30/ohio-pharmacy-board-reverses-hydroxychloroquine-ban-mike-dewine-request/5547751002/

    The writer of the article then followed up with this comment:

    “Hydroxychloroquine has been touted by President Donald Trump despite medical studies showing the drug to be ineffective at treating the disease. The drug may also cause serious cardiac side effects, according to the Food and Drug Administration.”

    I thought the cardiac side effects claim had been largely debunked. I learned that in early June. So who’s right the reporter or me?

    He also claims that there are “medical studies showing the drug to be ineffective at treating the disease.” What studies is he talking about? The Lancet study? Did he get the memo? And what does he mean by ineffective? Completely and totally ineffective? How is that possible? What he appears to be claiming is that these so-called studies have been able to prove a negative. Really? What about all the studies (many of which have been cited here) that show evidence that HCQ is effective? Even if it is just somewhat effective and safe isn’t that a good enough reason to allow physicians with their patients knowledge and consent to prescribe it for an off label use?

    Personally as someone who is in the high risk category I want my doctor to have that freedom. It could save my life.

  43. 43
    rhampton7 says:

    How do you rethink this?

    “ Some drugs may demonstrate a certain degree of efficacy for treatment in clinical observation studies but there are no effective antiviral drugs confirmed by double-blind, placebo-controlled clinical trials”

    Pretend the clinical trials never happened?

    Pretend that observational data is conclusive?

  44. 44
    jerry says:

    Kf,

    I am a huge fan of Benjamin Franklin. As a young man, teenager, he sent to his brother’s newspaper a bunch of anonymous letters ridiculing Mather. Especially about small pox. His brother printed them not knowing they were from his own brother. Mather became a laughingstock because of this. Mather was central to the Salem Witch trials and not well liked by many.

    A few years later he ran into Mather when He was a young adult and had a positive encounter with him. It changed his mind about Mather.

    One of Franklins sons died of small pox because he wouldn’t vaccinate him.

    Later in his life Franklin ran into Mathers grandson and spoke well of him.

    From memory as I type on my iPad. Somewhere I have the exact copy.

  45. 45
    jerry says:

    Kf,

    Watch this. It’s an hour long and by a doctor, surgeon who is highly critical of everything going on. Given in Las Vegas recently at a conference.

    If half true, it’s very scary especially how virus spread in the environment. Says masks are a joke. Be careful about vaccines. But loaded with references.

    Actually discusses the origins of the term “conspiracy theory.” This so called origin Of the term is now a conspiracy theory.

    https://www.youtube.com/watch?v=sjYvitCeMPc&feature=emb_logo

  46. 46
    ET says:

    RHampton7- Please tell China that I concur. I also advise against the use of HCQ. Especially in scenarios in which it is being misused. 😎

  47. 47
    daveS says:

    Doctors for Disaster Preparedness, eh?

    Looks like a clearinghouse for those “alternative facts” we hear so much about.

  48. 48
    jerry says:

    Science and Alice in Wonderland

    How the hydroxychloroquine debate proves politics can get in the way of science

    Hydroxychloroquine has been in use worldwide for more than 65 years. It’s been prescribed safely billions of times. And yet, for political reasons — and, more specifically, for anti-Trump reasons — there is a lobbying campaign to block hydroxychloroquine from patients with COVID-19.

    Based on the best evidence available today, hydroxychloroquine — HCQ, for short — has been shown to be effective in early-stage treatment of COVID-19, the illness brought on by the novel coronavirus. Because of hyper-politization, however, this evidence is being ignored. After all, if there’s an effective treatment for COVID-19, then maybe the shutdowns and distance learning for our children and mask mandates and social distancing requirements aren’t necessary, from a medical standpoint.
    And if they’re not necessary from a medical standpoint, then what excuse could we use to keep the schools closed for in-person learning, and to keep the businesses shuttered, and to keep the rest of society under the government’s thumb?

    https://bit.ly/2Qb5OaC

  49. 49
    JVL says:

    A New York-based nonprofit that has worked for decades to better understand and prevent the type of coronavirus pandemic now engulfing the world was abruptly stripped of its federal research funding in April. The White House specifically directed the National Institutes of Health to cancel the multimillion-dollar research grant after President Donald Trump promoted an unfounded conspiracy theory that the pandemic coronavirus, SARS-CoV-2, was released from a lab in Wuhan, China—a lab that collaborates with the nonprofit.

    Now, the NIH has told the nonprofit, EcoHealth Alliance, that it may have its funding back—if it collects and hands over materials and information about the Chinese lab, which is part of the Wuhan Institute of Virology (WIV).

    https://arstechnica.com/science/2020/08/coronavirus-researchers-must-examine-trump-backed-conspiracy-or-lose-funding/

  50. 50
    ET says:

    LoL! If they have worked for decades and still don’t have an answer, let them find their own funding.

    The EVMS has put out a list of OTC supplements that will do the job of preventing the pandemic we are currently mired in.

  51. 51
    jerry says:

    From Alex Berenson today

    Today’s #Covid update:

    Masks don’t work.
    Lockdowns don’t work.
    Kids and young adults are at roughly zero risk.
    Adults under 50 are at tiny risk.
    Adults under 75 (80?) who aren’t already at death’s door are at very low risk.
    Many people already have immunity.

    PANIC FOREVER!

    And then there is this.

    Fauci lied about HCQ. Bill Gates lied about HCQ. Both are heavily invested in a vaccine with about $100 billion worldwide at stake. Is it a coincidence?

    What if a vaccine is not necessary? It must be conspiracy theory.

    Is calling something a conspiracy theory a way to hide a conspiracy? Sounds like Russian dolls within each other.

    Aside: By the way I want to thank the Mel Gibson movie, “Conspiracy Theory” for introducing me to Frankie Valli and the Jersey Boys.

  52. 52
    jerry says:

    The Media Sabotage of Hydroxychloroquine Use for COVID-19: Doctors Worldwide Protest the Disaster

    https://www.globalresearch.ca/media-sabotage-hydroxychloroquine-covid-19-doctors-worldwide-protest-disaster/5717382

    A dangerous, life-threatening sequence of events has unfolded since The Lancet’s fraudulent hydroxychlorquine (HCQ) article appeared May 22, followed by headlines demonizing this ancient anti-malarial drug – aka quinine, aka chloroquine, and known to antiquity as the “sacred bark”.

    Is Fox News the most reliable source of news. This will make some heads spin. I didn’t know this till reading this article about the reporting around the Lancet debacle and Risch’s response.

    On May 27, less than a week into this disaster, a top world epidemiology journal, the American Journal of Epidemiology, issued an urgent call from award-winning Yale Professor, Harvey Risch: “Early Outpatient Treatment of Symptomatic, High-Risk Covid-19 Patients that Should be Ramped-Up Immediately as Key to the Pandemic Crisis.

    A Google News search reveals the astonishing truth that the corporate media, with the exception of Fox News,[vi] did not report this article.

    Is it all about money? Or power? Will we all crawl on our hands and knees if the medical establishment says it’s necessary to avoid the virus? See end of long video linked to above.

  53. 53
    john_a_designer says:

    Before the U.S. was shut down due to Covid-19 did the CDC do a randomized double-blind study of the effectiveness (and risks) of a nationwide shutdown? Where is the study written up? I’d like to read it.

    From what I remember the CDC was more or less shooting from the hip. But I suppose I could be wrong about that. Again, where are the studies?

  54. 54
    jerry says:

    From the hottest of the hot spots in the US. Hidalgo county Texas.

    https://www.themonitor.com/2020/08/11/health-authority-older-overweight-make-majority-virus-deaths/

    Hidalgo County’s death toll from the COVID-19 pandemic reached 829 Monday evening, and data on the deaths along with observations from health authorities has painted a picture of the average virus victim in the area that can be summed up in two words: older and overweight.

    Actually it’s over a thousand now. As of this morning it’s 1019 just behind Houston, country’s fourth largest city which is at 1095.

  55. 55
    JVL says:

    David Icke (https://davidicke.com) thinks that COVID-19 is a complete hoax. Listen to his interview on the Skeptiko podcast but make sure you buckle in safely.

  56. 56
    Seversky says:

    Wikipedia on Icke:

    Icke believes that the universe is made up of “vibrational” energy and consists of an infinite number of dimensions that share the same space.[14][15][16]:26–27 He claims that an inter-dimensional race of reptilian beings called the Archons (or Anunnaki) have hijacked the earth, and that a genetically modified human–Archon hybrid race of shape-shifting reptilians known as the Babylonian Brotherhood, the Illuminati, or the “elite”, manipulate global events to help keep humans in constant fear. Thus, the Archons can feed off the “negative energy” this creates

    I remember Icke as a sports reporter on the BBC and he seemed perfectly normal then.

  57. 57
    jerry says:

    The main stream press is just the same in Spain. Here is a broadcast from Madrid from the last few days. It is in Spanish but an English translation is provided below the video. The two from the TV studio would do just fine here in the US. Shrill and clueless. Boy do they talk fast in Spain.

    The doctor says all is in control and not serious. but the two talking heads want panic in the streets. Fear is the name of the game.

    https://bit.ly/31fEn5E

  58. 58
    rhampton7 says:

    at first we said HCQ might work. In fact, some providers were guilty of self-prescribing and hoarding it. Now we say it doesn’t work for COVID-19 and could actually do harm. But not everyone believes us, including the president and several members of his administration, as well as many of our own patients.

    We in health care are quick to dismiss our mixed messages by saying, “Oh, that’s just how science works.” And, yes, science is a messy process. But that’s not the only reason we get things wrong. The truth is, we’re human and influenced by more than just science.

    Sometimes, we engage in wishful thinking. We assume that because something should work, it will work. For example, if you have chronic chest pain due to a blocked coronary artery, doesn’t it just make sense to prop it open with a stent? And if you come in with knee pain, and we see torn cartilage on MRI, surely an operation to fix it will give you relief? Well, it turns out that in many cases, those stents are no better than low-cost medications and that knee surgery is no better than physical therapy. We have had to learn (and re-learn) the hard lesson that intuition is not always a reliable guide to illness and health.

    Sometimes, we succumb to conflicts of interest, even if we are not always conscious of them. When there is more money to be made in stenting an artery or operating on a knee, it makes it harder for us to simply prescribe a medication or send a patient to physical therapy.

    Sometimes, we just want to make our patients happy. In fact, our livelihoods can depend on it. Providing evidence based care does not always correlate with patient satisfaction.

    Sometimes, we’re simply pressed for time. It might take 30 seconds for a clinician to say yes to a patient’s request for an antibiotic to treat the common cold, but 30 minutes to have a conversation explaining why it won’t help.

    https://www.newsweek.com/coming-clean-about-hydroxychloroquine-opinion-1526225

  59. 59
    rhampton7 says:

    Continued…

    Here’s what we can say about HCQ: There is no conflict of interest at play. Hospitals don’t make money taking care of COVID-19 patients. In fact, they lose money, even with government bailouts. Health care professionals are taking pay cuts or getting laid off.

    If cheap HCQ could get us back to business as usual—making money doing elective surgical procedures—and writing these prescriptions would help us secure our jobs and our pay, hospitals would be giving it out for free given the amazing return on investment.

    Furthermore, the easiest and quickest thing to do for providers would be to just write the prescription, which some are. But it’s not the right thing to do.

    Let’s say you were to go into a fatal heart rhythm, a known side effect of HCQ, and die. How could we defend our decision to a jury, let alone to your bereaved family? Referencing a video posted on Twitter, even a viral one, would be woefully insufficient. To prescribe something that can harm without helping violates our most fundamental oath.

    We were hopeful at first that HCQ would work for COVID-19. It showed promise in the lab and in small human studies. But, ultimately, our wishful thinking did not pan out.

    https://www.newsweek.com/coming-clean-about-hydroxychloroquine-opinion-1526225

  60. 60
    rhampton7 says:

    Why RCTs are important:

    Doctors form Boston Medical Center (BMC) showed in a recent study that interleukin-6 inhibitors like sarilumab and tocilizumab can reduce mortality in severe COVID-19 cases. We mentioned at the time that the research wasn’t a randomized, double-blind, placebo-controlled study, but rather an observational one.

    This brings us to Roche’s version of tocilizumab — Actemra — which has been featured in news reports dating as far back as mid-April. The Swiss drugmaker started a Phase 3 study of the rheumatoid arthritis drug back in mid-March, and the conclusions arrived a few weeks ago.

    As BioSpace explained in late July, Roche’s San Francisco-based partner Genentech announced that the COVACTA study did not meet its “primary endpoint of improved clinical status in hospitalized adult patients with severe COVID-19 associated pneumonia.” Furthermore, “the key secondary endpoints, which included the difference in patient mortality at week four, were not met.” In other words, this version of tocilizumab combined with standard care could not improve the condition of COVID-19 patients or prevent deaths.

    We can now add another new drug to the list of failures: tocilizumab, a promising drug that we’ve seen mentioned in a variety of studies, but which has proven to be ineffective in its Phase 3 trial.

    There is a silver lining here, as researchers observed a positive trend in discharge times with patients who received Actemra. Placebo patients needed 28 days to leave the hospital, while those on Roche’s tocilizumab left after 20 days. The study was still a failure though, since the primary endpoint was not met.

    https://bgr.com/2020/08/20/coronavirus-cure-tocilizumab-actemra-phase-3-results/

  61. 61
    rhampton7 says:

    A Chinese doctor who was at the epicentre of the COVID-19 outbreak in Wuhan has warned against developing treatments based on anecdotes rather than evidence, adding that there is “no magic bullet” for the disease.

    Professor Cao Bin, vice-director of the National Clinical Research Centre for Respiratory Disease in China, had moved from Beijing to Wuhan to help during the initial surge of COVID-19 cases in China.

    Speaking at a National University of Singapore (NUS) webinar on Thursday (Aug 20), Prof Cao recalled that during the early days of the pandemic, people were grasping at straws to find a treatment for COVID-19.

    “We have heard a lot of stories about the successful treatment of this disease, such as a new drug, or even a kind of drink … for the ill patients,” he said. “But unfortunately, there is no magic bullet – not only during the early days, but for now.”

    He detailed how hydroxychloroquine was initially granted approval by the US Food and Drug Administration (FDA) after US President Donald Trump touted it as way to ward off the coronavirus.

    Treating some COVID-19 patients is “complicated”, with some developing severe pneumonia, kidney injury and cardiac injury, said Prof Cao.

    “Even during a pandemic, even during fear or helplessness, we clinicians should trust evidence, and we should not trust anecdotes,” Prof Cao added. “I think smart clinicians should make clinical decisions based on evidence, even in the era of COVID-19.”

    Prof Cao was one of the first doctors in the world to use antiviral drugs lopinavir and ritonavir – normally given to HIV patients – to treat COVID-19 patients.

    “You can tell that as doctors, you want to find a magic bullet. To tell you the truth, this is what I thought in the early days of January 2020. “My colleagues and I wanted to get a kind of magic bullet, but after … we have gathered all the evidence … I have to admit that it’s hard to get a kind of magic bullet.”

    https://www.channelnewsasia.com/news/asia/covid-19-coronavirus-wuhan-china-singapore-treatment-evidence-13038720

  62. 62
    Mac McTavish says:

    ET

    The EVMS has put out a list of OTC supplements that will do the job of preventing the pandemic we are currently mired in.

    Are these the same OTC supplements that the EVSM state have not been demonstrated to have any prophylactic benefits but that there is no harm in taking them?

  63. 63
    kairosfocus says:

    RH7, it has long since been shown that the “gold standard” tests you pointed to are misdirected, being post viral growth phase or the wrong segments of pop, those not showing the vulnerability. And yet, once there was a crack in a study, and the effectiveness manifested itself. Your insistence on such cites in the face of cogent correction shows us just how dangerous a fallacy is involved in erecting such “gold standards” that lock out valid empirical evidence. KF

    PS: Pretending that placebos don’t have serious ethical and epistemological problems and dismissively labelling evidence as instead “anecdotes” manages only to underscore just how pernicious this “gold standard” fallacy is.

  64. 64
    ET says:

    Mac:

    Are these the same OTC supplements that the EVSM state have not been demonstrated to have any prophylactic benefits but that there is no harm in taking them?

    That isn’t what the EVMS states. Clearly you have reading comprehension issues.

    Acartia Eddie George had the same reading comprehension issue. Weird.

  65. 65
    ET says:

    From the EVMS:

    11. For prophylaxis and treatment of the early symptomatic phase we suggest the combination of
    Quercetin (a plant polyphenol), Vitamin C and Zinc. This is based on intriguing basic science data
    which indicates that:
    a. Zinc is essential for innate and adaptive immunity.[10] In addition, Zinc inhibits RNA
    dependent RNA polymerase in vitro against SARS-CoV-2 virus.[9]
    b. Quercetin has direct viricidal properties against a range of viruses, including SARS-CoV2.[3,7] In addition, quercetin acts as a zinc ionophore. [148]
    c. Vitamin C improves the potency of Quercetin and has antiviral activity.[3]

    12. It should also be noted that Vitamin D may be a very powerful prophylactic and treatment
    strategy against COVID-19. [18-25] Vitamin D deficiency explains, in part, the enormous
    geographic variation in mortality of this disease.

    The only reason “extremely limited data” for the efficacy of OTC cocktail exists is because no one is running any trials- or they haven’t reported them. What we would need is the nutrient information for everyone who had the virus, those who are asymptomatic and those who cannot get infected.

  66. 66
    Mac McTavish says:

    ET

    That isn’t what the EVMS states. Clearly you have reading comprehension issues.

    Well, I was paraphrasing. But here is what they say.

    While there is extremely limited data, the following “cocktail” may have a role in the prevention/mitigation of COVID-19 disease. It should however be noted that a recent publication suggests that melatonin my reduce the risk of COVID-19 infection.[1] This cocktail is cheap, safe, and widely available.
    • Vitamin C 500 mg BID (twice daily) and Quercetin 250-500 mg BID [2-8]
    • Zinc 50-75 mg/day (elemental zinc). Zinc lozenges are preferred. After 1 month, reduce the
    dose to 30-50 mg/day. [2,9-13]
    • Melatonin (slow release): Begin with 0.3mg and increase as tolerated to 2 mg at night [1,14-17]
    • Vitamin D3 2000-4000 u/day [18-25]
    • Optional: Famotidine 20-40 mg/day [26]

    Not exactly the definitive claim that you have repeatedly made.

    The only reason “extremely limited data” for the efficacy of OTC cocktail exists is because no one is running any trials- or they haven’t reported them.

    The only reason there is limited evidence for the efficacy of crystal therapy and pyramid power is because no one is running any trials- or they haven’t reported them.

  67. 67
    Bob O'H says:

    kf @ 63 –

    RH7, it has long since been shown that the “gold standard” tests you pointed to are misdirected, being post viral growth phase or the wrong segments of pop, those not showing the vulnerability.

    The lack of such studies is surely a criticism to be levelled at people like Raoult, who had the resources to run them, but chose not to.
    FWIW, I’m not sure what you mean by the “post viral growth phase”, but RCTs are being done both the pre-exposure prophylaxis and post-exposure
    prophylaxis stages. The post-exposure prophylaxis trials both show no effect (I thought a pre-exposure trial had too, but I can’t find a reference to that).

  68. 68
    kairosfocus says:

    BO’H: Apparently it STILL hasn’t registered that there are grave ethical issues involved, or that full bore investigations to test through the ponderous protocols will by and large deliver too late for there to be a timely pandemic response, much less that there is already reasonable, responsible evidence in hand. I don’t need to further point out the built to fail biases of studies that have been promoted: too late in the U/L trajectory, wrong focus (not on the vulnerable), trying to separate components of a synergistic treatment, etc. Remember, just on Zn, something like a 1/4 of the population is Zn deficient, which is a real confounding issue if there is refusal to use an integrated protocol. Something drastic will have to be done about how such medical studies are conducted, but that is for later, again, as that will take too much time. Indeed, it seems they are going to do some sort of emergency acceleration on vaccines, which face the hurdle that after decades of trying, there are no established vaccines for corona virus epidemics, they mutate too fast duet o their nature. Already, it is too late for the main surge of this pandemic and it is clear that tens to hundreds of thousands have needlessly died because of the gold standard fallacy and linked selective hyperskepticism. KF

  69. 69
    jerry says:

    Hopefully true

    Delhi’s Sero Survey Results Show We Are Fast Approaching Herd Immunity’: Epidemiologist J P Muliyil

    https://www.outlookindia.com/website/story/india-news-delhis-sero-survey-results-show-we-are-fast-approaching-herd-immunity-epidemiologist-j-p-muliyil/357205

    Q) One-fourth of Delhi developed immunity without a vaccine. Is that a good sign?

    The result is pretty encouraging. This is herd immunity. A vaccine is supposed to do this. Unfortunately, we don’t have one. It would have been tragic if there were only deaths and no immunity. This result means we are not completely lost. The news of the vaccine from Oxford is also good. Once we reach herd immunity, we can unlock gradually. The reason is that lockdown doesn’t prevent transmission, it only causes inconveniences and affects the industries. Despite all the containment efforts, people got a high level of immunity. That means the virus is happily moving around.

  70. 70
    jerry says:

    Is the virus more of a political not a medical problem

    Attorneys General In 20 States Tell Social Media Giants To Censor More Free Speech, Keith Ellison Among Signers

    https://www.nationalistreview.net/2020/08/19/attorneys-general-in-20-states-tell-social-media-giants-to-censor-more-free-speech-keith-ellison-among-signers/

    All Democrats. They are admitting they believe they can control votes by suppression of speech. The result is they are killIng people who will die from C19

    Misinformation. They use that word throughout the letter, because that’s what this is really about. It’s not about so-called hate speech (which is really just distasteful, yet legally protected, free speech). This is about censoring wrong-think. It’s about censoring stories they don’t want you to read.

    Of course some of this misinformation is true and actually information but just not convenient to a particular political ideology.

    For example, we could probably have a long discussion here on which comments contained misinformation. Then there is what exactly is misinformation?

    People are moving to Parler and Rumble to prevent suppression of their points of view.

  71. 71
    ET says:

    Mac, obviously you have reading comprehension issues. The SCIENCE supports the use of those OTC supplements. Read the reference papers or continue to wallow in your ignorance. I don’t care but just don’t think your ignorance is an argument.

    Not exactly the definitive claim that you have repeatedly made.

    Again, my claim is based on the SCIENCE, that is why you are so confused.

  72. 72
    ET says:

    And “extremely limited data” means that data does exist. That means you lied, again.

    It’s pathetically sad that Mac tells me to grow up all the while Mac acts like an ignorant infant

  73. 73
    jerry says:

    Is C19 unique?

    Of course every virus is unique but in what ways is C19 different from other viruses?

    One major difference is the age effect. This has been explained by the susceptibility of older people due to inadequate immune systems and prevalence of comorbidities. But hasn’t that always been true? So why this one? Why now?

    I haven’t seen any answers that make sense. If anyone has insight it would be useful. One characteristic that had temporary interest was that younger people have less ACE2 receptors.

    Is ACE2 the key? Do other viruses attack the ACE2 receptors? Attacking ACE2 explains the cardiovascular problems due to clotting?

    Here is a comparison with the 1957 flu epidemic.

    World – 1957 dpm (deaths per million) 383 dpm- 2020 84 dpm (estimate for year)
    so much higher in 1957

    US – 1957 674 dpm – 2020 680 dpm (estimate for year)

    UK – 1957 641 dpm – 2020 673 dpm (estimate for year)

    So about same in US and UK and very much higher than rest of world.

  74. 74
    Mac McTavish says:

    ET, you really are incapable of behaving like an adult. I’m surprised that any website allows you to comment.

  75. 75
    john_a_designer says:

    Let me repeat a point that I raised earlier @ 53.

    Before the U.S. was shut down due to Covid-19 did the CDC do a randomized double-blind study of the effectiveness (and risks) of a nationwide shutdown? Where is the study written up? I’d like to read it.

    From what I remember the CDC was more or less shooting from the hip. But I suppose I could be wrong about that. Again, where are the studies?

    Then recently on another thread one of our regular interlocutors said this:

    The promotion of HCL before its efficacy has been demonstrated is also ethically suspect.

    I pointed out that…
    By the same logic:

    The mandate of a nationwide lockdown before its efficacy has been demonstrated is also ethically suspect.

    The mandate of social distancing and mask wearing before its efficacy has been demonstrated is also ethically suspect.

    Well actually the only thing that is ethically suspect is the logic. But it doesn’t take much to convince the lemmings.

    https://uncommondescent.com/intelligent-design/cs-lewis-covid-19-and-scientism/#comment-710237

    Now let’s look at what the recommends about wearing masks.

    CDC recommends that people wear masks in public settings and when around people who don’t live in your household, especially when other social distancing measures are difficult to maintain.

    Masks may help prevent people who have COVID-19 from spreading the virus to others. (emphasis added)

    https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/cloth-face-cover-guidance.html

    So what’s the ethical difference of using a drug that’s been around for over 60 years, is already in wide use and has been proven not only safe but very safe and the use of masks simply because they “may help prevent people who have COVID-19 from spreading the virus to others”? Once again, the claim that the commenters here, who are arguing for the widespread use of HCQ, have been making is there is good evidence (the testimony of physicians treating Covid-19 patients) for efficacy of the drug in the early phases of the disease. So what’s the alternative? We should just continue to let people die? How is that ethical?

  76. 76
    ET says:

    Mac- you are an ignorant infant. Deal with that before you go blaming others for your issues.

  77. 77
    Bob O'H says:

    Jerry @ 70 what does that letter have to do with Covid-19?

  78. 78
    jerry says:

    what does that letter have to do with Covid-19?

    Specifically nothing but coming after a massive censoring of information about C19 it just reemphasizing where we are on free speech. Everything is political including free speech. One can always censor anything by saying it does not meet some sort of guideline. Throwing in the word, “community” makes is seem caring when it is anything but.

    They are after censoring legitimate points of view which includes at the same time the censoring of information about C19.

  79. 79
    jerry says:

    Update on Ivermectin from Australia

    Australian GPs Can Legally Prescribe Ivermectin Triple Therapy Protocol — Professor Thomas Borody

    The Centre for Digestive Diseases issued today a press release titled “Ivermectin Triple Therapy Protocol for COVID-19 Released to Australian GPs for Infected Elderly and Frontline Workers.”

    As we previously covered, this early treatment protocol combines ivermectin with doxycycline and zinc.

    “Triple therapy specialist Professor Thomas Borody, famous for curing peptic ulcers using a triple antibiotic therapy saving millions of lives, today released the COVID-19 treatment protocol to Australian GPs, who can legally prescribe it to their COVID-19 positive patients. They can also prescribe it as a preventative medication. Borody says this could be the fastest and safest way to end the pandemic in Australia within 6-8 weeks.”

    https://bit.ly/3j10ItD

    See how fast the use of this treatment spreads if at all even in Australia.

  80. 80
    Mac McTavish says:

    We are on track to hit another couple sad milestones in the next little while. 180,000 deaths before the end of the weekend, and over 200,000 by the first day of fall. I don’t think anyone here would have predicted 200,000 COVID deaths in a seven month period.

  81. 81
    Truthfreedom says:

    Mac McTavish is very “saddened” about the 40+ million abortions performed since 1973 (only in the USA).

    He cries.

  82. 82
    ET says:

    It’s called natural selection. And given that A) democratic governors basically killed tens of thousands of their elderly, and B) how this virus attacks the unhealthy, I am surprised the death total is so low. I predicted 500,000 dead, on the low end, for the first year, in the USA.

  83. 83
    john_a_designer says:

    Here is a recent article, by psychiatrist Norman Doidge, which gives a good history of the currently evolving controversy around HCQ and covid-19. It takes an especially close look at the way it is being researched and some of the ethical questions, such as relying RCT’s, in exclusion to any other empirical approach, in the midst of a pandemic.

    We tend to think of methodology as a dry question that has nothing to do with morality. The methodologist asks what is the best technique to get at the most certainty most quickly, and usually answers: a randomized control trial, or RCT. But in medicine, moral concerns can’t be humanely divorced from methodology. Early in a pandemic, when we know little, there is a moral imperative to start gathering data. While RCTs are often (but not always, see below) the best kind of study, they take more time, and involve randomly assigning, say, half the patients to a new unknown but promising treatment, and half to either a placebo (sugar pill) or treatment-as-usual (which might be nothing). They are a type of experiment…

    That is one reason why so many researchers, like Raoult, opted for observational studies, in which as many patients as possible are treated. This is not a matter of choosing a design that is “fatally flawed,” it is a matter of choosing a design that is not unnecessarily fatal to the patients. It’s is not sloppiness (as some of his critics would allege), but being true to the study question as he saw it: How can we save as many lives as possible. These observational studies could begin almost immediately, and didn’t require the slow approval process that RCTs require, in part because of the moral dilemmas they raise.

    https://www.tabletmag.com/sections/science/articles/hydroxychloroquine-morality-tale

    Indeed we need to keep in mind that science begins with observation, gathering data.

  84. 84
    kairosfocus says:

    Notice, the mechanisms are still on the table.

  85. 85
    Mac McTavish says:

    KF

    Notice, the mechanisms are still on the table.

    I don’t think anybody has been questioning the possible mechanisms. What’s in question is whether these translate into measurable benefits in vivo. Unfortunately for all of us, the clinical trials completed to date don’t support its efficacy in treating COVID. I wish it were different, but hopes can’t be forced into reality.

  86. 86
    ET says:

    And yet there are doctors and patients swearing to its efficacy. There is even a $200,000 challenge for anyone who can demonstrate the protocol is ineffective.

    THAT is the reality.

    There is even a scientifically sound prophylaxis. More than half of the deaths could have been prevented just by proper nutrition.

  87. 87
    jerry says:

    FDA and HCQ

    Senators Demand Answers on Hydroxychloroquine from the FDA, Reports the Association of American Physicians & Surgeons (AAPS)

    The senators ask the FDA to provide the Committee, by Aug 25, with all information pertaining to FDA decisions that discourage the outpatient use of HCQ for early treatment or prophylaxis of COVID-19, and also “any public statements or records that FDA has issued to clarify that the FDA does not regulate the practice of medicine and that state governments may not regulate the sale or prohibit the sale of prescription drugs.”

    https://apnews.com/a3e99384b955d60f4c0fd7c738c6b2a8

  88. 88
    jerry says:

    the clinical trials completed to date don’t support its efficacy in treating COVID. I wish it were different, but hopes can’t be forced into reality.

    This is a nonsense statement. No one in the world has presented a relevant study which shows it’s not effective. And there are over 50 analysis that show efficacy. It is this cavalier attitude that has led to tens of thousands dying unnecessarily.

    It is a safe, extremely inexpensive drug that has been used widely with positive results. How could anyone morally argue against it. There is no way to justify such a stance.

    Why is such nonsense repeated again and again? Why isn’t their valid criticism of each analysis? It may say more about the critics than the protocol.

    https://c19study.com/

  89. 89
    jerry says:

    More hope!

    Artemisia Annua Could Be Promising Treatment for COVID-19

    Recent lab studies by chemists at the Max Planck Institute of Colloids and Interfaces (Potsdam, Germany) in close collaboration with virologists at Freie Universität Berlin have shown that extract from the medicinal plant Artemisia annua, also known as Sweet Wormwood, is active against SARS-CoV-2, the virus that has caused the COVID-19 pandemic.

    The new potential treatment has been added to the University of Kentucky’s innovative clinical trial for experimental COVID-19 therapies, which was launched by leaders from UK’s Markey Cancer Center, College of Medicine and College of Pharmacy in May.

    https://uknow.uky.edu/research/artemisia-annua-could-be-promising-treatment-covid-19

  90. 90
    jerry says:

    Understanding despair. How to counteract it.

    The Battle for Pandemic Sanity: Hydroxychloroquine Efficacy vs. Its Suppression

    It’s difficult to understand where the despair comes from. But there is plenty of sensible ways to counteract it.

    Read this for a partial explanation for the suppression of HCQ. It’s not everything but explains a lot. A very good analysis. If already linked, I apologize.

    Something I did not know. Some government medical agencies Including the CDC get money from the drug companies. So “Follow the Money.”

    https://www.globalresearch.ca/hydroxychloroquine-efficacy-suppression/5718676

    The ongoing question is why does Fauci lie so much?

  91. 91
    john_a_designer says:

    Good question! Who is suppressing the use of HCQ?

    On May 29, [FDA Commissioner Dr. Stephen] Hahn stated: “Prescribing a product for uses not specifically included in the official labeling is common in the practice of medicine. In oncology and mental health, many patients are treated this way.”

    He notes that with COVID-19 “health care professionals are looking for every possible treatment option for their patients,” and that patients and their doctors “must ultimately decide what treatment is likely to be best for the individual patient.”

    Dr. Hahn recognizes that “hydroxychloroquine and chloroquine have received particular attention. Both are FDA-approved to treat or prevent malaria, and hydroxychloroquine is also approved to treat autoimmune conditions such as chronic discoid lupus erythematosus, systemic lupus erythematosus in adults, and rheumatoid arthritis. They have been prescribed for years to help patients with these debilitating, or even deadly, diseases and have a well-established safety profile for these conditions.”

    https://apnews.com/a3e99384b955d60f4c0fd7c738c6b2a8

    If this is true, why is its use being restricted by pharmacy boards in certain U.S. states like Texas?

