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:

HEADLINED: The Frontline Doctors put some “plausible” mechanisms for Hydroxychloroquine on the table
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.
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:
Kairosfocus @ 4
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.
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.
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:
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.
U/D: I have found a Dr Been vid (the Dr who presented the summary for Frontline Doctors), and have embedded the lecture. KF
Kairosfocus @ 5
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:
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?
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.
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
JAD, excellent questions. usually, anarchy is the repeller pole that snaps back into tyranny on excuse of restoring order. KF
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.
Seversky @ # 2,
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?)
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.
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)
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
We should be looking at OTC supplements for a cure or to alleviate symptoms.
Oregano oil has antiviral and anti-inflammatory properties.
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.
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”.
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.
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.
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
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 venoms– The Power of Poison: Poison as Medicine
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.
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
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
Scott Adams has a new name for this. It’s called “social media poisoning.”
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.
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
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.
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.
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.
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.
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?
https://arstechnica.com/science/2020/08/coronavirus-creeps-into-us-mink-farms-unusually-larger-numbers-dead/
JVL, looks like animal models are possible. Mind you, this is quite late in the epidemic’s life cycle. KF
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
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
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
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:
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?
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.
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:
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
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
Here is an article from July 30 about Ohio’s then pending plan to ban HCQ.
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.
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?
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.
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
RHampton7- Please tell China that I concur. I also advise against the use of HCQ. Especially in scenarios in which it is being misused. 😎
Doctors for Disaster Preparedness, eh?
Looks like a clearinghouse for those “alternative facts” we hear so much about.
Science and Alice in Wonderland
https://bit.ly/2Qb5OaC
https://arstechnica.com/science/2020/08/coronavirus-researchers-must-examine-trump-backed-conspiracy-or-lose-funding/
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.
From Alex Berenson today
And then there is this.
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.
https://www.globalresearch.ca/media-sabotage-hydroxychloroquine-covid-19-doctors-worldwide-protest-disaster/5717382
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.
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.
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?
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/
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.
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.
Wikipedia on Icke:
I remember Icke as a sports reporter on the BBC and he seemed perfectly normal then.
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
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
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
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/
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
ET
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?
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.
Mac:
That isn’t what the EVMS states. Clearly you have reading comprehension issues.
Acartia Eddie George had the same reading comprehension issue. Weird.
From the EVMS:
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.
ET
Well, I was paraphrasing. But here is what they say.
Not exactly the definitive claim that you have repeatedly made.
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.
kf @ 63 –
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).
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
Hopefully true
https://www.outlookindia.com/website/story/india-news-delhis-sero-survey-results-show-we-are-fast-approaching-herd-immunity-epidemiologist-j-p-muliyil/357205
Is the virus more of a political not a medical problem
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
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.
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.
Again, my claim is based on the SCIENCE, that is why you are so confused.
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
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.
ET, you really are incapable of behaving like an adult. I’m surprised that any website allows you to comment.
Let me repeat a point that I raised earlier @ 53.
Then recently on another thread one of our regular interlocutors said this:
I pointed out that…
By the same logic:
https://uncommondescent.com/intelligent-design/cs-lewis-covid-19-and-scientism/#comment-710237
Now let’s look at what the recommends about wearing masks.
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?
Mac- you are an ignorant infant. Deal with that before you go blaming others for your issues.
Jerry @ 70 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.
Update on Ivermectin from Australia
https://bit.ly/3j10ItD
See how fast the use of this treatment spreads if at all even in Australia.
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.
Mac McTavish is very “saddened” about the 40+ million abortions performed since 1973 (only in the USA).
He cries.
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.
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.
https://www.tabletmag.com/sections/science/articles/hydroxychloroquine-morality-tale
Indeed we need to keep in mind that science begins with observation, gathering data.
Notice, the mechanisms are still on the table.
KF
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.
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.
FDA and HCQ
https://apnews.com/a3e99384b955d60f4c0fd7c738c6b2a8
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/
More hope!
https://uknow.uky.edu/research/artemisia-annua-could-be-promising-treatment-covid-19
Understanding despair. How to counteract it.
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?
Good question! Who is suppressing the use of HCQ?
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.
Cost of lockdowns.
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.
https://outline.com/Ur2Sg6
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.
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
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.
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.
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.
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.
Doesn’t help the tens of millions out of work which are heavily skewed to woman and poor.
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.
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
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
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
What is a “post exposure prophylaxis”? Holy cow, people are confused. Where’s the zinc? Where’s the vitamin’s C and D?
