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COVID-19 and the need for skeptics in science

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Now more than ever:

Since World War II, America has suffered two respiratory pandemics comparable to COVID-19: the 1958 “Asian flu,” then the 1969 “Hong Kong flu.” In neither case did we shut down the economy—people were simply more careful. Not all that careful, of course—Jimi Hendrix was playing at Woodstock in the middle of the 1969 pandemic, and social distancing wasn’t really a thing in the “Summer of Love.”

And yet COVID-19 was very different thanks to a single “buggy mess” of a computer prediction from one Neil Ferguson, a British epidemiologist given to hysterical overestimates of deaths, from mad cow to bird flu to H1N1.

For COVID-19, Ferguson predicted 3 million deaths in America unless we basically shut down the economy. Panicked policymakers took his prediction as gospel, dressed as it was in the cloak of science.

Now, long after governments plunged half the world into a Great Depression, those panicked revisions are being quietly revised down by an order of magnitude, now suggesting a final tally comparable to 1958 and 1969.

COVID-19 would have been a deadly pandemic with or without Ferguson’s fantasies, but had we known the true scale and parameters of the threat we might have chosen better tailored means to both safeguard the elderly and at-risk, while sustaining the wider economy. After all, economists have long known that mass unemployment and widespread bankruptcies carry enormous health consequences that are very real to the victims suffering drained life savings, ruined businesses, broken families, widespread mental and physical health deterioration, even suicide. Decisions involve tradeoffs.

COVID-19 has illustrated the importance of free and robust inquiry…

Indeed, every major scientific advance challenged the “settled science” of its day, and was often denounced as pernicious and false, even dangerous. The modern blood transfusion, for example, was developed in the late 1600s, then banned for nearly a century by a hostile medical establishment, “canceling” tens of millions of lives at the altar of groupthink and hostility to skeptics.

Peter St. Onge, “The COVID-19 Panic Shows Us Why Science Needs Skeptics” at Mises Wire

The thing is, it used to just be sympathizers of some unpopular viewpoint like ID getting deplatformed. Now, COVID-19 has raised the stakes, with so many official sources demanding obedience to conflicting and wrong ideas. And our neighbors can’t afford to ignore just how destructive the establishment line, unfettered and unhinged, can be.

It’s a good time to talk to them about the problems with Establishment Science today. Too much arrogance and politicking; not enough humility or integrity.

632 Replies to “COVID-19 and the need for skeptics in science

  1. 1
    Seversky says:

    COVID-19 is not a variant of flu. It is a novel virus, one that doctors have not met before, one for which there is, as yet, no vaccine and no drugs with proven efficacy. If the predictions of Ferguson’s models were wide of the mark, they were still better than taking medical advice from incompetent demagogues. And until drugs and vaccines become available then preventative measures such as masks, social distancing and isolation are the only effective ways of slowing the disease. Those areas that have been rigorous in the practice of such measures have seen the benefits. those which didn’t are suffering the consequences. Not the leadership, of course, they are well-protected but ordinary people are dying for the political convenience of their supposedly responsible leaders.

    No, science does not need arrogance and politicking. The researchers in the laboratories and the doctors in the hospitals need the time and resources to find the vaccines and drugs and to treat the victims. They don’t need to be used as cannon-fodder in election campaigns by politicians who are concerned only about themselves.

  2. 2
    ET says:

    Science is only as good as the people who are supposed to follow it. And it seems lime an inexpensive OTC covid-19 remedy exists. The research is there. All that is needed is for people to follow it

  3. 3
    BobRyan says:

    The median age of death in most American states is 80 years old. Someone who is 65 and under has a 0.2% chance of dying from COVID-19. Anyone who uses anti-bacterial soaps and lotions on a constant basis are working to weaken their own immune systems. The masks are a breeding ground for a lot of nasty stuff, since people are more concerned with washing their hands than cleaning their masks.

    If this were a true biological emergency situation, the masks would also cover the eyes and have a filtration system built in. The masks people are wearing end up exhaling towards their eyes. Anyone who wears glasses knows it’s not a tight fit between the nose and eyes. Biological agents of any kind can use the eyes just as easily as the mouth and nose to infect someone.

    The masks, much like constant hand washing, do nothing to improve the chances of someone staying healthy. It’s a psychological visual and nothing more.

    As far as novel goes, this is actually called SARS-COV-2, which is from the same family as SARS-COV. That was out in the public about 20 years ago. Novel does not mean the body cannot protect itself anymore than it means millions are going to start dying who do not have certain conditions that must be met first.

  4. 4
    jerry says:

    Seven things. Probably more.

    1) C19 is very infectious. Probably a lot of other viruses are equally infectious. H1N1 was extremely infectious less than 10 years ago. Many common colds seem to spread quickly.

    2) Like other infectious viruses the immune system eventually defeats the virus in most cases. However, it seems that a significant portion of the population’s immune system does not defeat C19 very quickly. They seem mostly to be older people.

    3) The C19 virus attacks an important enzyme on certain cell types that has at least two effects. It enables entry to cell and mass replication which destroys the cell. It also inhibits the function of the enzyme which leads to disruption of several processes that lead to clotting and cardiovascular problems. Maybe more but these two alone will cause lasting issues and death.