    So again, who’s suppressing HCQ’s off-label use? If it’s not the FDA, it’s either (1) big pharma, (2) the mainstream media (3) left wing politicians or (4) some combination of all three.

  92. 92
    jerry says:

    Cost of lockdowns.

    Merkel Warns Europe Against Reviving New Virus Lockdowns

    German Chancellor Angela Merkel called on European leaders to work together to avoid renewed lockdowns as a resurgence of the coronavirus threatens already battered economies.

    https://www.msn.com/en-us/news/world/merkel-warns-europe-against-reviving-new-virus-lockdowns/ar-BB18chNj?li=BBnbcA1

    A wide ranging political analysis but the first item focuses on the cost of lockdowns.

    Ten 2020 Issues, Policies, Personalities — and Chance

    #1

    1)The Lockdown. More or less, Americans followed the March–June lockdowns that seemed at least for a while to slow the viral spread. Of course, “flattening the curve” to prevent hospital overcrowding soon insidiously morphed into the impossible task of stopping the virus by shutting down the economy and quarantining the population. I suppose the theory was “we had to destroy the health of a society to ensure it was healthy.”

    We know from Sweden and the gradual diminution in cases in the hardest hit states of the U.S. Northeast that the virus has a say in such policies. It seems determined to have an initial spike followed by a lull and yet another lesser spike, before it finds it harder to infect more vulnerable victims, as antibodies and T-cells increasingly ensure either growing de facto immunity or asymptotic infection, all while herd immunity rises and the virus plays itself.

    We will soon, perhaps in a year or so, learn of the real tally of forced quarantines — the substance abuse, child abuse, retrogression in millions of young students denied K–12 learning and supervision, missed health diagnostics and preventative care, and delayed or cancelled surgeries. And the tab will likely be far higher than the coronavirus death count and the post-viral fatigue and morbidity of stricken but recovering patients. In other words, there were never blue/red choices or Democratic/Republican ones, but only bad and worse and all in between.

    https://outline.com/Ur2Sg6

  93. 93
    Mac McTavish says:

    There is definitely a cost to lockdowns but the cost of doing nothing is death. What this pandemic has shown us is the ingenuity of humans. Many of us are learning that you can effectively work from home, and that many businesses don’t need to have all staff in the office at the same time. I wouldn’t want to be in the commercial real estate market now and into the future. Many businesses are going to be downsizing their office footprint.

    Designer and branded masks have become a market opportunity. As have expanded on-line market place.

  94. 94
    kairosfocus says:

    MMT, evidence is evidence. Cumulative evidence is just that, cumulative. A few weeks back, mechanisms were a consideration and thanks to Dr Been and the Frontline Doctors, we now have readily accessible, more detailed answers than hitherto. In the case of HCQ, there is no doubt it can transit gut–> body and act in cells. Here, we have direct action mechanisms and Zn gun promotion mechanisms. These fit into the framework that CV19 has a viral phase [perhaps 5 – 7 days typical], providing a window of opportunity for intervention. Further, the narrative of being unsafe has been strongly corrected. Next, we have thousands of cases of effective use, with direct demonstration of sharp falls in viral load in 1 – 2 days and clearing in 5 – 7, similar to many other effective drugs; backed by patient and doctor reports of getting rapid relief in that sort of window (my son just went into an episode subsequent to sharing a corn on the cob with a 3 year old cousin). Such have long since been charted and reported. Such is in the further context of ethically responsible and epistemically valid observational studies on thousands of cases that show something like reducing deaths in vulnerable groups by up to 90%. But no, in steps the gold standard fallacy and all of that is swept away. Where, since placebo controls are not in fact universally demanded historically or currently [say, mask use and lockdowns] it is increasingly clear that HCQ does not fit a preferred narrative and agenda, with damaging direct and indirect consequences. A sorry situation. KF

  95. 95
    ET says:

    Wow, no one says to do nothing. A healthy nation wouldn’t have had to lock down. Why we aren’t focusing on that proves that we are not a smart race.

  96. 96
    kairosfocus says:

    MMT, nope, you fail the Economics, dismal science test. For months I have pointed out that once CV19 broke out of containment, large numbers of deaths were inevitable. Pandemics cost lives and lockdowns cost lives. Deaths of despair, deaths due to foregone or fatally postponed medical interventions and more are attributable deaths. For example just for the US, statistics of recessions seem to suggest for every 10 – 24 mn down in GDP, a life is lost. That does not count lives lost due to people not going to deal with strokes and heart attacks due to the shift in accessibility or to the shift in psychology. For cancer, time lost tracks to lives lost. And yes, electives covers a lot, where apparently there is a suggested 40% down on going for rapid medical attention. Panic comes with a price tag. Policy makes therefore face a dismal choice that many lives will be lost regardless of what they do, and headlined direct lives lost may trade off against potentially more lives lost less directly; leading to a devil’s negotiation in excessively polarised political systems. And more can be said. KF

    PS: As for do nothing, there is no significant local or national government that has done nothing.

  97. 97
    jerry says:

    There is definitely a cost to lockdowns but the cost of doing nothing is death.

    As you so often advocate. Doing nothing when there are effective treatments. So you advocate for death.

    Lockdowns kill in other ways. Economically and socially. There is no mandate to classify any other death as due to the lockdown when there may be hundreds of thousands that have already happened, in process or coming in the next year due to the lockdown.

    What this pandemic has shown us is the ingenuity of humans. Many of us are learning that you can effectively work from home, and that many businesses don’t need to have all staff in the office at the same time

    Yes, but it is the rapid displacing of tens of millions of Americans and maybe billions worldwide. Few who comment here witness first hand the destruction going on as they are safe.

    Designer and branded masks have become a market opportunity. As have expanded on-line market place

    Doesn’t help the tens of millions out of work which are heavily skewed to woman and poor.

  98. 98
    rhampton7 says:

    B’OH

    Pre esxposure RCT was done, don’t remember the details, but I did post it.

    KF, what is this right population nonsense? Who is that? Did Raoult describe this or is this your own addition?

    Also, at least one RCT was done with people exposed to COVID but pre-symptomatic. I also posted this before.

  99. 99
    rhampton7 says:

    Hydroxychloroquine, a drug commonly used in the treatment of rheumatoid arthritis, has received much negative publicity for adverse events associated with its authorisation for emergency use to treat patients with COVID-19 pneumonia. We studied the safety of hydroxychloroquine, alone and in combination with azithromycin, to determine the risk associated with its use in routine care in patients with rheumatoid arthritis.

    The study included 956?374 users of hydroxychloroquine, 310?350 users of sulfasalazine, 323?122 users of hydroxychloroquine plus azithromycin, and 351?956 users of hydroxychloroquine plus amoxicillin.

    Hydroxychloroquine treatment appears to have no increased risk in the short term among patients with rheumatoid arthritis, but in the long term it appears to be associated with excess cardiovascular mortality. The addition of azithromycin increases the risk of heart failure and cardiovascular mortality even in the short term. We call for careful consideration of the benefit–risk trade-off when counselling those on hydroxychloroquine treatment.

    https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(20)30276-9/fulltext

  100. 100
    rhampton7 says:

    A Randomized Trial of Hydroxychloroquine as Postexposure Prophylaxis for Covid-19

    We conducted a randomized, double-blind, placebo-controlled trial across the United States and parts of Canada testing hydroxychloroquine as postexposure prophylaxis. We enrolled adults who had household or occupational exposure to someone with confirmed Covid-19 at a distance of less than 6 ft for more than 10 minutes while wearing neither a face mask nor an eye shield (high-risk exposure) or while wearing a face mask but no eye shield (moderate-risk exposure). Within 4 days after exposure, we randomly assigned participants to receive either placebo or hydroxychloroquine (800 mg once, followed by 600 mg in 6 to 8 hours, then 600 mg daily for 4 additional days). The primary outcome was the incidence of either laboratory-confirmed Covid-19 or illness compatible with Covid-19 within 14 days.

    We enrolled 821 asymptomatic participants. Overall, 87.6% of the participants (719 of 821) reported a high-risk exposure to a confirmed Covid-19 contact. The incidence of new illness compatible with Covid-19 did not differ significantly between participants receiving hydroxychloroquine (49 of 414 [11.8%]) and those receiving placebo (58 of 407 [14.3%]); the absolute difference was ?2.4 percentage points (95% confidence interval, ?7.0 to 2.2; P=0.35). Side effects were more common with hydroxychloroquine than with placebo (40.1% vs. 16.8%), but no serious adverse reactions were reported.

    After high-risk or moderate-risk exposure to Covid-19, hydroxychloroquine did not prevent illness compatible with Covid-19 or confirmed infection when used as postexposure prophylaxis within 4 days after exposure. (Funded by David Baszucki and Jan Ellison Baszucki and others; ClinicalTrials.gov number, NCT04308668. opens in new tab.)

    https://www.nejm.org/doi/full/10.1056/NEJMoa2016638

  101. 101
    rhampton7 says:

    We conducted a multicenter, open label, randomized controlled trial in Catalonia (Spain) between March 17, and May 26, 2020. Eligible Covid-19 cases were non-hospitalized adult patients with recently confirmed SARS-CoV-2 infection and less than five days of symptoms. Patients were assigned to receive HCQ (800 mg on day 1, followed by 400 mg once daily for 6 days) or no antiviral treatment (not-placebo controlled). Study outcomes were the reduction of viral RNA load in nasopharyngeal swabs up to 7 days after treatment start, patient disease progression using the WHO scale up to 28 days, and time to complete resolution of symptoms. Adverse events were assessed up to 28 days.

    A total of 293 patients were eligible for intention-to-treat analysis: 157 in the control arm and 136 in the intervention arm. The mean age was 41.6 years (SD 12.6), mean viral load at baseline was 7.90 (SD 1.82) Log10 copies/mL, and median time from symptom onset to randomization was 3 days. No significant differences were found in the mean reduction of viral load at day 3 (-1.41 vs. -1.41 Log10 copies/mL in the control and intervention arm, respectively; difference 0.01 [95% CI -0.28;0.29]) or at day 7 (-3.37 vs. -3.44; d –0.07 [-0.44;0.29]). This treatment regimen did not reduce risk of hospitalization (7.1%, control vs. 5.9%, intervention; RR 0.75 [0.32;1.77]) nor shortened the time to complete resolution of symptoms (12 days, control vs. 10 days, intervention; p = 0.38). No relevant treatment-related AEs were reported.

    In patients with mild Covid-19, no benefit was observed with HCQ beyond the usual care.

    https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa1009/5872589

  102. 102
    ET says:

    What is a “post exposure prophylaxis”? Holy cow, people are confused. Where’s the zinc? Where’s the vitamin’s C and D?

  103. 103
    rhampton7 says:

    Randomized, double-blind, placebo-controlled trial conducted from 22 March through 20 May 2020. (ClinicalTrials.gov: NCT04308668)

    Internet-based trial across the United States and Canada (40 states and 3 provinces).

    Symptomatic, nonhospitalized adults with laboratory-confirmed COVID-19 or probable COVID-19 and high-risk exposure within 4 days of symptom onset.

    Oral hydroxychloroquine (800 mg once, followed by 600 mg in 6 to 8 hours, then 600 mg daily for 4 more days) or masked placebo.

    Measures: Symptoms and severity at baseline and then at days 3, 5, 10, and 14 using a 10-point visual analogue scale. The primary end point was change in overall symptom severity over 14 days.

    Of 491 patients randomly assigned to a group, 423 contributed primary end point data. Of these, 341 (81%) had laboratory-confirmed infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or epidemiologically linked exposure to a person with laboratory-confirmed infection; 56% (236 of 423) were enrolled within 1 day of symptoms starting. Change in symptom severity over 14 days did not differ between the hydroxychloroquine and placebo groups (difference in symptom severity: relative, 12%; absolute, ?0.27 points [95% CI, ?0.61 to 0.07 points]; P = 0.117). At 14 days, 24% (49 of 201) of participants receiving hydroxychloroquine had ongoing symptoms compared with 30% (59 of 194) receiving placebo (P = 0.21). Medication adverse effects occurred in 43% (92 of 212) of participants receiving hydroxychloroquine versus 22% (46 of 211) receiving placebo (P < 0.001). With placebo, 10 hospitalizations occurred (2 non–COVID-19–related), including 1 hospitalized death. With hydroxychloroquine, 4 hospitalizations occurred plus 1 nonhospitalized death (P = 0.29).

    Only 58% of participants received SARS-CoV-2 testing because of severe U.S. testing shortages.

    Hydroxychloroquine did not substantially reduce symptom severity in outpatients with early, mild COVID-19.

    https://www.acpjournals.org/doi/10.7326/M20-4207

  104. 104
    rhampton7 says:

    (Brazil)
    We conducted a multicenter, randomized, open-label, three-group, controlled trial involving hospitalized patients with suspected or confirmed Covid-19 who were receiving either no supplemental oxygen or a maximum of 4 liters per minute of supplemental oxygen. Patients were randomly assigned in a 1:1:1 ratio to receive standard care, standard care plus hydroxychloroquine at a dose of 400 mg twice daily, or standard care plus hydroxychloroquine at a dose of 400 mg twice daily plus azithromycin at a dose of 500 mg once daily for 7 days. The primary outcome was clinical status at 15 days as assessed with the use of a seven-level ordinal scale (with levels ranging from one to seven and higher scores indicating a worse condition) in the modified intention-to-treat population (patients with a confirmed diagnosis of Covid-19). Safety was also assessed.

    A total of 667 patients underwent randomization; 504 patients had confirmed Covid-19 and were included in the modified intention-to-treat analysis. As compared with standard care, the proportional odds of having a higher score on the seven-point ordinal scale at 15 days was not affected by either hydroxychloroquine alone (odds ratio, 1.21; 95% confidence interval [CI], 0.69 to 2.11; P=1.00) or hydroxychloroquine plus azithromycin (odds ratio, 0.99; 95% CI, 0.57 to 1.73; P=1.00). Prolongation of the corrected QT interval and elevation of liver-enzyme levels were more frequent in patients receiving hydroxychloroquine, alone or with azithromycin, than in those who were not receiving either agent.

    Among patients hospitalized with mild-to-moderate Covid-19, the use of hydroxychloroquine, alone or with azithromycin, did not improve clinical status at 15 days as compared with standard care. (Funded by the Coalition Covid-19 Brazil and EMS Pharma; ClinicalTrials.gov number, NCT04322123. opens in new tab.)

    https://www.nejm.org/doi/full/10.1056/NEJMoa2019014

  105. 105
    rhampton7 says:

    Why don’t you ask Dr Raoult why his protocol doesn’t require Zinc or Vitamins C and D?

  106. 106
    kairosfocus says:

    RH7, that you imagine the right population — the vulnerable [typ 60+, those with certain diseases etc] — is nonsense tells us all we need to know. KF

  107. 107
    jerry says:

    tells us all we need to know.

    I’m not sure Rhampton understands what he posts. I’ve asked him more than once if he is a native English speaker. He is obviously familiar with English but how much he understands seems limited. He just reposted the Boulware study which I’m sure he doesn’t understand.

    My guess is if he finds some article somewhere that is negative on HCQ he will post it without knowing the implications.

    He thinks our concern is solely about HCQ when our concerns are about saving lives. HCQ is just one of many ways we have focused on. As a result the negative purveyors including RHampton have painted themselves into a corner of advocating death just to win the HCQ argument. Very revealing!!!

    He is not the only one. There is an obsession with finding anyone who is positive here guilty of a wrong position on something even if it is bad grammar. Even if it forces them into advocating death in large numbers.

    It’s not just here but in any political argument in a lot of places.

  108. 108
    ET says:

    Earth to RH7- Dr. Zelenko’s challenge stands. His protocol includes zinc. I posted 2 papers saying that vitamin D deficiency led to the deaths of many patients. So either you are incapable of reading or you are willfully ignorant.

  109. 109
    john_a_designer says:

    Jerry,

    I’m not sure Rhampton understands what he posts…how much he understands seems limited. He just reposted the Boulware study which I’m sure he doesn’t understand… My guess is if he finds some article somewhere that is negative on HCQ he will post it without knowing the implications.

    Are you sure he/she is really human. Maybe Rhampton is a bot.

  110. 110
    jerry says:

    Soul searching for the anti HCQ faction

    China approves chloroquine (instead of hydroxychloroquine) against covid-19

    https://www.archyde.com/china-approves-chloroquine-instead-of-hydroxychloroquine-against-covid-19/

    Will the switch change our negative posters or will they double down? It will be a soul searching time for them.

    More good news but not for Bill Gates and Fauci

    T cells — not antibodies — may be key to long-term COVID-19 immunity. What are they?

    It’s the million dollar question: Can we develop long-term immunity against SARS-CoV-2, the virus that has taken the lives of over 783,000 people worldwide as of Aug. 19.

    Although there are no definitive answers, scientists believe there might be a light at the end of the immunity tunnel.

    Several studies, both peer reviewed and not, have looked beyond antibodies to the rest of the highly complex immune system. Now, all eyes are on T cells and B cells — key players in the response against foreign invaders that emerge after the body has been exposed to a pathogen.

    There may be no need for a vaccine.

    https://www.yahoo.com/news/t-cells-not-antibodies-may-225818680.html

    Parts of London and New York have already achieved ‘substantial’ immunity, Harvard epidemiologists say

    https://www.yahoo.com/news/parts-london-york-already-achieved-113750524.html

    Will they need vaccination?

  111. 111
    jerry says:

    Several scientists challenge negative analysis of HCQ studies.

    Experts contest studies that saw no benefits in chloroquine

    A group of 37 Brazilian and international researchers publishes an open letter stating that there was an error in the interpretation of the statistical tests.

    https://translate.google.com/translate?hl=&sl=auto&tl=en&u=https%3A%2F%2Fveja.abril.com.br%2Fsaude%2Fespecialistas-contestam-estudos-que-nao-viram-beneficios-na-cloroquina%2F&sandbox=1

    On a similar vein

    An open letter of concern about statistical analysis

    Some of the same people

    https://drive.google.com/file/d/1NZOJ57fM0RTaHD1t_9w2iua7lUJhOgWT/view

    From a statistician

    Reading a scientific paper: easy

    Identifying important, key flaws in a scientific paper: often pretty difficult

    Convincing the authors of the key flaws: nearly impossible

    Convincing authors and editors to set the record straight bc self correcting science: are you kidding?

  112. 112
    jerry says:

    HCQ protects heart

    hydroxychloroquine is protective to the heart, not Harmful: A systematic review

    Conclusions

    HCQ and azithromycin do not cause TDP cardiac mortality. HCQ decreases cardiac events. HCQ should not be restricted in use for COVID 19 patients because of fear of cardiac mortality.

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7439006/

    So should it be given to everyone who has C19 for this reason?

    Sounds like we should add it to the water so everyone can benefit. That would solve all the debate issues.

    By the way I am being sarcastic. HCQ does have some side effects – nausea and diarrhea.

  113. 113
    ET says:

    Strange- living has the same side effects as HCQ- nausea and diarrhea. 🙂

    Discussing HCQ with its opponents also has that same side effect- well the nausea part, anyway.

  114. 114
    john_a_designer says:

    Speaking to reporters from the White House Sunday, Trump said the FDA has “issued an emergency use authorization … for a treatment known as convalescent plasma.”

    https://www.foxnews.com/politics/trump-announces-emergency-authorization-of-breakthrough-coronavirus-treatment

    But just wait. The politics is yet to start. As they were leaving the room a reporter (sounded to me like Jim Acosta) yelled out to FDA commissioner Stephen Hahn, “Were you pressured to make this decision?” It never ends!

  115. 115
    kairosfocus says:

    H’mm:

    A summary by professor Risch (vid transcript) on the track record of gold standard fallacies, blocking bactrin against secondary infection for 2 years in the AIDS crisis:

    Dr. Risch: This has gone on before. Now we have Dr. Fauci denying that any evidence exists of benefit (of HCQ). And that’s pervaded the FDA. The FDA has relied on Dr. Fauci and his NIH advisory groups to make the statements saying that there is no benefit in using hydroxychloroquine in outpatients. And this is counter to the facts of the case. The evidence is overwhelming… Dr. Fauci and the FDA are doing the same thing that was done in 1987 [–> he demanded placebo control studies,. leading to a 2-year delay] and that’s led to the deaths of hundreds of thousands of Americans [–> maybe a bit overstated, or is he including secondary deaths?] that could have been saved by the usage of this drug! And this is the same thing that the FDA has done. It’s outrageous! People need to be writing or calling their congressman or senators and complaining that this is not the way the country should work

    The article notes on balance of studies:

    ** 53 global studies that show positive results with HCQ on COVID-19
    ** 14 global studies that show neutral or negative results with HCQ on COVID-19
    ** 10 of those 14 negative studies were of patients in very late stages of the disease
    ** 2 of those 14 negative studies were by the same doctor in Minnesota
    ** 1 of the studies used by Dr. Fauci from a Brazilian outlet was debunked
    ** The last study be Lancet was later found fraudulent and retracted

    Points to ponder

    KF

  116. 116
    kairosfocus says:

    JaD, it should be blatantly obvious that antibody-rich plasma will have an immunity transfer effect. Isn’t that parallel to what happens to infants taking “first milk” from their moms, colustrum isn’t it? Then, there is antivenin (which can make you quite ill but saves your life). KF

  117. 117
    jerry says:

    Any bets that reporters have been assigned by Washington Post and NY Times to look at the downside of plasma therapy?

    The Washington Post did a hit piece yesterday on the decision to build ventilators and how they are all wasted and sitting in warehouses.

    It appears that similar objections are being made about plasma as were with HCQ. No RCT so how can we know? It also appears to be aimed at those who have reached a serious stage of virus progression.

    Results so far are positive but not dramatic. But it hasn’t been looked at with scrutiny so we will see. But it will be political I bet.

  118. 118
    bornagain77 says:

    Risch gave a no holds barred interview on FOX’s ‘Life, Liberty and Levin’ last night. He was just excoriating of Fauci’s record

    Renowned epidemiologist sees ‘massive disinformation campaign’ against hydroxychloroquine
    https://news.yahoo.com/renowned-epidemiologist-sees-massive-disinformation-005033779.html

  119. 119
    jerry says:

    Hope on other fronts

    Controversy with bromhexine in COVID-19; where we stand

    19.In this clinical trial, 78 patients were randomized into two groups. Both groups were on low dose 200 mg/day hydroxychloroquine (HCQ). The treatment group, in addition to HCQ, received bromhexine 8 mg TID. The ICU admissions (2 out of 39 versus 11 out of 39, P = 0.006), intubation (1 out of 39 vs. 9 out of 39, P = 0.007) and death (0 out of 39 vs. 5 out of 39, P = 0.027), were all significantly lower in the bromhexine group.

    https://www.researchgate.net/publication/343615686_Controversy_with_bromhexine_in_COVID-19_where_we_stand

    The controversy is small sample size, use of HCQ with it, and some other things. It appears safe.

  120. 120
    kairosfocus says:

    jerry, the real root controversy is they want to do business as usual in the face of existential crisis, and refuse to attend to ethical-epistemological issues that are inconvenient to their agendas. I suppose they imagine we have forgotten how they were pressing for ventilators and were decrying want of reserves. We have not forgotten, nor will we forget what has been going on. KF

  121. 121
    jerry says:

    the real root controversy is they want to do business as usual in the face of existential crisis

    I don’t agree! It’s a convenient excuse because they have other objectives. If a non RCT approach lined up with their wants they would be all in as in poker. See what they do with a vaccine.

    nor will we forget what has been going on

    There is another phenomenon in poker called the ”tell.” Those who are holding a negative hand leave one tell after the other at the table. So it is easy to read them. But they cannot help themselves. Especially the press. Their tells reveal who they really are.

    It is also possible to read them when they have a positive hand. Again they cannot help themselves.

    If the negative posters here had money in the game, we could fund a lot of poor from our winnings.
    ——————————-
    Along the lines of the Risch interview published by BA77, here is an article by someone with a background in virology.

    Why Is The Media Suppressing Information About Hydroxychloroquine’s Effectiveness Against COVID?

    https://thefederalist.com/2020/08/20/why-is-the-media-suppressing-information-about-hydroxychloroquines-effectiveness-against-covid/

    Would not make RHampton’s top 40 list.

  122. 122
    RHolt says:

    KF

    it should be blatantly obvious that antibody-rich plasma will have an immunity transfer effect.

    Herein lies the problem. With Ebola we saw that initial, small number, trials showed a positive trend in treatment with convelescencent plasma. Once more detailed studies were performed it was discovered that the use of plasma was of little to no benefit. We now see a similar case with COVID with the added benefit of politics and pressure from the current US administration foisting plasma use before the necessary data is in hand.

    Many question remain unanswered and likely will remain unanswered thanks to the hamstringing of research by the USA administration and spineless FDA leaders. The presentation yesterday by the president was nothing more than an exageration of what we know about convelescent plasma and COVID treatment. The citation of ‘35% improvement’ was so lacking in context (purposely) that it is misleading. The 35% figure comes from a bit of data that showed that patients recieving the highest antibody-titer plasma showed a difference between those receiving a low-titer dose. Then of course one must ask how does this compare to no plasma use? Is plasma use better than no plasma use? The answer is we don’t know since this has been rushed to the forefront before these key parameters are known. We don’t know what dose might be effective. Give to little and its useless. Give too much and it is a waste of a valuable resource.

    So the key question remains unanswered (mirrored by doctor and scientists criticism of the public move for EUA) and that is ‘What titer-dose plasma is efficacious and what dose is ineffective?’. Doctors and patients clamoring for plasma use will struggle with finding a way forward and there will be many ineffective treatments administered simply because these doctors do not know what dose to administer.

    The move to make this announcement was an obvious political ploy by a struggling incumbent president facing an immenent election where he appears to be behind in the polls. It was a sad day in the pursuit of an effective treatment for this disease.

  123. 123
    kairosfocus says:

    RHolt, studies have been done, and show an effect. That is good enough for an emergency, on the principle of prudence; yes, prudence. To demand what would with high probability cost many lives by dismissing cumulative evidence to date and demanding what will clearly be too late, there is responsibility for lives needlessly lost. The jump to projecting base political motivation (which in some cases is multiplied by see we already killed off HCQ) in the teeth of a reasonable difference of views, simply tells me to look to the mirror principle. You just told me politics is part of your own motives and that of those you support. I duly discount your and their credibility a notch or two. KF

    PS: Dream on. Your political narrative is a fantasy. You all have managed to turn the contractor in chief into the champion of civilisation in the face of red guards and their backers. With the stunt that took down a govt in Austria unravelling in the courts, we can now dot in some backers. I do not think the American people are so far gone that they would hand power over to such demonic chaos. Of course, enough chaos is rolling that a 4th gen civil war is in progress with kinetic element steadily ramping up. What do you think it says when a stunned man, already mobbed and beaten, is kicked in the back of the head after a run-up, by a self-appointed vigilante? (And I simply do not believe the talking point he tried to run us down; he may have tried to flee in fear for his life [do you know how fast a modern vehicle accelerates, if he had really tried to run people down?] . . . a fear that events proved was fully warranted. The name for that was attempted murder, motivated by automatic projection of racism/nazism, thus hate. The next worse case will be someone who will be shooting when mobbed, you will likely get your optics for a cynical narrative but that will come with rule 6.5 mm at 1000 yards range and worse. At that point, the narrative will be useless; agit prop operatives will for cause be afraid to leave house much less go to work. The wind has already been sown, the whirlwind is at hand. The next 6 – 18 months will be decisive, the issue is how much damage the chaos will cause.)

  124. 124
    RHolt says:

    KF

    studies have been done, and show an effect.

    Do they? Can you cite the data that demonstrates efficacy beyond not administering plasma? Can you cite the data that indicates which antibody-titer is necessary for a positive repsonse and what dose has been shown to lack efficacy?

    You can’t do it because the data doesn’t exist. It was being collected in ongoing trials but there is nothing definitive to hang your hat on. What happens when people are given an ineffective dose (assuming efficacy) of convelescent plasma? Does that help the patient? Does it harm the patient? Does it do nothing? If you can’t answer these questions you should ask yourself ‘How is my doctor going to determine which antibody titer plasma dose s/he will give me?

    Lives will be ultimately lost because of this political-rush to make this announcement. Without knowing what dose is effective (if any) how can you support release to the general public when you cannot even say what dose the patient shoudl receive and what window is the best time to administer it? I would like my doctor to have something to base his/her treatment decisions on rather than some uncharacterised treatment where they are shooting in the dark.

    Remember Ebola and how initial data suggested efficacy and further trials demonstrated a lack of efficacy. Those who ignore the past and what we learned are doomed to repeat those failures!

    I would condemn any administration of any political bent for making the decision to overide, and pressure, FDA scientist to release and support use of any drug or therapeutic before knowing what dose is efficacious let alone safe. To think that politics affects my determinations of what the data does, and does not, support is ludicrous and a false narrative. To take that stance says a lot of your credibility and what actualy is your motivating factor in this debate.

  125. 125
    kairosfocus says:

    PPS: A bit of modelling i/l/o a recent NBC/WSJ poll, where the dominant population splits about 3:2 for Trump with those below College degree and the reverse, above. I note from The Hill, on Census, “More than 37 percent of non-Hispanic white Americans have a college degree.” 60% of 40% is 24%. 60% of 60% is 36%. That’s a big gap, room enough to drive a C21 hinterland, peasant uprising through, similar to 2016. And that’s before discounting for the polling bias which will tend to be against Mr Trump. In short, it’s going to be like 2016, only worse and with the toxic polarisation even higher. And of course, guess where has been the principal stronghold of culture form marxism with critical studies, deconstructionism, promotion of socialist collectivism, etc?

  126. 126
    kairosfocus says:

    RHolt, your credibility is discounted, for cause. KF

  127. 127
    john_a_designer says:

    There are now 53 studies that show positive results of hydroxychloroquine in COVID infections. There are 14 global studies that show neutral or negative results — and 10 of them were of patients in very late stages of COVID-19, where no antiviral drug can be expected to have much effect. Of the remaining four studies, two come from the same University of Minnesota author. The other two are from the faulty Brazil paper, which should be retracted, and the fake Lancet paper, which was.

    https://thefederalist.com/2020/08/20/why-is-the-media-suppressing-information-about-hydroxychloroquines-effectiveness-against-covid/

    Who is making this claim?

    The author of the article is Steven Hatfill who “is a veteran virologist who helped establish the Rapid Hemorrhagic Fever Response Teams for the National Medical Disaster Unit in Kenya, Africa. He is an adjunct assistant professor in two departments at the George Washington University Medical Center where he teaches mass casualty medicine. He is the principal author of the prophetic book ‘Three Seconds Until Midnight — Preparing for the Next Pandemic,’ published by Amazon in 2019.”

    So whose analysis of the data should I believe? Hatfill or RHolt? I must missed it. What exactly are RHolt’s qualifications?

  128. 128
    RHolt says:

    KF

    RHolt, your credibility is discounted, for cause

    LOL…I suppose any excuse is better than none-at-all when someone needs to dismiss inconvienient facts for their outlook on issues. Of course you could actually demonstrate that I am mistaken and cite the data that indicate what antibody titer is required for an efficacious response. Well see if that happens.

    KF, you have often quoted your UNI professor making the statement to new students akin to ‘the dose makes the poison’. However, there is a flip side to that coin with the dose making the therapeutic. If dosing is insufficient, i.e., low antibody titer in plasma, that doesn’t help the patient at all and will, obviously, cost lives. If the dose is too high than you’ve wasted precious resources in ‘overdosing’ patients when it could have been diluted and, perhaps, treated two, or more, people. So with that in mind, KF, can you cite the data that demonstrates what antibody titers should and should not be used on treating patients? When you find yourself unable to find that data ask yourself why that is and then ask how are doctors supposed to treat patients with no idea of what dosing is necessary to elicit a postive patient outcome?

    This rollout is premature and has compromised ongoing trials targetted at elucidating what dose, if any, is effficacious.

    PS: Don’t forget the outcome with Ebola and convalescent plasma!

  129. 129
    RHolt says:

    JAD

    So whose analysis of the data should I believe? Hatfill or RHolt? I must missed it. What exactly are RHolt’s qualifications?

    You do know that ‘argument from authority’ is a logical fallacy, don’t you?

    The author you cite, Hatfill, claims there are only 67 studies published on HCQ. He has missed analyzing quite a few studies as there are over a 100 published studies of various quality in the literature. Why didn’t he include those other studies? I think I know why.

  130. 130
    jerry says:

    MedCram’s latest video is on convalescent plasma. #103 Well worth watching. https://www.youtube.com/watch?v=pvmtT_XV4aw

    Most of the treatment with it has been on hospitalized patients. While the numbers are fairly high in terms of those who received it, the effects are positive but not dramatic. The sooner it is given and the higher the concentration of anti bodies the more positive the effects are including Lower mortality rates.

    My guess is that because of limited supplies, it will be limited to patients further along in virus progression.

    So HCQ plus zinc still leads the pack for early treatment with many promising others in the treatment quiver.

