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

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

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

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

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

https://www.youtube.com/watch?v=yjkPdwlhI8A

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:

https://www.youtube.com/watch?v=3ywj-PZTt4g

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

Comments
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-rhampton7
September 17, 2020
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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-covid19rhampton7
September 17, 2020
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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/rhampton7
September 17, 2020
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Well, as long as you have a "herd mentality", everything is gong to work out fine for you in the US.TimR
September 16, 2020
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F/N: While I am at it, let's do some more clipping from Tablet, here, on the much belittled and sidelined Dr Didier Raoult, Backdrop, from Doidge:
We live in a culture that has uncritically accepted that every domain of life is political, and that even things we think are not political are so, that all human enterprises are merely power struggles, that even the idea of “truth” is a fantasy, and really a matter of imposing one’s view on others. For a while, some held out hope that science remained an exception to this. That scientists would not bring their personal political biases into their science, and they would not be mobbed if what they said was unwelcome to one faction or another. But the sordid 2020 drama of hydroxychloroquine—which saw scientists routinely attacked for critically evaluating evidence and coming to politically inconvenient conclusions—has, for many, killed those hopes. Phase 1 of the pandemic saw the near collapse of the credible authority of much of our public health officialdom at the highest levels, led by the exposure of the corruption of the World Health Organization. The crisis was deepened by the numerous reversals on recommendations, which led to the growing belief that too many officials were interpreting, bending, or speaking about the science relevant to the pandemic in a politicized way. Phase 2 is equally dangerous, for it shows that politicization has started to penetrate the peer review process, and how studies are reported in scientific journals, and of course in the press. Those who have their doubts about hydroxychloroquine rightly point out that the public is scared, and we are longing for a magical potion to rescue us. The history of plagues is rife with such potions and the charlatans who sold them were well documented in Daniel Defoe’s Journal of a Plague Year. A pandemic is not a remedy for the innate tendency toward wishful thinking. What is unique about the hydroxychloroquine discussion is that it is a story of “unwishful thinking”—to coin a term for the perverse hope that some good outcome that most sane people would earnestly desire, will never come to pass. It’s about how, in the midst of a pandemic, thousands started earnestly hoping—before the science was really in—that a drug, one that might save lives at a comparatively low cost, would not actually do so. Reasonably good studies were depicted as sloppy work, fatally flawed. Many have excelled in making counterfeit bills that look real, but few have excelled at making real bills look counterfeit.
Hard words, but as we already saw, warranted. Next, our maverick, anti-hero:
Especially influential in much of the world in the early days (if not the U.S., which often, focuses, it seems, mostly on studies from the Anglosphere) were studies commissioned by the French government and led by the microbiologist, physician, and professor of infectious disease and virology, Didier Raoult, from l’Institut hospitalo-universitaire (IHU), which he directs in Marseille, and which had assembled one of the largest datasets in Europe. Raoult is the most highly cited microbiologist in Europe, recognized for having identified 468 novel species of bacteria, most in humans, and for his team having discovered the largest virus ever documented at the time (so large it had been mistaken for an intracellular bacterium). He has boldly asserted that viruses—which had been classified as nonliving—are alive. He has published over 2,000 papers, many of them through the IHU, with him as a contributing or lead author. He has been given major awards, the French Legion d’honneur, and perhaps the most important one for a microbiologist, having a bacteria genus, “Raoutella,” named in his honor . . . . At 68 years of age, he rides a Harley to work. He still treats patients. He sees himself as more like a philosopher or anthropologist than a typical French scientist, and teaches epistemology, the study of how we know that we know things, to his lab scientists, He believes an ever-increasing homogeneity is ruining scientific thought. He told Paris Match: I am Nietzschean, I am looking for contradiction, trouble to strengthen myself. The worst is the comfort: It makes you silly ... The more humans you have, the less they think differently. The “politically correct,” the “compliant thinking” are only a mass effect, to be avoided, even if it is difficult to resist! ... To follow the herd no brain is needed, legs are sufficient ... I don’t like movements, I run in the opposite direction. In general, that is where there are nuggets.