    4) there are drugs that interfere with these two effects of the virus when used appropriately. One is HCQ and another is zinc. We are finding several others that also interfere with the virus’s actions. So there are potential cures available.

    5) Opposition to the use of these drugs seems to be political as opposed to medical. There also seems to be financial reasons to oppose or promote certain treatments/drugs.

    6) there seems to be no one who has a complete grasp on what to do. For example, no one in authority has a grasp on how to treat the virus since even today there is no official treatment other than palliative or what is called standard care.

    7) no one has a good grasp on the cost benefits of any of the social and economic recommendations being put forward. Obviously people are dying from the virus but maybe far more will die from the economic consequences of trying to contain the virus. So no doctor or expert in infectious diseases or economist or politician can have any reliable understanding of what trying to contain the virus will do either medically, socially or economically.

  5. 5
    Barry Arrington says:

    Sev.

    If the predictions of Ferguson’s models were wide of the mark, they were still better than taking medical advice from incompetent demagogues.

    Even if the incompetent demogogues’ predictions were much closer to what would actually happen than Ferguson’s? So let me get this straight. Sev prefers grossly erroneous estimate pushed by someone in a lab coat to a far better estimate advanced by a politician he does not like (“incompetent demagogue” is a phrase that means the same thing as “politician I do not like”).

    No Sev. In no sense were Ferguson’s idiotic predictions “better” than predictions that were orders of magnitude closer to the truth. That you would think they are says volumes about how you prefer your political narrative to truth. That is immensely sad.

  6. 6
    Bob O'H says:

    Even if the incompetent demogogues’ predictions were much closer to what would actually happen than Ferguson’s?

    Can you provide the figures to back this up?

  7. 7
    Barry Arrington says:

    Bob

    Can you provide the figures to back this up?

    Pick any other prediction made by anyone. They were all better than Ferguson’s. It turns out that we based our policy reaction on the absolute worst projection of all.

  8. 8
    JVL says:

    Barry Arrington: Pick any other prediction made by anyone. They were all better than Ferguson’s.

    You own included? 🙂

  9. 9
    Bob O'H says:

    Thank you Barry for leaving the door wide open. Fortunately, the Washington Post has a few predictions from pres. Trump:
    Feb. 26:

    When you have 15 people [with confirmed cases] — and the 15 within a couple of days is going to be down to close to zero — that’s a pretty good job we’ve done.

    The number of cases got nowhere near to zero.
    Feb. 19:

    I think it’s going to work out fine. I think when we get into April, in the warmer weather, that has a very negative effect on that and that type of a virus. So let’s see what happens, but I think it’s going to work out fine.

    It isn’t working out fine. The warmer weather hasn’t helped (also look at Brazil, hardly a chilly country).
    April 19:

    It looks like we’ll be at about a 60,000 [death] mark, which is 40,000 less than the lowest number thought of.

    Deaths are now considerably above 60k, and are still rising.
    April 20:

    But we’re going toward 50- or 60,000 people [dead]. That’s at the lower — as you know, the low number was supposed to be 100,000 people. We — we could end up at 50 to 60.

    See above.

    So, between “it’s going to go away” and “it’s going to get worse, and a lot of people will die”, which has been more accurate?

  10. 10
    ET says:

    It is working out fine. A very, very, very small % of people are dying. And most were people on their way out or being artificially kept alive. And the fatality rate continues to drop.

    Evos should be happy to see a case of natural selection in the wild.

  11. 11
    Barry Arrington says:

    Bob, I know you progressive types have blinders on and want to think that Trump is uniquely evil. So I guess that his why you didn’t include Nancy Pelosi telling everyone to calm down and go join the big Chinese New Year parties.

    So, between “it’s going to go away” and “it’s going to get worse, and a lot of people will die”, which has been more accurate?

    Move the goal posts much? We are talking about who made a better prediction, Ferguson are pretty much anyone else. Nothing you have said changes the fact that Ferguson made the worst prediction of all.

  12. 12
    jerry says:

    Trump is a salesman as well as president. He has to put a bright side on things or else people would really panic. He has a style that turns a lot of people off.

    But has he told us anything that was egregiously wrong that wasn’t provided by his brain trust? I believe Fauci told everyone not to worry in early March.

    Is there anyone in world with a good track record on accuracy? I believe there are a few but they been treated as Cassandra.

    There is a rooting for the dark side of this pandemic that has generated tons of fake news and fake narratives. It has a new name, “Panic Porn.” We see it here in some of the comments posted. UD is just a microcosm of the much larger world.

  13. 13
    Mac McTavish says:

    This is an interesting and non-partisan comparison between US response to COVID-19 and that of our neighbors to the North.

    https://www.washingtonpost.com/world/the_americas/coronavirus-canada-united-states/2020/07/14/0686330a-c14c-11ea-b4f6-cb39cd8940fb_story.html

  14. 14
    ET says:

    LoL! You have to be desperate to compare Canada with the USA.

  15. 15
    ET says:

    A prophylaxis exists that could have saved more than 50% of the fatalities. The information is out there. It has been posted on UD many times.