  131. 131
    jerry says:

    We are starting to get more statistics on the effects of the lockdowns. Here is one analysis

    Lockdowns are killing more people than the coronavirus, death records from doctors around the world show

    For months, doctors and other medical experts have been warning about the negative impacts of lockdown measures put in place by governments around the world. During those times, there was no concrete data to support their warnings.
    Now for the first time, doctors worldwide are recording more deaths due to lockdowns than to COVID-19. Their findings confirmed a long-suspected fear of the Covid-19 lockdowns. A new study from doctors in Colorado looked at the number of cardiac arrest deaths occurring at home in the time of coronavirus and compared it to the stay-at-home period to prior months. The team of doctors found there is a direct correlation to the quarantine orders.

    https://techstartups.com/2020/08/21/lockdowns-killing-people-coronavirus-death-records-doctors-around-world-show/

    There will be more. Last week I linked to increased suicidal tendencies amongst young adults.

  132. 132
    jerry says:

    there are over a 100 published studies of various quality in the literature.

    You should tell RHampton this. It will make his day. He has yet to find a relevant study denigrating HCQ. This despite publishing hundreds of negative posts.

    What happened to all those meat packing plants that were doomed with the virus? Where I am there is no problem getting meat.

  133. 133
    john_a_designer says:

    Appeal to authority.

    Exception: Be very careful not to confuse “deferring to an authority on the issue” with the appeal to authority fallacy. Remember, a fallacy is an error in reasoning. Dismissing the council of legitimate experts and authorities turns good skepticism into denialism. The appeal to authority is a fallacy in argumentation, but deferring to an authority is a reliable heuristic that we all use virtually every day on issues of relatively little importance. There is always a chance that any authority can be wrong, that’s why the critical thinker accepts facts provisionally. It is not at all unreasonable (or an error in reasoning) to accept information as provisionally true by credible authorities. Of course, the reasonableness is moderated by the claim being made (i.e., how extraordinary, how important) and the authority (how credible, how relevant to the claim).

    https://www.logicallyfallacious.com/logicalfallacies/Appeal-to-Authority

    So whose analysis should I accept as provisionally true and/or credible? Some anonymous person who shows up on line who appears to have no expertise at all or somebody I have good reason to think they know what they are talking about?

    So again, what exactly are RHolt’s qualifications?

    Oops! I’m sorry I appealed to an authority on logical fallacies but so did RHolt. Didn’t he?

  134. 134
    kairosfocus says:

    RHolt, it is obvious, first, that there is a moving target effect. I doubt, for cause (such as banning outpatient use . . . a truly dumb regulatory move) that the material problems have changed. You confirm the implication of the mirror principle. Next, it is equally clear that otherwise valid evidence regarding HCQ based cocktails has been suppressed. On the new subject, the cases in hand of success would not be there if a reasonable knowledge of dosing were not present; this is not the dark ages of alchemy. When an objection put on the table has apparently been, oh therapeutic use will make quantities for the gold standard tests go short and/or fewer people will participate in same making them take longer, I suggest that actual responsible use is an implicit test by track record. Which goes to the core ethics and epistemology problems involved in these exchanges. In such a context the patently mean spirited spiteful party-spirited projections that have already begun tell me, use the mirror principle. KF

  135. 135
    jerry says:

    More hope! Another positive HCQ study. This time with hospitalized patients.

    Low-dose Hydroxychloroquine Therapy and Mortality in Hospitalized Patients with COVID-19: A Nationwide Observational Study of 8075 Participants

    Abstract
    Background
    Hydroxychloroquine (HCQ) has been largely used and investigated as therapy of COVID-19 across various settings, at total dose usually ranging from 2400 mg to 9600 mg. In Belgium, off-label use of low-dose HCQ (2400 mg in total over five days) was recommended for hospitalized patients with COVID-19.

    Methods
    We conducted a retrospective analysis of in-hospital mortality in the Belgian national COVID-19 hospital surveillance data. Patients treated either with HCQ alone and supportive care (HCQ group) were compared to patients treated with supportive care only (no-HCQ group) using a competing risks proportional hazards regression with discharge alive as competing risk, adjusted for demographic and clinical features with robust standard errors.

    Results
    Of 8075 patients with complete discharge data on 24th of May and diagnosed before the 1st of May, 4542 received HCQ in monotherapy and 3533 were in the no-HCQ group. Death was reported in 804/4542 (17.7%) and 957/3533 (27.1%), respectively. In the multivariable analysis, the mortality was lower in the HCQ group compared to the no-HCQ group (adjusted hazard ratio [HR] 0.684, 95% confidence interval [CI] 0.617–0.758). Compared to the no-HCQ group, mortality in the HCQ group was reduced both in patients diagnosed ? 5 days (n=3975) and > 5 days (n=3487) after symptom onset (adjusted HR 0.701, 95% CI 0.617–0.796 and adjusted HR 0.647, 95% CI 0.525–0.797, respectively).

    Conclusions
    Compared to supportive care only, low-dose HCQ monotherapy was independently associated with lower mortality in hospitalized patients with COVID-19 diagnosed and treated early or later after symptom onset.

    From Belgium. Still a lot of deaths that may have been prevented if early administration of HCQ with effective additives had been administered. This was post Raoult and Zelenko appearing on the scene.

    Will anyone be held accountable? I doubt it since we still have people advocating for not using HCQ as we have seen even on this thread.

    https://bit.ly/2CTCnXl

  136. 136
    jerry says:

    An opinion from an Israeli doctor criticizing the lockdowns

    History will judge the hysteria’

    There is a very great interest for anyone who has supported the draconian measures taken around the world to say that Sweden’s policy has failed. Because if it succeeded, and trillions went down the drain for no reason, someone will have to answer for it.”

    “That is why all over the world they prefer to claim that [Sweden] was wrong. But in the end, the truth came to the surface. In a world where decision makers, their advisers and the media were able to admit their mistake and the initial panic that gripped them, we would have long since returned to routine. The ongoing destruction due to the inability to admit this mistake, despite the epidemic’s small mortality numbers, is outrageous….

    He said smart behavior would be the opposite of what we do today; Populations not at risk should become infected and create chains of immunity, which will protect the sick and the elderly. We are currently working for sweeping social distancing, which prevents such differential immunity, he said.

    He went on to explain that infection of children is a welcome thing, because it protects at-risk populations. “For the same reason, I would open up the whole education system, because the vast majority is made up of people who are not at risk. Of course a solution needs to be found for teachers suffering from diabetes or other background diseases, but I see no reason to prevent activities that encourage the economy. Not only because it allows parents to go to work, but also because it lowers mortality in the long run.

    Prof. Udi Qimron will soon head the Department of Clinical Microbiology and Immunology at Tel Aviv University.

    https://www.israelnationalnews.com/News/News.aspx/285341

    Let’s just say his opinions would not find a welcome reception with members of one political party in the United States.

    A separate point – in many countries recommendations on how to respond to the virus comes down to politics. Certainly this is true in the United States, Brazil, Canada and parts of Europe and definitely in Israel. In the latter, they went through 3 elections in the last year trying to get to a government.

  137. 137
    RHolt says:

    KF

    On the new subject, the cases in hand of success would not be there if a reasonable knowledge of dosing were not present; this is not the dark ages of alchemy.

    Then you should have no problem with posting the literature citation that documents which antibody titers provide an efficacious dose and what antibody titer is ineffective. Don’t you think this information is kinda important for treating physcians to have available? If yes, why the premature rollout.

    It is telling that this information has not been posted already. It doesn’t surprise me at all but everyone should ask themselves why is this data not available? Why was this rolled out before this data was collected/analysed? Why are scientists/doctors who are treating COVID patients, e.g., Vin Gupta a pulmonologist in WA treating patients everyday pushing back on this premature announcement?

    The pushback is warrented based on these, and other treating physcians experience and expertise with how this all works.

  138. 138
    Seversky says:

    “May have been prevented” The whole point is we are not yet in a position to say with any confidence “would have been prevented” or “would not have been prevented”.

  139. 139
    RHolt says:

    JAD, if you want to defer to authorities do you recall a citation that Jerry provided a few days ago where the largest COVID treatment facility came out and stated the (paraphrasing) “HCQ alone or combined with Zn and/or AZ has not success in treatment of COVID infected patients’.

    Where does this authority get placed in your hierarchy of ‘experts’?

    By all means do not take anything I say at face value. I encourage you to verify everything I post and other’s posts as well. For example when someone posts a critique of a published study and makes statments that are easily refuted to be factually incorrect( simply by quoting pertinent sections of the published manuscript) then I would say their credibility is zero and discard pretty much everything else forthcoming……unless of course admissions of error are acknowledged and clarified. If that occurs there is hope!

  140. 140
    RHolt says:

    SEV

    “May have been prevented” The whole point is we are not yet in a position to say with any confidence “would have been prevented” or “would not have been prevented”.

    Could not have made the point any clearer!

  141. 141
    jerry says:

    Designer and branded masks have become a market opportunity. As have expanded on-line market place.

    As a case in point, I was vacationing at the New Jersey shore for two weeks and while there had some designed masks made. One said

    Live Free or Die

    I now live in New Hampshire and have adopted our state motto. I have an idea for another one

    Fear never stops death, it stops life.

    Maybe a little long for a face mask. Perhaps a T-shirt.

  142. 142
    jerry says:

    May have been prevented” The whole point is we are not yet in a position to say with any confidence “would have been prevented” or “would not have been prevented”.

    A position that advocates “let them die.”

    As I said above the negative people reveal their inner selves with tells. This is an example.

  143. 143
    jerry says:

    It is telling that this information has not been posted already.

    But it has. I recommended all watch the MedCram videos. A study came out last week and #103 discusses in detail.

  144. 144
    jerry says:

    Will FDA stop obstructing COVID-19 treatment?

    The Food and Drug Administration (FDA) has approved an Emergency Use Authorization (EUA) requested by Mayo Clinic for use of plasma from patients who recovered from COVID-19 to treat hospitalized patients.

    “The tipping point for the agency appeared to be that ‘optimal’ patients who were treated with ‘convalescent plasma at the highest [antibody] titers’ showed ‘significant clinical benefit’ of a 35% improvement in survival, which ‘clearly meets the criteria published for an EUA,

    The idea is not new. Before the discovery of antibiotics, type-specific serum from recovered patients was used to treat otherwise hopeless pneumococcal pneumonia.

    https://aapsonline.org/will-fda-stop-obstructing-covid-19-treatment/

    The article goes on to say

    FDA denied a request for EUA of hydroxychloroquine (HCQ) for preventive and early treatment of COVID-19 filed by Dr. John McKinnon’s team at Henry Ford Hospital in Detroit, supported by Dr. Peter McCullough’s cardiology team at Baylor Heart and Vascular Institute in Dallas.

    A clinical trial of HCQ given early in hospitalized patients at Henry Ford Health System showed a 51% reduction in mortality

  145. 145
    jerry says:

    Plasma therapy is not new

    Pneumonia before antibiotics Therapeutic evolution and evaluation in twentieth-century America 2006

    Scott Podolsky, an internist and lecturer in the Department of Social Medicine at Harvard Medical School, focuses on a sometimes untold story in the evolution of therapy for pneumococcal pneumonia, the development and implementation of type-specific serum therapy. Serum therapy, when it is discussed, is often presented as a footnote in this historical parade, a brief stop between the hopelessness of Osler’s time and the triumph of the antibiotic era. Podolsky tells a story that is much richer, full of scientific and medical giants, such as Oswald Avery, Rufus Cole, and Maxwell Finland. Before the coming of the antibiotic era, which marks the end of the narrative, a massive public health system will have been mobilized and subsequently dismantled, pharmaceutical companies will have devoted massive resources to serum production, and debates will have simmered throughout the medical community as to how and when serum might best be used.

    The three parts of the book trace the development, wide implementation, and subsequent decline of serotherapy over a period of more than 40 years. Podolsky is at his best when he illustrates the many instances in which debates over serotherapy foreshadowed questions that the medical community continues to face today.

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1555639/

  146. 146
  147. 147
    jerry says:

    Some more hope!

    FDA Authorizes Convalescent Plasma for COVID-19 Patients

    Convalescent plasma shows promising efficacy in hospitalized patients with COVID-19, and the benefits outweigh the risks, the FDA said in announcing emergency use authorization (EUA) for such products on Sunday.

    The EUA was granted to the Office of Assistant Secretary for Preparedness and Response within the Department of Health and Human Services. It is not for any particular convalescent plasma product, but rather any such preparation “collected by FDA registered blood establishments from individuals whose plasma contains anti-SARS-CoV-2 antibodies, and who meet all donor eligibility requirements,” according to a fact sheet for healthcare providers.

    https://www.medpagetoday.com/infectiousdisease/covid19/88225

    Article provides some basic details.

  148. 148
    jerry says:

    Even more hope!

    Coronavirus data 2 weeks into Germany’s school year “reassures” expert

    Germany’s politicians widely agree that students must be allowed to return to schools, and United Nations Secretary-General Antonio Guterres has warned that if governments don’t prioritize that in-class learning, the could face “a catastrophe for an entire generation.”

    But many educators, and parents, are still nervous.

    https://www.cbsnews.com/news/covid-19-school-cornavirus-data-2-weeks-into-germany-school-year-reassures-expert/

    Definitely some glitches that we will also see in the United States in coming weeks but progress. Students are a low risk group. But individuals should be taken care of just as special needs students are.

  149. 149
    RHolt says:

    Jerry

    But it has. I recommended all watch the MedCram videos. A study came out last week and #103 discusses in detail.

    Watched the video and I noted a few key take-home points:

    The emphasis on the need for control groups in the quest for evaluating if a treatment is efficacious or not. This underscores the weakness of retrospective studies and how limited conclusions are based on these type of studies where control groups are often not paired accurately with treatment arms. Also the repeated emphasis that the Mayo trial had no control group and was of limited clinical value in evaluating efficacy of plasma treatment.

    Additionally, in the discussion of the results of the Mayo observational study there was no statistical significance in the use of low versus high titer antibody treatment even when the focus was only on patients treated within 3 days of diagnosis. (looks like the EBOLA case all over again). Again there was the emphasis on the need for control group to even begin to evaluate if convalescent plasma treatment is better than standard care.

    Pretty much a resounding confirmation of everything I have stated in this thread in regards to convalescent plasma.

  150. 150
    RHolt says:

    Jerry

    Plasma therapy is not new

    Not even in question. However as the medcram video you posted points out sometimes it works and sometimes it doesn’t with a case in point (from recent history) being Ebola and from the Mayo data appearance treatment of COVID with plasma may not live up to the hope of it being efficacious. It is not, as KF states, blatantly obvious that plasma with antibodies are a given to be a efficient treatment for anything. Only way to determine this, as Jerry’s medcram citation underlines, is the need for RCT with properly paired control treatment arm.

  151. 151
    Kushanto says:

    Jerry@135

    “More hope! Another positive HCQ study. This time with hospitalized patients.”

     Dr. Fauci and the media have been promulgating the line that hydroxychloroquine is ineffective as a treatment of COVID-19 infection, and that it is even harmful due to cardiac side effects. This is suspicious, because a number of studies show just the opposite.

    For instance, yet another one, reported here: https://www.henryford.com/news/2020/07/hydro-treatment-study . Interestingly enough, the death vs. survival statistics are very close to those of the  study cited by Jerry.

    Usually, at least in many areas of life, it is most instructive to “follow the money”. Hydroxychloroquine is cheap, around $4.00 per dose, whereas Remdesvir for instance costs something like $5000 for a course of treatment.

    What l would like to know is what difference would double blinding and making the study prospective rather than retrospective make in the decision whether to use hydroxychloroquine early in the disease progression with patients in the high risk group. And double blinding with use of placebos would be highly unethical.

    This is an example it seems of excessive caution considering the plight of these patients, and the fact that for years hydroxychloroquine has been routinely prescribed to patients for other conditions. And an example of big pharma and money entering into the medical decision process.

    Here’s some highlights from this study.

    DETROIT – Treatment with hydroxychloroquine cut the death rate significantly in sick patients hospitalized with COVID-19 – and without heart-related side-effects, according to a new study published by Henry Ford Health System.
     
    In a large-scale retrospective analysis of 2,541 patients hospitalized between March 10 and May 2, 2020 across the system’s six hospitals, the study found 13% of those treated with hydroxychloroquine alone died compared to 26.4% not treated with hydroxychloroquine. None of the patients had documented serious heart abnormalities; however, patients were monitored for a heart condition routinely pointed to as a reason to avoid the drug as a treatment for COVID-19.

    The study was published today in the International Journal of Infectious Diseases, the peer-reviewed, open-access online publication of the International Society of Infectious Diseases (ISID.org).

    Patients treated with hydroxychloroquine at Henry Ford met specific protocol criteria as outlined by the hospital system’s Division of Infectious Diseases. The vast majority received the drug soon after admission; 82% within 24 hours and 91% within 48 hours of admission. All patients in the study were 18 or over with a median age of 64 years; 51% were men and 56% African American.
    ……………….
    Dr. Zervos also pointed out, as does the paper, that the study results should be interpreted with some caution, should not be applied to patients treated outside of hospital settings and require further confirmation in prospective, randomized controlled trials that rigorously evaluate the safety and efficacy…

  152. 152
    Mac McTavish says:

    Trump touts HCQ and KF and others here find every cherry picked reason to support it. Trump now supports plasma therapy, which is questionable at best with COVID and, no surprise, KF and others here support it.

    I think that both HCQ and plasma therapy have their place in reacting to the pandemic. But neither is a panacea, or even a string treatment candidate.

  153. 153
    ET says:

    They were talking about the plasma treatment months ago. They should have some data

  154. 154
    ET says:

    Mac:

    Trump touts HCQ and KF and others here find every cherry picked reason to support it.

    Trump touts HCQ and RH7, Mac and others here find every cherry picked reason to not support it and undermine its use.

    Trump now supports plasma therapy, which is questionable at best with COVID and, no surprise, KF and others here support it.

    Being hopeful, Mac. It’s called being hopeful.

    That said, my money is on the EVMS prophylaxis and the fact that our eating habits have left us nutritionally deficient.

  155. 155
    ET says:

    If covid-19 was as (un)contagious as ebola, no one would be worrying about a treatment, let alone plasma.

  156. 156
    Mac McTavish says:

    ET

    That said, my money is on the EVMS prophylaxis and the fact that our eating habits have left us nutritionally deficient.

    That is fine. Are you willing to put your money where your abusive mouth is? Are you volunteering in high risk old age homes? Hospitals? Etc. Btw, just saying “yes”, doesn’t cut it. I would need some proof of your claims, something you have a long history of avoiding.

  157. 157
    ET says:

    Mac:

    That is fine.

    I am glad you agree.

    Are you willing to put your money where your abusive mouth is?

    Your question is leading and proves that you are a loser. I call them as I see them. Don’t mistake honesty for abuse.

    I would need some proof of your claims, something you have a long history of avoiding.

    So you finish with a lie? Lying is a form of abuse. And it seems that lying is all that you have.

    But anyway, come to town and follow me. That is how I will prove it to you. Don’t chicken out.

    If you are just going to be another lying troll, why bother?

  158. 158
    ET says:

    Again: Raising vitamin D blood concentrations above 40ng/mL seems to be highly recommended. It, alone, most likely would have saved thousands of people:

    Ilie PC, et al. “The role of vitamin D in the prevention of coronavirus disease 2019 infection and mortality.” Aging Clin Exp Res. 2020;1:4.

    Grant WB, et al. “Evidence that vitamin D supplementation could reduce risk of influenza and COVID-19 infections and deaths.” Nutrients. 2020;12(4):E988.

  159. 159
    rhampton7 says:

    KF, please show me where in Dr Raoult’s papers he either 1) only gives HCQ to people 60 and over, or 2) recommends that HCQ be only be given to those 60 and over.

    All those people he treated and counted as successes – guess what percentage was under 60?

    Should they have not counted as successes because they were not the “right” population?

    Did Raoult ever receive your advice on which people should take HCQ?

  160. 160
    rhampton7 says:

    The “right” population:

    Early treatment of COVID-19 patients with hydroxychloroquine and azithromycin: A retrospective analysis of 1061 cases in Marseille, France

    Matthieu Million, Jean-Christophe Lagier, […], and Didier Raoult

    A total of 1061 patients were included in this analysis (46.4% male, mean age 43.6 years – range 14–95 years). Good clinical outcome and virological cure were obtained in 973 patients within 10 days (91.7%).

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7199729/

  161. 161
    rhampton7 says:

    Dr Raoult’s “right” population:
    46.4% male, mean age 43.6 years – range 14–95 years

    versus

    the esteemed medical opinion of KF:
    the right population — the vulnerable [typ 60+, those with certain diseases etc]

    The difference “tells us all we need to know.”

    Obviously KF s right and Dr Raoult needlessly treated hundreds of the “wrong” patients to inflate his success rate

    Or, maybe, just maybe, KF doesn’t understand Dr Raoult’s treatment regimen which, ironically, is the basis for his unrelenting promotion of the HCQ miracle.

  162. 162
    RHolt says:

    RH7

    The “right” population

    The doctor leading Jerry’s medcram video repeatedly made the case for RCT’s and the inclusion of a controll treatment arm as the only means of making a determination of a treatment regime’s efficacy. In this study you posted this oversight could not be more clear and also makes another line under the weaknesses of retrospective studies.

    In this study we have 95% of the patient’s with a low NEWS score (over 900 out of 1061 patients)and being treated at home. A low NEWS score is indicative of mild disease with a prognosis of them being unlikely to progress to serious disease. We see this with many patients being treated at home with palliative care. Patient home care generally follows the same time course of this studies ‘treatment’ with similar outcomes as reported in this paper. Also treatment was initiated on day 6 of symptoms being presented (presented as a mean in the paper). For the at home treated patient this is half-way through the natural progression of this disease with patients often released from quarantine at the 10-14 day point after infection. Is it really any surprise that patients in this category had such a successful outcome? The rub is that without the requisite control treatment arm we don’t know if HCQ regime was successful or if, like the majority of patients with these characteristics, Tylenol and rest is all that would have been required. From the reported demographics of patients in this study this would have been the likely outcome.

    The criticisms I provide above have also been relayed long ago by Raoult’s peers and other researchers worldwide…..and justifiably so!

  163. 163
    rhampton7 says:

    In anticipation of a rebuttal about the “vulnerable”:

    Care to show where in Dr Raoult’s paper where he claims to only have treated the vulnerable (followed by the criteria they used to make that determination)? Because it sure seems like he treated everyone, vulnerable or not.

  164. 164
    rhampton7 says:

    More from Dr Raoult, in contrast to KF

    “ In our institute in Marseille, France, we initiated early and massive screening for coronavirus disease 2019 (COVID-19). Hospitalization and early treatment with hydroxychloroquine and azithromycin (HCQ-AZ) was proposed for the positive cases.”

    We retrospectively report the clinical management of 3,737 screened patients, including 3,119 (83.5%) treated with HCQ-AZ (200?mg of oral HCQ, three times daily for ten days and 500?mg of oral AZ on day 1 followed by 250?mg daily for the next four days, respectively) for at least three days and 618 (16.5%) patients treated with other regimen (“others”). Outcomes were death, transfer to the intensive care unit (ICU), ?10 days of hospitalization and viral shedding.

    The patients’ mean age was 45 (sd 17) years, 45% were male, and the case fatality rate was 0.9%. We performed 2,065 low-dose computed tomography (CT) scans highlighting lung lesions in 592 of the 991 (59.7%) patients with minimal clinical symptoms (NEWS score?=?0). A discrepancy between spontaneous dyspnoea, hypoxemia and lung lesions was observed. Clinical factors (age, comorbidities, NEWS-2 score), biological factors (lymphocytopenia; eosinopenia; decrease in blood zinc; and increase in D-dimers, lactate dehydrogenase, creatinine phosphokinase, troponin and C-reactive protein) and moderate and severe lesions detected in low-dose CT scans were associated with poor clinical outcome. Treatment with HCQ-AZ was associated with a decreased risk of transfer to ICU or death (Hazard ratio (HR) 0.18 0.11–0.27), decreased risk of hospitalization ?10 days (odds ratios 95% CI 0.38 0.27–0.54) and shorter duration of viral shedding (time to negative PCR: HR 1.29 1.17–1.42). QTc prolongation (>60?ms) was observed in 25 patients (0.67%) leading to the cessation of treatment in 12 cases including 3 cases with QTc> 500?ms. No cases of torsade de pointe or sudden death were observed.

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7315163/

    * No Zinc, Vitamin C or D
    * No restriction for only those 60+
    * No restriction for only those deemed “vulernable”

    Success rates, promoted all over by those like KF, are based on this wide population and treatment.

    So tell me again why Dr Raoult is correct – AND – Zinc, Vitamin C & D, the “right” population are necessary?

  165. 165
    ET says:

    $200,000 to anyone who can show Dr. Zelenko’s protocol is ineffective. Actions speak louder than words. And the inaction towards that challenge speaks volumes.

  166. 166
    ET says:

    Unbelievable. Vitamin and mineral DEFICIENCY are being observed in the fatalities.

    Again: Raising vitamin D blood concentrations above 40ng/mL seems to be highly recommended. It, alone, most likely would have saved thousands of people:

    Ilie PC, et al. “The role of vitamin D in the prevention of coronavirus disease 2019 infection and mortality.” Aging Clin Exp Res. 2020;1:4.

    Grant WB, et al. “Evidence that vitamin D supplementation could reduce risk of influenza and COVID-19 infections and deaths.” Nutrients. 2020;12(4):E988.

    Dr. Pauling was right.

  167. 167
    rhampton7 says:

    ET,
    So Dr Raoult’s treatment is wrong?

  168. 168
    RHolt says:

    @164-RH7

    More from Dr Raoul

    A repeat of the previous study. No control treatment arm and a heavy emphasis on patients that did not appear to need any treatment whatsoever.

    In this one 91..5% had low NEWS score so they were unlikely to have an adverse outcome from the start of the study. Age distribution had 89% under the age of 60 and of the 702 patients (out of 3737) that were over the age of 60 there were 5% that died (no deaths in the majority of the patients that were under age 60).

    From the study

    We proposed standardized treatment and follow-up for all individuals >18 years of age with PCR-documented SARS-CoV-2 RNA from a nasopharyngeal sample.

  169. 169
    ET says:

    Only if it doesn’t work. Perhaps his patients have a healthy level of D and zinc.

  170. 170
    kairosfocus says:

    RHolt, kindly cease and desist from putting words in my mouth that don’t belong there. This seems to be part of the projection game. Perhaps, first, it has not registered that the therapy has been used on a significant number of patients already (with a modicum of success), which directly implies that dosing has been determined at least on initial basis. Likewise, some reasonable estimate had to be in hand for test patient no 1, based on the state of the art in general. In that context, I have noted adequate evidence that inherently experimental/provisional, emergency use authorisation is considered . . . as opposed to general release. Adequacy to proceed prudently is not absolute proof, indeed such is not in the gift of inductive, empirical investigation (something you surely know that I would always have in mind); rare cases are always a possibility even with a strong and reliable result. It seems, there is a strong motive to not consider hopeful possibilities, backed up by demands for gold standard results that generally speaking will be too late for a pandemic. At this stage, the mirror principle is in play, as you already resorted to projections of base motives. KF

  171. 171
    kairosfocus says:

    RH7, more strawman setup, knockover games. Your mischaracterisation of results to date is duly noted as is refusal to register things like the strong trend to reduction in viral load and linked relief from the first two days and going on to the 5 to 7 to clear the infection. Where, at this stage it is by no means just Dr Raoult, many, many physicians and patients have weighed in. This situation has given us excellent reason to understand why, for example, no evidence of design not even finding algorithmic digital code in the living cell, will ever suffice to correct the sufficiently locked in. Having key decision making, gate keeping and lockout power in such hands is a most imprudent thing. And it is obvious that such is going on all across our civilisation. We are in trouble. KF

  172. 172
    RHolt says:

    KF

    kindly cease and desist from putting words in my mouth that don’t belong there.

    I certainly don’t want to put words in your mouth so I want to make sure this is an accurate quoting of you (from current #116)

    aD, it should be blatantly obvious that antibody-rich plasma will have an immunity transfer effect.

    It is an incorrect statement posing fact. There are numerous examples to support the opposite of what you claimed to be blatantly obvious. I hope you realize that. You could listen to Jerry’s medcram citation and the good doctor there states that sometimes it works and sometimes it doesn’t. It is not a given that transfusion of convalescent plasma will be efficacious in treating a specific disease. There is only one way to find out and that is RCT trials. The data gleaned from properly conducted RCT are the only way we have to keep from fooling ourselves that something works or not.

    KF

    Perhaps, first, it has not registered that the therapy has been used on a significant number of patients already (with a modicum of success), which directly implies that dosing has been determined at least on initial basis.

    Not how they gathered the data. they collected plasma, administered it, THEN sent a sample for antibody titer determination. They, the FDA, do not know if it is efficacious or not. They have made several statements to attest to this fact. They are reasonably confident that it is safe but they acknowledge that they don’t know if it works or not.

    KF

    In that context, I have noted adequate evidence that inherently experimental/provisional, emergency use authorisation is considered . . . as opposed to general release.

    A EUA is a general release! This is the source of the outcry of this premature rollout. What this EUA does is sabotages all the ongoing RCT seeking the answer to the question of efficacy. That ship has sailed. No patient is going to volunteer to be treated in a trial when they can go to any doctor and receive the plasma treatment….of course after going through the hoops to obtain the plasma but it is open to all now.

    KF

    It seems, there is a strong motive to not consider hopeful possibilities, backed up by demands for gold standard results that generally speaking will be too late for a pandemic.

    No there isn’t. And as Jerry’s medcram doctor clearly states RCT are the only way to gather the data required to determine efficacy. RCT for a disease like ‘COVID wouldn’t take the years you claim they do. They aren’t like a breast cancer trial where 5 year survival is an endpoint. For Covid the results are known in a month or less for individual patients. It might take a bit of time to gather the patients in sequence to fill the requisite numbers of participants but to not do so leads to proliferation of marginal, or useless, therapies. I think you might agree that does no patient any good.

    FDA officials, however, have warned that more rigorous study is needed to prove whether the treatment, while safe, is in fact effective.

    Janet Woodcock, the head of the agency’s drug division, told POLITICO on Friday that plasma has not been “proven as an effective treatment.”

    And in its statement Sunday, the FDA said plasma “does not yet represent a new standard of care based on the current available evidence.”

  173. 173
    kairosfocus says:

    RHolt, it is patent that antibodies are a key part of the immune system, and it is well established that they are transferred starting with colustrum and antivenin. Yes, there are challenges, difficulties and hiccups but the basic fact I put in the specific context just given is indubitable. Further to this, in this case, the news context I have seen specifies that: “[t]he FDA said more than 70,000 patients had been treated [using] convalescent plasma, made using the blood of people who have recovered from coronavirus infections.” It has been working, they have reasonable dosage, there is reason to be confident it will continue to work. Yes, objections were made by several NIH officials, further studies and reviews were done, the FDA found that on balance, release is warranted under emergency use authorisation, which is obviously a fast track provisional permit to use in the face of pandemic. This is specifically because the FDA has found that the “known and potential benefits of the product outweigh the known and potential risks of the product.” As Jerry noted on the FDA in 144 above “[t]he tipping point for the agency appeared to be that ‘optimal’ patients who were treated with ‘convalescent plasma at the highest [antibody] titers’ showed ‘significant clinical benefit’ of a 35% improvement in survival, which ‘clearly meets the criteria published for an EUA . . . ” Where, with that balance in hand in the face of crisis, life saving holds obvious priority over further research that promises to deliver “proof” — itself a dubious, loose usage, as empirical investigations at most can warrant to moral certainty; such language is a tell that there are gaps in understanding the epistemology and logic at work. Moral certainty is of course a prudential judgement that to act on X as though it were false given evidence E would be irresponsible, which obviously shifts with context and consequences of error. As say we see with different standards of warrant in different parts of the law. This of course points to the gold standard fallacy issue and linked ethics-epistemology issues. With that backdrop, you are only managing to further degrade your credibility. KF

  174. 174
    kairosfocus says:

    PS, of course by similar criteria, HCQ cocktails and Ivermectin etc should be sung from the housetops. That’s not the world we are in and the why is slowly being dragged out of dark corners.

  175. 175
    jerry says:

    The cost of lockdowns – loss of life years

    An analysis of excess deaths broken down as C19 deaths and other excess deaths due to lockdowns. Then compared life year lost for each. Here’s a comparison 650,000 life years lost to C19 vs 2,200,000 life years lost to lockdowns.

    https://twitter.com/EthicalSkeptic/status/1297225513124204547

  176. 176
    kairosfocus says:

    F/N: kinetic degree of 4GW on rise, warning shots in residential neighbourhood, rioters flee to cars https://twitter.com/stillgray/status/1298118316951707648 Not to support such, just noting that people will spill blood in defence of hearth and home. Especially, as evidence of mob violence circulates. KF

    PS: It is being suggested, people were trapped in an apt set afire by rioters. Arson is next to murder, and arson is now a well established pattern with the rioters.

  177. 177
    jerry says:

    Kf,

    they are not here to have a constructive conversation. They are here to play games. Logic and reason have no effect.

    For example, all the negative commenters are essentially advocating doing nothing except palliative care which leads to a certain percentage dying. They have offered nothing else and denigrate all attempts to lower that percentage by the various forms of treatment proposed. They are essentially advocating to let them die. All to win a rhetorical or political argument.