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
(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
Why don’t you ask Dr Raoult why his protocol doesn’t require Zinc or Vitamins C and D?
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
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.
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.
Jerry,
Are you sure he/she is really human. Maybe Rhampton is a bot.
Soul searching for the anti HCQ faction
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
There may be no need for a vaccine.
https://www.yahoo.com/news/t-cells-not-antibodies-may-225818680.html
https://www.yahoo.com/news/parts-london-york-already-achieved-113750524.html
Will they need vaccination?
Several scientists challenge negative analysis of HCQ studies.
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
Some of the same people
https://drive.google.com/file/d/1NZOJ57fM0RTaHD1t_9w2iua7lUJhOgWT/view
From a statistician
HCQ protects heart
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.
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.
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!
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:
The article notes on balance of studies:
Points to ponder
KF
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
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.
Risch gave a no holds barred interview on FOX’s ‘Life, Liberty and Levin’ last night. He was just excoriating of Fauci’s record
Hope on other fronts
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.
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
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.
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.
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.
KF
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.
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.)
KF
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.
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?
RHolt, your credibility is discounted, for cause. KF
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?
KF
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!
JAD
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.
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.
We are starting to get more statistics on the effects of the lockdowns. Here is one analysis
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.
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.
Appeal to authority.
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?
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
More hope! Another positive HCQ study. This time with hospitalized patients.
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
An opinion from an Israeli doctor criticizing the lockdowns
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.
KF
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.
“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”.
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!
SEV
Could not have made the point any clearer!
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
I now live in New Hampshire and have adopted our state motto. I have an idea for another one
Maybe a little long for a face mask. Perhaps a T-shirt.
A position that advocates “let them die.”
As I said above the negative people reveal their inner selves with tells. This is an example.
But it has. I recommended all watch the MedCram videos. A study came out last week and #103 discusses in detail.
https://aapsonline.org/will-fda-stop-obstructing-covid-19-treatment/
The article goes on to say
Plasma therapy is not new
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1555639/
Lockdowns have cost
https://tucson.com/news/state-and-regional/arizona-sees-20-rise-in-deaths-not-all-directly-from-virus/article_fba3f8ed-3d34-5523-ae07-21e528b024d3.html
Some more hope!
https://www.medpagetoday.com/infectiousdisease/covid19/88225
Article provides some basic details.
Even more hope!
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.
Jerry
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.
Jerry
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.
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.
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.
They were talking about the plasma treatment months ago. They should have some data
Mac:
Trump touts HCQ and RH7, Mac and others here find every cherry picked reason to not support it and undermine its use.
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.
If covid-19 was as (un)contagious as ebola, no one would be worrying about a treatment, let alone plasma.
ET
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.
Mac:
I am glad you agree.
Your question is leading and proves that you are a loser. I call them as I see them. Don’t mistake honesty for abuse.
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?
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.
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?
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/
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.
RH7
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!
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.
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?
$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.
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.
ET,
So Dr Raoult’s treatment is wrong?
@164-RH7
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
Only if it doesn’t work. Perhaps his patients have a healthy level of D and zinc.
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
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
KF
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)
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
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
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
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.
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
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.
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
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.
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.
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
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.
An extensive list of early outpatient treatments
https://bit.ly/2QqlKWx
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.
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.
Hot off the press….
FDA chief issues mea culpa for his plasma treatment claims
some key quotes:
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.
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:
Nope no influence of politics on this decision….oh wait…..nevermind!
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.
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:
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
Dr. Raoult on RCTs
Interesting title. Does Dr. Raoult expect the French medical community will believe it is about them.
https://bit.ly/3lbQUiq
Jerry,
I observe his first detail point:
In short, [ALT – 0TB] – [BAU – 0TB] = ALT – BAU
Then, we see:
As in, gold standard fallacy.
Going on:
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
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
“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
RH7, you apparently missed the point. KF
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.
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.
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.
“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/
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.
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
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
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.
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?
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.
Again, RHampton7- we are MISSING the relevant data. What we do have sheds doubt on what they are testing
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
ET we are missing the same data from Raoult but that hasn’t stopped you from jumping to conclusions
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.
https://www.medrxiv.org/content/10.1101/2020.08.20.20178772v1
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.
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/
Someone is daft. I never said anything about Raoult. Dr. Zelenko has a $200,000 challenge, however.
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
rhampton7 @ 204 –
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.
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
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:
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
More hope. Positive news on HCQ. From Italy
https://bit.ly/32wkwOW
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.