If you went off the typical anglophone press over the past several months, likely, you wouldn't expect that sort of eminence. That his research centre has 85 scientific staff and is based in a 4-hospital cluster in Marseilles, with about 3500 beds likely was not noted. Nor, that for instance, he could whistle up thousands of CT scans as part of his research. That he is an epistemologist is also significant. He understands styrengths and limitations of empirical knowledge claims. likely, including the intersection of epistemology and ethics with issues of prudence that lie at the pivot of the issues on HCQ based cocktails, likely ivermectin etc too. So, too
Raoult was the one in his lab who came up with the idea of combining the two older drugs, HCQ and azithromycin, for COVID-19. A contrarian specialty of his has been “repurposing” or “repositioning” inexpensive generic and already available medications to fight infections. Repurposing has huge advantages. If a drug can be repurposed as an antiviral in an outbreak, it provides an already approved drug on hand, one with which we have had years of experience, so we know its drug interactions, how to monitor its effects on the major organs, how to test for blood levels, as well as its “posology,” or the science of how a drug’s dosing changes in different situations, and its safety profile and side effects. Moreover, old drugs have huge advantages over new ones in this area, because often bad effects don’t show up for years after the drug is brought to market. For instance, we now know that methotrexate, which is used for certain kinds of arthritis, can cause cancer years later; certain chemotherapies for cancer can cause heart problems years later. New psychiatric drugs, often heralded to have better side effect profiles than the current ones on the market, turn out, as time passes to be far worse, and cause diabetes. The only way to learn about long term effects of anything is via time . . . . People who get cold viruses and ask their physicians if they can have an antibiotic are told that old adage: “Antibiotics kill bacteria, not viruses.” And that is true for most antibiotics. But Raoult’s team was able to show that azithromycin, classically described as “an antibiotic that fights bacteria,” was effective in protecting cells that were infected with the Zika virus. His team also had 20 years of experience of repurposing HCQ for the long-term treatment of a kind of Q fever—another infectious disease. Sometimes drugs developed for noninfectious disease turn out to fight infection. Some antihypertensives, for example, have antiviral properties, it turns out. By investigating these relationships systematically—simply trying old drugs on new conditions and seeing what happened—Raoult was making a career of, or increasing the probability of, making the kinds of “chance” observations that the Chinese physicians had made when they saw that lupus patients on HCQ seemed not to be getting COVID-19. He was making his luck. The idea of studying HCQ as part of a “drug cocktail” to treat COVID-19 had a personal resonance for Raoult. Part of his childhood was spent in French Senegal (in Dakar) where his father, a military physician, was stationed, and as a kid Raoult took chloroquine to prevent malaria. He had a realistic sense of its long-term side-effect profile, and didn’t take at all seriously the media characterization of its safer version, HCQ, as especially dangerous, if taken for several weeks to treat COVID-19, if patients were properly monitored. When the pandemic broke, the first thing that Raoult studied was the effects of HCQ and azithromycin on “viral load,” or how much COVID-19 virus a given patient had. Leaving aside other factors—including the patient’s general health, immune system, diet, Vitamin D status, age, and more—Chinese physicians knew the amount of virus present correlated with severity of symptoms in sick patients, and doctors were beginning to think that “how much virus” the patient has to deal with was likely a factor in how they would ultimately fare. The longer that virus had to replicate in the body, especially in a vulnerable person, the harder it might be to defeat. So, early in the battle against the virus physicians realized that if a medication was to work, the earlier it was given to an infected person the better.
So, we came to:
Raoult’s clinical group found that for the medications to work, they had to be given early—something since replicated. This happens with anti-flu drugs as well—there is a need to stop the virus in its tracks before it overwhelms the body. This was not only a viral load issue. It had to be given, it seemed, before the cytokine storms got fully underway. COVID-19 is almost like two illnesses—one before the storm, and one after. Any evidence about the use of HCQ and azithromycin given after the storm starts might well be irrelevant to its effectiveness before the storm. As well, HCQ is cleared out of the body in significant part by the kidneys. But the COVID-19 disease process can attack small blood vessels, and seriously harm the kidneys (and other organs, including the heart and brain). Basic physiology suggests that giving HCQ after the kidneys are destroyed would likely mean they would not be able to filter and clear many of the medications the patients were on, including HCQ, and so those patients would be more vulnerable to overdose complications. Meanwhile, some American physicians and specialists in infectious disease working on the frontlines began reporting to American media that they were seeing HCQ benefits in their own patients too, from some large groups of physicians at the Henry Ford Health Systems in Detroit, to ones in private clinics. Two physicians with decades of experience with epidemics—Drs. Jeff Colyer and Daniel Hinthorn—wrote in the Wall Street Journal, “the therapy [HCQ plus azithromycin] appears to be making a difference. It isn’t a silver bullet, but if deployed quickly and strategically the drug could potentially help bend the pandemic’s ‘hockey stick’ curve.” Given that the American political class and pharmaceutical industry had outsourced the making of essential medications abroad, chiefly to China and India, Colyer and Hinthorn publicly asked for federal help to secure the supply. Hydroxychloroquine was not yet a household word. It was just another molecule, making its way through the world, with a good-enough reputation.