    Adapt or die. But most of all take responsibility for your actions and your life

  16. 16
    jerry says:

    Comment this morning by Alex Berenson

    The real story out of Florida is incredible: 150,000 #SARSCoV2 positive tests in the last two weeks, and effectively NO change in either total hospitalizations or ICU use statewide. Case mix? A huge advance in medicine? This is the story real reporters should chase.

    By the way Texas has done better than Canada. New York and New Jersey if countries would be world leaders in deaths per million.

  17. 17
    Mac McTavish says:

    ET

    LoL! You have to be desperate to compare Canada with the USA.

    As my father used to say, “ If you have nothing of substance to say, saying anything just makes you look like a fool.” I suggest that you might want to heed his advice.

  18. 18
    ET says:

    LOL! @ Mac McTavish- We have already beaten your dead horse- that is it’s a fool that tries to compare Canada and the USA. Meaning you didn’t add anything of substance.

  19. 19
    rhampton7 says:

    ‘A doubting Thomas’ is a term often used in reference to the biblical story of the apostle Thomas, as indicated in the Biblical text above who refused to believe that the other apostles had seen the resurrected Jesus until he could actually see and feel the wounds Jesus received during his crucifixion.

    It is never in doubt that many world governments, including our own, the Kenyan Government, were never prepared for the virus; nobody was. That is why it is referred to as ‘novel’ meaning new. It is also true that many mistakes and initial, mix-ups and false test results have added to the confusion like our own Lancet Laboratories in Nairobi and The Kenya Medical Research Institute (KEMRI) /MOH, tiff over discordant Covid19 test results.

    But it should not fool you to believe that the virus is not there. Of course, it is not there, or that is just a figment of the government for clowns who have not come face to face with it.

    Trump’s previous stance, chided presumed Democratic presidential nominee Joe Biden when he wore a black mask during the ‘Memorial Day.’ In swallowing his previous words, Trump had this to say before leaving White House: “I’ve never been against masks, but I do believe they have a time and a place.”

    On Monday 13, July 2020, Former “Love Connection” and “Wheel of Fortune” game show host Chuck Woolery accused medical professionals and Democrats of lying about the virus to hurt the economy and President Trump’s reelection chances. But on Wednesday 15th, July 2020, he had to eat humble pie and forced out of embarrassment rather than the guilt to delete his tweeter account after his son tested positive for Covid19.

    An Ohio veteran, Richard Rose III had this to say about wearing a face mask, two months before he got covid19 and went down with it: “I’ve made it this far by not buying into that damn hype.”

    And of course, Pastor Landon Spradlin described the news of covid19 as mass ‘hysteria’ over nothing, claiming the virus is overhyped. He died after attending Louisiana Mardi Gras Festivals… to ‘save souls.’

    You or someone close to you may not be there next time an article of this kind appears in newspapers or social media, so if you have never believed in coronavirus, you better do. You are not better than the 12,062 positive Kenyans or 222 people who have died, so as of 17th July 2020. They were taxpayers, mothers, fathers, brothers, sisters and uncles, and aunties just like you are.

    Stay Safe.

    https://www.standardmedia.co.ke/ureport/article/2001379312/coronavirus-skeptics-don-t-be-a-doubting-thomas-over-your-own-life

  20. 20
    ET says:

    My family is taking the medically recommended prophylaxis. It has protected us from the flu for over a decade. I have no doubts that it will protect us against covid-19

  21. 21
    rhampton7 says:

    For its first public study, Lucy, a new tool for analyzing conversations on Twitter , launched by the Majorelle agency, ventures into the field of “anti” to study the behavior of seven communities: anti-5G, anti big pharma, anti-vaccines, anti-nucelaria, anti-tech, the supporters of the thesis of “the revenge of nature against man” and the unscientific followers of hydroxychloroquine.

    “Certain pockets of public opinion are clearly overexposed to conspiratorial conversations,” the study said. Certain factors, such as following certain accounts, will encourage overexposure to these messages. “While 7% of French people follow at least one alternative media *, they are 35% among anti-nuclear agents and 57% among anti-vaccines.

    This means that when you follow at least one alternative media, the probability of being exposed to skeptical content explodes: 75% of skeptics who follow an alternative media are exposed to at least one anti-vaccine content every month (against 14% among French people on average), 72% are exposed to anti-5G content (compared to 13% among French people on average) or 86% are exposed to pro-chloroquine content (compared to 24% among French people on average) ). In other words, those who follow alternative media are literally regularly bombarded with messages on certain themes.

    This is verified with chloroquine: “The French received an average of 20 pro-chloroquine messages per day between May 8 and June 8, 2020. Those who follow at least one alternative medium received 230 per day on average in the same period ”, details the study. If the period between May 8 and June 8 could have given the impression that the whole of France was passionate about chloroquine, in a fairly counter-intuitive way, this is much less true on the panel: while the social network seemed to saturate of messages on chloroquine, in reality only 1.8% of French accounts expressed themselves on this subject

    https://www.lepoint.fr/politique/anti-vaccins-anti-5g-hydroxychloroquine-quand-la-defiance-deferle-sur-twitter-10-07-2020-2383828_20.php

  22. 22
    ET says:

    Cholesterol-lowering drug could see coronavirus treated like common cold, study finds

    “By understanding how the SARS-CoV-2 controls our metabolism, we can wrestle back control from the virus and deprive it from the very resources it needs to survive,” said Prof Yaakov Nahmias from the Hebrew University of Jerusalem. He continued: “With second-wave infections spiking in countries across the globe, these findings couldn’t come at a better time. “If our findings are borne out by clinical studies, this course of treatment could potentially downgrade Covid-19’s severity into nothing worse than a common cold.”