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?
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
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.
The above analysis is continued on the author’s blog.
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?
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.
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.
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.
Are you referring to Fauci? He’s constantly lying and his lies have caused tens of thousands of people to die.
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?
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.
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
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
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
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.
Well then, now you have no reason to dismiss the RCTs.
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
Kairosfocus @ 223
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.
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
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
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
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..
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.
HCQ at the appropriate stage, works.
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.
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?
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.
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 still haven’t seen any such explanation.
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
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.
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.
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
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/
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
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.
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.
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.
kf @ 238 –
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?
BO’H, I pointed to thewider generally accepted vulnerability patterns also. KF
kf – Yes, so …?
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.>>
I’m sorry, kf, I’m still not getting what you are trying to communicate.
CDC predicts 200,000 deaths by September 19.
https://www.cdc.gov/coronavirus/2019-ncov/covid-data/forecasting-us.html
Mac Mc Tavish
Fine.
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.
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
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?
Jerry
No.
If we had acted earlier with social distancing, restricting travel and wearing masks, almost certainly.
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.
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.
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
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.
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
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
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
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/
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
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…
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
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
KF
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.
Didier Raoult Trashing Darwin
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
Hope! Very large meta analysis on HCQ
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
https://bit.ly/2DdPAuq
FDA approves drug with no benefit for more patients. Why?
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
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.
Read this short article and replace Bactrim with HCQ
With Fauci, follow the money not the doctors.
https://bit.ly/2QAUl4e
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!!!
An assessment of the C19 virus now. How accurate?
https://bit.ly/32AVz58
Jerry, I added the main chart as a PPS. It speaks, yet again. KF
KF
Then maybe you should watch something other than Fox News, Sean Hannity, and Rush.
Didier Raoult Trashing 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…
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
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.
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.
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
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.
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/
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
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
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/
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/
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/
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
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
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/
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.
https://bit.ly/31O5W6h
From FDA website
https://bit.ly/2EFa3ZU
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
What the . . . .
https://arstechnica.com/science/2020/09/trump-admin-shuns-global-covid-19-vaccine-program-citing-beef-with-who/
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/
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
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
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
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
“ 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
But we wantz moar than sufficient. We wantz a blood concentration of 40nG/ mL.
That is what ten previous studies were recommending, anyway.
Hope. Vitamin D.
Calcifediol is essentially Vitamin D https://bit.ly/355b5cs
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?
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.
Bill
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.
Another sad milestone was reached today. Deaths due to COVID have now surpassed 190,000.
How many have to die while Fauci lies.
He did the same thing with HIV. But to many he is a hero.
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.
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.
Jerry 308
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.
If you believe the observational data presented by miracle worker Dr Raoult, then all you need is HCQ and azithromycin. That’s it.
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
Thanks Jerry. I haven’t been following Fauci that closely.
Does politics affect how many die from C19?
https://bit.ly/2QXnoPJ
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?
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.
https://bit.ly/35iUwK2
One of the commenters said that back in May, zinc was being prescribed by Raoult.
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
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
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/
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.
J’accuse–
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.
https://www.youtube.com/watch?time_continue=197&v=1q5teMsw2h4&feature=emb_logo
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
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
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/
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
Didier Raoult Trashing Darwin
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
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
RH7, you need to take some time out and read the two linked articles at Tablet. KF
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/
Kairosfocus/324
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
COVID-19 should be a wake up call for improving nutritional standards.
198,000 and counting.
ET, you are right, esp. given the evident significance of vitamin D deficiency. KF
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):
Continuing:
For instance:
Bringing it home,
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
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.
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.
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.
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.
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.
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
F/N: A Hong Kong exile physician is raising questions of signs of genetic engineering in the SARS-2 virus genome:
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
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.
Questions
The Price of Panic
“How the Tyranny of Experts turned a Pa demic into a Catastrophe”.
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:
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!
Jerry
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.
Materialist’s goddess “science” seems not to be very pleased.
Maybe they have not offered her enough child sacrifices (a.k.a. abortions).
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
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
349 Kairosfocus
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).
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
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:
Hard words, but as we already saw, warranted.
Next, our maverick, anti-hero:
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
So, we came to:
Then came the follytricks of 2020. This largely drowned out:
Where, too let us note:
There’s more, but this is enough to spark more balanced thought.
KF
Well, as long as you have a “herd mentality”, everything is gong to work out fine for you in the US.