Then came the follytricks of 2020. This largely drowned out:
On April 9, Dr. Raoult’s French center released the initial abstract reporting their team had now put 1,061 patients on HCQ (for 10 days) and azithromycin (for five days), and it was ultimately published in Travel Medicine and Infectious Disease on May 1. All the patients had had viral tests, to establish the diagnosis, and had electrocardiograms. Genetic analysis of their viruses was also performed. By publication time 91.7% of those patients had a good clinical outcome and a virological cure. Eight patients (0.75%) died, ranging from 74-90 years of age, often having several other complicating illnesses. These were far better results than in most centers. They also found that only 5% of the patients were shedding the virus after the first week of treatment. They reported that none of the patients had the dreaded cardiac side effects that were being discussed by some. Was this the last word on HCQ? No. According to Raoult’s own scholarly interest in how epidemics are expressed differently in different locales, other studies would have to be done. For instance, in Marseille, Raoult found hardly any obesity in his study population. But in America, the COVID-19 epidemic was happening on top of another epidemic: According to the CDC, 71.6% of American adults are overweight, and 39.8% are overweight to the point of being obese; and obesity, often associated with diabetes, are two huge risks factors for COVID-19. They might somehow lower the drug’s effectiveness. One couldn’t assume that because a study showed the drugs worked in Marseille, they would work in the United States. By the same token, just because an American study might get poor results for the combo, wouldn’t mean the Marseille study was inaccurate.
Where, too let us note:
This study also wasn’t a randomized control trial, intentionally. As noted, Raoult doesn’t believe in them during a pandemic (nor at some other times). As he told the Times: “We’re not going to tell someone, ‘Listen, today’s not your lucky day, you’re getting the placebo, you’re going to be dying.” [--> or worse, not telling though there is a clear record that the person is being given sugar pills or the like or even fake surgeries etc.] What was emerging in scientific circles now was a debate about “methodology,” or what kind of scientific study of HCQ was appropriate in an emerging, lethal pandemic. We tend to think of methodology as a dry question that has nothing to do with morality. The methodologist asks what is the best technique to get at the most certainty most quickly, and usually answers: a randomized control trial, or RCT. But in medicine, moral concerns can’t be humanely divorced from methodology. Early in a pandemic, when we know little, there is a moral imperative to start gathering data. While RCTs are often (but not always, see below) the best kind of study, they take more time, and involve randomly assigning, say, half the patients to a new unknown but promising treatment, and half to either a placebo (sugar pill) or treatment-as-usual (which might be nothing). They are a type of experiment. With a milder disease, slow to overtake its victims, with some viable treatments to compare, one would perform RCTs sooner rather than later. If the disease is slow to kill, and patients don’t get better in the study, they might try another treatment or two after the study ends. But COVID-19 is lethal, kills within weeks when it does, and there was no good standard treatment for very sick patients, which meant that in a randomized study, some people would most likely get no effective treatment, and no second chance with another treatment after the study was done. Raoult was saying those people were being randomly assigned to death. That is one reason why so many researchers, like Raoult, opted for observational studies, in which as many patients as possible are treated. This is not a matter of choosing a design that is “fatally flawed,” it is a matter of choosing a design that is not unnecessarily fatal to the patients. It’s is not sloppiness (as some of his critics would allege), but being true to the study question as he saw it: How can we save as many lives as possible. These observational studies could begin almost immediately, and didn’t require the slow approval process that RCTs require, in part because of the moral dilemmas they raise. Still, given that pandemics kill tens of thousands, if not millions, why not favor the cold-hearted methodologist, who is willing to stand back on a high hill, like a general in a war, and take some casualties to get a win sooner? Isn’t that more moral in the long run? Not necessarily. It is a common conceit of methodologists that they alone can improve the quality of medicine, which, without them, would be hopelessly unscientific. But diseases are very complicated. I know, from personal experience, that pure methodologists—like “armchair generals”—i.e., researchers who have perhaps have never treated a single patient with the relevant illness—often make very elementary errors in design because they don’t understand how people react to illness, the illnesses themselves, or the burden of side effects, but rather work from models. Here is just one kind of such elementary methodological error. The kind of Russian Roulette RCT I described above, which involves withholding a possible treatment from a lethal disease, is a methodologist’s dream design. But you won’t likely volunteer yourself or loved ones for it if there is a more direct access to a promising treatment in a dire situation. Almost no sane, nonsuicidal person will, if properly informed about what is going on (which doesn’t always happen). This is why