    RHampton doesn’t understand English well and makes ridiculous statements because of it. People end up trying to answer his misconceptions due to language which will then fall on death ears.

  178. 178
    kairosfocus says:

    Jerry:

    >>they are not here to have a constructive conversation.>>

    1: So, the irresponsibility needs to be exposed, as we have done over and over for months now.

    2: And with the ethics-epistemology-inductive logic breakdowns we see, we can now stand on that demonstrated pattern in addressing other matters. Such as, why the resistance to the design inference?

    >> They are here to play games.>>

    3: Thus, dirty rhetoric, which needs to be exposed. Where, fallacious and/or outright dishonesty in argument needs exposure. On which, credibility is self-destroyed if there is unwillingness to be corrected and to change to more prudent footing.

    4: Which, in too many cases, we are seeing.

    >> Logic and reason have no effect.>>

    5: Actually, if one shows that one is resistant to sound ethics, epistemology, inductive logic and reasoning more generally, due to indoctrination and ideology, that has a wide ranging, devastating effect.

    6: As we are seeing.

    >>For example, all the negative commenters are essentially advocating doing nothing except palliative care which leads to a certain percentage dying.>>

    7: Business as usual, which is known ineffective. And when presented with the logic behind considering a direct alternative, they duck. Recall, the algebra, with BAU, ALT and an artificial placebo based zero treatment base, 0TB:

    [ALT – 0TB] – [BAU – 0TB] = ALT – BAU.

    8: Where, we can similarly compare alt1, alt 2 etc, to see which is best. The demand for gold standards that are ethically dubious, is groundless, despite the huffing and puffing on how superior it is.

    >>They have offered nothing else>>

    9: With scarce exception, e.g. months after we talked about it, ivermectin was suggested.

    >> and denigrate all attempts to lower that percentage by the various forms of treatment proposed.>>

    10: On demand for a gold standard you deride and dismiss what is possible in a very imperfect situation, in time to make a difference. Now, to have made a difference.

    >> They are essentially advocating to let them die.>>

    11: hence, an ethical issue tied to the epistemological-logical one. The reaction to plasma antibody treatments after 70,000 test cases speaks, as does the attempt to nit pick a population of 3000 as though that is not adequate to show what was needed, rapid clearing of virus accompanied by avoidance of complications and death.

    >> All to win a rhetorical or political argument. >>

    12: I think more is at work, defective education and institutionalisation of procedures that are cumbersome and flawed, with the promised in case of emergency locked up in polarised conflict in institutions and media.

    13: the whole framework that was sold to us as oh so wonderful turns out to be decisively broken and unworkable in the real, deeply polarised world.

    KF

  179. 179
    jerry says:

    Kf,

    I admire your patience but it is pointless to answer their comments. It takes up too much valuable time. I have rarely seen them respond to any logic or evidence. Their response is to obfuscate or nitpick.

  180. 180
    jerry says:

    An extensive list of early outpatient treatments

    Pathophysiological Basis and Rationale for Early Outpatient Treatment of SARS-CoV-2 (COVID-19) Infection

    Abstract
    Approximately 9 months of the SARS-CoV-2 virus spreading across the globe has led to widespread COVID-19 acute hospitalizations and death. The rapidity and highly communicable nature of the SARS-CoV-2 outbreak has hampered the design and execution of definitive randomized, controlled trials of therapy outside of the clinic or hospital. In the absence of clinical trial results, physicians must use what has been learned about the pathophysiology of SARS-CoV-2 infection in determining early outpatient treatment of the illness with the aim of preventing hospitalization or death. This paper outlines key pathophysiological principles that relate to the patient with early infection treated at home. Therapeutic approaches based on these principles include: 1) reduction of reinoculation, 2) combination antiviral therapy, 3) immunomodulation, 4) antiplatelet/antithrombotic therapy 5) administration of oxygen, monitoring, and telemedicine. Future randomized trials testing the principles and agents discussed in this paper will undoubtedly refine and clarify their individual roles, however we emphasize the immediate need for management guidance in the setting of widespread hospital resource consumption, morbidity, and mortality.

    https://bit.ly/2QqlKWx

  181. 181
    jerry says:

    We all know that the virus strikes the elderly extremely disproportiantely. Here is an article from a month ago that outlines the effect by state in elderly care facilities.

    Nursing Homes & Assisted Living Facilities Account for 45% of COVID-19 Deaths

    The 45% is low since the state (New York) with the most cases did not count most deaths from residents in nursing homes unless they took place in the actual facility.

    https://bit.ly/3lg79Lj

    These facilities were an almost perfect place for early care outpatient treatment and in nearly all cases they were not treated early. Could over half of the deaths been prevented.

    From above comment on excess deaths, the estimated life years lost to a C19 patient is about 4 years.

  182. 182
    RHolt says:

    Hot off the press….

    FDA chief issues mea culpa for his plasma treatment claims

    some key quotes:

    FDA Commissioner Stephen Hahn issued a mea culpa late Monday, conceding that he had overstated the benefits of convalescent plasma as a treatment of coronavirus at a press conference last weekend with President Donald Trump.

    “I have been criticized for remarks I made Sunday night about the benefits of convalescent plasma. The criticism is entirely justified,” the commissioner said in a string of tweets. “What I should have said better is that the data show a relative risk reduction not an absolute risk reduction.”

    While the therapy is considered safe, plasma has not yet been proven effective against the coronavirus.

    As I stated repeatedly and some have a problem coming to grips with the lack of data or demonstration of efficacy….but it is safe…….but don’t know if it works even after 70,000 patients being administered it.

    The authorization was based on anecdotal data from a 70,000-person program run by the Mayo Clinic. Hahn defended the use of that data to issue the emergency use authorization, arguing that FDA scientists made the decision to approve emergency use of the treatment “a few weeks ago” and that while questions may remain about its efficacy, “the safety profile is well defined.”

    But as Hahn later conceded, that statistic distorts the findings from the Mayo program. Scientists found that patients given plasma early in their illness fared better than those who received it later. But the Mayo study lacked a control group that would have let them compare the outcomes of those who received plasma against those who did not — the only way to prove whether or not the treatment works.

    Several leading scientists — including a Johns Hopkins University researcher leading randomized, controlled trials of plasma — have said they can’t figure out how the administation arrived at its 35-to-1 statistic, based on the data the Mayo team published this month.

    It is obvious that the 35% figure is a fabrication ( as I previously pointed out and has been echoed by many frontline doctors using plasma to treat patients, e.g., Dr. Vin Gupta.. As Jerry’s medcram video doctor points out there was no significant difference in any of the treatments and with no control group one has to wonder where did they come up with this figure?

    And just so we realize there could never be any political influence or pressure on the FDA to make a premature rollout announcement we have this:

    But in announcing FDA’s granting of an emergency use authorization for the treatment on Sunday, the White House billed the decision as a “historic announcement.”

    Nope no influence of politics on this decision….oh wait…..nevermind!

  183. 183
    jerry says:

    From MedCram @103/ on plasma therapy

    It’s not 35%. It’s almost 50% reduction in deaths for treatment less than 3 days and with high antibody levels. The death rate went from 14.9% to 7.6% and was statistically significant. I suggest all who are interested watch the video.

    A pdf of the actual study is here. https://bit.ly/32rDcPM

    No RCTs are necessary to expand treatment since the control group is in the millions, those who have not received the treatment.

    But best if early treatment is used so they don’t get to hospital where the plasma therapy is used.

  184. 184
    kairosfocus says:

    Jerry,

    you are obviously correct that the sensible thing to do is consistently the last resort. That speaks. I won’t bother to take up more on the point that there is reasonable cause for emergency use authorisation, and that there is clear evidence that 70k have been tested which directly answers various rhetorical demands above.

    The paper you linked is manifestly on target:

    There has been considerable focus on two major areas of response to the pandemic: 1) containment of the spread of infection, 2) reducing inpatient mortality. These efforts while well-justified, have not addressed the ambulatory patient with COVID-19 who is at risk for hospitalization and death. The current epidemiology of rising COVID-19 hospitalizations serves as a strong impetus for an attempt at treatment in the days or weeks before a hospitalization occurs

    It continues, ” it is conceivable that some if not a majority of hospitalizations could be avoided with a treat-at-home first approach with appropriate telemedicine monitoring and access to oxygen and therapeutics.” I would stress the therapeutics, given what we have learned for months about effective protocols and given the force of the algebra: [ALT – 0TB] – [BAU – 0TB] = ALT – BAU .

    That seemingly simple expression underlines that we indeed have a BAU control, in the millions of cases with characteristic outcomes that can be credibly reduced in terms of deaths by perhaps 90%.

    But, when systems are institutionally entrenched, the last thing done is the manifestly best. That’s why going forward we are going to have to admit systematic breakdowns in seemingly sound systems.

    KF

  185. 185
    jerry says:

    Dr. Raoult on RCTs

    Nullane salus extra ecclesiam

    Abstract
    Randomized clinical trials are not relevant for infectious disease outbreaks due to a new pathogen, for which public health decisions have to be made urgently. An approach based on group comparisons, in silico, may provide valuable results in a reasonably short period of time for a negligible amount of money.

    Interesting title. Does Dr. Raoult expect the French medical community will believe it is about them.

    https://bit.ly/3lbQUiq

  186. 186
    kairosfocus says:

    Jerry,

    I observe his first detail point:

    In a randomized controlled trial (RCT), participants are assigned to receive either the treatment under investigation or, as a control, a placebo or the current standard treatment. The randomization process ensures that the various groups are, as far as possible, identical in demographics, socio-economic status and other conditions, which minimizes the potential for bias and the influence of confounding factors. The usually high number of required participants depends on the magnitude of the expected effect, implying a long duration of inclusion period. [–> RHolt should duly note] RCTs are considered the reference standard of clinical research for testing new drugs for chronic disease [1]. Among their limitations, RCTs are long-lasting and expensive, and usually directed towards high-risk groups to increase the likelihood of capturing enough end points [1]. RCTs are typically interventions aimed at assessing the effectiveness of a new preventive or curative treatment, as opposed to observational studies conducted in patients under standard care treatments. Interestingly, based on careful review of meta-analyses of RCTs and cohort or case–control studies assessing the same intervention, the ‘average results’ from the latter did not systematically overestimate the magnitude of the associations between exposure and outcome compared with RCTs [2].

    In short, [ALT – 0TB] – [BAU – 0TB] = ALT – BAU

    Then, we see:

    In addition, RCTs are not relevant for urgent health matters such as infectious disease outbreaks due to a new or re-emerging pathogen, for which public health decisions have to be made urgently [1]. In such situations, decisions have to be taken on the basis of limited and often imperfect available data. In the current context of the coronavirus disease 2019 (COVID-19) pandemic, measures that have good rationale, but for which few data are available (e.g. travel restrictions, lockdowns and compassionate use of drugs [–> as in, off label, experimental use on cumulative evidence on balance of relative risks, with consent]) should also be considered as options and should be assessed and amended in a continuous manner [3]. Such an approach—almost empirical but pragmatic—is likely to be considered highly blasphemous by those believing that there is no salvation outside the RCT church, whatever the context.

    As in, gold standard fallacy.

    Going on:

    Expressing a view against the main stream, i.e. against the dogma of RCT supremacy, is at high risk of virulent reactions from some colleagues with a conservative view. Nevertheless, and fully aware of the heretic component of our position, we would like to suggest an alternative to RCT with the aim of challenging the efficacy of chloroquine derivatives and of their combination with azithromycin, which are currently used against severe acute respiratory syndrome coronavirus 2 infections by a majority of physicians, based on the results of preliminary studies [4,5] . . . . it may become possible to carefully compare a selection of outcomes in patients treated with chloroquine derivatives with the outcomes of matched patients receiving another treatment or standard care. Such an approach based on group comparisons, in silico, may provide valuable results in a reasonably short period of time for a negligible amount of money. Our group conducted such an analysis using aggregated data from published studies matched with our own observational data showing that individuals treated with a combination of hydroxychloroquine and azithromycin were three times less likely to die than matched patients treated with either lopinavir-ritonavir or standard care. Compared with patients included in a remdesivir study, we also showed a significant difference in the clinical outcome (proportion of cured individuals with negative viral load) in favour of hydroxychloroquine and azithromycin [11].

    In short, de computah does help match statistrix.

    And RH7, there’s your answer. The studies were big enough to match subsets more or less — I suspect treatments were later in U/L — and still showed the pattern, to be expected given its fairly obvious strength.

    KF

  187. 187
    kairosfocus says:

    F/N: Going to a key link, no 2:

    https://www.scopus.com/record/display.uri?eid=2-s2.0-0034702175&origin=inward&txGid=73b8e681a7b6215b09b78364380f1b91

    >> New England Journal of MedicineVolume 342, Issue 25, 22 June 2000, Pages 1887-1892
    Randomized, controlled trials, observational studies, and the hierarchy of research designs(Article)

    Concato, J., Shah, N., Horwitz, R.I. . . . .

    Abstract

    Background: In the hierarchy of research designs, the results of randomized, controlled trials are considered to be evidence of the highest grade, whereas observational studies are viewed as having less validity because they reportedly overestimate treatment effects. We used published meta-analyses to identify randomized clinical trials and observational studies that examined the same clinical topics. We then compared the results of the original reports according to the type of research design. Methods: A search of the Medline data base for articles published in five major medical journals from 1991 to 1995 identified meta-analyses of randomized, controlled trials and meta-analyses of either cohort or case-control studies that assessed the same intervention. For each of five topics, summary estimates and 95 percent confidence intervals were calculated on the basis of data from the individual randomized, controlled trials and the individual observational studies. Results: For the five clinical topics and 99 reports evaluated, the average results of the observational studies were remarkably similar to those of the randomized, controlled trials. For example, analysis of 13 randomized, controlled trials of the effectiveness of bacille Calmette-Guerin vaccine in preventing active tuberculosis yielded a relative risk of 0.49 (95 percent confidence interval, 0.34 to 0.70) among vaccinated patients, as compared with an odds ratio of 0.50 (95 percent confidence interval, 0.39 to 0.65) from 10 case-control studies. In addition, the range of the point estimates for the effect of vaccination was wider for the randomized, controlled trials (0.20 to 1.56) than for the observational studies (0.17 to 0.84). Conclusions: The results of well-designed observational studies (with either a cohort or a case-control design) do not systematically overestimate the magnitude of the effects of treatment as compared with those in randomized, controlled trials on the same topic. (C) 2000, Massachusetts Medical Society.>>

    Let’s see again, [ALT – 0TB] – [BAU – 0TB] = ALT – BAU

    KF

  188. 188
    rhampton7 says:

    “Randomized clinical trials are not relevant for infectious disease outbreaks due to a new pathogen, for which public health decisions have to be made urgently.”

    True for the first month or two.

    But this has been more than 6 months, during which many RCTs have been accomplished. The triage phase has long since passedt

  189. 189
    kairosfocus says:

    RH7, you apparently missed the point. KF

  190. 190
    ET says:

    Right, 6 months. Had they been pushing the OTC prophylaxis for that time the world’s population would be better equipped to fight off the virus. Deaths would be way down.

    My guess is someone wanted a mass culling and they aren’t getting what they wanted.

  191. 191
    rhampton7 says:

    KF and the rest – you have missed the point.

    In March when very little was known, HCQ was given emergency use authorization, pending more evidence.

    Since then, many RCTs were run and subsequently those data were used to adjust medical decisions throughout the world.

    But in this forum, those RCTs are immediately dismissed. Some reasons given:
    * zinc wasn’t prescribed
    * vitamins C &D weren’t prescribed
    * the “wrong” people were treated (younger than 60)

    Well if that’s true, then you also have to dismiss Dr Raoult’s observational studies for the very same reasons. He too did not use Zinc, Vitamins C and D , nor limit treatment to those 60 and older.

    So pick your poison – the RCTs are valid OR Dr Raoult’s studies were invalid. Consistency demands it.

  192. 192
    ET says:

    Pfft- No one needs to prescribe the vitamins. The FACT remains that most fatalities occurred due to nutritional deficiencies.

    Also the use of HCQ alone was to prevent the virus and not once someone had it. The science behind HCQ and zinc is still very sound. But again, not for once the virus has gotten hold.

  193. 193
    rhampton7 says:

    “What do you have to lose?” This question was first asked rhetorically by President Trump during a press briefing in early April, but has since become the oft-repeated rallying cry for HCQ use in COVID-19 treatment.
    But for those who already thought HCQ was great (for example, the hundreds of thousands of people diagnosed with lupus in the U.S., many of which rely on HCQ, the only drug shown to prevent progression to serious end-organ damage), there is a lot to lose. The FDA reported HCQ shortages from 11 different manufactures from late March through the end of June.
    Beyond the struggle of those trying to fill routine prescriptions, there are far-reaching consequences of the HCQ political debacle when it comes to public trust for other COVID-19 related advancements — such as vaccines. If science seemingly changed its mind about HCQ, will the same scenario play out with vaccines?
    While science has proven itself to be self-correcting over time, many Americans have proven themselves to be impatient when facing the restrictions of a public health emergency. Even as science does everything in its power to quicken the pace of progress, political rhetoric and chronic misinformation continue to create more barriers than solutions, and nothing illustrates this better than the never-ending saga of HCQ.

    https://www.pharmamanufacturing.com/articles/2020/making-hydroxychloroquine-great-again/

  194. 194
    rhampton7 says:

    ET

    So Dr Raoult’s patients had no zinc or vitamin deficiencies, yet all the patients in all the RCTs did.

    Perfectly reasonable explanation, especially when when you consider there is no evidence to support such a conspiracy theory.

  195. 195
    kairosfocus says:

    RH7, maybe it has not registered that this started c Oct 2019, so Dec or beginning Jan was two months in; Chinese deceit has been a key factor in the mess ever since. Granting that, It is clear that by imposing a too late regimen, studies using placebo methods you prefer have been fatally flawed. We can compound with, oh let’s slice apart synergistic cocktails and oh we study groups not most vulnerable — which you projected to try to dismiss Dr Raoult. Lo, behold, he has aptly responded. Your next move? Further projections and distractions. It’s over RH7. KF

  196. 196
    kairosfocus says:

    The conclusion is clear, systems that look good on paper, emergency use provisions and more have failed in the face of reality. That has needlessly cost tens or more thousands their lives. Worse, it had led to deep polarisation that mere facts and logic will not resolve. Reforms will be needed but that will not come easily given depth of polarisation. Quite a fix. KF

  197. 197
    jerry says:

    One of the things that gets little publicity about testing early for a clinical trial is recruiting people. It’s easy to get hospitalized patients but not early high risk C19 infected outpatients. People just go to their regular doctor.

    Consequently it’s almost impossible to get them and then if you could identify them who in their right mind would volunteer to possibly die. And what kind of doctor would allow their patients to enter such a trial when there’s already of plenty of information that the treatment works. I wouldn’t want any such doctor to be my doctor.

  198. 198
    rhampton7 says:

    Deep polarization about the validity of RCTs is not the fault of those who conducted the trials, but those who dismissed them out of hand. Care to guess who that would be?

  199. 199
    rhampton7 says:

    HCQ is no different than any other treatment save for one thing – the importance of RCTs.

    Of course they matter for all the other drug treatments, but HCQ? No, then a different standard is applied. Because Trump supported it? Because people want to believe there is a miracle?
    Don’t know, don’t care, but it is obvious hypocrisy.

  200. 200
    ET says:

    Again, RHampton7- we are MISSING the relevant data. What we do have sheds doubt on what they are testing

  201. 201
    rhampton7 says:

    But what about the long history of safe use, I can hear you reply.

    Well, the same can be said of blood plasma treatment and steroids like dexamethasone, and both are emergency use pending RCTs (which are ongoing!)

    Yet where is the outcry by you and the other HCQ promoters? Where are the endless posts of observational studies? Where is the pre-determined touting of success without RCTs.

    Very telling

  202. 202
    rhampton7 says:

    ET we are missing the same data from Raoult but that hasn’t stopped you from jumping to conclusions

  203. 203
    jerry says:

    As an example, a study in New Jersey just posted today saw a reduction in hospitalization by administration of HCQ. But it was an observational study. Much easier than a RCT.

    Hydroxychloroquine in the treatment of outpatients with mildly symptomatic COVID-19: A multi-center observational study

    Results: Among 1274 outpatients with documented SARS-CoV-2 infection 7.6% were prescribed hydroxychloroquine. In a 1067 patient propensity matched cohort, 21.6% with outpatient exposure to hydroxychloroquine were hospitalized, and 31.4% without exposure were hospitalized. In the primary multivariable logistic regression analysis with propensity matching there was an association between exposure to hydroxychloroquine and a decreased rate of hospitalization from COVID-19 (OR 0.53; 95% CI, 0.29, 0.95). Sensitivity analyses revealed similar associations. QTc prolongation events occurred in 2% of patients prescribed hydroxychloroquine with no reported arrhythmia events among those with data available.

    Conclusions: In this retrospective observational study of SARS-CoV-2 infected non-hospitalized patients hydroxychloroquine exposure was associated with a decreased rate of subsequent hospitalization. Additional exploration of hydroxychloroquine in this mildly symptomatic outpatient population is warranted.

    https://www.medrxiv.org/content/10.1101/2020.08.20.20178772v1

  204. 204
    rhampton7 says:

    Observational studies have known flaws and because of that, are used to determine what treatments should undergo RCTs. That’s the way we did it before Covid-19, and the way we still do for all other current treatment options.

  205. 205
    rhampton7 says:

    Observational studies can never identify causal relationships because even though two variables are related both might be caused by a third, unseen, variable. Since the underlying laws of nature are assumed to be causal laws, observational findings are generally regarded as less compelling than experimental findings.

    Observational studies can, however:

    Provide information on “real world” use and practice

    Detect signals about the benefits and risks of the use of practices in the general population

    ** Help formulate hypotheses to be tested in subsequent experiments

    ** Provide part of the community-level data needed to design more informative pragmatic clinical trials

    A major challenge in conducting observational studies is to draw inferences that are acceptably free from influences by overt biases, as well as to assess the influence of potential hidden biases.

    A confounding variable is an extraneous variable in a statistical model that correlates (positively or negatively) with both the dependent variable and the independent variable. A perceived relationship between an independent variable and a dependent variable that has been misestimated due to the failure to account for a confounding factor is termed a spurious relationship, and the presence of misestimation for this reason is termed omitted-variable bias.

    Confounding by indication has been described as the most important limitation of observational studies. Confounding by indication occurs when prognostic factors cause bias, such as biased estimates of treatment effects in medical trials. Controlling for known prognostic factors may reduce this problem, but it is always possible that a forgotten or unknown factor was not included or that factors interact complexly.

    **Randomized trials tend to reduce the effects of confounding by indication due to random assignment.

    Confounding variables may also be categorised according to their source:

    The choice of measurement instrument (operational confound) – This type of confound occurs when a measure designed to assess a particular construct inadvertently measures something else as well.

    Situational characteristics (procedural confound) – This type of confound occurs when the researcher mistakenly allows another variable to change along with the manipulated independent variable.

    Inter-individual differences (person confound) – This type of confound occurs when two or more groups of units are analyzed together (e.g., workers from different occupations) despite varying according to one or more other (observed or unobserved) characteristics (e.g., gender).

    https://courses.lumenlearning.com/boundless-statistics/chapter/observational-studies/

  206. 206
    ET says:

    Someone is daft. I never said anything about Raoult. Dr. Zelenko has a $200,000 challenge, however.

  207. 207
    kairosfocus says:

    RH7,

    again, the cases record, properly done will have in it reasonable profiles of business as usual treatments and alternatives credible enough to be widespread.

    The BAU — palliative treatment then hospital and ventilators etc — is a natural baseline with its typical outcomes, and the alts will have their own profiles. The algebra shows there is no need to construct an artificial zero treatment baseline — in this case, comparable to jumping without a parachute — ie, [ALT – 0TB] – [BAU – 0TB] = ALT – BAU.

    And, historically, we did have such a test with parachutes, the German vs the Allied design. Modern designs derive from the Allied, as it proved superior.

    From the very beginning, I used decision theory (something I am familiar with for day job reasons), which was studiously ignored, as was similar use by various sources I cited since months ago.

    Where, the observed BAU vs ALT contrast is very capable of feeding causal models and technical evolution, where plausible causal models — studiously ignored — are the substance of the OP; real world, these and near relatives would have been part of the cumulative case behind off label prescription, currently 20% of prescriptions for the US. That is, track record as accepted drug, in lab results, microbiology/biochem models, animal analogues . . . minks seem a good prospect onward . . . and more all contribute to getting to being an alternative that is seriously considered.

    That even includes in this case that for 40 years, fish have thrived and crud across entire kingdoms of life died in fish tanks treated with HCQ and near relatives, implying attack modes on core cellular life functions with dosage ranges such that complex life forms can be treated, fitting in with models on the table.

    We do not lack for ways to connect to plausible cause and testing causal models, that new rhetorical gambit on your part fails. Yet again.

    Therefore, for cause I infer you are not interested in causal models, just in making objections because you are locked into BAU.

    As for the ethical-epistemological limitations of placebo studies, those have been brushed aside too, pointing to a pearls before pigs failure. Unsurprising in a moment where huge, powerful institutions with ruinous agendas have been busily wrecking the greatest human inheritance in history, our civilisation.

    In short, all of this fits a terrible, civilisation-suicidal pattern.

    KF

  208. 208
    Bob O'H says:

    rhampton7 @ 204 –

    Observational studies have known flaws and because of that, are used to determine what treatments should undergo RCTs.

    Eeek, no! Before drugs are tested in large RCTs they have to go through a variety of other stages, not observational. The first human tests are Phase 1 clinical trials, where the drug is tested in a small number of healthy subjects to make sure it’s not toxic at the doses it’s likely to be effective. Then there are Phase 2 trials, designed to find the optimal dose (and check for side effects). Onlt then are big RCTs performed.

    HCQ didn’t take this path because it’s been in use for a long time, before the clinical trial pathway was formalised. So the Phase 1 trials were unnecessary, and there was a lot of information that could be used to sidestep Phase 2.

  209. 209
    kairosfocus says:

    Jerry,

    yet more evidence that HCQ-based cocktails work as advertised. However, those indoctrinated into the gold standard mentality were miseducated, not adequately exposed to decisional issues such as epistemology, ethics, bounded rationality, the satisficing trap, cost of additional information vs costs of continued BAU or inaction, garbage can organisation and consequences, and various cost/benefits tradeoffs much less such in the dismal calculus context of which option will cost fewer lives or net life-years.

    Further to this, as such miseducation was mislabelled as science and sound statistics, it is bound up in the progressivist mentality that they are the centre of gravity of genuine progress, political, economic, societal, technological, scientific, medical, legal, you name it. Where in fact we have only entrenched yet another nihilistic new magisterium that has locked in ethical, epistemological, cultural relativism etc, leading to de facto enthronement of the destructive principle, might and manipulation make ‘right’/ ‘truth’/ knowledge’/ ‘rights’/ ‘justice’/ ‘science’ etc.

    They are now reaching for lockout power, censorship, marginalisation, stigmatisation and ‘justifying” violence against those who beg to differ, complete with power backed red guards running riot. Resemblance to Arab Spring insurgencies and various colour revolutions is NOT coincidental, these are all manifestations of 4th gen war and linked geostrategic agendas, world war IV continues, since 1979, it is manifestly exploiting Islamism, Culture Form Marxism, never let a crisis go to waste cynical hegelianism and more to lock in a shadowy global power elite. But 4GW can be so subtle that it is not seen as war, especially in insurgencies or civil wars. That happened in my homeland. WWIII, of course was the cold war. Won at near ruinous cost by a core coalition of Reagan, Thatcher and John Paul II after nearly being lost across the 70’s.

    Profound reformation is called for and at this stage, that cannot be by consensus, but by counter-culture strategies, critical mass coalitions of change agents based in centres of refuge and resurgence backed by the rise of C21 peasant uprisings by ballot box . . . as opposed to easily defrauded loose mail in voting schemes currently being touted by those who obviously hope to benefit from chaos.

    (BTW, notice how there was studious silence once the numbers from recent polling were on the table on the deplorables 2, given the folly that has turned a contractor in chief with obvious crudities and flaws into a defender of our civilisation’s inheritance? No, he is not desperate, trailing in polls, he is consolidating a critical mass that will likely deliver another electoral college victory, likely by a more decisive margin than four years past. Given the folly of extremism driven by culture form marxist indoctrination, ruinous impact of so called critical theories, deconstructionism and red guards running riot with obvious backing, a great many are waking up and will vote for civilisation over wrecking lawful policing, courts, business climate and general SA bully boyism . . . and girlism, the mobs deliberately exploit the civilised principle protecting women from violence.)

    As I already noted, the juggernaut is out of control (esp. in the US), some are already being crushed, things are heading over a cliff. For some kinds of ideological intoxication, only pain at the foot of the cliff will wake people up. (Did you notice how resistant E Europeans are to the sort of nonsense nostrums being touted in the media and from academic and policy platforms?)

    Sadly, without sober reflection, some of the truly deluded will not even wake up from the pain at the foot of the cliff. That’s a lesson from my homeland.

    KF

  210. 210
    kairosfocus says:

    PS: Let me do a markup:

    https://research.uci.edu/compliance/human-research-protections/researchers/placebo.html

    >>The use of a placebo in clinical research continues to be a topic of debate in the medical community.>>

    1: With the sort of touting we have seen for months not just here at UD but from media and many “expert” voices generally, who woulda thunk that?

    2: Nevertheless, we have it from the outset, there are enduring ethics-epistemology controversies regarding placebo control designs.

    3: Where, with 0TB, null treatment constructed baseline, the algebra of business as usual vs reasonable alternatives is clear:

    [ALT – 0TB] – [BAU – 0TB] = ALT – BAU.

    –> That is, once there is a reasonably defined baseline, business as usual, with results that can be compared with alternatives, null treatment baselines are strictly redundant; especially in cases where do no harm is material.

    >>Some argue that use of placebos is often unethical because alternative study designs would produce similar results with less risk to individual research participants. >>

    4: As in, first, do no harm. As I just noted to RH7:

    The algebra shows there is no need to construct an artificial zero treatment baseline — in this case, comparable to jumping without a parachute — ie, [ALT – 0TB] – [BAU – 0TB] = ALT – BAU.

    And, historically, we did have such a test with parachutes, the German vs the Allied design. Modern designs derive from the Allied, as it proved superior.

    From the very beginning, I used decision theory (something I am familiar with for day job reasons), which was studiously ignored, as was similar use by various sources I cited since months ago.

    Where, the observed BAU vs ALT contrast is very capable of feeding causal models and technical evolution, where plausible causal models — studiously ignored — are the substance of the OP; real world, these and near relatives would have been part of the cumulative case behind off label prescription, currently 20% of prescriptions for the US. That is, track record as accepted drug, in lab results, microbiology/biochem models, animal analogues . . . minks seem a good prospect onward . . . and more all contribute to getting to being an alternative that is seriously considered.

    5: Such of course involves Drs Raoult, Zelenko and Risch. From the way they were treated by the media and spokesmen for the gold standard so called you would have imagined, there is no room for debate. That sort of unjustified marginalisation on matters ethical and epistemological is telling.

    >>Others argue that the use of placebos is essential to the protect society from the harm that could result from the widespread use of ineffective medical treatments.>>

    6: What part of, first do no harm and comparable results are otherwise obtainable is it that is not registering here?

    >>Per the OHRP guidebook, “Placebos may be used in clinical trials where there is no known or available (i.e., FDA-approved) alternative therapy that can be tolerated by subjects.”>>

    7: see the little insertion of officialdom there? Repeat, off-label prescription is about 1/5 in the US, pointing to a clear body of praxis, evidence, knowledge, and so to a basis for reasonable alternatives.

    >> The use of placebos in controlled clinical trials must be justified by a positive risk-benefit analysis,>>

    8: Exposure of patients to rapid deterioration and death or serious debilitation through deceptively mislabelled sugar pills etc administered under false colours and ceremonies of medicine or research gold standards simply cannot be ethically or epistemologically justified.

    9: Current malpractice may be subtler than the Tuskegee syphilis atrocities, but the substantial issues are the same.

    10: There is no responsible benefits claim in calculatedly exposing patients to serious, fast moving harm or death in the face of pandemic.

    >>and subjects must be fully informed of the risks involved in assignment to the placebo group. >>

    11: Why is that? A fallback, so people can recognise what makes no sense. But today’s powers of manipulation are obviously off the chart relative to what has gone before. Informed consent has been utterly hollowed out.

    >>Continued assignment of subjects to placebo is unethical once there is good evidence to support the efficacy of the trial therapy.>>

    12: So, how much more then, if reasonably accessible differential studies on cases will show the efficacy? As in BEFORE the placebos are cooked up? The answer per a fortiori is patent, but this is a day in which the powers of manipulation are manifestly unprecedented.

    KF

  211. 211
    jerry says:

    More hope. Positive news on HCQ. From Italy

    Use of hydroxychloroquine in hospitalised COVID-19 patients is associated with reduced mortality: Findings from the observational multicentre Italian CORIST study

    Abstract
    Background
    Hydroxychloroquine (HCQ) was proposed as potential treatment for COVID-19.

    Objective
    We set-up a multicenter Italian collaboration to investigate the relationship between HCQ therapy and COVID-19 in-hospital mortality.