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/
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
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-
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-
Prof. Didier Raoult Trashing Darwin
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
KF, you neglected the most important point:
“ Researchers noted that combining hydroxychloroquine with azithromycin further increased risk for heart failure and cardiovascular mortality, even in the short term.”
Interventions for treatment of COVID-19: A living systematic review with meta-analyses and trial sequential analyses (The LIVING Project)
This is the first edition of a living systematic review of randomized clinical trials comparing the effects of all treatment interventions for participants in all age groups with COVID-19. We planned to conduct aggregate data meta-analyses, trial sequential analyses, network meta-analysis, and individual patient data meta-analyses. Our systematic review is based on Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) and Cochrane guidelines, and our 8-step procedure for better validation of clinical significance of meta-analysis results. We performed both fixed-effect and random-effects meta-analyses. Primary outcomes were all-cause mortality and serious adverse events. Secondary outcomes were admission to intensive care, mechanical ventilation, renal replacement therapy, quality of life, and nonserious adverse events. We used Grading of Recommendations Assessment, Development and Evaluation (GRADE) to assess the certainty of evidence. We searched relevant databases and websites for published and unpublished trials until August 7, 2020. Two reviewers independently extracted data and assessed trial methodology.
We included 33 randomized clinical trials enrolling a total of 13,312 participants. All trials were at overall high risk of bias.
Our results show that dexamethasone and remdesivir might be beneficial for COVID-19 patients, but the certainty of the evidence was low to very low, so more trials are needed. We can exclude the possibility of hydroxychloroquine versus standard care reducing the risk of death and serious adverse events by 20% or more. Otherwise, no evidence-based treatment for COVID-19 currently exists. This review will continuously inform best practice in treatment and clinical research of COVID-19.
https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003293
R7
Ouch.
Is Prof. Didier correct in blaming Africans, Jews and Gypsies?
Answering a question about the profile of people who have tested positive today; Didier Raoult indicated that these are people of all ages; noting that no remarkable incidence in small children has been observed. Continuing in this direction, the doctor did not hesitate to propose a curious theory; to explain the increase in the number of Covid-19 contaminations in France.
“This upsurge seems to have started in July with a mutant that came from North Africa”; he advanced. Indeed, according to the speaker, this new wave would be the work of North Africans, Jews and Roma. “The IHU Méditerranée Infection has identified several viruses carrying numerous mutations; including the one that was named Marseille; would have arrived in the region and then spread during the celebrations of the Jewish and Roma communities ”; Raoult explained.
“We know that in Marseille, weddings among the Roma or parties in the Jewish community were extremely important sources of contagion,” said Didier Raoult, which would have helped to spread this new strain within the Marseille population . Since the city’s port does have a connection with regular shipping lines to Algeria and Tunisia.
However, this theory remains unlikely for many researchers and specialists who have refuted this assertion. “The strain of the virus that circulates mainly in France remains the one detected last March and is therefore not new”; they decided. Moreover, it should be remembered, Algeria has kept its borders closed since last March until today.
Only a few rare ferries made the crossing, especially for the repatriation of French people stranded in Algeria. In fact, so far no date has been communicated about the opening of the borders. As for Tunisia, it only had a few cases during the period concerned.
https://www.dzairdaily.com/didier-raoult-hausse-contagions-france-vient-maghreb/
Wow, a leftist trying to play the “racism” card. What a typical, pathetic strategy. 🙂
Didier Raoult Trashing Darwin
Quasi-theological creed is not a good thing, is it? 😉
RH7, the claim has little merit, given what has already been discussed and what is in protocols. KF
Prof Raoult tried to blame Africans for the current surge in France; “ One strain, Raoult theorized, was brought in by people coming from North Africa after France lifted its lockdown in June. “
There is a problem with that hypothesis, “ The mutation has now disappeared, though others have popped up, the outlet reported.”
Then Raoult tried to minimize the current outbreak in France, “ They are less severe, so something is happening with this virus, which makes it different,” Raoult testified. “The mutations we have are a rather degraded version of the initial form. At least that is our impression.”
Except that, “ In the past few weeks, France has seen COVID-19 intensive care admissions and deaths grow. To try to curb the numbers, the cities of Nice, Marseille and Bordeaux have imposed new restrictions on bar hours and the size of gatherings.”