the role of the “clinician-researcher” developed. A union of humane medicine with the certitude-seeking scientific researcher, these people don’t solve all research design problems; rather their role is, ideally, not to lose sight of the inherent tension of the enterprise. Anyone who has performed both sides of that compound discipline in good faith knows there are profound ongoing moral conflicts between the good doctor, who thinks of the patient in front of him or her, and the scientist who thinks of the ideal methodology, which—it is hoped—might benefit other patients in the future. The randomization conflict almost always exists in serious illness, because we don’t generally study treatments on dying people that we think have no chance of working. Any clinician-researcher deserving the name knows that being a researcher does not cancel out the clinician’s Hippocratic oath to do no harm, or give them permission not to do what is best for the patient.
There's more, but this is enough to spark more balanced thought. KFkairosfocus
September 16, 2020
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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. KFkairosfocus
September 16, 2020
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349 Kairosfocus
gold standards that fail the epistemological test.
Most people do not understand what these words mean. Scientism has clouded the Western mind. The West needs a philosophical re-do. Or it will disappear (Islam is aware of our sorry state and China would like for the USA to totally surrender to the marxist pestilence). Materialism’s Failures: Hylemorphism’s Vindication. (Aristotle is back). Truthfreedom
September 16, 2020
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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 GovernmentET
September 16, 2020
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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. . KFkairosfocus
September 16, 2020
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Materialist's goddess "science" seems not to be very pleased. Maybe they have not offered her enough child sacrifices (a.k.a. abortions). Truthfreedom
September 16, 2020
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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.jerry
September 16, 2020
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Jerry
You have continually announced these milestones. But yet fail to comment on why the numbers grow. We have an unprecedented situation where a disease is claiming lives but there is no recommended treatment.
I have mentioned several times why the numbers keep growing. Poor federal leadership, mixed messages, etc.Mac McTavish
September 16, 2020
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Another sad milestone. We now have over 200,000 COVID deaths. Back in March I don’t think any of us would have predicted this.
You have continually announced these milestones. But yet fail to comment on why the numbers grow. We have an unprecedented situation where a disease is claiming lives but there is no recommended treatment. When has this happened last? Especially when there are known effective treatments but politicians, many medical authorities and the press denounce them. Are all those who oppose effective treatmentS the ones guilty for these deaths? Are those who seem to celebrate these deaths, the ones who have blood on their hands? J’accuse!jerry
September 16, 2020
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TF, 30 years of climate change policy-making turned into precedent. Esp. when multiplied by failure to understand that economic valuation cannot effectively be centralised, making nonsense of overly ambitious macro-level economy centralisation in the hands of bureaucrats. Mix in the toxic brew that demonises the investor class and scholarship that escapes the politically correct reservation. Policy induced deep recession and also stagnation in such . . . depression . . . is a serious issue with its own uncounted casualties that credibly already do/will far exceed the 900k global numbers from SARS2. Where, suppression of effective but inconvenient treatment protocols is part of the picture. KF PS: Blurb:
For the first time in history, the world shut itself down—by choice—all for fear of a virus, COVID-19, that wasn’t well understood. The government, with the support of most Americans, ordered the closure of tens of thousands of small businesses—many never to return. Almost every school and college in the country sent its students home to finish the school year in front of a computer. Churches cancelled worship services. “Social distancing” went from a non-word to a moral obligation overnight. Moral preening on social media achieved ever new heights. The world will reopen and life will go on, but what kind of world will it be when it does? It can’t be what it was, because of what’s just happened. Professors Jay Richards, William Briggs, and Douglas Axe take a deep dive into the crucial questions on the minds of millions of Americans during one of the most jarring and unprecedented global events in a generation. What will be the total cost in dollars, lives, and livelihoods of this response from governments, on advice from Science? What role have national and global health organizations such as WHO played in this? To whom are they accountable? What evidence do they rely on in sounding the alarm? How did science bureaucrats, relying on murky data and speculative computer models, gain the power to shut down the global economy? How did politicians, who know nothing of the science, decide whom to trust? We need to know what and how it happened, to keep it from ever happening again.