    Methods
    In a retrospective observational study, 3,451 unselected patients hospitalized in 33 clinical centers in Italy, from February 19, 2020 to May 23, 2020, with laboratory-confirmed SARS-CoV-2 infection, were analyzed. The primary end-point in a time-to event analysis was in-hospital death, comparing patients who received HCQ with patients who did not. We used multivariable Cox proportional-hazards regression models with inverse probability for treatment weighting by propensity scores, with the addition of subgroup analyses.

    Results
    Out of 3,451 COVID-19 patients, 76.3% received HCQ. Death rates (per 1,000 person-days) for patients receiving or not HCQ were 8.9 and 15.7, respectively. After adjustment for propensity scores, we found 30% lower risk of death in patients receiving HCQ (HR=0.70; 95%CI: 0.59 to 0.84; E-value=1.67). Secondary analyses yielded similar results. The inverse association of HCQ with inpatient mortality was particularly evident in patients having elevated C-reactive protein at entry.

    Conclusions
    HCQ use was associated with a 30% lower risk of death in COVID-19 hospitalized patients. Within the limits of an observational study and awaiting results from randomized controlled trials, these data do not discourage the use of HCQ in inpatients with COVID-19.

    https://bit.ly/32wkwOW

  212. 212
    jerry says:

    There seems to be a lot of confusion about positions on HCQ. No one is proposing it as a wonder drug or a magic bullet but that it has positive effects especially when used with other drugs or over the counter additives.

    The question is just how much positive effect? And when best to use it during the progression of the virus.? And in what combination? Use with zinc appears to be extremely beneficial as it makes use of another property of HCQ, namely as an ionophore.

    There is no dispute that HCQ is safe and inexpensive. So if HCQ has even a small positive effect, it would be unethical to not recommend it unless the specific individual has some other medical problems contraindicating its use.

    So recommending the use of HCQ early in the progression of the virus is not only ethical but extremely prudent. Anyone disputing this has got to be ill informed.

    Given that, there are other highly recommended treatments both prophylactically and at early stages. For example, it is highly recommended that vitamin D levels be kept fairly high. There is evidence that Quercetin is also beneficial as well as vitamin C.

    Then there are drugs such as Ivermectin that has shown promise which is also inexpensive and safe. There was a review above on these and other drugs. https://bit.ly/2QqlKWx

    Treatments in the hospital are a different matter but even here there is evidence that HCQ may be having some effect. The plasma treatment discussed above is one of those that seems to have a positive effect. But again it is not a cure all or magic. Many are helped but some are obviously not. But again how does one know ahead of time who will be helped or not?

    The ethical approach with plasma in the hospital would be to make it available to as many as possible. Problems with logistics are part of the problem as an infinite amount is not available and readily manufactured as for most of the drugs.

    As I said there are others and there is an extreme consistency here amongst commenters looking for any treatment that is safe, inexpensive and has a positive effect both early and in the hospital. We are also not against expensive treatments but if they are no more effective than low cost options, then why.

    For example, Remdesivir has not proven very effective and is extremely expensive. But even here it is being used on a “why not” basis.

  213. 213
    jerry says:

    Almost finished watching a video about the 1918 Flu. Highly, highly recommend it. It’s over an hour but keep with it. https://bit.ly/2QoTYcL

    Made 6 years ago the author explains what probably happened to kill so many and why it will not happen again. It points to two important things

    First, most who died from influenza do so by pneumonia which is a bacterial infection and can be treated by antibiotics. So the administering of antibiotics with an anti viral seems reasonable.

    Second, it may be that the elderly lack the specific anti-bodies to fight the virus because of their cohort as opposed to just being old. In the 1918 flu pandemic, the elderly were less at risk than those born in the 1889 to 1900 period.

    These are just hypotheses but the video is very intriguing. Apparently ferrets are the best animals to do research on but have not seen that brought up at all during this virus.

    Wonder what this guy is saying today?

  214. 214
    RHolt says:

    Jerry, I don’t know if it is mentioned in the video you are watching but aspirin overdoses is hypothesized to have led to many deaths. Although the exact number of deaths that can be attributed to aspirin overdose is unavailable there was little doubt that it was a major contributing cause of pulmonary edema leading to death. Doses of up to 30 grams per day were administered in a misguided attempt to treat patients. The phramocokinetic profile, e.g., zero order kinetics versus linear first order kinetics, of aspirin was unknown at the time. There are numerous articles on the subject and provide a interesting read of the history of the 1918 flu event. Here is one example:

    Salicylates and Pandemic Influenza Mortality, 1918–1919 Pharmacology, Pathology, and Historic Evidence

    https://academic.oup.com/cid/article/49/9/1405/301441

  215. 215
    jerry says:

    How a False COVID-19 Narrative Was Created & Sustained for Six Months

    Dr. Meryl Nass has compiled a damning checklist that keeps increasing; it currently lists 47 fully documented facts that constitute a case against government officials’ collusion to demonize an effective existing medicine. They even designed clinical trials that required high doses of hydroxychloroquine and chloroquine that were known – to the medical profession – to be toxic and potentially lethal. These officials bear responsibility for causing preventable deaths of possibly hundreds of thousands of patients.

    https://ahrp.org/how-a-false-covid-19-narrative-was-created-sustained-for-six-months/

    The US is notorious for legal actions. Will the lawyers turn on the Democrats and start suing them and people sympathetic to them for gross negligence in the C19 treatment response. Lawyers are their biggest contributors.

  216. 216
    jerry says:

    The above analysis is continued on the author’s blog.

    It is remarkable that a large series of events taking place over the past 3 months produced a unified message about hydroxychloroquine, and produced similar policies about the drug in the US, Canada, Australia, NZ and western Europe. The message is that generic, inexpensive hydroxychloroquine is dangerous and should not be used to treat a potentially fatal disease, Covid-19, for which there are no (other) reliable treatments.

    https://anthraxvaccine.blogspot.com/2020/06/how-false-hydroxychloroquine-narrative.html

    It is very long and very detailed. Hypocrisy is rampant on this issue.

    As I said the lawyers will notice and will they sue?

  217. 217
    Seversky says:

    There’s a lot of conspiracy theorizing and quackery building up around this issue as well. The Lancet paper was not fraudulent. There was no intent to deceive for gain. It was withdrawn because questions were raised about the accuracy of the records in the database on which the research was founded. Surgisphere, the company which provided the database, refused to release it in full so there was no alternative but to retract the paper. What is more concerning is that there are a number of MD’s out there who hold eccentric views and whose ethics are questionable.

  218. 218
    jerry says:

    The Lancet paper was not fraudulent.

    It just was impossible for it to be true. There have been paper after paper coming out with positive results and no medical issues. All these reports would have been from the Surgisphere data base. Are the hiding all the negative ones? Now that is an amazing conspiracy theory.

    There was no intent to deceive for gain.

    Have you read anything by the editors talking about the pressure put on them by the pharmaceutical industry? My guess not or else you would know your statement is nonsense.

    there are a number of MD’s out there who hold eccentric views and whose ethics are questionable.

    Are you referring to Fauci? He’s constantly lying and his lies have caused tens of thousands of people to die.

  219. 219
    rhampton7 says:

    Jerry, KF, ET

    You have claimed countless times that the HCQ treatment only works if given in the first 5-7 days of exposure.

    Furthermore, any RCT that studied HCQ in hospitalized patients was automatically rejected for the “obvious” reason that it doesn’t work after the magical time window closes.

    Now we have an Italian observational study that says the opposite. HCQ does work on hospitalized patients!

    So, are you going to reconsider the RCTs you previously discounted? Or are you going to admit you were wrong all along and that HCQ can be used anytime?

  220. 220
    rhampton7 says:

    Axel Kahn from June 21:

    Professor Didier Raoult, an infectious disease specialist of high reputation, was perfectly legitimate to think that treatment with hydroxy-chloroquine (HCQ) could be effective against the Sars-CoV-2 virus: he has personally used chloroquine (CQ) for years. and HCQ in the treatment of various infectious diseases. These products decrease viral production in cell culture. Chinese colleagues have spoken of its effectiveness. Likewise, since Covid-19 manifests itself in particular by viral pneumonitis, it is understandable that he imagined associating the antibiotic azithromycin (AZI) with HCQ. However, this is only a hunch. Active in cell cultures on the Sarc-CoV-1, H1N1, dengue and chikungunya viruses, HCQ and CQ are totally ineffective in patients. As for the Covid-19, its unfavorable developments are not linked to a bacterial superinfection, so that the systematic use of an antibiotic is not obvious. It was therefore up to Professor Raoult to verify his legitimate intuition by submitting the suggested treatment to a controlled clinical trial: it is always up to the promoter of a new treatment or in a new indication to do so, the powerful University Hospital Institute of the Mediterranean had the duty and the means. Not having done so is a fault. It is undoubtedly based on DR’s brazen confidence in the veracity of his intuition, a feeling whose psychological mechanisms are understood but a behavior which is impossible to accept in the days of evidence-based medicine. On arrival, the proposed treatment does not appear to be effective. Too bad, I had hoped it would be useful.

    More recently, another university hospital, Professor Christian Perronne, not only took up the case for the treatment recommended by DR, which is admissible. But he further declared that those who did not use it, or even whose clinical trials disqualified HCQ, are killers. And that the unbelievers of the Covid-19 scientific council are sold to the adults of the »pharmaceutical industry. Considering the above, imagine what such an accusation, denunciation, slander represents? No doubt liable to criminal prosecution, in this case. But first, from an ethical standpoint? Be careful? Respect for the freedom of prescription? Reference to data really available in June 2020?

    https://axelkahn.fr/la-deontologie-et-lethique-dun-medecin/

    And today:

    Axel Kahn on hydroxychloroquine: “What Didier Raoult had to do is a controlled trial”

    At the microphone of Anne Roumanoff in the program It feels good Wednesday on Europe 1, the doctor and scientist Axel Kahn, whose book ETHICS in all its states comes out in paperback on September 3, has returned on the work of Professor Raoult on hydroxychloroquine. He points out in particular the shortcomings of these.

    https://www.europe1.fr/emissions/anne-roumanoff-ca-fait-du-bien/extrait-axel-kahn-sur-lhydroxychloroquine-ce-que-didier-raoult-devait-faire-cest-un-essai-controle-3987751

    Who is Axel Kahn?

    (born 5 September 1944) is a French scientist and geneticist. He is the brother of the journalist Jean-François Kahn. He was a member of the French National Consultative Ethics Committee from 1992 to 2004 and worked in gene therapy. He first entered the INSERM with a specialization in biochemistry. He was named in 2002 as a counsellor for biosciences and biotechnologies matters by the European Commission. Head of French laboratories specialized in biomedical sciences between years 1984 and 2007, he has been elected as the President of the Paris Descartes University in December 2007, where he was the sole candidate.

  221. 221
    kairosfocus says:

    RH7, again, you have failed to comprehend what was said. First, long since, incubation period varies, up to 14 days is known commonly hence use in quarantine regulations; a warning on variability. Second, discussion on early in U/L trajectory would not have a precise cutoff, there will be trends. Third, the charts shown give a gradual shift from virus phase to complications, scroll up to OP. Fourth, diminishing effect will undermine the statistical quality of hospitalisation based studies, without need for a sharp cutoff. Finally, it is good news that some effect continues, not a refutation of the efficacy; indeed, one use of ivermectin is because it apparently stretches further down the U/L. KF

  222. 222
    ET says:

    I have said the following about HCQ:

    1- My preference is quercetin
    2- When used alone it needs to be used before getting infected
    3- Because it’s purpose is to change the pH of the lysosome, which causes a change in shape to the ACE2 receptor
    4- That change means the virus is unable to dock with the receptors which means they cannot invade the cell
    5- Once already infected that part of the strategy diminishes in efficacy, depending on the level of infection
    6- When used in conjunction with zinc, yes, the sooner the better. And always best to already have it in your system.
    7- I am more than OK with it working well after infection. I would think that Jerry and kairosfocus are OK with it, too.
    8- Our point is, and has always been, the sooner the better. Because after that there are many contingencies to consider- like the prevailing diets of the patients

  223. 223
    kairosfocus says:

    Sev, I would suggest that the Lancet paper should have been known to be of dubious quality to one or more of its authors, and on being challenged, refusal to provide data is suspicious. The context to shape policy on questionable tactics — and to do so in ways that credibly would cause many serious harm — is manifest. KF

  224. 224
    jerry says:

    You have claimed countless times that the HCQ treatment only works if given in the first 5-7 days of exposure.

    Never claimed that nor do I know anyone else that claimed it. I and others claim it works best in the first 5-7 days. Not that it only works then. Two completely different concepts.

    Your understanding of English is limited which may be the problem. We have claimed it is best used early before the virus has spread very far. Not that it would have no effect if used later. Later is not the best time to use it because the virus has spread substantially. So the later timing will probably reduce its efficacy for most. So it is not a valid way to evaluate it when it will have less of an effect.

    But even having partial effect at later times indicates it may be even more effective if used earlier before the virus has spread. It obviously does not work on everyone infected the same way and later on may not work at all on some when it might have worked on the same person earlier in the virus’s progression.

    The earlier the better.

  225. 225
    rhampton7 says:

    Well then, now you have no reason to dismiss the RCTs.

  226. 226
    rhampton7 says:

    Excellent paper, technical and detailed.

    COVID-19: Pharmacology and kinetics of viral clearance
    Pharmacological Research
    Volume 161, November 2020, 105114

    Here we evaluate the level of evidence of available published interventional studies, with a focus on randomised controlled trials and the efficacy of therapies on clinical outcomes. Moreover, we present data on a large cohort of well-characterized patients hospitalized at a single University Hospital in Milano (Italy), correlating viral clearance with clinical and biochemical features of patients. . .

    Despite the efforts of the scientific community, there is a dearth of high-quality data deriving from RCTs. Promising results from retrospective case series have only been partially confirmed by RCTs and no agent has shown to reduce the mortality rate in COVID-19 patients. Only an early combined approach with interferon, ribavirin and lopinavir/ritonavir showed an association with an improved virological result. Nonetheless, data from the literature and from our own experience with serial COVID-19 swab testing suggests that viral clearance might be uncoupled from inflammation and tissue damage if COVID-19 patients are considered as a homogeneous group. Conversely, distinct patterns of interaction between the immune system and SARS-CoV-2 among different individuals might sustain heterogeneous disease phenotypes, which, in turn, could possibly be susceptible to different pharmacological interventions. A precise characterisation of the variability of immune response dynamics during SARS-CoV-2 infection is therefore urgently needed to better understand the reasons behind the failure of trialed drugs in reducing COVID-19 mortality and to provide a reliable basis for the rational design of future studies.

    As our review indicates, these trials should be led on a large number of patients and on relatively homogenous groups of patients in order to avoid possible confounders in the assessment of treatment efficacy. Even if a link between the high inflammatory burden that develops in a subset of patients and a failure in the clearance of SARs-CoV-2 might be intuitive, there is paucity of published data to support this connection.

    We analysed virological data of a large COVID-19 population and found that both neoplasms and a higher inflammatory burden can lead to a delayed negative conversion of viral RNA load, suggesting that an exaggerated and misdirected inflammatory response might not be sufficient to eliminate the virus, despite possibly contributing to tissue lung damage. Moreover, even if in daily clinical practice RT-PCR tests are often serially repeated to check for viral elimination, this information does not represent a significant prognostic factor since viral clearance does not seemingly affect the mortality rate.

    https://www.sciencedirect.com/science/article/pii/S1043661820314225

  227. 227
    Seversky says:

    Kairosfocus @ 223

    Sev, I would suggest that the Lancet paper should have been known to be of dubious quality to one or more of its authors, and on being challenged, refusal to provide data is suspicious. The context to shape policy on questionable tactics — and to do so in ways that credibly would cause many serious harm — is manifest. KF

    I agree. The authors should have noticed the issues with the Surgisphere database before they published. That said, once concerns were raised and the company refused to release the full database for investigation there was no alternative but to retract the paper. In other words, the system worked as it should. There was no attempt to hide the problems or suppress reporting of them.

    I would argue the only real question is whether or not HCL is efficacious for the treatment of COVID-19. The most rigorous method for deciding that is the RCT. There is no ethical bar to such trials providing that the participants are fully informed volunteers and that no other treatment known to be effective is being withheld.

  228. 228
    rhampton7 says:

    From the Heritage Foundation

    To tell definitively whether hydroxychloroquine is responsible for the reduction in mortality, what’s required is a randomized controlled trial. That is, a prospective study designed to test the direct effect of a drug or intervention…

    It is an open question as to whether hydroxychloroquine in combination with any number of other drugs may have a beneficial effect on the disease course of COVID-19.

    A great deal of evidence says it doesn’t work, but enough evidence says hydroxychloroquine does work that it would be irresponsible to write it off completely at this time, especially in combination with other drugs. In fact, researchers around the world are conducting hundreds of trials with hydroxychloroquine.

    Hydroxychloroquine is dominating the news again for many reasons, not the least of which is that results from several important studies recently have been released. But the angst, the controversy, and cynical politicking around the drug is completely unwarranted.

    We don’t know for certain if, and in what manner, hydroxychloroquine works. We should trust clinicians to review the data for themselves, and it would behoove the media, the politicians, and the public to let the science play out.

    https://www.heritage.org/public-health/commentary/what-we-know-now-about-hydroxychloroquine-treat-covid-19

  229. 229
    kairosfocus says:

    RH7, you obviously imagine you have a gotcha. I suggest again that you scroll up to the OP, observe the phases diagram and understand the overlap. At this point, your credibility to handle relevant analysis is drastically undermined. KF

  230. 230
    kairosfocus says:

    Sev, no, one or more of the authors were doing what they knew they shouldn’t, likely the principal for Surgisphere. They thus acted and spoke with disregard to truth in hope of profiting by what they said or suggested being taken as true. KF

  231. 231
    jerry says:

    Well then, now you have no reason to dismiss the RCTs

    Yes, we do have reason because they are not relevant. How many times does this have to be pointed out to you. HCQ is recommended for those most likely to be hospitalized but at an early stage before hospitalization. But now we are given reason to suspect the value of the RCTs used at the hospitalization stage.

    The RCTs say zero about the use of HCQ at the recommended stage with the recommended patient population. The observational studies say there may be a problem with the RCTs.

    You cannot dismiss the value of a fire extinguisher by its failure in a burning house. But even here it is working some of the time.

    What some of the observational studies are saying is that even in a burning house a fire extinguisher has an effect In some cases.

    What we have is contradictory information about the use of HCQ at the later stage. We have no contradictory information about it at the appropriate stage with the appropriate patient population.

    One reason to suspect the RCTs is that they were poorly done. Just because something was randomized and uses large numbers does not make it relevant. For example, the dosages were all wrong in the Recovery study.

    What we are arguing is that HCQ helps some if it is used ar the right time. Arguing against that by saying it doesn’t work 100% of the time, is a logical fallacy. We will agree that it doesn’t work 100% of the time.

    Every time one makes the wrong analysis that person just affirms the opposite is true..

  232. 232
    Bob O'H says:

    What we have is contradictory information about the use of HCQ at the later stage. We have no contradictory information about it at the appropriate stage with the appropriate patient population.

    But we do have information about HCQ use at the appropriate stage. I’ve not seen any explanation why there should be a qualitative difference in effect of HCQ in different populations, so I’m not sure there’s any strong reason to say the studies are irrelevant.

  233. 233
    ET says:

    HCQ at the appropriate stage, works.

  234. 234
    jerry says:

    But we do have information about HCQ use at the appropriate stage

    But we don’t. There is a survey without verification and that’s it

    If I were to present the study as support it would be laughed at by everyone. By the way the irony is it does support an effect for HCQ even in this very flawed survey study on the wrong patient population using the wrong criteria.

    I suggest you argue with the statisticians who you disagree with. But even if you prove right it does nothing because it was a crap study.

  235. 235
    Bob O'H says:

    Srooy, Jerry, what is the appropriate stage? Clearly it’s not before someone has been in contact with a person infected with Covid-19. Or after they’ve been in contact but before they’ve shown symptoms. Or after they’ve shown symptoms. Or after they’ve gone to hospital. So when is the appropriate stage? Post mortem?

  236. 236
    jerry says:

    what is the appropriate stage?

    after they’ve shown symptoms and before they require hospitalization
    and
    If they are high risk because most will recover without treatment if they are not.

    But you already know this so why your nonsense question.

    But there are treatments for everyone that are recommended for preventive and for those with mild symptoms in the non risk population. For example, quercetin, zinc, vitamins C and D. There are others to help the immune system in general.

    If you want to argue with the latter, feel free to contact the doctors who recommend them. I suggested it to a friend and he asked his doctor about them. His doctor’s response was it could do no harm so why not.

    You obviously have never heard or read Zelenko. Or else you would never ask such nonsense. He discusses this in detail. So does Risch and others.

  237. 237
    Bob O'H says:

    Jerry – well there have been RCTs for “after they’ve shown symptoms and before they require hospitalization”. Here are 3 showing no effect:
    https://doi.org/10.1093/cid/ciaa1009
    https://www.acpjournals.org/doi/10.7326/M20-4207
    https://www.nejm.org/doi/full/10.1056/NEJMoa2019014
    Being “high risk” isn’t a stage, of course, So, to repeat what I wrote @ 232

    I’ve not seen any explanation why there should be a qualitative difference in effect of HCQ in different populations, so I’m not sure there’s any strong reason to say the studies are irrelevant.

    I still haven’t seen any such explanation.

  238. 238
    kairosfocus says:

    BO’H: isn’t it obvious that older people are sicker with less effective immune systems, aka aging? That people fighting cancer or diabetes or with heart problems have bodies already under stress? That asthmatics and the like have stressed, malfunctioning, over-reactive immune systems? And the like? Why would such be even in the faintest degree a puzzle? Likewise, deficiencies of diet etc are patently material. KF

  239. 239
    jerry says:

    there have been RCTs for “after they’ve shown symptoms and before they require hospitalization”. Here are 3 showing no effect:

    All three of the studies listed show positive effects for HCQ, but sample sizes are too small for statistics significance. Two of the three studies are survey studies and have no way to ascertain what really happened. There was no doctor overseeing the interview and compliance with anything. Essentially there are the useless because of this despite the positive results for HCQ.

    The third study from Spain also had small positive results for HCQ but it too lacked the numbers for statistics significance. The samples were too small.

    All three are irrelevant because of the young sample who were mostly health care workers. These individuals would be expected to eliminate the virus naturally almost at a rate of 100% if infected. None of the studies used hospitalization or death as a way of evaluating the intervention.

    These reflect the difficulty of recruiting relevant patients. Best to use the information from doctors who have been treating the high risk patients. With high risk patients there would be an ethical challenge to admit anyone to a treatment that would ensure that some would die.

    But this has all been explained before and the same irrelevant studies keep being linked to.

    I still haven’t seen any such explanation.

    Of course you have seen explanations. Age being the main one indicating the strength of the immune system is very different. Also relatively young active individuals such as health care workers may represent an unusual population.

  240. 240
    rhampton7 says:

    And it’s also been pointed out that DR Raoult’s studies had a mean age of 45.

    So his results are untrustworthy because maybe half his subjects would have cleared the virus naturally

  241. 241
    rhampton7 says:

    The researchers looked at data from nine hospitals in the Netherlands, two of which never prescribed HCQ and seven which prescribed the drug routinely – three immediately on a positive test and four only when the patient’s condition deteriorated.

    The data ranged from 27 February when the first case was reported in the Netherlands to 15 May, when government guidelines no longer supported the use of HCQ. In all, the data on 1,893 patients was included.

    On initial examination, it appeared that mortality among the 1,552 subjects at HCQ hospitals was 23.4%, whereas it was 17% among the 341 subjects from the non-HCQ hospitals.

    However, once the figures were adjusted for age, sex and co-morbidities – pre-existing conditions like diabetes and cardiac disease likely to increase the severity of Covid-19 – there was very little difference at all in mortality rates. Likewise, there was no difference between those who received HCQ immediately on testing positive and those who received the drug only when their condition deteriorated.

    In other words, the use of HCQ on patients with Covid-19, either immediately or only when symptoms increased, made no appreciable difference to the patients’ chances of survival.

    “This clearly shows that prescribing the drug had no positive effect,” another of the researchers, Jonne Sikkens, told De Volkskrant.

    “Our conclusion would be to stop using it in the treatment of Covid-19.”

    https://www.brusselstimes.com/news/belgium-all-news/health/128697/dutch-study-shows-no-benefits-from-hydroxychloroquine/

  242. 242
    rhampton7 says:

    An international collaboration of researchers across more than 80 countries has come to the conclusion that chloroquine (CQ) and hydroxchloroquine (HCQ) are unlikely to provide clinical benefit against COVID-19. In a new commentary paper co-authored by Wyss Founding Director Donald Ingber, M.D., Ph.D., a group of scientists describe multiple recent studies in human Organ Chips and other multi-tissue in vitro models, mice, hamsters, and non-human primates, all of which strongly indicate the drugs do not have the efficacy suggested by earlier results obtained from in vitro studies with cultured cell lines. The paper was published today in Nature Communications.

    I n an effort to provide more accurate data about the drugs’ potential activity in humans than could be obtained from in vitro cells or mice, the co-authors of the new paper oversaw research projects in several different countries that evaluated CQ and HCQ’s anti-SARS-CoV-2 activity in human Organ Chips and other more complex in vitro human tissue models, as well as hamsters and two species of non-human primates.

    Human lung chips developed at the Wyss Institute and commercialized by Emulate, Inc. were used to test CQ’s effect on lung cells infected with SARS-CoV-2 pseudoviruses (lentivirus particles engineered to express the SARS-CoV-2 spike protein). CQ did not significantly inhibit the replication of the SARS-CoV-2 Spike pseudotyped viruses in the lung cells, and more recent findings confirmed that HCQ is ineffective as well. Meanwhile, in France, a research team at Inserm developed another complex human in vitro model system called MucilAir, which is derived from primary nasal or bronchial cells differentiated and cultivated under an air/liquid interface. In alignment with the findings by the Wyss Institute, Inserm concluded that HCQ does not significantly inhibit SARS-CoV-2 infection in their human respiratory tissue model.

    More https://medicalxpress.com/news/2020-08-hydroxychloroquine-inhibit-sars-cov-infection-preclinical.html

  243. 243
    jerry says:

    maybe half his subjects would have cleared the virus naturally

    Probably much higher would be expected.

    Raoult did an analysis of over 3700 patients with C19 and about 94% had a good clinical outcome. This is what is expected. Most indeed were below 60 years old. But no one under 60 died with or without treatment. So if you look at percentages that died over 60 it is 3.2% for treatment and 9.3% without treatment.

    For those who went to ICU the percentages for over 60 were 3.0% for treatment and 10.4% without treatment.

    For death and or ICU the percentages for over 60 were 5.0% for treatment and 17.6% without treatment.

    For the young patients who were infected and went to the ICU the percentages were 0.5% for treatment and 7.2% without treatment.

    Those with a poor clinical outcome, death, ICU or greater than 10 days in hospital the percentages were 3.9% for treatment and 17.6% without treatment.

    So this points to a positive effect for HCQ. Not 100% but much better than the alternative. If the percentage reduction in death were applied to the non HCQ treated people who died of C19 the number saved would be almost a half million people world wide.

    So those who argue against HCQ are arguing for having a lot of unnecessary dead people.

  244. 244
    jerry says:

    Five studies focused on HCQ effectiveness.

    Author – Location….number of patients….mortality HCQ….mortality no HCQ….Relative Risk….dosage

    Sbidian Paris….4,415….17.8….21.9….-18.7% Low
    https://bit.ly/3b109gG

    Catteau Belgium….8,075….17.7….27.1…-34.7% Low
    https://bit.ly/2CTCnXl

    Castelnuovo Italy….3,451….14.7….23.3….-36.9% Low
    https://bit.ly/32wkwOW

    Arshad USA….2,541….13.5….26.4….-48.9% Low
    https://bit.ly/3dVshSq

    RECOVERY UK….4,716….26.8….25.0….+7.2% High

    Did the Recovery study actually kill patients by administering high dosages of HCQ? Will they ever admit it? Unlikely even if true.

    These studies are just for HCQ and do not include any additives such as zinc or Azithromycin which may be much more effective. And now we have other possible positives for treatments. How many dead are due to the pressure from certain sectors to malign the treatments with HCQ.

    There are others that I will add to this list.

  245. 245
    jerry says:

    Hope!!

    Incredible video on HCQ based on Belgian study. https://bit.ly/2Qv3BqH

    A doubter changes his mind. Realizes Recovery travel was giving 8-10 times the recommended dose of HCQ. Were they poisoning the patients?

    Includes analysis of Brazilian study which shows no difference but with about 10% of the number of patients as the Belgian study.

  246. 246
    Bob O'H says:

    kf @ 238 –

    BO’H: isn’t it obvious that older people are sicker with less effective immune systems, aka aging?

    Yes, which explains why they are more likely to succumb to Covid-19. But for me that’s a quantitative difference, not a qualitative one: some younger people also have less effective immune systems (and immune system efficacy is also quantitative).

    Jerry @ 239 – you’re just moving the goalposts now, aren’t you?

  247. 247
    kairosfocus says:

    BO’H, I pointed to thewider generally accepted vulnerability patterns also. KF

  248. 248
    Bob O'H says:

    kf – Yes, so …?

  249. 249
    kairosfocus says:

    a point of balance, as you wrote earlier as if I had not pointed to such, to wit: 238 >>That people fighting cancer or diabetes or with heart problems have bodies already under stress? That asthmatics and the like have stressed, malfunctioning, over-reactive immune systems? And the like? Why would such be even in the faintest degree a puzzle? Likewise, deficiencies of diet etc are patently material.>>

  250. 250
    Bob O'H says:

    I’m sorry, kf, I’m still not getting what you are trying to communicate.

  251. 251
    Mac McTavish says:

    CDC predicts 200,000 deaths by September 19.
    https://www.cdc.gov/coronavirus/2019-ncov/covid-data/forecasting-us.html

  252. 252
    Truthfreedom says:

    Mac Mc Tavish

    CDC predicts 200,000 deaths by September 19.

    Fine.

    “In a Universe (or multiverse*) of electrons and selfish genes, blind physical forces and genetic replication, some people are going to get hurt, other people are going to get lucky, and you won’t find any rhyme or reason in it, nor any justice. The Universe that we observe has precisely the properties we should expect if there is, at bottom, no design, no purpose, no evil, no good, nothing but pitiless indifference”.
    Richard Dawkins, River Out of Eden: A Darwinian View of Life

  253. 253
    jerry says:

    CDC predicts 200,000 deaths by September 19

    Were most deaths caused by opposition to early treatment? Could most of these deaths have been avoided?

    Do those who have opposed early treatment have blood on their hands? A lot of people are accusing Fauci of this. Do they have a valid point? What is the morality of arguing against early treatment with what appears to be a treatment that has some or a lot of effectiveness?

    Will the lawyers start taking up the cause of those who died unnecessarily? Will see if they eat their own?

    A lot of questions that a lot of people don’t want any answers to.

  254. 254
    jerry says:

    Where is this study?

    A report was issued in a press release in New York City in early May about a study that was conducted at NYU and posted by BA77. https://bit.ly/3hCIK0r

    Drug Combo with Hydroxychloroquine Promising: NYU Study

    The study looked at the records of 932 COVID-19 patients treated at local hospitals with hydroxychloroquine and azithromycin.

    More than 400 of them were also given 100 milligrams of zinc daily.

    Researchers said the patients given zinc were one and a half times more likely to recover, decreasing their need for intensive care.

    I searched and couldn’t find it anywhere. Fits in with the “people did not need to die” narrative just above. On May 12, the date of the article the total US deaths were 86 thousand. Now it is 85 thousand more. Could most of these have been prevented? Zelenko started to get traction in late March and NY Times quickly did a hit piece instead of saying why not try this. It’s harmless and cost next to nothing.

    Or are they just dots on the landscape as we justify them for our personal motives?

  255. 255
    Mac McTavish says:

    Jerry

    Were most deaths caused by opposition to early treatment?

    No.

    Could most of these deaths have been avoided?

    If we had acted earlier with social distancing, restricting travel and wearing masks, almost certainly.

  256. 256
    jerry says:

    Were most deaths caused by opposition to early treatment?

    No.

    If I were interested in the money I would be arguing yes, and all the information is on my side. The Belgian study reference above reduced deaths a third in hospital. That good for 50-60 thousand in the US. That’s after the periods where treatments would prevent people getting to hospital should have been given. So my guess double that a minimum.

    If we had acted earlier with social distancing, restricting travel and wearing masks, almost certainly.

    And most certainly killed a lot more. I was social distancing since early March and so was everyone I saw and still see most today.

    There is an expression, “going viral.” Lockdowns and all that go with it do not get rid of the virus so it will get most eventually.

    I would take that side in the argument too. Lockdowns kill big time.

  257. 257
    jerry says:

    Turkey apparently has a good record with the virus. Its current deaths per million is 74. I assume it is close to accurate but it’s hard to know for sure. An article was published today what one major medical center was doing.

    https://link.springer.com/article/10.1007/s10096-020-04016-1

    A novel approach to managing COVID-19 patients; results of lopinavir plus doxycycline cohort.