Note Marseille’s inclusion.
https://nypost.com/2020/09/19/france-uncovers-mutant-fast-moving-covid-19-strains/
RH7, it is long since clear that no actual accumulation of evidence will move you from your chosen distractive and dismissive red herring and strawman narratives. The reality is, that there is good reason to see that the placebo based testing “gold standard” is a fallacy that leads to selectively hyperskeptical dismissal of reasonable evidence and what it warrants. It is clear in particular that the focus of the OP above — plausible mechanisms of action — stands as just that, plausible. HCQ — on direct action — is absorbed by the body, is able to enter cells, acts as a weak base; disrupting the viral attack process. On indirect action it is a Zn-promoting ionophore, further promoting antiviral action by that ion. Azithromycin and/or doxycycline have ability to attack secondary infections and the former at least has antiviral action. Zn supplementation is obviously advisable. Vitamins D and C likewise, with some reason to believe D-deficiency [come on, sunlight!] is a serious risk factor. So, we are not just arguing statistical correlations, we have hard to dismiss action mechanisms on the table. Where the stitch in time saves nine principle makes it clear that there is patent justification to administer early before serious damage is done; reports indicate off-label use is up to 20% of prescriptions in the US. . Likewise, potentially harmful side effects are highly manageable, these are decades proved drugs. We can also add/substitute ivermectin, which has similar support. The real issue is why, since March/April, so much fight-down has been seen, and the answers to that are not happy ones. History is going to judge us harshly, for cause. KF
Kf,
Depends on who will write the history. That is what the fight is about. HCQ is a side show and so is the million deaths that could have been prevented or delayed.
For those who care there is a web site that keeps track of studies on C19
https://c19study.com/
Jerry, the current magisterium is as unknowingly doomed as were the European Aristocracy c May 1914. they and their designated successors will be in the history but they will not be writing it — and I do not mean victory propaganda, I mean serious well-founded history. The American status of a certain Mr Benedict Arnold comes to mind. KF
F/N: On the safety narrative, I note this study published 21st as medrxiv:
https://www.medrxiv.org/content/10.1101/2020.07.16.20155531v3
>>Safety of Hydroxychloroquine among Outpatient Clinical Trial Participants for COVID-19
View ORCID ProfileSARAH M LOFGREN, View ORCID ProfileMelanie R Nicol, Ananta S Bangdiwala, View ORCID ProfileKatelyn A Pastick, View ORCID ProfileElizabeth C Okafor, View ORCID ProfileCaleb P Skipper, View ORCID ProfileMatthew F Pullen, View ORCID ProfileNicole W Engen, View ORCID ProfileMahsa Abassi, Darlisha A Williams, View ORCID ProfileAlanna A Nascene, View ORCID ProfileMargaret L Axelrod, Sylvian A Lother, View ORCID ProfileLauren J MacKenzie, View ORCID ProfileGlen Drobot, Nicole Marten, View ORCID ProfileMatthew P Cheng, Ryan Zarychanshi, View ORCID ProfileIlan S Schwartz, Michael Silverman, View ORCID ProfileZain Chagla, Lauren E Kelly, View ORCID ProfileEmily G McDonald, View ORCID ProfileTodd C Lee, View ORCID ProfileKatherine Huppler Hullsiek, View ORCID ProfileDavid R Boulware, View ORCID ProfileRadha Rajasingham
Abstract
Introduction: Use of hydroxychloroquine in hospitalized patients with COVID-19, especially in combination with azithromycin, has raised safety concerns. Here, we report safety data from three outpatient randomized clinical trials. Methods: We conducted three randomized, double-blind, placebo-controlled trials investigating hydroxychloroquine as pre-exposure prophylaxis, post-exposure prophylaxis and early treatment for COVID-19. We excluded individuals with contraindications to hydroxychloroquine. We collected side effects and serious adverse events. We report descriptive analyses of our findings. Results: We enrolled 2,795 participants. The median age of research participants was 40 (IQR 34-49) years, and 59% (1633/2767) reported no chronic medical conditions. Overall 2,324 (84%) participants reported side effect data, and 638 (27%) reported at least one medication side effect. Side effects were reported in 29% with daily, 36% with twice weekly, 31% with once weekly hydroxychloroquine compared to 19% with placebo. The most common side effects were upset stomach or nausea (25% with daily, 18% with twice weekly, 16% with weekly, vs. 10% for placebo), followed by diarrhea, vomiting, or abdominal pain (23% for daily, 16% twice weekly, 12% weekly, vs. 6% for placebo). Two individuals were hospitalized for atrial arrhythmias, one on placebo and one on twice weekly hydroxychloroquine. No sudden deaths occurred. Conclusion: Data from three outpatient COVID-19 trials demonstrated that gastrointestinal side effects were common but mild with the use of hydroxychloroquine, while serious side effects were rare. No deaths occurred related to hydroxychloroquine. Randomized clinical trials can safely investigate whether hydroxychloroquine is efficacious for COVID-19.>>
The mechanisms on the table make it hard to argue, ineffective.