    The best news is humans are looking at how to fight this thing from all angles.

  23. 23
    Mac McTavish says:

    ET

    Meaning you didn’t add anything of substance.

    All I did was provide a link to an article for people to discuss. No more, no less. Your decision to deride and insult rather than address substance is a prime example of the type of childish foolishness that my father cautioned me to avoid so as not to make a fool of myself.

  24. 24
    ET says:

    Again- The USA – Canada comparison has already been discussed. The comparison has been deemed a fool’s errand for obvious reasons.

    Notice my response to your initial post did NOT say that YOU, personally, were being desperate:

    You have to be desperate to compare Canada with the USA.

    Or do you feel guilty.

  25. 25
    Mac McTavish says:

    ET, so, what about the comparison made in the linked article do you disagree with? Is it the part that said it was difficult to draw conclusions because of the differences in population density? I wouldn’t think so. Is it the part that said that the Canadian government response was far less partisan? That is easily confirmed. Is it the part about the Canadian health care system making it easier for some to seek help because they won’t have to worry about hospital bills? Again, easily confirmed.

    Frankly, I don’t understand your animosity towards this article. An article which, it appears obvious, you have not read. All it did was point out the differences in the two approaches that may have resulted in different outcomes.

    Or are you one of those who feel that we are so superior to other countries that we can’t learn from their experiences? Personally, I think we should look at all other experiences and not be so blinded by our pride that we refuse to admit that other approaches may be better than ours. But don’t get me wrong. I am not claiming that Canada’s approach is better than ours, just that we would be foolish to ignore it.

  26. 26
    Retired Physicist says:

    Jerry, I saw that comment on Twitter this afternoon and it’s bizarre, Florida’s new cases, new hospitalizations, and new deaths from Covid have all three risen drastically in the last month. I suspect he’s trying to pick one outlier point from two weeks ago and claim the trend line as such. Or he’s trying to make some bullshit argument about the death *rate* going down. The absolute numbers of hospitalizations and deaths here in Florida have doubled in the last month and a half.

    https://tinyurl.com/y5rn7r2l

  27. 27
    ET says:

    Population density is the key. That much is obvious. Jerry has made a minor career out of debunking the comparison.

    The problem with the USA is the people. There are too many of us who really think they know better. And there are too many of us who don’t want any of our freedoms infringed upon for a virus whose fatality rate is dropping. Too many people who understand that life comes with risks and they are willing to take them, Too many people who don’t like being told how they have to live their lives.

    We also have an unhealthy population. Obesity has become a public health crisis. Most of it is due to poor personal choices.

    But anyway- yes, if we could spread out the people, as in Canada, we would fare much the same, regardless of our inclinations.

  28. 28
    Bob O'H says:

    Barry @ 11 – Your “move the goalposts much” comment is a nice touch, when rather than respond to my comments about Trump, you decide to bring Pelosi into this.

    Which prediction of Ferguson’s do you mean? The headline prediction of 2m deaths in the US was based on the US doing nothing, which didn’t happen. I don’t know if anyone has checked his models with the actual responses, but my guess is that they would still over-predict deaths. But at least they did predict an epidemic, with a lot of people dying. The models have also been right in suggesting mitigation strategies (social distancing etc.). How is that worse than “it’ll go away”, which it clearly hasn’t.

  29. 29
    jerry says:

    it’s bizarre

    The claim is correct and uses official Florida statistics. It is supported by the charts you referenced which use different y axis values and are not comparable on a visual basis. (18,000 600 180)

    Yes, deaths have risen. This was always the expectations from opening up. If proper treatment is given, it would have probably been a lot less.

  30. 30
    kairosfocus says:

    Folks,

    I think the following from Scott Morefield, is food for thought:

    We Can’t Stop Coronavirus, But We Can Limit the Damage We’re Doing to Ourselves

    . . . .

    We are now told the area-specific lockdowns, forced-masking, and social distancing measures will remain in place until there is a vaccine, despite the fact that there has never been a successful vaccine for any coronavirus strain. In other words, area-specific lockdowns, masking, and social distancing measures will remain in place forever … for a disease that 99.8 percent of people who contract survive and that mostly kills people who have lived beyond the average human lifespan already (those lives are important too and should be protected, obviously, but there are ways to do that without society-killing measures like we’ve done).