    We managed COVID-19 patients with a 3-step treatment approach in our institute. First, mild cases were isolated at home and prescribed with hydroxychloroquine plus doxycycline for 3 days. Second, moderate to severe cases were hospitalized and prescribed with a regimen of lopinavir plus doxycycline plus ceftriaxone for 5 days. Third, we used a salvage therapy for patients who did not respond to or whose conditions worsened under the lopinavir treatment. This therapy involved the oral administration of favipiravir 600 mg twice daily after two loading doses

    It’s not necessarily a report on what has worked or not worked but a report on what they are doing in one medical center and why.

  258. 258
    jerry says:

    What’s really happening with the virus. Here is a report by a guy calling himself Gummi Bear that is making the rounds. Is T cell immunity what is happening?

    Does it explain why East Asia and Southeast Asia are doing so well? And why the rest of us are next?

    https://threadreaderapp.com/thread/1298246346974154757.html

  259. 259
    rhampton7 says:

    Australia’s Acting Chief Medical Officer Paul Kelly has said the drug – which has been labelled “potentially harmful” by the country’s peak COVID research body – “doesn’t work”.

    Australia’s Deputy Chief Medical Officer Nick Coatsworth backed him up on Friday. “Paul Kelly, like myself, like all clinicians around Australia, understands that regrettably hydroxychloroquine is not effective for COVID-19.

    “While I understand why there are many Australians out there looking for a solution, we have solutions come across our desk literally every day and have to work whether they are or they aren’t effective.”

    “I believe we have tonnes of hydroxychloroquine in this country, which was really generously donated by Clive Palmer, early on in the pandemic where there was a possibility hydroxychloroquine would be useful,” he said.

    “Now, there are no circumstances where we, as government, or clinicians, would sit on several tonnes worth of hydroxychloroquine in the national medical stockpile if it were useful for COVID-19. We would be giving it to patients right now.

    “But unfortunately it’s not — the trials are very clear on that.

    https://www.news.com.au/lifestyle/health/health-problems/coatsworths-hilarious-response-to-hydroxychloroquine-question/news-story/55584b3641b86f8437a58f05557ce1bd

  260. 260
    rhampton7 says:

    Hydroxychloroquine was one of the most heavily studied drugs this spring, and study after study has shown that it’s not an effective treatment for sick patients. But scientists still don’t, and may never, know if it works as a prophylaxis that prevents infections.

    “The fact that it’s August and it’s still an open question is an embarrassment,” Walid Gellad, who leads the Center for Pharmaceutical Policy and Prescribing at the University of Pittsburgh, told BuzzFeed News.

    The deeper systemic issue is that there have only been a handful of large, rigorous trials for hydroxychloroquine or, for that matter, any potential treatment. These randomized controlled trials, where some people receive a treatment and others a placebo, are the gold standard in medicine for determining if a drug works.

    In the near-absence of coordination among national and global health agencies, separate clusters of scientists have run smaller, less definitive trials. And for months, the FDA allowed hydroxychloroquine to be given to COVID-19 patients outside of clinical trials. That further drained the pool of people who might be willing to enroll in a trial and risk getting a placebo, in turn muddling the evidence about what worked and didn’t.

    History is now repeating itself with convalescent plasma.

    https://www.buzzfeednews.com/article/stephaniemlee/hydroxychloroquine-clinical-trials-prevention

  261. 261
    rhampton7 says:

    Carol Iwuoha, Consultant, Public Health and Community Medicine Physician, has warned against self-medication in the handling of COVID-19. She said that several cases of drug toxicity, especially from irrational use of chloroquine and hydroxychloroquine, had been recorded.

    Iwuoha, who is the Chairman, Abia State Inter-Ministerial Committee on COVID-19, warned against the management of COVID-19 at chemist and patent medicine stores. She called for adherence to COVID-19 protocols, including regular hand-washing, use of hand sanitisers and face masks as well as physical distancing. She said that the protocols provide barrier protection to people and their neighbours.

    Iwuoha, a former state Chairman of the Nigeria Medical Association, advocated early presentation when one had the symptoms of COVID-19. According to her, this has made the difference between those who survived and those we have sadly lost to COVID-19.

    https://naija247news.com/2020/08/28/covid-19-expert-warns-against-self-medication/

  262. 262
    rhampton7 says:

    For Florian Cova, co-author of the hoax on scooters and hydroxychloroquine, the Marseille professor mistreats thinkers in order to justify his practices.

    The whole world, or almost, now knows the thunderous positions taken by Didier Raoult on the Covid-19 epidemic. But for many years now, through both his chronicles and his books, the Marseille microbiologist has been giving equally strong opinions on the history of science and philosophy, relying in particular on epistemologists such as Karl Popper, Thomas K. Kuhn and Paul Feyerabend. A pure intellectual sham according to Florian Cova, assistant professor in the philosophy department of the University of Geneva. This researcher has just published a scathing text in Medium in which he assures us that Didier Raoult only appeals to philosophy, and in particular to the philosophy of science, only to justify his own unorthodox methods and to be able to stage himself as a solitary genius. and revolutionary, even if it means making gross errors in its philosophical references. Florian Cova is also the co-author of a resounding hoax on the links between hydroxychloroquine and scooters to denounce the predatory journals that have published bogus studies on hydroxychloroquine.

    While the Marseille microbiologist has just returned to the media, he explains to the Express how Didier Raoult is becoming more and more radicalized, supported by a base of anti-system supporters.

    https://www.lexpress.fr/actualite/idees-et-debats/didier-raoult-fait-dire-aux-philosophes-le-contraire-de-ce-qu-ils-ont-ecrit_2133662.html

  263. 263
    Mac McTavish says:

    I think this speaks for itself.

    https://apple.news/AgN9JbA4XRDqf-7fT69UCUg

    It speaks volumes that countries that were initially hit hard (eg Spain and Italy) think that their governments responded well to COVID. US, on the other hand…

  264. 264
    kairosfocus says:

    MMT, the US is sliding over the cliff into high kinetic 4th gen civil war, with its toxic media bearing heavy responsibility. Such has utterly no relevance to what has been shown, including what after a quarter of a thousand comments has yet to be either confuted or taken seriously by objectors. Credible mechanisms which match to actual observations. We will take due note on what the patterns tell us. KF

  265. 265
    kairosfocus says:

    RH7, you would be advised to note the just above. More than enough evidence of effectiveness of HCT-based cocktails is on the table, what is relevant is the ways and means by which dismissiveness has been turned into a domineering, censoring narrative and interference with the professional judgement of physicians. KF

  266. 266
    Mac McTavish says:

    KF

    MMT, the US is sliding over the cliff into high kinetic 4th gen civil war, with its toxic media bearing heavy responsibility.

    Yes, the media bears responsibility. Just as they bore responsibility when reporting on repeated civil rights abuses in the 60s. And they bore responsibility for continuing to investigate Nixon and the Watergate scandal. And they bore responsibility for reporting on the “me too” movement. And they bore responsibility for reporting on the injustices born against homosexuals for decades. And they bore responsibility for holding men responsible for how they treat women.

    The media is far from perfect, but they do have a tendency of reflecting the concerns of the majority of the population.

    The fact that you disagree with them so much may be a greater reflection on you than on them.

  267. 267
    Truthfreedom says:

    Didier Raoult Trashing Darwin

    “Charles Darwin’s vision of the world deeply influenced biology in the twentieth century. Today, however, his theory of evolution is more a hindrance than a help, because it has become a quasi-theological creed that is preventing the benefits of improved research from being fully realized.” Didier Raoult, Life After Darwin

  268. 268
    kairosfocus says:

    MMT, this is not mere objective reporting, what has been happening is outright deceitful toxic defamation, willful distortion of history, events, issues and more in service to agendas amounting to insurrectionist agit prop (not mere irresponsible tabloidisation though that is a factor) with enabling of destruction and bloodshed. As a yardstick, ponder enabling of the holocaust of 800+ million of our living posterity in the womb over 40+ years, advancing at about 800 k per week currently, and ask yourself whether those who enable such have any true concern for rights, justice, life — or whether they find that toxic emotions are amenable to manipulation. For cause, there is now accelerating loss of credibility, unfortunately that is also a contributory factor to where things are on this and many other issues. As, sound media in the net are vital buttressing for sustainable constitutional democracy. A reckoning is palpably coming and it will not be enjoyable. KF

  269. 269
    jerry says:

    Hope! Very large meta analysis on HCQ

    REAL-TIME META-ANALYSIS FOR HCQ / MORTALITY / COVID

    From Dr. Raoult’s group. Over 40,000 patients. Most of these patients would have been in the Surgisphere study which is more proof it was phony. https://bit.ly/2DdPAuq

    Results

    Meta-analysis on chloroquine derivatives and COVID-19 mortality
    August, 26, 2020 Update
    Studies with PCR-confirmed diagnosis assessing the « death » outcome – Random effects model – Comprehensive meta-analysis (Biostat inc.)

    14 comparisons from clinical studies: 4,121 patients

    Authors include physicians who take care of patients – Connexion between data scientists and clinical ward

    Odds ratio 0.60, 95% confidence interval 0.50 – 0.73, p = 1.04 x 10^-7
    Consistent results: I2 = 20%, p = 0.23
    ———————–
    12 comparisons from Big data studies: 35,985 patients
    Authors analyzed data from electronic health records – Disconnexion between data scientists and clinical ward
    Odds ratio = 0.84, 95% confidence interval 0.75 – 0.94, p = 0.003
    Inconsistent results: I2 = 76%, p <.001

    https://bit.ly/2DdPAuq

  270. 270
    jerry says:

    FDA approves drug with no benefit for more patients. Why?

    COVID-19 Update: FDA Broadens Emergency Use Authorization for Veklury (remdesivir) to Include All Hospitalized Patients for Treatment of COVID-19

    Why not? If it could help. But HCQ has much better numbers. So why?

    My guess, is follow the money.

    https://bit.ly/2QBrCwk

    And in Nigeria. https://bit.ly/3hAEWN8

    Chloroquine potent for COVID-19 prevention , says NAFDAC

    The National Agency for Food and Drug Administration and Control (NAFDAC), yesterday, declared that chloroquine prevents the dreaded coronavirus.

    Its Director General, Prof. Christianah Mojisola Adeyeye, during an online interactive session with journalists said: “We realise that chloroquine can be used in the early stage of the COVID-19 infection as prophylactic treatment. Science does not lie.”

    Also

    “My colleague in Ghana has a robust study on chloroquine use on COVID-19 patients that is going to be released soon. Also, several people that had COVID-19 in Senegal recovered after using the drug.”

    Are the Africans ahead of the US? It looks that way!

    Will not make RHampton’s top 40 list. It saves lives. Not the narrative of some.

  271. 271
    jerry says:

    Read this short article and replace Bactrim with HCQ

    Whitewashing AIDS History

    With Fauci, follow the money not the doctors.

    https://bit.ly/2QAUl4e

  272. 272
    jerry says:

    While top Australian medical people are proud that they are letting people die (documented by RHampton), Dr. Kulvinder Kaur from Ontario, will be on Australian radio with other doctors explaining why they are wrong to let people die. https://bit.ly/31C3v6U

    Dr. Kaur has been attacked by Canadian medical authorities for recommending something that works and for being against things that don’t work.

    Follow the money!

    Yes, it is an Alice in Wonderland world out there. And we have people everywhere defending Wonderland. Including several on this site. What they don’t realize is that eventually the Queen of Hearts will come for them. Remember Robespierre!!!

  273. 273
    jerry says:

    An assessment of the C19 virus now. How accurate?

    We’re getting close to end of this crisis
    It’s going to be shifting away from a scientific issue to a political1
    Not sure many of us can do much more
    The science is pretty clear
    I feel like I repeat myself alot lately

    https://bit.ly/32AVz58

  274. 274
    kairosfocus says:

    Jerry, I added the main chart as a PPS. It speaks, yet again. KF

  275. 275
    Mac McTavish says:

    KF

    MMT, this is not mere objective reporting, what has been happening is outright deceitful toxic defamation, willful distortion of history, events, issues and more in service to agendas amounting to insurrectionist agit prop (not mere irresponsible tabloidisation though that is a factor) with enabling of destruction and bloodshed.

    Then maybe you should watch something other than Fox News, Sean Hannity, and Rush.

  276. 276
    Truthfreedom says:

    Didier Raoult Trashing Darwin

    “Charles Darwin’s vision of the world deeply influenced biology in the twentieth century. Today, however, his theory of evolution is more a hindrance than a help, because it has become a quasi-theological creed that is preventing the benefits of improved research from being fully realized.” Didier Raoult, Life After Darwin.

    Because it is not about saving lives or not. It is a power struggle (atheism/ evolutionism) vs theism.
    The a/evos do not want to give an inch (150 years of darwinian non-sense has served them well).
    The Academia is full of marxist parasites that are not willing to abandon their host. It’s so warm and nutritious…

  277. 277
    kairosfocus says:

    MMT,

    your projections tell us all we need to know, by mirror principle. The blame the “fascists” game is 30 years past sell-by date and is diagnostic of Marxist left influence (however indirect and dated, going back to Stalin et al). FYI, I rarely watch news and commentary (though I will monitor . . . and YouTube is going to be the main source I can use here for vids), I much prefer reading.

    My sources in this thread — manifestly, despite your patently false and irresponsible suggestions — are the Frontline Doctors and associated documents, in the primary instance, cf OP. It took Yandex of all places for me to get a key chart. After nearly 300 comments, it is noteworthy that no one has seriously undermined the plausible mechanisms on the table.

    If you mean to point to culture form marxism, critical theories etc, a main source is that horrible Fox News source, Standford Enc of Phil. As for Red Guards, I have the temerity to cite that Right Wing rag, Wikipedia [duly noted as admitting against interest].

    As for decision theory, why, I studied it and have used it professionally for decades.

    Geostrategy? Oh, I have the gall to refer to Mackinder and Spykman et al on Heartland and Rimlands, with a Dash of Mahan et al on sea power, extending to C21 by dint of comparing Russia c 1904 and Africa today, with a dash of the Spanish C16 grab of C and S America. Oh yes, Jackie Fisher used to speak of having the keys to the five key gates for sea commerce in his back pocket too. I forgot, I read the early will of that rapist of a continent, Cecil Rhodes. Read it some time and compare the rise of certain international institutions including the scholarship named after him.

    As for the re-working of political spectra, I think Plato, Aristotle, Alcibiades, Cicero, Machiavelli, locke, world history sources and general background on the printing revolution [is that Gutenberg, Aldus et al?] as well as Web Archive with classic documents had some influence. Did I forget, histories on the French Revolution, Russia, rise of Nazism [Shirer influenced me going back to childhood, and there was always Mom, who lived through it . . . as a teen she used to read the sole paper’s war news for the district to the assembled people at Grandpa’s shop across from St Aidan’s], the Cuban Revolution, Jamaica’s civil war and more. Churchill, history of the English speaking peoples lurks.

    When did such last appear on Fox as guests?

    Does that station regularly discuss such? If so, then maybe it might be intellectually worthwhile to watch it!

    KF

  278. 278
    jerry says:

    Then maybe you should watch something other than Fox News, Sean Hannity, and Rush.

    I believe Kf lives on a small West Indies island. I doubt he is a listener to these.

    I often wonder when he sleeps since he posts at very early times for the US and is often posting in the evening.

    By the way, I personally do not have access to television so haven’t seen Fox News in a long while or Sean Hannity. Rarely listen to Rush so do not know what he is saying these days. When I am in the car, I usually listen to an audio book.

    But I have a face mask that has on it “Live Free or Die” which is the state motto for New Hampshire where I live. I believe it also is the name of Sean Hannity’s new book which I have not ordered or have access to.

    You should tell us what these sources are saying that is wrong so we can evaluate them. Otherwise it is just a meaningless irrelevant talking point.

  279. 279
    ET says:

    In ten USA it is the STATE governments that bear responsibility for their people. Only losers try to blame the federal government. The President wanted to take control. The States wouldn’t have any part of that. Democratic Governors killed tens of thousands of their elderly. That is not on the President.

    The USA is loaded with unhealthy people. Again, that is not on the President.

  280. 280
    kairosfocus says:

    Jerry, indeed I live on a small Caribbean island, though were I interested, I could get US Cable TV with I think up to hundreds of channels. That I don’t even know that much should tell on my utter lack of interest; I have seen more than enough on YouTube to tell me there is a vast wasteland there. I can find utterly no good reason to waste money on such trash. MMT seems unaware of what actually influences my thought, what is original to me or the like and simply projects strawman caricatures. He is likely unaware of how much the projection reveals, by the mirror principle . . . especially, as I have the academic habit of giving sources. KF

  281. 281
    jerry says:

    MMT seems unaware of what actually influences my thought,

    My assessment is truth in the form of evidence and logic. That is sadly missing in too many as it is emotions that rule. Emotions are often wrong.

    Off to Walmart where I have to wear a mask. Today it will be the “Live Free or Die” one.

  282. 282
    rhampton7 says:

    The truth about hydroxychloroquine’s (HCQ’s) efficacy as a prophylactic/administered-in-response drug against Covid-19 has become a casualty of conflicting reports. A recent observational study led by a hospital in Italy claims that the anti-malarial drug reduced the risk of death amongst hospitalised Covid-19 patients by 30%.

    ICMR and other government-affiliated researchers had published the findings of an observational study in the Indian Journal of Medical Research (IJMR) to claim that HCQ was effective, in combination with wearing of PPE, in staving off SARS-CoV-2 infection in health workers. The study couldn’t clearly state whether PPEs and other external factors had a greater role to play in protecting against Covid-19 than HCQ. But, it reported a much lower proportion of Covid-19 cases among those who received HCQ for the longest duration (six weeks) than among those who received it for 4-5 weeks and three weeks. It is important to consider the questions raised by some researchers—including some doctors at AIIMS Delhi and AIIMS Raipur—over the methodology of the study.

    It is equally important to consider the claims, as reported by The Print, that HCQ trials have come under much greater scrutiny while risks associated with remdesivir, manufactured by the US pharma major Gilead, seem to be getting played down. Given India is a major HCQ producer, it would be tempting to probe for a possible agenda.

    But the more effective, and scientifically convincing, way to settle questions over HCQ’s efficacy, and in the process tackle any agenda, would be for ICMR to conduct thorough RCTs and make the findings public. One way or the other, the truth about HCQ could finally be agreed upon then.

    https://www.financialexpress.com/opinion/hcq-debate-icmr-must-conduct-thorough-randomised-control-trial-make-findings-public/2068536/lite/

  283. 283
    rhampton7 says:

    HCQ reincarnated:

    Does convalescent plasma help COVID-19 patients? Studies will answer

    Efficacy has been challenging to prove. A study in the Netherlands was stopped after investigators saw no difference from placebo in mortality, length of hospital stay or disease severity.

    Recent results from the largest study to date, run by the Mayo Clinic, showed a lower mortality rate if convalescent plasma was administered early, within three days of diagnosis, compared to later but the study has no control group so the treatment effect cannot be definitively confirmed.

    At least 10 randomized trials in the U.S. are struggling to recruit participants since severe infections are waning.

    Per ClinicalTrials.gov, there are 96 registered studies that are recruiting, enrolling by invitation or active not recruiting, including 19 Phase 3s.

    Seven of the late-stage studies should wind up this year, followed by 10 next year and two in 2022. Only five are based in the U.S. All are still recruiting patients, only one (Stanford University) by invitation.

    The largest is a 15,000-subject trial led by the University of Oxford that also includes lopinavir/ritonavir, azithromycin, tocilizumab and hydroxychloroquine. Its primary completion date is December of next year.

    https://seekingalpha.com/news/3609798-convalescent-plasma-help-covidminus-19-patients-studies-will-answer

  284. 284
    rhampton7 says:

    Three U.S. senators are demanding answers from federal agencies about how they’re tracking and regulating the use of hydroxychloroquine, a drug once touted as an effective treatment for COVID-19, in nursing homes.

    The Resort at Texas City in April was one of the first Texas nursing homes to report an outbreak of COVID-19 among its residents and staff.

    In the days after the outbreak, Dr. Robin Armstrong, the medical director at the nursing home, announced he was treating some of the residents with hydroxychloroquine. The nursing home was able acquire the drug with the help of Texas Lt. Gov. Dan Patrick, according to news reports.

    In addition to being a doctor, Armstrong also is a Republican activist and one of two Texas delegates on the Republican National Committee.

    The Resort at Texas City was cited in May for violating regulations requiring it to “ensure that residents are fully informed and understand their health status, care and treatments” and to “develop and implement a complete care plan that meets all the residents’ needs,” according to the inspection survey.

    In interviews with The Daily News and others earlier this year, however, Armstrong said he gave some of his patients hydroxychloroquine without discussing it with patients or their families.

    Armstrong in May said he treated 38 people at the facility with hydroxychloroquine after those patients had tested positive for COVID-19. Three of those people later died, and the other 35 recovered, Armstrong said.

    https://www.galvnews.com/news/free/article_790a2d17-6c31-5190-92ce-b4335a2a03d7.html

  285. 285
    rhampton7 says:

    But does hydroxychloroquine, combined or not with an antibiotic, azithromycin, allow, as its defenders claim, to save lives in the face of the coronavirus when it is prescribed as a treatment? A new study (article in English), published Wednesday August 26 in the review Clinical Microbiology and Infection, official journal of the European Society for Clinical Microbiology and Infectious Diseases, intends to provide a definitive answer.

    This is a meta-analysis: a large-scale study that examines the findings of other scientific studies. Researchers from Inserm, the University of Lausanne and that of Neuchâtel began their investigations in mid-April, explains to franceinfo one of the authors, Thibault Fiolet, doctoral student in public health at the University of Paris-Saclay and member of Inserm. “We searched the databases of scientific publications. We entered the keywords: hydroxychloroquine, Covid-19, mortality … We obtained 839 results”, exposes the scientist.

    The authors then eliminated the 254 duplicates (the same article can be published on several platforms) and operated a drastic sorting. “We read the titles and excerpts of all these articles, and we came up with 29 articles that met our inclusion criteria, namely that they dealt with mortality in hospitalized patients on hydroxychloroquine., whether or not in combination with azithromycin, compared to control groups “, details Thibault Fiolet.

    Among these 29 studies, 25, known as “observational”, retrospectively observe the effects of a treatment on a sample of patients. Three relate to randomized controlled clinical trials (including Recovery, in the United Kingdom) which test a drug on a group of patients composed for the occasion. Finally, another focuses on a non-randomized trial. The analysis covers a total of 11,932 patients on hydroxychloroquine only, 8,081 on hydroxychloroquine and azithromycin, and 12,930 in the control group.

    Analysis of all the studies shows that mortality in patients hospitalized on hydroxychloroquine is lower (-17%) than in the control groups. But if we focus on randomized studies, the mortality of patients on hydroxychloroquine is slightly higher (+ 9%) than that of people in the control group.

    https://pledgetimes.com/what-is-the-new-meta-analysis-worth-on-the-ineffectiveness-of-hydroxychloroquine-against-the-coronavirus/

  286. 286
    rhampton7 says:

    Problems with meta-analysis and studies that are not RCTs – specifically Dr Raoult’s studies

    A meta-analysis provides a precise idea of ??the state of scientific knowledge produced by researchers on a subject. “One of the interests is to take into account all the studies produced on a subject. Those for, like those against”, points out Thibault Fiolet. But a meta-analysis also consists in evaluating the quality of the studies carried out, using statistical tools. This gives the opportunity “to rank them against each other, and see which ones are the most solid”, comments the researcher.

    To this end, researchers scrutinize the “biases” of the studies. “One of the most common occurs when the treatment group and the control group are not comparable. For example, when patients in the control group are older than those on treatment.”, and therefore more likely to develop a severe or even fatal form of the disease. “Or when they receive treatments other than that studied. In this case, this imbalance is a factor of confusion: we do not really know if the result is due to the imbalance between the two groups or not”, highlighted Thibault Fiolet.

    “We note that the observational studies are of lower quality [que les essais randomisés], and with different groups regarding risk and severity factors, therefore with bias “, summarizes Nathan Peiffer-Smadja, doctoral student in public health at Imperial College London, affiliated with Inserm, and co-author of the study. “We observe a strong tendency to have control groups in which the state of health of the patients is more severe than the treated group, as is the case in the studies of the IHU of Marseille. There are more men. , more elderly patients, more comorbidities, etc. “

    “The second bias encountered is the ‘positive’ observational studies (those which show an effect), which have a favorable publication bias”, continues Nathan Peiffer-Smadja, commenting: “It is easier to post something that suggests an effect of the treatment than something that shows no effect. “ The studies presenting too important biases, called “critical”, were excluded. The work of Didier Raoult’s team at the IHU in Marseille has thus been put aside. “If we combine studies with many biases, we inevitably have a biased result”, notes Thibault Fiolet.

    https://pledgetimes.com/what-is-the-new-meta-analysis-worth-on-the-ineffectiveness-of-hydroxychloroquine-against-the-coronavirus/

  287. 287
    rhampton7 says:

    continued…

    Dominique Costagliola, research director at Inserm and member of the Academy of Sciences, salutes the seriousness of the work carried out. “They clearly explain their search strategy and the grids they use to assess the risk of bias in studies. This is the Cochrane methodology, recognized for doing this type of study. They filed their protocol as it should be. They do not include studies at risk of critical bias, which is recommended. But in the appendix, we still have the results that are obtained if we include these studies. We really have everything we need to be able to judge the relevance of what is done and the results. “

    “You can definitely see that well-done observational studies don’t find things very different from clinical trials.”, she notes. Conversely, notes the epidemiologist, “when we have studies with critical biases, we find more favorable things, and that’s the problem.”

    https://pledgetimes.com/what-is-the-new-meta-analysis-worth-on-the-ineffectiveness-of-hydroxychloroquine-against-the-coronavirus/

  288. 288
    rhampton7 says:

    This latest study, published in the journal Nature Communications, highlights the result of testing the protease inhibitors used in cats in SARS-CoV-2 cell culture.

    The researchers noted that Vederas synthesized the compounds, and Tyrrel tested them against the SARS-CoV-2 virus in test tubes and human cell lines.

    The team has found that GC373 and GC376 are potent inhibitors of SARS-CoV-2 replication in cell culture, making them strong candidates in treating human coronavirus infections because they have been successful in animals.

    The crystal structure of the drug has been identified and described as it binds with the protein. The team also revealed the three-dimensional shape of the protease with the drug in the active site pocket, showing how it inhibits virus replication. With the new information and data, the team believes that the study will allow for the development of more effective drugs.

    The researchers plan to test modifications of the inhibitor to develop it further so it can fit inside the virus. However, they emphasized that with the results of the study, showing that the drug is effective against SARS-CoV-2, it can already be used in human trials.

    https://www.news-medical.net/news/20200831/Cat-drug-that-inhibits-SARS-CoV-2-fast-tracked-for-human-clinical-trials.aspx

  289. 289
    rhampton7 says:

    In a recent meeting of the Southwest District Health board in Caldwell, board members briefly pondered the high coronavirus rate among Latino residents of the health district, who continue to be disproportionately sickened by COVID-19 in Idaho and across the country.

    Southwest District Health Director Nikki Zogg explained to board members she believed so many Latinos in the district were testing positive because of jobs in the agricultural and food processing industry, where social distancing can be almost impossible. They are more likely to live in multi-generational, larger households, Zogg said.

    “There’s something else that you’re missing when it comes to the Hispanic, Black and Asian population,” said Adams County Commissioner Vicki Purdy. “They are all very low in Vitamin D … why aren’t we telling people to check their Vitamin D levels?”

    Purdy, who has shared COVID-19 misinformation on her personal social media in past months, then went on to discuss the contested benefits of hydroxychloroquine and claimed it was impossible for children to pass coronavirus to adults, which is false, according to the CDC. The district’s medical staff immediately refuted these assertions, and the district issued a press release shortly after clarifying there was scant evidence hydroxychloroquine could successfully treat coronavirus.

    https://magicvalley.com/news/local/why-are-more-latinos-in-idaho-contracting-covid-it-s-probably-not-vitamin-d-deficiency/article_fa80e15c-9fde-5a1d-92ef-e95ed575bf19.html

  290. 290
    rhampton7 says:

    The president of the United States retweeted a link to a post on Gateway Pundit, asserting that the real death toll from COVID-19 is merely 9,000, and that the other roughly 178,000 deaths were because of other factors. That was a pretty egregious misinterpretation of the CDC’s data; the CDC stated, “For 6 percent of the deaths, COVID-19 was the only cause mentioned [on the death certificate]. For deaths with conditions or causes in addition to COVID-19, on average, there were 2.6 additional conditions or causes per death.”

    The list of conditions is long and varied: diabetes, various heart-related conditions including hypertension, cardiac arrest, ischemic heart disease (hardening of the arteries), cardiac arrhythmia and heart disease, chronic kidney disease, chronic obstructive pulmonary disease, chronic lower respiratory diseases, obesity, an immunocompromised state from an organ transplant, coronary art disease, or sickle cell disease.

    None of the conditions listed above are death sentences by themselves. With treatment and medication, most people diagnosed with those conditions can live long and happy lives. No one with the slightest understanding of human health can look at someone with one of those conditions listed above dying from COVID-19 and conclude, “that person was going to die soon anyway.”

    And if your takeaway from this data is that SARS-CoV-2 is only a risk to those with one of those conditions . . . great, now we just have to worry about the 100 million or so Americans with diabetes or prediabetes, the roughly 100 million Americans with high blood pressure, the one in three American adults at risk for chronic kidney disease, the 16 million to 24 million Americans believed to be at risk for chronic obstructive pulmonary disease, the 1 in 500 adults who have cardiomyopathy, the millions of Americans either being treated for cancer or who have recovered from cancer . . .

    https://www.nationalreview.com/the-morning-jolt/no-one-wants-to-solve-real-problems/

  291. 291
    jerry says:

    Why the opposition to HCQ? I am reluctant to post this because it will also just point to the nonsense of RHampton. But I have seen this in a few places in the last couple days.

    Aha. Now I understand why they’re fighting HCQ so fiercely… if there’s an approved treatment, they can’t issue an Emergency Use Authorization for a rushed vaccine

    One of the stipulations to getting emergency approval for a vaccine is there must be no adequate, approved, and available alternative.

    https://bit.ly/31O5W6h

    From FDA website

    d. No Alternatives

    For FDA to issue an EUA, there must be no adequate, approved, and available alternative to the candidate product for diagnosing, preventing, or treating the disease or condition. A potential alternative product may be considered “unavailable” if there are insufficient supplies of the approved alternative to fully meet the emergency need. A potential alternative product may be considered “inadequate” if, for example, there are contraindicating data for special circumstances or populations (e.g., children, immunocompromised individuals, or individuals with a drug allergy), if a dosage form of an approved product is inappropriate for use in a special population (e.g., a tablet for individuals who cannot swallow pills), or if the agent is or may be resistant to approved and available alternative products.

    https://bit.ly/2EFa3ZU

  292. 292
    rhampton7 says:

    The Centers for Disease Control and Prevention has been confusing Americans for months about what to do to stay safe and disease-free during the coronavirus pandemic.

    Earlier this week, the agency again confused public health experts and lay-people alike when it changed course on testing recommendations for the coronavirus.

    Former CDC Director Tom Frieden, who directed the agency from 2009 to 2017, says this is not how the CDC usually operates, and it’s “a big problem.”

    “I don’t think there has ever been a time before when people from the White House or HHS are dictating what goes on technical documents on the CDC website,” Frieden told Insider during a question-and-answer session on Thursday. “This is dangerous.”

    These mandates from above “are frankly not scientifically supportable,” Frieden said.

    “That’s problematic because it undermines our trust in government,” he said, calling the move one that’s ultimately “self-defeating.”

    https://www.businessinsider.com/former-cdc-director-move-to-end-asymptomatic-testing-unscientific-2020-8

  293. 293
    JVL says:

    What the . . . .

    The Trump administration will not take part in a global effort to help develop and equitably distribute a COVID-19 vaccine—a decision experts called “shortsighted” and “self-defeating”—according to a report by The Washington Post.

    The White House cited the involvement of the World Health Organization in its decision to shun the effort. President Donald Trump has repeatedly criticized the WHO for being soft on China during the global health crisis, despite the fact that Trump himself repeatedly praised China for its “transparency” and response to the pandemic in January and February. At the end of May, Trump abruptly announced that he was “terminating our relationship” with the WHO, a move that alarmed public health experts.

    https://arstechnica.com/science/2020/09/trump-admin-shuns-global-covid-19-vaccine-program-citing-beef-with-who/

  294. 294
    rhampton7 says:

    In the last few weeks, COVID-19 infection rates have been on the decline in Nigeria and many Nigerians are wondering if the country has reached the peak of the outbreak.

    The Director-General of the Nigeria Centre for Disease Control, NCDC, Dr Chikwe Ihekweazu speaks to Chioma Obinna on this development and challenges in the response.

    We are very grateful for the leadership of our sister-agency, NAFDAC in the conduct of clinical trials for COVID-19.

    Currently, our case management guidelines advise that chloroquine and hydroxychloroquine are only used in the context of clinical trials. The results from these clinical trials and other scientific processes will determine if these will be used as part of treatment modalities for COVID-19 in Nigeria.

    https://www.vanguardngr.com/2020/09/covid-19-chloroquine-used-only-in-clinical-trials-in-nigeria-says-ncdc-boss-2/

  295. 295
    rhampton7 says:

    A deadly pandemic isn’t the time for leading U.S. health agencies to disagree on data and treatment benefits, but that’s the situation playing out as new COVID-19 treatment guidelines from the National Institutes of Health (NIH) rejected the FDA’s word on convalescent plasma.