KF
PS: Of course, I have questions on resort to placebo based studies in face of a deadly pandemic.
HCQ is safe and inexpensive. Given that there is no effective alternative why not prescribe it? The upside is hundreds of thousands of lives saved. The downside is the patient is out $10-$20.
The answer is there no reason except politics and greed, both the result of extreme callousness.
F/N: A reflection on needless politicising of the HCQ issue and its consequences. Overview:
>>The COVID-19 pandemic struck America nine months before a presidential election, turning basic medical activities like testing and treatment into partisan battlegrounds. No subject has been more distorted than hydroxychloroquine (HCQ), a safe, versatile medicine that has treated hundreds of millions of people for numerous diseases for seven decades.
HCQ was adopted as a COVID-19 treatment in Asia in January 2020 without fanfare, based on lab tests with the related coronavirus SARS-1. But when President Trump stated in March that the U.S. would also begin studying the drug’s potential against the virus, political opponents defied longstanding scientific and medical consensus to portray HCQ as harmful and Trump as a mortal danger to public health. Flawed and even falsified studies [–> Lancet, FYI] were published and promoted by media outlets eager to discredit Trump, while positive studies were impugned or ignored.
This campaign persists even as evidence of HCQ’s benefit against COVID-19 grows – including scores of observational controlled trials showing therapeutic effect when administered early in disease progression. Hundreds of drugs have been approved for both indication-specific and general usage on the basis of similar observational trials, especially when conducted in large numbers and subject to careful meta-analysis. As a matter of medical practice and especially in a pandemic emergency, it is flatly not the case that only randomized controlled trials can justify adopting a treatment, as HCQ detractors have insisted while publicizing randomized controlled trials results that are themselves deeply flawed.
The U.S. is an international outlier on HCQ. Right now, doctors around the world are prescribing HCQ to treat COVID-19 outside of hospitals, as well as prophylactically to prevent infection among healthcare workers and vulnerable populations. This paper argues that HCQ has met the appropriate burden of proof and urges members of the U.S. news media, public health community, and regulatory agencies to stop politicizing the use of this medicine. Tens of thousands of lives still hang in the balance.>>
KF
Jerry, there is the gold standard fallacy that gives pseudojustification for dismissing evidence that does not fit a dominant narrative. A very familiar problem. I notice on the OP how there has been conspicuous lack of cogent response to mechanisms on the table — it’s hard to dismiss ionophore and weak base absorbed by cells etc, a failure to recognise manageability of risks and a tendency to attack the man. Though, Dr Been is quite different from Dr Raoult. History will not smile indulgently on this year’s fiasco. I am thinking of how the seemingly wonderful, glittering aristocrats stumbled into catastrophe in 1914. Four years later the credibility of monarchy was gone and four empires collapsed, triggering the instabilities of the past 100 years. KF
Kairofocus
As if the (mainly darwinist oriented) left cared just a little bit. “Survival of the fittest” is their mantra.
If imposing their ideals costs millions of lives, so much the worse for the “less adapted” monkeys.
The darwinian idea has to be imposed (very “funny” because according to these deranged individuals, both the mind and ideas “do not exist”).
Kf,
You may be interested in article from 2011 on medical recommendations by the IDSA
While RCTs are the best source for recommendations, they make up a small percentage of the basis for recommendations.
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/226373
The issue is complicated but essentially blind adherence to RCTs as the only source for medical treatments would prevent effective medical recommendations.
Nowhere is anyone arguing that RCTs are not useful but as we have seen for example in the two Boulware studies, they are sometimes poorly designed and implemented. Or in the testing of obvious treatments ethically appropriate when one of the likely outcomes is death
But politics Trumps morals. Which indicates “what morals?”
Médias24: How do you perceive the Covid situation in Morocco, which you follow on a daily basis?
El Mahdi El Mhamdi : I often wonder if there is a real monitoring of the progress of scientific knowledge.
You don’t have to be a professor of medicine to understand that hydroxychloroquine is not a cure. There are public statements, for example in Switzerland, from the health ministers of the various centers for disease control and prevention (CDC) … who say so …
Since May, this subject is almost closed scientifically speaking . There is a sterile controversy in France around Raoult, but the directives of learned societies are very clear. The Swiss, for example, communicated well in May, on the fact that this product is not prescribed; except in controlled clinical trials in hospital settings (which have mostly stopped testing chloroquine since the evidence against it accumulated).