    One of the seemingly illogical aspects of “hiding” from this virus, and perhaps the thing that bothers those of us who like to use logic and common sense along with data and analytics to analyze our predicament, is the panic-stricken approach the media and our leaders are taking. There’s an obvious reason the virus is in places like Houston and Phoenix now and not in New York City: it’s simply their turn. In other words, would it not stand to reason that every major metropolitan area is likely going to “take a turn” with this virus, no matter what they do? Sure, Governor Cuomo could have saved half the deaths by not sending infected patients into nursing homes, but regardless, the virus hit New York City first because it is a highly traveled international destination. America is a big country that spans across several time zones. It’s ridiculous to compare us to Italy, Denmark, Japan, or the U.K., except that New York City alone might be compared to Italy in the sense that both places are winding down in infections after losing more than 30,000 of their people.

    Why are they winding down, and what’s to stop them from picking up again? The media doesn’t believe in herd immunity, apparently, but it’s the only thing that makes sense. Without it, any little outbreak is bound to spread exponentially. The pattern, established time and again, seems to be six to eight weeks of spread in a specific area, then a winding down. Not because of masks, not because of lockdowns, but because herd and T cell immunity eventually do their thing. In New York City, for example, Dr. Scott Gottlieb estimated in late June that 25 percent of residents likely have had the disease. That, combined with T cells currently existing in many in response to fighting common colds, could be more than enough to do the trick.

    In other words, we can hide, but not forever. And when we do come out, especially in any densely populated area, coronavirus will be there, waiting for us. This fact, of course, belies any of the government’s efforts to “stop the spread.” It belies the hysteria about “cases! cases! cases!” Suppose we do magically lockdown again in all 50 states, then emerge a month later, after untold suffering and a ravaged economy. When we do emerge, is anyone naive enough to think the virus will just be gone? Inevitably someone will have it, somewhere, and they’ll spread it again. Maybe it’ll take a few weeks to get going, but get going it will. Viruses virus. It’s what they do.

    Given that, what is the point of locking down, as long as hospitals can manage the flow? What is the point of masks, even if they worked? Sometimes, the best way out of a dire predicament is to power right through it. Thankfully, our treatments have improved as has our capability to protect the vulnerable and those in nursing homes. That, combined with some form of herd immunity, is the only way out, as anyone with some intellectual honesty and a lick of common sense can surmise. No matter what we do, that’s how coronavirus will end. The question is, how long will it take, and how much pain will we do to ourselves in the process?

    I add, that had there been a more responsible response regarding HCQ-based cocktails etc, we may have curtailed much of the death rates we have seen. That opens up ethics-epistemology issues tied to gold standard fallacies.

    We must recognise that once this disease broke out, epidemic with high surges in deaths was inevitable. This then forced a tradeoff between higher deaths directly and from displaced medical care + deaths of despair due to economic and social dislocation + onward famine in places without the economic resources to withstand prolonged stagnation aka depression. With war lurking (now playing out in 4th gen form with steadily escalating kinetic dimension.)

    There is a reason why WW2 followed a depression.

    We need to realise the matches we are playing with.

    KF

  31. 31
    rhampton7 says:

    It’s not just deaths, but organ damage that persists after the virus has been cleared from the body.

    The people making the 99.8% of infected don’t die miss how expensive and debilitating the virus really is.

  32. 32
    rhampton7 says:

    Now, more than 300 studies from around the world have found a prevalence of neurological abnormalities in Covid-19 patients, including mild symptoms like headaches, loss of smell (anosmia) and tingling sensations (arcoparasthesia), up to more severe outcomes such as aphasia (inability to speak), strokes and seizures. This is in addition to recent findings that the virus, which has been largely considered to be a respiratory disease, can also wreak havoc on the kidneys, liver, heart, and just about every organ system in the body.

    Estimates of exact prevalence vary, but it seems that roughly 50% of patients diagnosed with Sars-CoV-2 – the virus responsible for causing the illness Covid-19 – have experienced neurological problems.

    The extent and severity of these neurological issues has flown largely under the radar. Most people, including physicians, may not recognise neurological abnormalities for what they are when they appear – someone experiencing a seizure may simply look dazed, without any trembling or shaking.

    https://www.bbc.com/future/article/20200622-the-long-term-effects-of-covid-19-infection

  33. 33
    rhampton7 says:

    “For many diseases, it can take years before we fully characterize the different ways that it affects people,” said nephrologist Dan Negoianu of Penn Medicine. “Even now, we are still very early in the process of understanding this disease.”

    What they are understanding is that this coronavirus “has such a diversity of effects on so many different organs, it keeps us up at night,” said Thomas McGinn, deputy physician in chief at Northwell Health and director of the Feinstein Institutes for Medical Research. “It’s amazing how many different ways it affects the body.”

    Kidneys: The cells lining the tubules that filter out toxic compounds from the blood are rife with ACE2 receptors. Last month, scientists studying 1,000 Covid-19 patients at a New York City hospital reported that 78% of those in intensive care developed acute kidney injury.

    Pancreas: Chinese researchers also found blood markers for pancreas damage in Covid-19 patients, including in about 17% of those with severe disease.

    Heart: Studies from around the world suggest that 7% to 31% of Covid-19 patients experience some sort of cardiac injury.

    https://www.statnews.com/2020/06/26/from-nose-to-toe-covid19-virus-attacks-like-no-other-respiratory-infection/

  34. 34
    rhampton7 says:

    Covid-19 is not the Flu. Even asymptotic individuals can have organ damage.