    Days after the FDA granted plasma a controversial emergency authorization, NIH experts concluded there are “currently no data from well-controlled, adequately powered randomized clinical trials that demonstrate the efficacy and safety” of the treatment in COVID-19. Plasma “should not be considered” standard of care for treating COVID-19 patients, the agency said.

    In response to the debacle, Medscape editor-in-chief and prominent physician Eric Topol called on Hahn to “tell the truth or resign.” In an open letter, Topol said the agency’s handling of the hydroxychloroquine saga—plus convalescent plasma and the latest remdesivir emergency use authorization—show Hahn’s “willingness to deviate” from the FDA’s “bedrock premise” of relying on “accurate, science-based information.” He called on the commissioner to hold a press conference and explain the plasma announcement and any pressure that went into it. Otherwise, he said, Hahn should resign.

    https://www.fiercepharma.com/pharma/rebuking-fda-nih-experts-say-no-data-support-plasma-as-a-covid-19-treatment

  296. 296
    rhampton7 says:

    Why is the COVID-19 virus more dangerous in people with comorbidities?

    In the Physiological Reviews paper, the researchers noted that all those comorbidities feature elevated levels of the extracellular protease plasmin. Plasmin is able to nick proteins at amino acid sequences called furin sites. For many viruses, this nicking at furin sites increases their infectivity. Both SARS and MERS — the two virulent coronaviruses that are related to the COVID-19 virus — “have evolved an unusual two-step furin activation for fusion, suggestive of a role during the process of emergence into the human population,” the researchers wrote.

    They noted that the COVID-19 virus, SARS-CoV-2, also has a furin site on its spike protein, the vital, viral protein for viral attachment to a lung cell. The researchers proposed that plasmin may cleave that furin site in the spike protein to increase its infectivity and virulence, and they hypothesized that, “the plasmin system may prove a promising therapeutic target for combating COVID-19.”

    Ness already knew there is an inexpensive, commonly used drug — tranexamic acid, or TXA — that targets plasmin by inhibiting its conversion from the inactive precursor, plasminogen, to the active protease, plasmin.

    TXA is approved by the U.S. Food and Drug Administration for treatment of heavy menstrual bleeding because having lower plasmin levels allows better clotting. TXA has a long track record of safety and is commonly given off-label.

    For the clinical trial, Ness and colleagues have started a double-blind study, giving either TXA or a placebo pill to COVID-19 outpatients who were recently diagnosed with COVID-19. Patients also receive an anticoagulant. The overall goal of the exploratory study is to assess both safety and efficacy of five days of TXA versus placebo in the COVID-19 population. Enrollment is ongoing.

    https://www.uab.edu/news/research/item/11529-clinical-trial-will-test-possible-covid-19-treatment-for-outpatients

  297. 297
    rhampton7 says:

    Dozens of major hospitals across the U.S. are grappling with whether to ignore a federal decision allowing broader emergency use of blood plasma from recovered COVID patients to treat the disease in favor of dedicating their resources to a gold-standard clinical trial that could help settle the science for good.

    As many as 45 hospitals from coast to coast have expressed interest in collaborating on a randomized, controlled clinical trial sponsored by Vanderbilt University Medical Center, said principal investigator Dr. Todd Rice.

    Officials at some hospitals said they are considering committing only to the clinical trial — and either avoiding or minimizing use of convalescent plasma through an emergency use authorization issued Aug. 23 by the federal Food and Drug Administration.

    A National Institutes of Health panel this week countered the FDA’s decision, saying that the therapy “should not be considered the standard of care for the treatment of patients with COVID-19” and that well-designed trials are needed to determine whether the therapy is helpful. Data so far suggests the treatment could be beneficial, but it’s not definitive.

    https://www.webmd.com/lung/news/20200903/dozens-of-us-hospitals-poised-to-defy-fdas-directive-on-covid-plasma

  298. 298
    rhampton7 says:

    French health authorities reported 7,017 new confirmed coronavirus cases on Wednesday, marking a big jump up from Tuesday’s 4,982 figure.

    Marseille, in the Bouches-du-Rhône department, is currently the worst affected by the epidemic. The infection rate there has risen from 131.4 cases per 100,000 inhabitants to 168.8 over the last week.

    The majority of Covid patients are at Marseille city hospital, in the service headed up by Professor Didier Raoult, known for his controversial advocacy of using hydroxychloroquine to treat Covid-19.

    The hospital, which registered 350 cases per day at the height of the epidemic in April, is now registering around 150 cases, Professor Philippe Brouqui told La Provence daily.

    “Since June, we have had 2,000 cases,” he said. “In the beginning it was young people and up until a fortnight ago there were very few hospitalisations.

    “With the admissions, which are the heavier cases, there is a risk of an increase in mortality.”

    He insisted however, that “in Marseille, as elsewhere in France, we are ready”.

    https://www.rfi.fr/en/france/20200903-fresh-spike-in-french-covid-19-cases-as-hospital-admissions-rise-marseille-paris-neymar-psg

  299. 299
    Mac McTavish says:

    “ A new study suggests a correlation between vitamin D deficiency and the risk of contracting COVID-19, though the authors believe further research is needed.
    The study, published Thursday in the Journal of the American Medical Association, examined 489 people who had been tested for COVID-19 between March 3 and April 10 and had been tested for vitamin D deficiency in the year prior.
    The results showed that 19 per cent of the vitamin D deficient people tested positive for COVID-19, compared to 12 per cent of the vitamin D sufficient people.”

    https://apple.news/A_4pe9ftiRxmchFxbbQSVLw

  300. 300
    ET says:

    But we wantz moar than sufficient. We wantz a blood concentration of 40nG/ mL.

    That is what ten previous studies were recommending, anyway.

  301. 301
    jerry says:

    Hope. Vitamin D.

    “Effect of Calcifediol Treatment and best Available Therapy versus best Available Therapy on Intensive Care Unit Admission and Mortality Among Patients Hospitalized for COVID-19: A Pilot Randomized Clinical study”

    The vitamin D endocrine system may have a variety of actions on cells and tissues involved in COVID-19 progression.

    Administration of calcifediol or 25-hydroxyvitamin D to hospitalized COVID-19 patients significantly reduced their need for Intensive Care United admission.

    Calcifediol seems to be able to reduce severity of the disease.

    Results
    Of 50 patients treated with calcifediol, one required admission to the ICU (2%), while of 26 untreated patients, 13 required admission (50%) p value X2 Fischer test p?<?0.001.

    Calcifediol is essentially Vitamin D https://bit.ly/355b5cs

    Calcifediol, also known as calcidiol, 25-hydroxycholecalciferol, or 25-hydroxyvitamin D, is a prehormone that is produced in the liver by hydroxylation of vitamin D3 by the enzyme cholecalciferol 25-hydroxylase. Physicians worldwide measure this metabolite to determine a patient’s vitamin D status. At a typical daily intake of vitamin D3, its full conversion to calcifediol takes approximately 7 days.

  302. 302
    jerry says:

    Hope. Sweden.

    Comment by author. Other countries have lost their f_____ mind.

    https://bit.ly/32STgug

    Compare this to Australia where they throw a pregnant woman in jail for suggesting a protest of the lockdown. The new Gestapo takes her away in front of her two children. https://bit.ly/3jKNkKJ

    Photo of arrest. https://bit.ly/3jKZLWK

    Could it happen here?

  303. 303
    bill cole says:

    Mac @ 299
    I have done significant research on the effect of low vitamin d levels in cancer risk. I have briefly looked at how low blood levels could increase covid risk. Vitamin D down regulates the NFkB pathway that transcribes cytosine’s like IL6. This mechanism would indicate it could potentially reduce morbidity risk given adequate blood levels of 40ng/ml or more.

  304. 304
    Mac McTavish says:

    Bill

    I have done significant research on the effect of low vitamin d levels in cancer risk.

    My doctor recommends it for all her adult patients for that very reason. I take it every day but I have no idea what my blood levels are.

  305. 305
    Mac McTavish says:

    Another sad milestone was reached today. Deaths due to COVID have now surpassed 190,000.

  306. 306
    jerry says:

    How many have to die while Fauci lies.

    Another sad milestone was reached today. Deaths due to COVID have now surpassed 190,000.

    He did the same thing with HIV. But to many he is a hero.

  307. 307
    ET says:

    What were Fauci’s lies?

  308. 308
    jerry says:

    What were Fauci’s lies?

    I am using the word “lie” while in reality he is grossly misrepresenting something. When a supposedly competent person misrepresents something, then this misrepresentation is tantamount to lying.

    In front of congress Fauci lies about the effect of HCQ in Henry Ford study by using weasel words to say it was not a RCT and had confounding variables.

    The problem with the former is that RCTs are almost impossible to conduct properly in a short time and unethical because a certain percentage will die. He never even considers this and the subsequent need to get information other ways. Some people have to agree to possibly die and others have to agree to take a drug that has been openly maligned in the media. Given that, how do you recruit people?

    The problem with the latter is that it showed a treatment to have a 50% reduction in death and he dismisses it. If anything he should have been all over the combination of HCQ and the steroids. I believe Henry Ford did a reanalysis and showed it was just HCQ to have an effect. Someone who was interested in saving lives would be pushing for any combination that worked. But no, he dismissed it. It reveals who he is as a person.

    In the same interview he said none of the RCTs have shown any efficacy of HCQ. This is a blatant lie. While the studies were crap because they were survey studies the studies conducted in Minnesota each showed HCQ to have a positive effect. They argued because their study was too small that the effect was not statistically significant. He should have been all over getting a more powerful study.

    https://bit.ly/2EY4Hcd

    Here he is on MSNBC repeating the same lies. https://bit.ly/31Z8wGU

    There is an article in Huffington Post from 6 years ago where he made the same bogus claims about research design to suppress what became an effective drug for HIV.

    https://bit.ly/2QAUl4e

    If he is smart as people say he is, then why the lies? One has to use their insight of human nature to conjecture motives.

  309. 309
    bill cole says:

    My doctor recommends it for all her adult patients for that very reason. I take it every day but I have no idea what my blood levels are.

    How many IU’s are you taking? I take 5000IU per day and my current blood level is 63 NG per ML. It was 33 NG per ML before taking supplements. When you get a blood test ask that your levels are checked. This is the cheapest way I know to avoid major health problems.

  310. 310
    bill cole says:

    Jerry 308

    If he is smart as people say he is, then why the lies? One has to use their insight of human nature to conjecture motives.

    I agree with you. The government agency’s are about raising money. I have seen similar misinformation regarding vitamin d. The problem with HCQ is it is cheap. The proper cocktail appears to be HCQ + z pac antibiotic + zinc. This was never tested by the NIH to the best of my knowledge.

  311. 311
    rhampton7 says:

    If you believe the observational data presented by miracle worker Dr Raoult, then all you need is HCQ and azithromycin. That’s it.

  312. 312
    rhampton7 says:

    Although the preponderance of evidence indicates that there is no benefit of hydroxychloroquine in the treatment of COVID-19, fewer studies have evaluated azithromycin, a broad-spectrum antibiotic that has anti-inflammatory properties.

    Azithromycin is commonly used for bacterial respiratory infections, and could potentially treat or prevent co-infection with SARS-CoV-2. Azithromycin might also have antiviral activity against some RNA viruses.4, 5 Azithromycin has been shown to be effective in vitro against viruses such as Zika and rhinovirus, in addition to SARS-CoV-2,4, 5 and to have antiviral effects in bronchial epithelial cells.6 Azithromycin has also been shown to be immunomodulatory,7 and can reduce exacerbations in chronic airway diseases.8 Azithromycin is widely available and has an excellent safety profile; thus, if shown to be effective, could be easily scaled up as a first-line treatment for patients with COVID-19.

    In The Lancet, Remo Furtado and colleagues9 report the primary results of COALITION II, an open-label randomised trial evaluating azithromycin in addition to standard of care, which included hydroxychloroquine, compared with standard of care alone in patients admitted to hospital with severe COVID-19, including patients receiving oxygen supplementation at more than 4 L/min, or use of high-flow nasal cannula or non-invasive or invasive mechanical ventilation.

    The trial enrolled 447 adult participants (aged >18 years) at multiple hospitals in Brazil, approximately a third of whom were women. The primary outcome was clinical status at 15 days, assessed using a six-level ordinal scale ranging from not hospitalised to death. Participants were followed up for 29 days in total to assess 29-day mortality.

    Furtado and colleagues found no benefit of azithromycin on clinical outcomes, including clinical status or mortality, when added to the standard of care regimen (odds ratio 1·36 [95% CI 0·94–1·97]; p=0·11), and no evidence of an increase in adverse events with the addition of azithromycin. There was no evidence of a difference in outcomes by sex, although a prespecified subgroup analysis suggested potentially worse clinical status at 15 days in younger patients receiving azithromycin.

    A major strength of COALITION II was that it was randomised, which eliminated the confounding by indication inherent in observational analyses. Despite the open-label design, the authors attempted to minimise bias in outcome ascertainment by using a masked outcome adjudicator.

    The results of COALITION II corroborate those of COALITION I,10 which was done by the same study group and evaluated hydroxychloroquine with or without azithromycin in patients admitted to hospital with mild or moderate COVID-19.

    In COALITION I, there was no significant difference in outcomes in patients receiving hydroxychloroquine with or without azithromycin, and no evidence of an increase in adverse events. The results of these trials suggest that azithromycin might not provide benefit to patients once the disease has progressed and patients require hospitalisation.

    Because azithromycin is currently the most commonly prescribed outpatient therapy for COVID-19, establishing whether azithromycin is helpful earlier in the disease course is an important research priority. If azithromycin does not have a role in the treatment of COVID-19, avoiding its use would reduce unnecessary antibiotic consumption.

    https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31863-8/fulltext

  313. 313
    ET says:

    Thanks Jerry. I haven’t been following Fauci that closely.

  314. 314
    jerry says:

    Does politics affect how many die from C19?

    Pandemic and social changes, political fate

    https://bit.ly/2QXnoPJ

  315. 315
    jerry says:

    I know this topic is dead here but a few may be interested in some recently published papers.

    The issue of terminology. Have we lockdowned for nothing?

    COVID – why terminology really, really matters

    https://bit.ly/2ZjR26i

    The new protocol from Raoult’s hospital now includes zinc and that low zinc levels are associated with severity. This is a very thorough review.

    Natural history and therapeutic options for COVID-19

    The authors review the literature and provide an overview of the current state of knowledge regarding the natural history of and therapeutic options for COVID-19.

    https://bit.ly/35iUwK2

    One of the commenters said that back in May, zinc was being prescribed by Raoult.

  316. 316
    rhampton7 says:

    Looks like Dr Raoult is in trouble. For some reason the hospital beds in his home region are almost 100% occupied. What happened to his great success rate? . . .

    (Translated from French by Google)
    Marseille, the question of the saturation of hospitals is starting to arise: there are only 3 places left in intensive care, out of the 70 beds reserved for the Covid case available throughout the Bouches-du-Rhône. A figure which fluctuates, but which worries. Health professionals now fear they will be saturated if the health situation worsens and if severe cases continue to increase. Professor Didier Raoult, a controversial infectious disease specialist usually more optimistic than his counterparts, himself warns of a worsening of the situation: “Undoubtedly there have been more deaths associated with Covid-19, for 10 days than there are had in the previous two months, that’s true, “he says.

    The difficulty of finding extra beds
    A real headache will then begin for the doctors, since they will be obliged to take resuscitation beds reserved for other emergencies: heart attacks, road accidents, serious illness. If this had been made possible during confinement since these beds were empty – people were at home, accidents fewer – it will be much more complicated today.

    We must now deal with 95% occupation of the intensive care unit in the town of Marseille. If there is no panic among the medical profession, Marseille caregivers are alarmed and ask the population to be more vigilant and to respect barrier gestures.

    https://www.lci.fr/sante/covid-19-a-marseille-le-pr-didier-raoult-reconnait-hausse-du-nombre-de-morts-depuis-10-jours-2163963.html

  317. 317
    rhampton7 says:

    The abundance of COVID-19 clinical trials taking place internationally is leading to complete chaos in the research world, according to a group of experts. The rush to find answers has lead to oversights in the distinct phases of the mysterious disease. The findings were outlined in a piece published online by the Lancet last month, and was authored by several Canadian researchers.

    The article states that “inadequate details on the trial and only superficial scrutiny by the public and scientific decision makers” have lead to “disastrous effects on clinical trial funding, permission, recruitment, and interpretation.”

    An example of this would be the media attention that surrounded the malaria drug hydroxychloroquine, which was being studied as a potential treatment for COVID-19. That was further politicized, after U.S. President Donald Trump and Brazilian President Jair Bolsonaro touted the drug. While there was compelling evidence for the drug, it was focused on the prevention stage or during the early onset of COVID-19. When studies looked at the drug’s effect on hospitalized patients, it didn’t prove successful. As a result, many trials got cancelled.

    “We still don’t know whether hydroxychloroquine works for the condition it was initially purported for, which was prevention or early treatment,” he says.

    Mills says because people are stuck at home, genuine scientific discussions and debates aren’t happening like they would at conferences or grand rounds, where findings could be debated.

    “Because we’re not having that at the moment, we’re having a preponderance of advice being handed out that is not based on good evidence at all,” says Mills.

    Of the 1,900 trials currently registered, Mills believes only about a dozen will provide reliable information. He adds that in Canada, there’s no leadership on clinical trials.

    https://sports.yahoo.com/covid-19-clinical-trials-leading-to-chaos-medical-article-211914592.html

  318. 318
    rhampton7 says:

    large, Phase 3 study testing a Covid-19 vaccine being developed by AstraZeneca and the University of Oxford at dozens of sites across the U.S. has been put on hold due to a suspected serious adverse reaction in a participant in the United Kingdom.

    A spokesperson for AstraZeneca, a frontrunner in the race for a Covid-19 vaccine, said in a statement that the company’s “standard review process triggered a pause to vaccination to allow review of safety data.”

    It was not immediately clear who placed the hold on the trial, though it is possible it was placed voluntarily by AstraZeneca and not ordered by any regulatory agency. The nature of the adverse reaction and when it happened were also not immediately known, though the participant is expected to recover, according to an individual familiar with the matter.

    https://www.statnews.com/2020/09/08/astrazeneca-covid-19-vaccine-study-put-on-hold-due-to-suspected-adverse-reaction-in-participant-in-the-u-k/

  319. 319
    Mac McTavish says:

    I had said earlier that if we didn’t do something we would have over 200,000 COVID deaths by the first day of fall. Sadly, I think we will see this by the end of the upcoming weekend.

  320. 320
    jerry says:

    J’accuse

    I had said earlier that if we didn’t do something we would have over 200,000 COVID deaths by the first day of fall. Sadly, I think we will see this by the end of the upcoming weekend.

    And there have been forces in the US and the world fighting against doing anything. There has been an effective treatment known for months. Anyone arguing against it is partly responsible for these deaths.

    The jury is in on Hydroxychloroquine – ‘it saves lives’: Rowan Dean

    https://www.youtube.com/watch?time_continue=197&v=1q5teMsw2h4&feature=emb_logo

  321. 321
    rhampton7 says:

    Earlier this year it seemed possible that one or two pharmaceutical firms might be able to obtain some sort of limited approval by the time Americans cast their ballots. That may still be possible. It is certainly desirable, given the pandemic’s toll on lives and livelihoods. But on September 8th, in an unprecedented move, nine global drugmakers, including AstraZeneca, gsk, Pfizer and Sanofi, announced a pledge to uphold scientific and ethical standards in the search for a coronavirus vaccine.

    The message is intended to reassure the public that the companies will not bow to mounting political pressure from the White House to rush through a vaccine without the proper safety and efficacy tests. But it is also a rebuke to the president, who has been politicising the drug-approval process—and eroding public confidence in the Food and Drug Administration (fda). This could undermine trust in any vaccine that arrives, as sooner or later one almost certainly will.

    https://www.economist.com/business/2020/09/12/why-drugmakers-are-telling-donald-trump-to-cool-his-heels

  322. 322
    rhampton7 says:

    Peruvian Health Minister Pilar Mazzetti informed Congress’ Special COVID-19 Commission that hydroxychloroquine will be removed from the treatment guide for novel coronavirus patients, but ivermectin will remain on the list.

    “The latest publications on hydroxychloroquine tell us that it does not seem to be useful. It will only be withdrawn from the guide for COVID-19 (treatment), it cannot be withdrawn from the request because hydroxychloroquine is a drug used in rheumatology,” she reported.

    Concerning ivermectin, the high-ranking official said that there is still a whole debate about this drug.

    “As long as there is nothing conclusive that tells us that it does not work, we will continue to use it as it is used in other countries,” she indicated.

    https://andina.pe/Ingles/noticia-perus-health-min-hydroxychloroquine-to-be-withdrawn-from-covid19-treatment-guide-813036.aspx

  323. 323
    rhampton7 says:

    How can Americans tell when the Food and Drug Administration has become so politically impaired that it cannot serve its mission to protect the public? One measure is when pharmaceutical manufacturers become the voice of caution and prudence about when new vaccines should be released to the public.

    Hell has frozen over. Nine leading pharmaceutical and biotechnology companies issued a joint statement this week to assure the public they will not distribute their vaccines for Covid-19 before their safety and effectiveness have been firmly established.

    There’s no question that the FDA is politically impaired. The Trump administration cowed it into announcing emergency use authorization for hydroxychloroquine and chloroquine for the prevention and treatment of coronavirus infection, only to revoke it later for lack of effectiveness and worries about adverse effects.

    as the pharmaceutical industry took shape and began sophisticated marketing operations, the FDA became an important counterforce to the commercial objective to sell as much product as possible. That industry relied on the FDA to stop commercial practices that could pose greater risks than benefits.

    Without a functioning FDA, pharmaceutical manufacturers can lose this important guardrail.

    Except, apparently, when the guardrail is damaged. Incredibly, it is the long-term reputational risks and business motives of the pharmaceutical industry that are left to prevent a collapse in public trust. Vaccine makers are sensing this could currently be the case, with huge numbers of Americans expressing hesitancy about the Covid-19 vaccines in development because of the warp speed at which they are to receive FDA approval. So the companies are pledging to withhold their vaccines from commercial distribution until they themselves are satisfied they can be used with the confidence the FDA is otherwise expected to generate.

    https://www.statnews.com/2020/09/10/hell-has-frozen-over-pharmaceutical-industry-stands-in-for-politically-impaired-fda/

  324. 324
    kairosfocus says:

    Tablet (HT News) begins to counterbalance the dominant narrative on HCQ and Dr Raoult:

    https://www.tabletmag.com/sections/science/articles/hydroxychloroquine-morality-tale

    Further to this, there is a rebalancing on placebo controlled studies in the face of pandemics:

    https://www.tabletmag.com/sections/science/articles/randomized-control-tests-doidge

    –> a rich motherlode to be mined.

    KF

  325. 325
    Truthfreedom says:

    Didier Raoult Trashing Darwin

    “Charles Darwin’s vision of the world deeply influenced biology in the twentieth century. Today, however, his theory of evolution is more a hindrance than a help, because it has become a quasi-theological creed that is preventing the benefits of improved research from being fully realized.” Didier Raoult, Life After Darwin

  326. 326
    rhampton7 says:

    The combination of hydroxychloroquine and azithromycin was associated with significant cardiovascular risks, including mortality, in the largest ever safety study comparing hydroxychloroquine treatment with hydroxychloroquine and azithromycin treatment for rheumatoid arthritis (RA) patients.

    The study included 956,374 users of hydroxychloroquine, 310,350 users of sulfasalazine, 323,122 users of hydroxychloroquine plus azithromycin, and 351,956 users of hydroxychloroquine plus amoxicillin, over a 20-year period spanning six nations (Germany, Japan, Netherlands, Spain, United Kingdom, United States).
    No excess risk of severe adverse events was identified when 30-day hydroxychloroquine and sulfasalazine use were compared. Self-controlled case series confirmed these findings.
    However, long-term use of hydroxychloroquine appeared to be associated with increased cardiovascular mortality (calibrated HR 1.65 [95% CI 1.12–2.44]).
    The addition of azithromycin appeared to be associated with increased 30-day cardiovascular mortality risk (calibrated HR 2.19 [95% CI 1.22–3.95]), chest pain or angina (1.15 [1.05–1.26]), and heart failure (1.22 [1.02–1.45]), compared with hydroxychloroquine combined with amoxicillin.
    There was a higher prevalence of acute respiratory disease among azithromycin versus amoxicillin users (62.5% vs 50.7%).

    https://www.medscape.com/viewarticle/937231

  327. 327
    rhampton7 says:

    Where is Dr Raoult’s miracle? How are patients ending up in the hospital?

    Doctors in Marseille — the country’s latest virus hotspot — started sounding the alarm this week. The 70 ICU beds dedicated to virus patients in France’s second-biggest city and the surrounding Bouches-du-Rhone region were all occupied by Tuesday. The number of ICU virus patients in the region has doubled in the past 10 days and now surpasses 100.

    “The beginning of summer was relatively calm but in the past few weeks there is a new rise,” said Laveran’s chief doctor, Pierre-Yves. He can only be identified by his first name according to military policy. “What is going on here is just like what is going on in other hospitals of the region.”

    The region’s hospitals are re-activating emergency measures put in place when the pandemic first hit, to ensure they’re able to handle growing new cases. Since they’ve outgrown COVID-specific ICU wards, they’re putting people in units meant for non-virus patients instead.

    While the central government tries to avoid a new nationwide lockdown, officials are focusing on local action instead. Marseille regional authorities on Wednesday ordered bars and restaurants to close early, and banned any unauthorized gatherings of more than 10 people.

    Other regions are watching Marseille closely, wary that they too could see a similar situation in the coming weeks.

    Laveran’s chief doctor says preparation and coordination is key: “We need to stay a step ahead.”

    https://www.stripes.com/news/middle-east/france-sees-covid-beds-fill-up-as-virus-pressure-builds-in-marseille-1.644765

  328. 328
    kairosfocus says:

    RH7, you need to take some time out and read the two linked articles at Tablet. KF

  329. 329
    rhampton7 says:

    COVID-19 has been a wake-up call for improving healthcare in India. Our investment in public healthcare facilities needs to at least double in the next two years, and quadruple in five years. Linking quality to government hospitals is key, making them the go-to for the common person.

    Treatment strategies – in spite of the thousands of trials – have been fairly disappointing for COVID-19. With the exception of steroids (to decrease mortality) and to a lesser extent remdesivir (to clear the virus from the body faster), there have been no dramatic proven therapies.

    The COVID-19 epidemic has also taught us not to jump the gun with ‘promising’ therapies. From hydroxychloroquine to convalescent plasma therapy to other drugs (including monoclonal antibodies and other antiviral substances) – all of these were touted as “proven” treatment options only to be debunked by randomised trials.

    When you look at the hundreds of thousands of patients treated by these drugs, I can’t help but think what a wasted opportunity it has been.

    What we need to do in India is to make sure we don’t get carried away with unproven claims and allow the desperation of the pandemic to “do something” and use ineffective drugs to treat. That is just a wasteful use of resources when we already have significant constraints.

    https://science.thewire.in/health/india-unlock-covid-19-epidemic-raging-remember-hygiene-distancing/

  330. 330
    Seversky says:

    Kairosfocus/324

    Tablet (HT News) begins to counterbalance the dominant narrative on HCQ and Dr Raoult:

    RH7

    And to counter this dangerous veneration of “mavericks”:

    Dr. Didier Raoult: Bad science on COVID-19 and bullying critics

    Didier Raoult in the NYT: The “brave maverick” narrative and bypassing science-based medicine

  331. 331
    ET says:

    COVID-19 should be a wake up call for improving nutritional standards.

  332. 332
    Mac McTavish says:

    198,000 and counting.

  333. 333
    kairosfocus says:

    ET, you are right, esp. given the evident significance of vitamin D deficiency. KF

  334. 334
    kairosfocus says:

    F/N: It is time to clip Dr Norman Doidge, a contributing writer for Tablet, who is a psychiatrist, psychoanalyst, and author of The Brain That Changes Itself and The Brain’s Way of Healing. Here, first, from Medicine’s Fundamentalists (language I don’t like as it itself reflects a successful smear job):

    The randomized control trial controversy: Why one size doesn’t fit all and why we need observational studies, case histories, and even anecdotes if we are to have personalized medicine

    August 14, 2020

    If the study was not randomized, we would suggest that you stop reading it and go on to the next article.
    —Quote from Evidence-Based Medicine: How to Practice and Teach EBM [–> notice the loaded language in the name of the movement, pivoting on an improper constriction on what counts as cogent empirical evidence for medical decision-making]

    Why is it we increasingly hear that we can only know that a new treatment is useful if we have a large randomized control trial, or “RCT,” that has positive results? Why is it so commonly said that individual case histories are “mere anecdotes” and count for nothing, even if a patient, who has had a chronic disease, suddenly gets better with a new treatment after all others failed for years—an assertion that seems, to many people, to run counter to common sense? [–> anecdotes is, of course, further loaded language. We are not talking about quaint humourous stories, nor are we just cherry picking coincidental cases, if there is a lawlike dynamic at work in a situation or there are strong odds at work, that can begin to appear from the very outset, within a few cases.]

    Indeed, some version of the statement, “only randomized control trials are useful” has become boilerplate during the COVID-19 crisis. It is uttered as though it is self-evidently the mainstream medical position. When other kinds of studies come out, we are told they are “flawed,” or “fatally flawed,” if not RCTs (especially if the commentator doesn’t like the result; if they like the result, not so often). The implication is that the RCT is the sole reliable methodological machine that can uncover truths in medicine, or expose untruths. But if this is so self-evident, why then, do major medical journals continue to publish other study designs, and often praise them as good studies, and why do medical schools teach other methods? [–> as in, we see here a fallacy being exposed]

    They do because, as extraordinary an invention as the RCT is, RCTs are not superior in all situations, and are inferior in many. The assertion that “only the RCTs matter” is not the mainstream position in practice, and if it ever was, it is fading fast, because, increasingly, the limits of RCTs are being more clearly understood. Here is Thomas R. Frieden, M.D., former head of the CDC, writing in the New England Journal of Medicine, in 2017, in an article [–> already cited and of course hyperskeptically dismissed] on the kind of thinking about evidence that normally goes into public health policy now:

    Although randomized, controlled trials (RCTs) have long been presumed to be the ideal source for data on the effects of treatment, other methods of obtaining evidence for decisive action are receiving increased interest, prompting new approaches to leverage the strengths and overcome the limitations of different data sources. In this article, I describe the use of RCTs and alternative (and sometimes superior) data sources from the vantage point of public health, illustrate key limitations of RCTs, and suggest ways to improve the use of multiple data sources for health decision making. … Despite their strengths, RCTs have substantial limitations.

    That, in fact, is the “mainstream” position now, and it is a case where the mainstream position makes very good sense. The head of the CDC is about as “mainstream” as it gets.

    The idea that “only RCTs can decide,” is still the defining attitude, though, of what I shall describe as the RCT fundamentalist. By fundamentalist I here mean someone evincing an unwavering attachment to a set of beliefs and a kind of literal mindedness that lacks nuance—and that, in this case, sees the RCT as the sole source of objective truth in medicine (as fundamentalists often see their own core belief). Like many a fundamentalist, this often involves posing as a purveyor of the authoritative position, but in fact their position may not be. As well, the core belief is repeated, like a catechism, at times ad nauseum, and contrasting beliefs are treated like heresies. What the RCT fundamentalist is peddling is not a scientific attitude, but rather forcing a tool, the RCT, which was designed for a particular kind of problem to become the only tool we use. In this case, RCT is best understood as standing not for Randomized Control Trials, but rather “Rigidly Constrained Thinking” (a phrase coined by the statistician David Streiner in the 1990s).

    Continuing:

    . . . In a randomized control trial, one takes a sufficiently large group of patients and randomly assigns them to either the treatment group, or the nontreatment (“placebo” or sugar pill) control group, for instance. Efforts are made to make sure that apart from the treatment, everything else remains the same in the lives of the two groups. It is hoped that by randomly assigning this large number of patients to either the treatment or nontreatment condition, that each of the confounding factors will have an equal chance of appearing in both groups—the factors we know, such as age, but also mysterious ones we don’t yet understand. While observational studies can, with some effort, match at least some confounding factors we do understand in a “group matched design” (and, for instance, make sure both groups are the same age, or disease severity), what they can’t do is match confounding factors we don’t understand. It is here, that RCTs are generally thought to have an advantage.

    With such a good technique as RCTs, one might wonder, why do we ever bother with observational studies?

    There are a number of situations in medicine in which observational studies are obviously superior to randomized control trials (RCTs), such as when we want to identify the risk factors for an illness. If we suspected that using crack cocaine was bad for the developing brains of children, it would not be acceptable to do an RCT (which would take a large group of kids, and randomly prescribe half of them crack cocaine and the other half a placebo and then see which group did better on tests of brain function). We would instead follow kids who had previously taken crack, and those who never had, in an observational study, and see which group did better. All studies ask questions, and exist in a context, and the moral context is relevant to the choice of the tool you use to answer the question. That is Hippocrates 101: Do no harm.