The same goes for several countries including the United States, England but also South Korea, China, Canada, Australia, Japan, Portugal, Germany, Italy etc., i.e. the most medically developed.
Moroccans must be told that there is no effective treatment , that hydroxychloroquine is not a treatment.
It is harmful to make people believe that there is a cure.
-Some will say that if it doesn’t hurt, it doesn’t hurt …
-It lowers the guard. A significant part of society believes that there is a cure, believes in the existence of a good protocol, which works well, which is effective. It lets your guard down.
There are Moroccan medical professors who speak of “national protocol”, of “sovereign decision” and persist in using these elements of language. Engaging the sovereignty of the country and tilting the debate towards a kind of nationalist populism on a subject of scientific debate is a serious mistake.
On the one hand, there are generally young doctors who read English and technical literature. On the other, an older or older generation, which does not have a very dynamic practice of scientific research, which is partly rentier, well established, which is very disconnected from modern research practice.
https://www.medias24.com/entretien-il-faut-cesser-de-faire-croire-que-l-hydroxychloroquine-est-un-traitement-13122.html
For Kf,
You said you monitor this thread so this is for you.
An article about treatments for virus infection. In an article on treating viruses
considers the reason behind all the anti-HCQ hysteria is that it threatens the very large vaccine market. If a simple treatment can defeat the C19 virus could it or something similar also defeat the flu?
We have been told for years that there is no treatment for the flu and similar viruses or the common cold except rest and our immune system. But would that all change if a simple treatment eliminated the need for a vaccine?
https://jpands.org/vol25no3/merritt.pdf
In a clinical trial testing whether a daily regimen of hydroxychloroquine could protect those most likely to be exposed to COVID-19, researchers from the Perelman School of Medicine at the University of Pennsylvania found there was no difference in infection rates among health care workers who took the drug versus those taking a placebo. While the researchers observed a lack of effect associated with hydroxychloroquine, infection levels were low among the participants, which the researchers believe points to the effectiveness of other prevention measures in the health system: social distancing, use of personal protective equipment, and proper hand hygiene. The study was published today in JAMA Internal Medicine.
This work represents the first randomized trial of hydroxychloroquine’s prophylactic effect for those not yet exposed to COVID-19,” said the study’s lead author, Benjamin Abella, MD, MPhil, a professor of Emergency Medicine and the director of Penn Medicine’s Center for Resuscitation Science. “And while hydroxychloroquine is an effective drug for the treatment of diseases like lupus and malaria, we saw no differences that would lead us to recommend prescribing it as a preventive medication for COVID-19 in front line workers.”
https://medicalxpress.com/news/2020-09-hydroxychloroquine-effective-placebo-covid-.html
A meme being shared across social media has falsely suggested the low COVID-19 death toll in Uganda is due to hydroxychloroquine being used widely by the population.
As of Sept. 29, 75 COVID-related deaths have been reported in Uganda along with 7,777 infections. Despite this being a higher number than cited in the meme, it is still a relatively low figure considering the size of the country and compared with the rest of the world.
The reason is not entirely clear, but it is inaccurate to suggest a link to Ugandans taking hydroxychloroquine “like candy” for malaria. In the early 2000s, treatment for malaria in the east African nation often consisted of a mix of chloroquine and sulphadoxine-pyrimethamine (SP) (here), but this treatment policy was changed in 2005 to focus on artemisinin-based therapies (here).
Early into the COVID-19 pandemic, in April, Ugandan officials said they had been using hydroxychloroquine on some virus patients (here), but the practice had been halted by July (here here). This was a month after the World Health Organization (WHO) discontinued experimental treatments involving the use of hydroxychloroquine and lopinavir/ritonavir after the initial results of an international trial showed the drugs produced little or no reduction in the mortality of hospitalised COVID-19 patients (here here).
Instead, experts have suggested Uganda’s low death toll may have more to do with an aggressive lockdown imposed early in the crisis, and three days before it confirmed its first domestic case (here here). Other reports have said the limited capacity of the Ugandan health system may mean many infections and deaths have not been reported (here) .
https://www.reuters.com/article/uk-factcheck-uganda-idUSKBN26L2KW
Professor Bernard Bégaud, pharmacologist and former president of the University of Bordeaux-II, has long headed one of the largest drug monitoring departments in France. He is also an expert who follows the work of Professor Didier Raoult with interest, without falling into controversy. He gives an update on hydroxychloroquine, after the publication of new studies on the subject. All, carried out abroad.