kairosfocus
September 16, 2020
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Questions
How did science bureaucrats, relying on murky data and speculative computer models, gain the power to shut down the global economy? How did politicians, who know nothing of the science, decide whom to trust? - We need to know what and how it happened, to keep it from ever happening again.
The Price of Panic "How the Tyranny of Experts turned a Pa demic into a Catastrophe". Truthfreedom
September 16, 2020
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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. Truthfreedom
September 16, 2020
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F/N: A Hong Kong exile physician is raising questions of signs of genetic engineering in the SARS-2 virus genome:
The COVID-19 pandemic caused by the novel coronavirus SARS-CoV-2 has led to over 910,000 deaths worldwide and unprecedented decimation of the global economy. Despite its tremendous impact, the origin of SARS-CoV-2 has remained mysterious and controversial. The natural origin theory, although widely accepted, lacks substantial support. The alternative theory that the virus may have come from a research laboratory is, however, strictly censored on peer-reviewed scientific journals. Nonetheless, SARS-CoV-2 shows biological characteristics that are inconsistent with a naturally occurring, zoonotic virus. In this report, we describe the genomic, structural, medical, and literature evidence, which, when considered together, strongly contradicts the natural origin theory. The evidence shows that SARS-CoV-2 should be a laboratory product created by using bat coronaviruses ZC45 and/or ZXC21 as a template and/or backbone. Building upon the evidence, we further postulate a synthetic route for SARS-CoV-2, demonstrating that the laboratory-creation of this coronavirus is convenient and can be accomplished in approximately six months. Our work emphasizes the need for an independent investigation into the relevant research laboratories. It also argues for a critical look into certain recently published data, which, albeit problematic, was used to support and claim a natural origin of SARS-CoV-2. From a public health perspective, these actions are necessary as knowledge of the origin of SARS-CoV-2 and of how the virus entered the human population are of pivotal importance in the fundamental control of the COVID-19 pandemic as well as in preventing similar, future pandemics . . . . We present three lines of evidence to support our contention that laboratory manipulation is part of the history of SARS-CoV-2: i. The genomic sequence of SARS-CoV-2 is suspiciously similar to that of a bat coronavirus discovered by military laboratories in the Third Military Medical University (Chongqing, China) and the Research Institute for Medicine of Nanjing Command (Nanjing, China). ii. The receptor-binding motif (RBM) within the Spike protein of SARS-CoV-2, which determines the host specificity of the virus, resembles that of SARS-CoV from the 2003 epidemic in a suspicious manner. Genomic evidence suggests that the RBM has been genetically manipulated. iii. SARS-CoV-2 contains a unique furin-cleavage site in its Spike protein, which is known to greatly enhance viral infectivity and cell tropism. Yet, this cleavage site is completely absent in this particular class of coronaviruses found in nature. In addition, rare codons associated with this additional sequence suggest the strong possibility that this furin-cleavage site is not the product of natural evolution and could have been inserted into the SARS-CoV-2 genome artificially by techniques other than simple serial passage or multi-strain recombination events inside co-infected tissue cultures or animals.