    Now, you might say that a study of risk factors is very different from the study of a treatment. But it is not that different. There can be very similar moral and even methodological issues.

    For instance:

    In the 1980s, quite suddenly, clinicians became aware that infants were dying, in large numbers, in their cribs, for reasons that couldn’t be explained, and a new disorder was discovered, sudden infant death syndrome, or SIDS, or “crib death.” Some people wondered if parents were murdering their children, or if it was infectious, and many theories abounded. A large observational study was done in New Zealand that observed and compared factors in the lives of the infants who died and those who didn’t. The study showed that the infants who died were frequently put to sleep on their tummies. It was “just” an observation. But on that basis alone, it was suggested that having infants sleep on their backs might be helpful, and that parents should avoid putting their infants on their fronts in their cribs. Lo and behold, the rates of infant death radically diminished—not completely, but radically. No sane caring person said: “We should really do an RCT, rule out confounding factors, and settle this with greater certainty, once and for all: All we have to do is randomly assign half the kids to be put to bed on their tummies and the other half on their backs.” That would have been unconscionable. The evidence provided by the observational study was good enough.

    Again, all studies have a context and are a means to answering questions. The pressing question with SIDS was not: How can we have absolute certainty about all the causes of SIDS? It was: How can we save infant lives, as soon as possible? In this case, the observational study answered it well.

    The SIDS story is a case where we can see how close, in moral terms, a study of risk factors and a study of a new treatment can be in a case where the treatment might be lifesaving. Putting children on their tummies is a risk factor for SIDS. Putting them on their backs is a treatment for it. The moral issue of not harming research subjects by subjecting them to a likely risk is clear.

    Bringing it home,

    Similarly, withholding the most promising treatment we have for a lethal illness is also a moral matter. That is precisely the position taken by the French researchers who thought that hydroxychloroquine plus azithromycin was the most promising treatment known for seriously ill COVID-19 patients, and who argued that doing an RCT (which meant withholding the drug from half the patients) was unconscionable. RCT fundamentalists called their study “flawed” and “sloppy,” implying it had a weak methodology. The French researchers responded, in effect saying, we are physicians first; these people are coming to us to help them survive a lethal illness, not to be research subjects. We can’t randomize them and say to half, sorry, this isn’t your lucky day today, you are in the nontreatment group.

    People are not lab rats or garden pea plants in blocks and plots sliced and diced for ANOVA.

    There’s much more but this is for starters.

    The hyperskeptics do not hold the default.

    KF

  335. 335
    Mac McTavish says:

    Another sad milestone. We now have over 200,000 COVID deaths. Back in March I don’t think any of us would have predicted this.

  336. 336
    TimR says:

    Mac @335. Some people predicted this. In fact, there was a bet between Barry and someone (i can’t remember who it was) on precisely this issue. Barry’s position was that he would lose the bet if the total deaths hit 200k. From memory he agreed to issue an apology if he lost the bet.

  337. 337
    Mac McTavish says:

    TimR, whoever made that bet, I would hope that he/she was hoping that they would lose.

    The whole idea of betting over the number of deaths in a pandemic is on the morbid side.

  338. 338
    ET says:

    If memory serves, Barry, Rush and bornagain77 (and many others) thought the death total would be lower than that of the seasonal flu- around 60,000. I knew that was crazy when bornagain posted Rush when it all just began. And no one could have foretold the Governors sending the sick elderly back to nursing homes to infect and kill other elderly.

    I was thinking we were going to have at least one million dead, just because we are an unhealthy nation. And the fact that people were and continue to travel all over, pretty much unabated. I figured many more people would have been infected.

  339. 339
    JVL says:

    https://uncommondescent.com/intelligent-design/insane-scaremongering-on-a-colossal-scale/

    From the above thread:

    Barry Arrington: Liar. Predicting 200,000 deaths when the actual number will almost certainly be less than 5,000 is the definition of scaremongering.

  340. 340
    kairosfocus says:

    ET, the key issue is not only the unhealthy state (think, Vit D and Zn deficiencies etc) but the politicised suppression of credibly effective but inconvenient treatments under false colours of science and research gold standards. There is good reason to suggest up to 10:1 reduction in deaths if treated pre-hospital. Mix in the avoidance of the nursing home fiascos and we would have a very different animal. Sound history is going to view us harshly, collectively. KF

  341. 341
    kairosfocus says:

    F/N: A Hong Kong exile physician is raising questions of signs of genetic engineering in the SARS-2 virus genome:

    The COVID-19 pandemic caused by the novel coronavirus SARS-CoV-2 has led to over 910,000 deaths worldwide and unprecedented decimation of the global economy. Despite its tremendous impact, the origin of SARS-CoV-2 has remained mysterious and controversial. The natural origin theory, although widely accepted, lacks substantial support. The alternative theory that the virus may have come from a research laboratory is, however, strictly censored on peer-reviewed scientific journals. Nonetheless, SARS-CoV-2 shows biological characteristics that are inconsistent with a naturally occurring, zoonotic virus. In this report, we describe the genomic, structural, medical, and literature evidence, which, when considered together, strongly contradicts the natural origin theory. The evidence shows that SARS-CoV-2 should be a laboratory product created by using bat coronaviruses ZC45 and/or ZXC21 as a template and/or backbone. Building upon the evidence, we further postulate a synthetic route for SARS-CoV-2, demonstrating that the laboratory-creation of this coronavirus is convenient and can be accomplished in approximately six months. Our work emphasizes the need for an independent investigation into the relevant research laboratories. It also argues for a critical look into certain recently published data, which, albeit problematic, was used to support and claim a natural origin of SARS-CoV-2. From a public health perspective, these actions are necessary as knowledge of the origin of SARS-CoV-2 and of how the virus entered the human population are of pivotal importance in the fundamental control of the COVID-19 pandemic as well as in preventing similar, future pandemics . . . .

    We present three lines of evidence to support our contention that laboratory manipulation is part of the
    history of SARS-CoV-2:

    i. The genomic sequence of SARS-CoV-2 is suspiciously similar to that of a bat coronavirus
    discovered by military laboratories in the Third Military Medical University (Chongqing, China)
    and the Research Institute for Medicine of Nanjing Command (Nanjing, China).

    ii. The receptor-binding motif (RBM) within the Spike protein of SARS-CoV-2, which determines
    the host specificity of the virus, resembles that of SARS-CoV from the 2003 epidemic in a
    suspicious manner. Genomic evidence suggests that the RBM has been genetically manipulated.

    iii. SARS-CoV-2 contains a unique furin-cleavage site in its Spike protein, which is known to greatly
    enhance viral infectivity and cell tropism. Yet, this cleavage site is completely absent in this
    particular class of coronaviruses found in nature. In addition, rare codons associated with this
    additional sequence suggest the strong possibility that this furin-cleavage site is not the product of
    natural evolution and could have been inserted into the SARS-CoV-2 genome artificially by
    techniques other than simple serial passage or multi-strain recombination events inside co-infected
    tissue cultures or animals.

    We already know the Chinese were utterly irresponsible in suppressing facts and in not locking down international travel. Now we need to ponder whether these signs are enough for us to raise questions about genetic engineering practices and bio-lab lab safety practices.

    Anyway, food for thought.

    KF

  342. 342
    Truthfreedom says:

    339 JVL
    Coming from the person that says (JVL) that “he does not go on thread-hunts”. 🙂
    Maybe your muscles moved automatically and forced you to visit Barry’s thread? That would be very darwinian.

  343. 343
    Truthfreedom says:

    Questions

    How did science bureaucrats, relying on murky data and speculative computer models, gain the power to shut down the global economy?
    How did politicians, who know nothing of the science, decide whom to trust?
    – We need to know what and how it happened, to keep it from ever happening again.

    The Price of Panic
    “How the Tyranny of Experts turned a Pa demic into a Catastrophe”.

  344. 344
    kairosfocus says:

    TF, 30 years of climate change policy-making turned into precedent. Esp. when multiplied by failure to understand that economic valuation cannot effectively be centralised, making nonsense of overly ambitious macro-level economy centralisation in the hands of bureaucrats. Mix in the toxic brew that demonises the investor class and scholarship that escapes the politically correct reservation. Policy induced deep recession and also stagnation in such . . . depression . . . is a serious issue with its own uncounted casualties that credibly already do/will far exceed the 900k global numbers from SARS2. Where, suppression of effective but inconvenient treatment protocols is part of the picture. KF

    PS: Blurb:

    For the first time in history, the world shut itself down—by choice—all for fear of a virus, COVID-19, that wasn’t well understood. The government, with the support of most Americans, ordered the closure of tens of thousands of small businesses—many never to return. Almost every school and college in the country sent its students home to finish the school year in front of a computer. Churches cancelled worship services. “Social distancing” went from a non-word to a moral obligation overnight. Moral preening on social media achieved ever new heights.

    The world will reopen and life will go on, but what kind of world will it be when it does? It can’t be what it was, because of what’s just happened.

    Professors Jay Richards, William Briggs, and Douglas Axe take a deep dive into the crucial questions on the minds of millions of Americans during one of the most jarring and unprecedented global events in a generation.

    What will be the total cost in dollars, lives, and livelihoods of this response from governments, on advice from Science?
    What role have national and global health organizations such as WHO played in this? To whom are they accountable?
    What evidence do they rely on in sounding the alarm?
    How did science bureaucrats, relying on murky data and speculative computer models, gain the power to shut down the global economy?
    How did politicians, who know nothing of the science, decide whom to trust?

    We need to know what and how it happened, to keep it from ever happening again.

  345. 345
    jerry says:

    Another sad milestone. We now have over 200,000 COVID deaths. Back in March I don’t think any of us would have predicted this.

    You have continually announced these milestones. But yet fail to comment on why the numbers grow. We have an unprecedented situation where a disease is claiming lives but there is no recommended treatment.

    When has this happened last? Especially when there are known effective treatments but politicians, many medical authorities and the press denounce them.

    Are all those who oppose effective treatmentS the ones guilty for these deaths? Are those who seem to celebrate these deaths, the ones who have blood on their hands?

    J’accuse!

  346. 346
    Mac McTavish says:

    Jerry

    You have continually announced these milestones. But yet fail to comment on why the numbers grow. We have an unprecedented situation where a disease is claiming lives but there is no recommended treatment.

    I have mentioned several times why the numbers keep growing. Poor federal leadership, mixed messages, etc.

  347. 347
    jerry says:

    I have mentioned several times why the numbers keep growing. Poor federal leadership, mixed messages, etc.

    Nonsense!!!

    Are you accusing Fauci? He has been the one lying to the public. Fauci definitely has blood on his hands.

  348. 348
    Truthfreedom says:

    Materialist’s goddess “science” seems not to be very pleased.
    Maybe they have not offered her enough child sacrifices (a.k.a. abortions).

  349. 349
    kairosfocus says:

    MMT, the messaging discrediting manifestly effective treatments has not been mixed, nor has the promotion of gold standards that fail the epistemological test. The marginalising, belittling and censorship of dissent has not been a mixed message either. It is clear too that the plausible mechanisms on the table in this thread are serious and the absence of pouncing on tells us they provide plausible action modalities for the marginalised treatments. It’s hard to deny weak base properties and 65 year track record for getting into cells, leading to hampering virus action, likewise, ionophore effects. . KF

  350. 350
    ET says:

    Mac and cheese is clueless. The President wanted control but the Governors said NO, it was their responsibility. The State Governments messed up. Not the Federal Government

  351. 351
    Truthfreedom says:

    349 Kairosfocus

    gold standards that fail the epistemological test.

    Most people do not understand what these words mean.
    Scientism has clouded the Western mind.
    The West needs a philosophical re-do.
    Or it will disappear (Islam is aware of our sorry state and China would like for the USA to totally surrender to the marxist pestilence).

    Materialism’s Failures: Hylemorphism’s Vindication. (Aristotle is back).

  352. 352
    kairosfocus says:

    TF, ideology — generally, evolutionary materialistic scientism etc and politically correct pseudo-consensus [dismissing coded language & algorithms in the cell, climate change hockey stick games, pandemic, other statistrix, HCQ vs placebos rule , etc] — dressed up in a lab or doctor’s coat, passing itself off as knowledge and driving policy on marches of folly. KF

  353. 353
    kairosfocus says:

    F/N: While I am at it, let’s do some more clipping from Tablet, here, on the much belittled and sidelined Dr Didier Raoult, Backdrop, from Doidge:

    We live in a culture that has uncritically accepted that every domain of life is political, and that even things we think are not political are so, that all human enterprises are merely power struggles, that even the idea of “truth” is a fantasy, and really a matter of imposing one’s view on others. For a while, some held out hope that science remained an exception to this. That scientists would not bring their personal political biases into their science, and they would not be mobbed if what they said was unwelcome to one faction or another. But the sordid 2020 drama of hydroxychloroquine—which saw scientists routinely attacked for critically evaluating evidence and coming to politically inconvenient conclusions—has, for many, killed those hopes.

    Phase 1 of the pandemic saw the near collapse of the credible authority of much of our public health officialdom at the highest levels, led by the exposure of the corruption of the World Health Organization. The crisis was deepened by the numerous reversals on recommendations, which led to the growing belief that too many officials were interpreting, bending, or speaking about the science relevant to the pandemic in a politicized way. Phase 2 is equally dangerous, for it shows that politicization has started to penetrate the peer review process, and how studies are reported in scientific journals, and of course in the press.

    Those who have their doubts about hydroxychloroquine rightly point out that the public is scared, and we are longing for a magical potion to rescue us. The history of plagues is rife with such potions and the charlatans who sold them were well documented in Daniel Defoe’s Journal of a Plague Year. A pandemic is not a remedy for the innate tendency toward wishful thinking.

    What is unique about the hydroxychloroquine discussion is that it is a story of “unwishful thinking”—to coin a term for the perverse hope that some good outcome that most sane people would earnestly desire, will never come to pass. It’s about how, in the midst of a pandemic, thousands started earnestly hoping—before the science was really in—that a drug, one that might save lives at a comparatively low cost, would not actually do so. Reasonably good studies were depicted as sloppy work, fatally flawed. Many have excelled in making counterfeit bills that look real, but few have excelled at making real bills look counterfeit.

    Hard words, but as we already saw, warranted.

    Next, our maverick, anti-hero:

    Especially influential in much of the world in the early days (if not the U.S., which often, focuses, it seems, mostly on studies from the Anglosphere) were studies commissioned by the French government and led by the microbiologist, physician, and professor of infectious disease and virology, Didier Raoult, from l’Institut hospitalo-universitaire (IHU), which he directs in Marseille, and which had assembled one of the largest datasets in Europe.

    Raoult is the most highly cited microbiologist in Europe, recognized for having identified 468 novel species of bacteria, most in humans, and for his team having discovered the largest virus ever documented at the time (so large it had been mistaken for an intracellular bacterium). He has boldly asserted that viruses—which had been classified as nonliving—are alive. He has published over 2,000 papers, many of them through the IHU, with him as a contributing or lead author. He has been given major awards, the French Legion d’honneur, and perhaps the most important one for a microbiologist, having a bacteria genus, “Raoutella,” named in his honor . . . .

    At 68 years of age, he rides a Harley to work. He still treats patients. He sees himself as more like a philosopher or anthropologist than a typical French scientist, and teaches epistemology, the study of how we know that we know things, to his lab scientists, He believes an ever-increasing homogeneity is ruining scientific thought. He told Paris Match:

    I am Nietzschean, I am looking for contradiction, trouble to strengthen myself. The worst is the comfort: It makes you silly … The more humans you have, the less they think differently. The “politically correct,” the “compliant thinking” are only a mass effect, to be avoided, even if it is difficult to resist! … To follow the herd no brain is needed, legs are sufficient … I don’t like movements, I run in the opposite direction. In general, that is where there are nuggets.

    If you went off the typical anglophone press over the past several months, likely, you wouldn’t expect that sort of eminence. That his research centre has 85 scientific staff and is based in a 4-hospital cluster in Marseilles, with about 3500 beds likely was not noted. Nor, that for instance, he could whistle up thousands of CT scans as part of his research.

    That he is an epistemologist is also significant. He understands styrengths and limitations of empirical knowledge claims. likely, including the intersection of epistemology and ethics with issues of prudence that lie at the pivot of the issues on HCQ based cocktails, likely ivermectin etc too.

    So, too

    Raoult was the one in his lab who came up with the idea of combining the two older drugs, HCQ and azithromycin, for COVID-19. A contrarian specialty of his has been “repurposing” or “repositioning” inexpensive generic and already available medications to fight infections. Repurposing has huge advantages. If a drug can be repurposed as an antiviral in an outbreak, it provides an already approved drug on hand, one with which we have had years of experience, so we know its drug interactions, how to monitor its effects on the major organs, how to test for blood levels, as well as its “posology,” or the science of how a drug’s dosing changes in different situations, and its safety profile and side effects. Moreover, old drugs have huge advantages over new ones in this area, because often bad effects don’t show up for years after the drug is brought to market. For instance, we now know that methotrexate, which is used for certain kinds of arthritis, can cause cancer years later; certain chemotherapies for cancer can cause heart problems years later. New psychiatric drugs, often heralded to have better side effect profiles than the current ones on the market, turn out, as time passes to be far worse, and cause diabetes. The only way to learn about long term effects of anything is via time . . . .

    People who get cold viruses and ask their physicians if they can have an antibiotic are told that old adage: “Antibiotics kill bacteria, not viruses.” And that is true for most antibiotics. But Raoult’s team was able to show that azithromycin, classically described as “an antibiotic that fights bacteria,” was effective in protecting cells that were infected with the Zika virus. His team also had 20 years of experience of repurposing HCQ for the long-term treatment of a kind of Q fever—another infectious disease.

    Sometimes drugs developed for noninfectious disease turn out to fight infection. Some antihypertensives, for example, have antiviral properties, it turns out. By investigating these relationships systematically—simply trying old drugs on new conditions and seeing what happened—Raoult was making a career of, or increasing the probability of, making the kinds of “chance” observations that the Chinese physicians had made when they saw that lupus patients on HCQ seemed not to be getting COVID-19. He was making his luck.

    The idea of studying HCQ as part of a “drug cocktail” to treat COVID-19 had a personal resonance for Raoult. Part of his childhood was spent in French Senegal (in Dakar) where his father, a military physician, was stationed, and as a kid Raoult took chloroquine to prevent malaria. He had a realistic sense of its long-term side-effect profile, and didn’t take at all seriously the media characterization of its safer version, HCQ, as especially dangerous, if taken for several weeks to treat COVID-19, if patients were properly monitored.

    When the pandemic broke, the first thing that Raoult studied was the effects of HCQ and azithromycin on “viral load,” or how much COVID-19 virus a given patient had. Leaving aside other factors—including the patient’s general health, immune system, diet, Vitamin D status, age, and more—Chinese physicians knew the amount of virus present correlated with severity of symptoms in sick patients, and doctors were beginning to think that “how much virus” the patient has to deal with was likely a factor in how they would ultimately fare. The longer that virus had to replicate in the body, especially in a vulnerable person, the harder it might be to defeat. So, early in the battle against the virus physicians realized that if a medication was to work, the earlier it was given to an infected person the better.

    So, we came to:

    Raoult’s clinical group found that for the medications to work, they had to be given early—something since replicated. This happens with anti-flu drugs as well—there is a need to stop the virus in its tracks before it overwhelms the body. This was not only a viral load issue. It had to be given, it seemed, before the cytokine storms got fully underway. COVID-19 is almost like two illnesses—one before the storm, and one after. Any evidence about the use of HCQ and azithromycin given after the storm starts might well be irrelevant to its effectiveness before the storm. As well, HCQ is cleared out of the body in significant part by the kidneys. But the COVID-19 disease process can attack small blood vessels, and seriously harm the kidneys (and other organs, including the heart and brain). Basic physiology suggests that giving HCQ after the kidneys are destroyed would likely mean they would not be able to filter and clear many of the medications the patients were on, including HCQ, and so those patients would be more vulnerable to overdose complications.

    Meanwhile, some American physicians and specialists in infectious disease working on the frontlines began reporting to American media that they were seeing HCQ benefits in their own patients too, from some large groups of physicians at the Henry Ford Health Systems in Detroit, to ones in private clinics. Two physicians with decades of experience with epidemics—Drs. Jeff Colyer and Daniel Hinthorn—wrote in the Wall Street Journal, “the therapy [HCQ plus azithromycin] appears to be making a difference. It isn’t a silver bullet, but if deployed quickly and strategically the drug could potentially help bend the pandemic’s ‘hockey stick’ curve.” Given that the American political class and pharmaceutical industry had outsourced the making of essential medications abroad, chiefly to China and India, Colyer and Hinthorn publicly asked for federal help to secure the supply.

    Hydroxychloroquine was not yet a household word. It was just another molecule, making its way through the world, with a good-enough reputation.

    Then came the follytricks of 2020. This largely drowned out:

    On April 9, Dr. Raoult’s French center released the initial abstract reporting their team had now put 1,061 patients on HCQ (for 10 days) and azithromycin (for five days), and it was ultimately published in Travel Medicine and Infectious Disease on May 1. All the patients had had viral tests, to establish the diagnosis, and had electrocardiograms. Genetic analysis of their viruses was also performed. By publication time 91.7% of those patients had a good clinical outcome and a virological cure. Eight patients (0.75%) died, ranging from 74-90 years of age, often having several other complicating illnesses. These were far better results than in most centers. They also found that only 5% of the patients were shedding the virus after the first week of treatment. They reported that none of the patients had the dreaded cardiac side effects that were being discussed by some.

    Was this the last word on HCQ? No. According to Raoult’s own scholarly interest in how epidemics are expressed differently in different locales, other studies would have to be done. For instance, in Marseille, Raoult found hardly any obesity in his study population. But in America, the COVID-19 epidemic was happening on top of another epidemic: According to the CDC, 71.6% of American adults are overweight, and 39.8% are overweight to the point of being obese; and obesity, often associated with diabetes, are two huge risks factors for COVID-19. They might somehow lower the drug’s effectiveness. One couldn’t assume that because a study showed the drugs worked in Marseille, they would work in the United States. By the same token, just because an American study might get poor results for the combo, wouldn’t mean the Marseille study was inaccurate.

    Where, too let us note:

    This study also wasn’t a randomized control trial, intentionally. As noted, Raoult doesn’t believe in them during a pandemic (nor at some other times). As he told the Times: “We’re not going to tell someone, ‘Listen, today’s not your lucky day, you’re getting the placebo, you’re going to be dying.” [–> or worse, not telling though there is a clear record that the person is being given sugar pills or the like or even fake surgeries etc.]

    What was emerging in scientific circles now was a debate about “methodology,” or what kind of scientific study of HCQ was appropriate in an emerging, lethal pandemic.

    We tend to think of methodology as a dry question that has nothing to do with morality. The methodologist asks what is the best technique to get at the most certainty most quickly, and usually answers: a randomized control trial, or RCT. But in medicine, moral concerns can’t be humanely divorced from methodology. Early in a pandemic, when we know little, there is a moral imperative to start gathering data. While RCTs are often (but not always, see below) the best kind of study, they take more time, and involve randomly assigning, say, half the patients to a new unknown but promising treatment, and half to either a placebo (sugar pill) or treatment-as-usual (which might be nothing). They are a type of experiment. With a milder disease, slow to overtake its victims, with some viable treatments to compare, one would perform RCTs sooner rather than later. If the disease is slow to kill, and patients don’t get better in the study, they might try another treatment or two after the study ends. But COVID-19 is lethal, kills within weeks when it does, and there was no good standard treatment for very sick patients, which meant that in a randomized study, some people would most likely get no effective treatment, and no second chance with another treatment after the study was done. Raoult was saying those people were being randomly assigned to death.

    That is one reason why so many researchers, like Raoult, opted for observational studies, in which as many patients as possible are treated. This is not a matter of choosing a design that is “fatally flawed,” it is a matter of choosing a design that is not unnecessarily fatal to the patients. It’s is not sloppiness (as some of his critics would allege), but being true to the study question as he saw it: How can we save as many lives as possible. These observational studies could begin almost immediately, and didn’t require the slow approval process that RCTs require, in part because of the moral dilemmas they raise.

    Still, given that pandemics kill tens of thousands, if not millions, why not favor the cold-hearted methodologist, who is willing to stand back on a high hill, like a general in a war, and take some casualties to get a win sooner? Isn’t that more moral in the long run?

    Not necessarily. It is a common conceit of methodologists that they alone can improve the quality of medicine, which, without them, would be hopelessly unscientific. But diseases are very complicated. I know, from personal experience, that pure methodologists—like “armchair generals”—i.e., researchers who have perhaps have never treated a single patient with the relevant illness—often make very elementary errors in design because they don’t understand how people react to illness, the illnesses themselves, or the burden of side effects, but rather work from models. Here is just one kind of such elementary methodological error. The kind of Russian Roulette RCT I described above, which involves withholding a possible treatment from a lethal disease, is a methodologist’s dream design. But you won’t likely volunteer yourself or loved ones for it if there is a more direct access to a promising treatment in a dire situation. Almost no sane, nonsuicidal person will, if properly informed about what is going on (which doesn’t always happen).

    This is why the role of the “clinician-researcher” developed. A union of humane medicine with the certitude-seeking scientific researcher, these people don’t solve all research design problems; rather their role is, ideally, not to lose sight of the inherent tension of the enterprise. Anyone who has performed both sides of that compound discipline in good faith knows there are profound ongoing moral conflicts between the good doctor, who thinks of the patient in front of him or her, and the scientist who thinks of the ideal methodology, which—it is hoped—might benefit other patients in the future. The randomization conflict almost always exists in serious illness, because we don’t generally study treatments on dying people that we think have no chance of working. Any clinician-researcher deserving the name knows that being a researcher does not cancel out the clinician’s Hippocratic oath to do no harm, or give them permission not to do what is best for the patient.

    There’s more, but this is enough to spark more balanced thought.

    KF

  354. 354
    TimR says:

    Well, as long as you have a “herd mentality”, everything is gong to work out fine for you in the US.

  355. 355
    rhampton7 says:

    While the short-term risks of hydroxychloroquine treatment were minimal, long-term use was associated with excess cardiovascular mortality in rheumatoid arthritis (RA), according to study results published in Lancet Rheumatology. Researchers noted that combining hydroxychloroquine with azithromycin further increased risk for heart failure and cardiovascular mortality, even in the short term.

    The multinational, retrospective cohort study enrolled adult patients with RA who were new users of hydroxychloroquine or sulfasalazine. Health records and claims data were obtained from 14 databases in Germany, Japan, the Netherlands, Spain, the United Kingdom, and the United States. The study period was from 2000 to 2020.

    The study cohort included 956,374 patients receiving hydroxychloroquine, 310,350 receiving sulfasalazine, 323,122 receiving hydroxychloroquine plus azithromycin, and 351,956 receiving hydroxychloroquine plus amoxicillin. No excess risk for any of the 16 adverse events was observed with hydroxychloroquine vs sulfasalazine over 30 days of follow-up. The same trends were observed in the self-controlled case series. However, longer use of hydroxychloroquine vs sulfasalazine was associated with increased cardiovascular mortality (HR, 1.65; 95% CI, 1.12-2.44).

    Compared to hydroxychloroquine plus amoxicillin, hydroxychloroquine plus azithromycin was associated with significantly increased risk for cardiovascular mortality (HR, 2.19; 95% CI, 1.22-3.95), chest pain or angina (HR, 1.15; 95% CI, 1.05-1.26), and heart failure (HR, 1.22; 95% CI, 1.02-1.45) in the short term.

    https://www.rheumatologyadvisor.com/home/topics/rheumatoid-arthritis/treatment-with-hydroxychloroquine-plus-azithromycin-linked-to-cardiovascular-mortality-in-ra/

  356. 356
    rhampton7 says:

    Among patients hospitalized for COVID-19 in the United States, male sex, age 60 years and older, obesity, chronic kidney disease, cardiovascular disease and living in the Northeast were associated with an increased risk for mechanical ventilation, data show.

    The findings, published in Clinical Infectious Diseases, also indicated that the same characteristics, except for obesity, were linked to an increased risk for mortality.

    Researchers reviewed data from 11,721 patients with COVID-19 who were admitted to 245 hospitals across 38 states between Feb. 15 and April 20. Among all patients, 48 received remdesivir (Gilead) and 4,232 received hydroxychloroquine.

    Patients who required mechanical ventilation were more likely to be:
    * men (63.9% vs. 51.3%);
    * over the age of 60 years (67.3% vs. 58.4%);
    * have a history of chronic kidney disease (15.2% vs. 11.6%), CVD (22.6% vs. 17.8%) or obesity (18.3% vs. 15.7%); and
    * live in the Northeast (52.3%) instead of the Midwest (4.1%), West (12%) or South (31.6%).

    “We expected to see older age, obesity and cardiovascular disease as risks,” Brown said. “But I was surprised that chronic lung disease and smoking did not seem to be conferring an increased risk. This requires further investigation.”

    https://www.healio.com/news/primary-care/20200917/six-traits-predict-need-for-mechanical-ventilation-in-patients-with-covid19

  357. 357
    rhampton7 says:

    Professor Raoult:

    I am a general practitioner and in contact with patients to whom I like being able to respond to this unique conference built on trust and contribution of knowledge from both.

    For months, however, I had not been able to answer the apparently simple question they asked me: “but doctor, hydroxychloroquine, does it work or not?”

    I could not answer that question because you have made the deliberate choice of empiricism, not the creation of academic studies that would have to have sufficient information to respond to these patients in doubt.

    In France and in Europe, in front of you studies were made but none followed the protocol of care which you recommended, these were therefore of no contribution in terms of the response to be provided to my patients.

    On September 15 during your hearing in the Senate, you responded with condescension to my colleague, general practitioner, Senator Bernard Jomier. You did not answer Bernard Jomier’s questions, nor did you agree to discuss your work with contradicting doctors …

    “I do not belong to you” you said.

    You have affirmed to refuse any randomized double-blind study whereas your protocol is dispensed at the beginning of the affection for a disease of which 99.5% of the patients recover (5 to 10% keeping chronic forms all the same). Since March you have been able to organize this type of study with strict monitoring and optimal security of volunteer patients, you could have done it and you did not.

    The “ethical” argument that you are making does not hold any more than the one that aims to make us swallow the authorship of 3,500 scientific publications, which has been published every 4 days for 40 years.

    You have knowingly turned your back on this solution to build affirmations without any basis other than your affirmations …

    I cannot, like many other colleagues, subscribe to it.

    https://www.atlantico.fr/decryptage/3592353/lettre-au-professeur-raoult-d-un-petit-medecin-generaliste-chloroquine-coronavirus-covid-19-pandemie-epidemie-jerome-marty-

  358. 358
    rhampton7 says:

    Letter to Professor Raoult from a “little” general practitioner
    Part 2

    I remember your multiple statements and successive reflections:
    * you weren’t going to panic for three Chinese people who are dying,
    * Covid-19 was going to kill fewer people than scooter accidents,
    * you had the treatment and it would be the most infectious disease.
    * easier to treat, the virus would go away in summer,
    * the epidemic was over,
    * the epidemic was resuming,
    * transmission was through the hands and
    * respiratory contamination had been expressed long ago for other ailments but was not to be taken seriously,
    * then talking about respiratory and manual contamination
    * returning during your hearing to mainly manual contamination

    You also said: take out those who are afraid and put forward those who are not afraid. I do not know caregivers paralyzed by fear, I only know caregivers aware of their role, their responsibilities, their missions, caregivers who, I repeat, have faced particularly difficult conditions, all over the place. territory and will do it again.

    You said so many things … “we must give hope” you said like this justified all the statements, all the lies. Hope has a placebo effect, you recalled, in a curious statement for anyone who refuses double-blind randomized studies.

    You have given hope to the point of establishing certainties in the treatment you advocate and that you do not want to submit to any validation other than your opinion, in your publications, supported by your teams, in your journals. Your ideas have spread abroad, Trump and Bolsonaro have defended it, should this be seen as a link with the management of the epidemic in the USA and in Brazil? History will tell …

    You played on the mistakes of politicians, their manipulations and the need to believe in the face of the unknown and fear. You have created a movement, a religion one could say so much the irrational is present there, where simple belief, conspiracy, anti-mask movement, or anti-ax are mingled … or the extremists meet and make your ideas a fertile ground. This you cannot ignore, yet you say nothing, you accept to be followed, greeted, adulated, whatever the bottle, as long as you are drunk.

    Dr Jérôme Marty
    president UFMLS

    https://www.atlantico.fr/decryptage/3592353/lettre-au-professeur-raoult-d-un-petit-medecin-generaliste-chloroquine-coronavirus-covid-19-pandemie-epidemie-jerome-marty-

  359. 359
    Truthfreedom says:

    Prof. Didier Raoult Trashing Darwin

    “Charles Darwin’s vision of the world deeply influenced biology in the twentieth century. Today, however, his theory of evolution is more a hindrance than a help, because it has become a quasi-theological creed that is preventing the benefits of improved research from being fully realized.” Didier Raoult, Life After Darwin

  360. 360
    kairosfocus says:

    RH7, long term use is of order 5 – 10 years and the incidence is small. We take that as a measure of onward comments. Kindly observe, too, the mechanisms on the table. KF

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