    John Swartzberg, clinical professor emeritus of infectious diseases and vaccinology in the UC Berkeley-UCSF Joint Medical Program:

    One thing we didn’t anticipate was that the virus seems to accelerate a great deal of scarring in the lungs. And if lung tissue is replaced with scar tissue, it is no longer functional as regular pulmonary tissue, which translates to poor gas exchange. What we really fear is long-term shortness of breath that could extend anywhere from being very mild to severely limiting. There is also a disturbing report looking at computerized tomography (CT) scans of asymptomatic people that found they were left with some scar tissue. So, this could even be happening on a subclinical level.

    Another area is the heart. There is evidence now that the virus can directly attack heart muscle cells, and there’s also evidence that the cytokine storm that the virus triggers in the body not only damages the lungs, but can damage the heart. We don’t know what the long-term effects of that may be, but it could be that we will have a population of people who survive COVID-19 only to go on and have chronic cardiac problems.

    The third organ system that we’re now pretty clear about is the central nervous system. There is evidence of direct involvement of the virus with neurons, and also the cytokine storm and inflammatory mediators can cause damage to the central nervous system. This is manifesting itself not only in neurologic clinical findings, but also psychological findings. We’re seeing patients post-discharge struggling with psychological challenges, almost like PTSD. And, we’re also seeing some cognitive defects in some people that are very disturbing.

    We’ve also seen damage to the kidneys from the cytokines, and there is also evidence that the virus can bind to receptors in the liver, though we haven’t seen significant liver disease yet in patients. Finally, the gastrointestinal tract itself has virus receptors, and about 15% of people, especially children, present with gastrointestinal symptoms. But, so far, there is no evidence that this will cause persistent symptoms.

    Finally, it has become clear that infection with SARS-CoV-2 triggers abnormal clotting of the blood in some people. This has led to pulmonary emboli, which are blood clots that travel to and damage the lungs, and strokes, which are blood clots in the vascular system of the brain. Both pulmonary emboli and strokes may have long-term consequences for these two organs.

    https://news.berkeley.edu/2020/07/08/from-lung-scarring-to-heart-damage-covid-19-may-leave-lingering-marks/

  35. 35
    jerry says:

    7% to 31% of Covid-19 patients experience some sort of cardiac injury.

    If anyone following the MedCram series of C19 will know, the cardiac effects probably flow from blood clotting effects when the virus attacks the endothelial cells of the blood vessels.

    MedCram has discussed several different ways the virus attacks the body but not apparently all. It’s a little technical but most of the lectures are understandable.

  36. 36
    rhampton7 says:

    Four months into the UK Covid-19 pandemic, we are only just beginning to understand the full extent of the havoc being wreaked by the coronavirus on the human body. Now, preliminary results from a new EU and Government-funded study show that up to one-third of Covid-19 patients have sustained organ damage, with 30% of patients scanned, using advanced magnetic resonance imaging (MRI), found to have measurable damage to their liver, heart or kidneys. Researchers don’t yet know if the damage will be long-term (paywalled)

    https://www.telegraph.co.uk/health-fitness/body/long-term-effects-covid-body-heart-brain/

  37. 37
    rhampton7 says:

    “ I add, that had there been a more responsible response regarding HCQ-based cocktails etc, we may have curtailed much of the death rates we have seen.”

    This has not been proven. In fact, the RCTs that have been done suggest that, at best, HCQ is mildly helpful and at worst, a treatment without positive affect.

    KF, I’ve never seen you try to deal with all of the studies that run counter Raoult’s Institute or the unbiased criticisms of their work. Have you even read any of it?

  38. 38
    rhampton7 says:

    Professor Raoult is not totally innocent. Because even if he has never claimed to have the panacea, that he relies on studies unconvincing in the eyes of the scientific community to promote a dosage that he probably allows himself to say more than he can. And because of this, he too should have accepted that “any science that is objective by its method and its object is subjective with regard to tomorrow. He lent more to medicine than she was able to. No doubt it would have been better to hold a humble position and be content to do as in other countries and say that Chloroquine a possible treatment, in the absence of any other.

    The fact is that Didier Raoult is a good doctor above all because he has always known how to address the patient and his illness. If not to begin with the reassuring nature of his remarks which contrasted sharply with the distressing nature of government communication. And he managed to do it by speaking on Youtube. He relied on the science at his disposal. Where he went beyond his role as a doctor was when he wanted to act as if we were dealing with an “objective pathology” when it was new and there was no proven treatment.

    https://www.europeanscientist.com/fr/editors-corner-fr/didier-raoult-mauvais-scientifique-et-bon-medecin/

  39. 39
    jerry says:

    This has not been proven. In fact, the RCTs that have been done suggest that, at best, HCQ is mildly helpful and at worst, a treatment without positive affect.

    This is a nonsense statement and just proves that RHampton does not understand the things that he posts.

    I’ve never seen you try to deal with all of the studies that run counter Raoult’s Institute or the unbiased criticisms of their work.

    The sad thing is that there are none that counter Raoult and Zelenko. RHampton does not understand this as he continues to post irrelevant articles on this topic.