We already know the Chinese were utterly irresponsible in suppressing facts and in not locking down international travel. Now we need to ponder whether these signs are enough for us to raise questions about genetic engineering practices and bio-lab lab safety practices. Anyway, food for thought. KFkairosfocus
September 16, 2020
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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. KFkairosfocus
September 16, 2020
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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.JVL
September 16, 2020
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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.ET
September 15, 2020
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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.Mac McTavish
September 15, 2020
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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
September 15, 2020
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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 McTavish
September 15, 2020
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F/N: It is time to clip Dr Norman Doidge, a contributing writer for Tablet, who is a psychiatrist, psychoanalyst, and author of The Brain That Changes Itself and The Brain’s Way of Healing. Here, first, from Medicine's Fundamentalists (language I don't like as it itself reflects a successful smear job):
The randomized control trial controversy: Why one size doesn’t fit all and why we need observational studies, case histories, and even anecdotes if we are to have personalized medicine August 14, 2020
If the study was not randomized, we would suggest that you stop reading it and go on to the next article. —Quote from Evidence-Based Medicine: How to Practice and Teach EBM [--> notice the loaded language in the name of the movement, pivoting on an improper constriction on what counts as cogent empirical evidence for medical decision-making]
Why is it we increasingly hear that we can only know that a new treatment is useful if we have a large randomized control trial, or “RCT,” that has positive results? Why is it so commonly said that individual case histories are “mere anecdotes” and count for nothing, even if a patient, who has had a chronic disease, suddenly gets better with a new treatment after all others failed for years—an assertion that seems, to many people, to run counter to common sense? [--> anecdotes is, of course, further loaded language. We are not talking about quaint humourous stories, nor are we just cherry picking coincidental cases, if there is a lawlike dynamic at work in a situation or there are strong odds at work, that can begin to appear from the very outset, within a few cases.] Indeed, some version of the statement, “only randomized control trials are useful” has become boilerplate during the COVID-19 crisis. It is uttered as though it is self-evidently the mainstream medical position. When other kinds of studies come out, we are told they are “flawed,” or “fatally flawed,” if not RCTs (especially if the commentator doesn’t like the result; if they like the result, not so often). The implication is that the RCT is the sole reliable methodological machine that can uncover truths in medicine, or expose untruths. But if this is so self-evident, why then, do major medical journals continue to publish other study designs, and often praise them as good studies, and why do medical schools teach other methods? [--> as in, we see here a fallacy being exposed] They do because, as extraordinary an invention as the RCT is, RCTs are not superior in all situations, and are inferior in many. The assertion that “only the RCTs matter” is not the mainstream position in practice, and if it ever was, it is fading fast, because, increasingly, the limits of RCTs are being more clearly understood. Here is Thomas R. Frieden, M.D., former head of the CDC, writing in the New England Journal of Medicine, in 2017, in an article [--> already cited and of course hyperskeptically dismissed] on the kind of thinking about evidence that normally goes into public health policy now:
Although randomized, controlled trials (RCTs) have long been presumed to be the ideal source for data on the effects of treatment, other methods of obtaining evidence for decisive action are receiving increased interest, prompting new approaches to leverage the strengths and overcome the limitations of different data sources. In this article, I describe the use of RCTs and alternative (and sometimes superior) data sources from the vantage point of public health, illustrate key limitations of RCTs, and suggest ways to improve the use of multiple data sources for health decision making. … Despite their strengths, RCTs have substantial limitations.
That, in fact, is the “mainstream” position now, and it is a case where the mainstream position makes very good sense. The head of the CDC is about as “mainstream” as it gets. The idea that “only RCTs can decide,” is still the defining attitude, though, of what I shall describe as the RCT fundamentalist. By fundamentalist I here mean someone evincing an unwavering attachment to a set of beliefs and a kind of literal mindedness that lacks nuance—and that, in this case, sees the RCT as the sole source of objective truth in medicine (as fundamentalists often see their own core belief). Like many a fundamentalist, this often involves posing as a purveyor of the authoritative position, but in fact their position may not be. As well, the core belief is repeated, like a catechism, at times ad nauseum, and contrasting beliefs are treated like heresies. What the RCT fundamentalist is peddling is not a scientific attitude, but rather forcing a tool, the RCT, which was designed for a particular kind of problem to become the only tool we use. In this case, RCT is best understood as standing not for Randomized Control Trials, but rather “Rigidly Constrained Thinking” (a phrase coined by the statistician David Streiner in the 1990s).