What can we say today about the effectiveness or not of hydroxychloroquine? Do we now have a precise opinion?
We can not say that the studies have definitively decided, in the sense that none provide certainty, but with time and the data that accumulate, all this leads us to note that hydroxychloroquine does not significant effect, neither on a reduction in the risk of developing a serious form linked to Covid-19 nor on the fact of preventing contamination or the passage to the disease.
https://www.liberation.fr/france/2020/09/30/covid-19-l-hydroxychloroquine-n-a-pas-d-effet-significatif_1800963
RH7, you are still not able to sweep away the plausible action mechanisms in the OP. There are no grounds to regard as excessively toxic and reanalysis of statistics is showing significant effects even in hospitalisation: https://www.worldtribune.com/effectiveness-of-hydroxychloroquine-was-hiding-in-plain-sight/ KF
PS: This paper (HT Jerry, IIRC) opens out the issue to the broad question of antiviral activity: https://jpands.org/vol25no3/merritt.pdf That is, it’s not just CV19, it is antivirals in general that have to be looked at. Let’s clip the opening remarks:
>>The Treatment of Viral Diseases: Has the
Truth Been Suppressed for Decades?
Lee D. Merritt , M.D.
Since I started medical school in 1976, until 2020, I have
heard the dogma that viral diseases are not treatable (with
some exceptions such as antivirals for HIV/AIDS), certainly
not with antimicrobials. My older son, a newly minted general
surgeon, was educated much more recently, but with the same
misunderstanding. Since viral diseases are not treatable, our
only weapon is vaccination. A friend who spent his life as an
academic university physician retiring in 2016 had never heard
this fact either.
As the “pandemic” broke out, I constantly watched and read
online publications. After reading about the Chinese, Indian,
and Korean use of hydroxychloroquine (HCQ), an antimalarial
agent, against coronavirus, within an hour I found more than
20 scientific papers, written in the last 40 years on the use of
lysosomotropic agents—specifically chloroquine—to treat
viruses. Like Rip Van Winkle, I suddenly awoke, after decades, to
a completely new medical reality.
For example, “numerous investigations have reported
in vitro antiviral activity of AZ [azithromycin] against viral
pathogens with 50% inhibitory concentrations ranging from ~
1–6 [micro]M[olar], with the exception of H1N1 influenza,” write Damle et al. 1
They state that in vitro evidence suggests that AZ has antiviral
properties at concentrations that are physiologically achievable
with doses used to treat bacterial infections in the lung.
Intracellular sequestration of AZ may prevent viral replication.
AZ is being used against COVID-19, with the generally stated
rationale being its antibacterial or antiinflammatory activity.
Antibiotics used in Lyme disease, including tetracyclines,
macrolides, metronidazole, and ciprofloxacin, may have activity
against a number of viruses. 2
How could all our medical education “overlook” this basic
science?
It may be difficult for non-physicians to appreciate the
magnitude of this world-shaking scientific omission—and
probable cover-up. It is the pharmaceutical equivalent of being
told for 40 years the world is flat—only to have it conclusively
exposed overnight to be round. This idea that viruses—like
the current pandemic SARS-CoV-2 virus—can be killed by
commonly used drugs—antibiotics, antimalarial, or antiparasitic
agents—profoundly changes the practice of medicine. >>
KF
You keep repeating this as if it’s relevant. I don’t think that anyone here is disagreeing with your description of the plausible action mechanism. What is relevant is that study after study, and there have been many, at all stages of infection, fail to find that HCQ has a significant benefit in recovery.
And yet there are many people who have recovered from the virus thanks to hydroxychloroquine. Obviously Mac is just another willfully ignorant troll.
Dr Zelenko has a $200,000 reward to anyone who can demonstrate his use of HCQ is ineffective. It is very telling that no one has claimed the cash.
ET: And yet there are many people who have recovered from the virus thanks to hydroxychloroquine. Obviously Mac is just another willfully ignorant troll.
Ah but how do you know it was the HCQ? That’s the tricky part to establish.
Dr Zelenko has a $200,000 reward to anyone who can demonstrate his use of HCQ is ineffective. It is very telling that no one has claimed the cash.
What are his criteria for falsifying his stance? Has he stated it explicitly and is it possible?
JVL:
The relevant professionals said it was.
Why are you asking me? You should be on google trying to figure that out. Jerry has posted the challenge on UD more than once.