    The last article RHampton links to is in French and titled

    bad scientist and good doctor?

    The bad scientist is the author of the article (the Editor in Chief of The European Scientist) who does not understand the issues relative to the virus and quotes irrelevant opinions.

    On the comment below RHampton again links to an irrelevant article about HCQ. He does not know when he is reading fake news and posting the comments from the fake news.

  40. 40
    rhampton7 says:

    A randomized control trial of the malaria drug hydroxychloroquine for nonhospitalized patients with mild symptoms of COVID-19 did not show the drug had any benefit, Reuters reported. About 24% of the patients given hydroxychloroquine in the study had persisting symptoms for 14 days compared with 30% of the group given a placebo, but this difference was not statistically significant. The study “provides strong evidence that hydroxychloroquine offers no benefit in patients with mild illness,” Neil Schluger, MD, from New York Medical College, said in an editorial on the study.

    In related news, data from a randomized, controlled trial in Spain of nearly 300 nonhospitalized patients with less than 5 days of symptoms also showed no benefit for hydroxychloroquine.

    Results of the UK RECOVERY trial’s test of hydroxychloroquine for more than 4500 hospitalized patients, posted to a preprint server Wednesday, found that the drug did not reduce mortality, but was associated with longer hospital stays and increased risk of dying or needing mechanical ventilation.

    https://www.medscape.com/viewarticle/934190

  41. 41
    rhampton7 says:

    In a study published yesterday in the Annals of Internal Medicine, researchers from the University of Minnesota, the University of Manitoba, and McGill University randomized 491 patients with laboratory-confirmed COVID-19 or probable COVID-19 and high-risk exposure to receive 5 days of oral hydroxychloroquine or placebo within 4 days of symptom onset. The aim of the study was to see whether starting hydroxychloroquine therapy within the first few days of symptoms could reduce symptom severity or duration and prevent hospitalization.

    The results showed that, among the 423 participants who provided data, hydroxychloroquine failed to cause a statistically significant difference in symptom severity or prevalence over the 14-day period. The hydroxychloroquine patients had a mean reduction from baseline of 2.60 points in the 10-point symptom severity scale, compared with a 2.33-point reduction for the placebo group (difference in symptom severity: relative, 12%; absolute, –0.27 points; 95% CI, –0.61 to 0.07 points; P = 0.117). At day 14, 24% of participants receiving hydroxychloroquine had ongoing symptoms compared with 30% of patients receiving placebo.

    “Hydroxychloroquine did not substantially reduce symptom severity or prevalence over time in nonhospitalized persons with COVID-19,” the authors of the study wrote.

    https://www.cidrap.umn.edu/news-perspective/2020/07/trial-data-support-dexamethasone-not-hydroxychloroquine-covid-19

  42. 42
    rhampton7 says:

    Continued:

    Jason Gallagher, PharmD, a clinical professor and specialist in infectious diseases at Temple University School of Pharmacy, says these trial results add to the growing body of evidence that hydroxychloroquine is not an effective treatment for COVID-19, either for hospitalized patients or those in the early stages of the infection.

    “I wish that hydroxychloroquine had been successful, but it has been conclusively found to be ineffective,” said Gallagher, who was not involved in either study. “All of the well-designed, randomized, controlled trials have found the same thing—it does not work.”

    Hope for hydroxychloroquine, which received an emergency use authorization from the US Food and Drug Administration in March, was based on the results of a small French study that found the drug reduced SARS-CoV-2 viral load when combined with azithromycin in a handful of patients. But several observational studies and randomized controlled trials, which are considered the gold standard for determining whether a drug is effective, have found no benefit.

  43. 43
    jerry says:

    But no RCT’s have been done that are relevant.

    But several observational studies and randomized controlled trials, which are considered the gold standard for determining whether a drug is effective, have found no benefit.

    They all are on the wrong group of patients or done at the wrong time of the virus progression.

  44. 44
    Mac McTavish says:

    Jerry

    They all are on the wrong group of patients or done at the wrong time of the virus progression.

    There have been studies that have shown that it is not effective as a prophylactic, others that show that it is not effective at early stages, others that show it is not effective at moderate stages and studies that show that it is not effective at late stages. Your repeated used of this argument is not supported by the evidence.

  45. 45
    rhampton7 says:

    How is this the wrong people or the wrong time?

    “491 patients with laboratory-confirmed COVID-19 or probable COVID-19 and high-risk exposure to receive 5 days of oral hydroxychloroquine or placebo WITHIN 4 DAYS OF SYMPTOM ONSET.”

  46. 46
    kairosfocus says:

    RH7, I will give you the recognition that organ/system damage is a valid concern. On this I note that Dr Raoult did was it 2500 CT scans on 500 patients and the result came back that damage is present at onset of noticeable symptoms. That too is part of the valuable work he has done. KF

  47. 47
    rhampton7 says:

    KF, so according to Raoult, once you have recognizedthat you may have Covid-19, you have already suffered some organ damage. Is that right?

  48. 48
    jerry says:

    491 patients with laboratory-confirmed COVID-19 or probable COVID-19 and high-risk exposure to receive 5 days of oral hydroxychloroquine or placebo WITHIN 4 DAYS OF SYMPTOM ONSET.