Continuing:
. . . In a randomized control trial, one takes a sufficiently large group of patients and randomly assigns them to either the treatment group, or the nontreatment (“placebo” or sugar pill) control group, for instance. Efforts are made to make sure that apart from the treatment, everything else remains the same in the lives of the two groups. It is hoped that by randomly assigning this large number of patients to either the treatment or nontreatment condition, that each of the confounding factors will have an equal chance of appearing in both groups—the factors we know, such as age, but also mysterious ones we don’t yet understand. While observational studies can, with some effort, match at least some confounding factors we do understand in a “group matched design” (and, for instance, make sure both groups are the same age, or disease severity), what they can’t do is match confounding factors we don’t understand. It is here, that RCTs are generally thought to have an advantage. With such a good technique as RCTs, one might wonder, why do we ever bother with observational studies? There are a number of situations in medicine in which observational studies are obviously superior to randomized control trials (RCTs), such as when we want to identify the risk factors for an illness. If we suspected that using crack cocaine was bad for the developing brains of children, it would not be acceptable to do an RCT (which would take a large group of kids, and randomly prescribe half of them crack cocaine and the other half a placebo and then see which group did better on tests of brain function). We would instead follow kids who had previously taken crack, and those who never had, in an observational study, and see which group did better. All studies ask questions, and exist in a context, and the moral context is relevant to the choice of the tool you use to answer the question. That is Hippocrates 101: Do no harm. Now, you might say that a study of risk factors is very different from the study of a treatment. But it is not that different. There can be very similar moral and even methodological issues.
For instance:
In the 1980s, quite suddenly, clinicians became aware that infants were dying, in large numbers, in their cribs, for reasons that couldn’t be explained, and a new disorder was discovered, sudden infant death syndrome, or SIDS, or “crib death.” Some people wondered if parents were murdering their children, or if it was infectious, and many theories abounded. A large observational study was done in New Zealand that observed and compared factors in the lives of the infants who died and those who didn’t. The study showed that the infants who died were frequently put to sleep on their tummies. It was “just” an observation. But on that basis alone, it was suggested that having infants sleep on their backs might be helpful, and that parents should avoid putting their infants on their fronts in their cribs. Lo and behold, the rates of infant death radically diminished—not completely, but radically. No sane caring person said: “We should really do an RCT, rule out confounding factors, and settle this with greater certainty, once and for all: All we have to do is randomly assign half the kids to be put to bed on their tummies and the other half on their backs.” That would have been unconscionable. The evidence provided by the observational study was good enough. Again, all studies have a context and are a means to answering questions. The pressing question with SIDS was not: How can we have absolute certainty about all the causes of SIDS? It was: How can we save infant lives, as soon as possible? In this case, the observational study answered it well. The SIDS story is a case where we can see how close, in moral terms, a study of risk factors and a study of a new treatment can be in a case where the treatment might be lifesaving. Putting children on their tummies is a risk factor for SIDS. Putting them on their backs is a treatment for it. The moral issue of not harming research subjects by subjecting them to a likely risk is clear.
Bringing it home,
Similarly, withholding the most promising treatment we have for a lethal illness is also a moral matter. That is precisely the position taken by the French researchers who thought that hydroxychloroquine plus azithromycin was the most promising treatment known for seriously ill COVID-19 patients, and who argued that doing an RCT (which meant withholding the drug from half the patients) was unconscionable. RCT fundamentalists called their study “flawed” and “sloppy,” implying it had a weak methodology. The French researchers responded, in effect saying, we are physicians first; these people are coming to us to help them survive a lethal illness, not to be research subjects. We can’t randomize them and say to half, sorry, this isn’t your lucky day today, you are in the nontreatment group.
People are not lab rats or garden pea plants in blocks and plots sliced and diced for ANOVA. There's much more but this is for starters. The hyperskeptics do not hold the default. KFkairosfocus
September 13, 2020
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ET, you are right, esp. given the evident significance of vitamin D deficiency. KFkairosfocus
September 13, 2020
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198,000 and counting.Mac McTavish
September 12, 2020
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COVID-19 should be a wake up call for improving nutritional standards.ET
September 12, 2020
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Kairosfocus/324
Tablet (HT News) begins to counterbalance the dominant narrative on HCQ and Dr Raoult:
RH7 And to counter this dangerous veneration of "mavericks": Dr. Didier Raoult: Bad science on COVID-19 and bullying critics Didier Raoult in the NYT: The “brave maverick” narrative and bypassing science-based medicine Seversky
September 12, 2020
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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/rhampton7
September 12, 2020
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RH7, you need to take some time out and read the two linked articles at Tablet. KFkairosfocus
September 11, 2020
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