    Found study. Wrong age. They were low risk and many not accurately identified as having C19. Looks like HCQ had some positive effect just not statistically significant.

  49. 49
    jerry says:

    If RHampton reads this, the average age of person dying from C19 is 75 years of age. The average for the two studies he used to invalidate HCQ was 40 years old. Or 35 years less than the average person dying.

    Nothing bad happened to either the treatment group or Placebo group which is what is expected for low risk patients. It is therefore illegitimate to conclude anything about the efficacy of HCQ when used with patients this age.

    Also over half were health care workers. So theses are not typical high risk patients for any disease. They were used because they were easy to recruit.

    In neither study was zinc a factor. Some used some didn’t but there was no control over how much or when.

    So the two studies are irrelevant.

  50. 50
    rhampton7 says:

    So you believe that only senior citizens in the first few days of infection should be taking HCQ? You know that is not Raoult’s treatment regimen.

    And now, all of a sudden, you need a control in a study to demonstrate the effectiveness of zinc, yet you have never argued that a control is necessary to demonstrate the effectiveness of HCQ — quite the opposite in fact.

    Are you just making stuff up as you go along?

  51. 51
    jerry says:

    And now, all of a sudden, you need a control in a study to demonstrate the effectiveness of zinc, yet you have never argued that a control is necessary to demonstrate the effectiveness of HCQ — quite the opposite in fact.

    Are you just making stuff up as you go along?

    No, just the opposite. It is you who are making stuff up. You have never listened even once to Zelenko. Or otherwise you wouldn’t be saying what you do. You have no understanding of anything you comment on.

    I am not arguing for a controlled study on anything. There is no need for one. Never was. There’s already plenty of information on what works. So no need for anything more.

    You just keep providing irrelevant information and demonstrate again and again you don’t understand the virus. You also don’t read the studies you post on to know why they are irrelevant.

    I’m not sure if your problem is with understanding English or that you don’t understand basic logic. Maybe both.

  52. 52
    jerry says:

    Your repeated used of this argument is not supported by the evidence.

    Just the opposite.

    You fail to understand what is involved. You couldn’t have read the studies to make your comment. You couldn’t have read much about the virus or else wouldn’t have made your comment. Yet you criticize.

    Everything I say is absolutely supported by the evidence.

    If a study is done late in the progression of the virus, it cannot be used to invalidate HCQ for early intervention. That’s what most of the studies were. So all are irrelevant for evaluating HCQ. No one is arguing for HCQ to be used at this stage yet this is what the medical establishment said was ok. It was setting it up for failure. My guess not by accident.

    If a study is done on young and healthy people it cannot be used to invalidate HCQ for preventing older people who are the ones susceptible to the virus from being hospitalized or dying. That’s what the prophylactic and early intervention studies did. Use younger people.

    Yet that is all that you and RHampton have presented as a basis for your comments. The studies you tout are non sequiturs.

    In the roughly 4;000 patients Raoult looked at no one under 60 died. So tell me how a study on healthy people average aged 40 who don’t die is valid for showing that people average aged 75 will also not die. It can’t. The studies are irrelevant.

    The funny thing is that I am not arguing for Raoult’s protocol or the efficacy of HCQ. I am arguing two things.

    First, there is nothing anywhere undermining HCQ. But we see a constant rhetorical onslaught against HCQ that is in essence fake news.

    Second, the better protocol is by Zelenko of HCQ, zinc and azithromycin. Absolutely nothing ever published undermines it. For all the negative things implied no one here has dug up any thing that undermines it.

    Zelenko’s protocol is what I have consistently argued for in the last three months.

    Why? Because it has two therapeutic ways of fighting the virus. First, HCQ interferes with the virus binding to the Ace2 receptor which is the way the virus enters the cell. Second, HCQ is an ionophore for zinc allowing it to enter cell. Zinc prevents the virus from replicating. Both will act to prevent the virus from taking hold if done early. Then the immune system kills the virus.

  53. 53
    Bob O'H says:

    There is a reason why WW2 followed a depression.

    I think it actually followed a period of German prosperity, and it was definitely the Germans who caused that war.

  54. 54
    kairosfocus says:

    RH7, you have it back ways. There is a decisive body of results on the table that shows that HCQ-based coscktails, administered early enough in the U/L trajectory of CV19, are credible treatments with not only statistics but in vitro results and plausible mechanisms. Until those are decisively discredited, touted studies trying to overturn such without dealing with the full credibility of that cluster can be safely dismissed. Remember, established drugs and active agents shown experimentally to have effect at plausible concentrations, where decades show manageable safety and ability to get to active sites in the body and its cells. So, the statistics make sense and so do the mechanisms. In addition, the implications of the Tuskegee syphilis studies tell us a lot on the ethics-epistemology challenges involved in research. And no, I don’t give 10c for alleged “growing bodies” of flawed studies in a highly polarised environment where leading spokesmen have been exposed as publicly lying with lives on the line. KF

  55. 55
    kairosfocus says:

    BO’H, nope. Absent the chaos extending through the 1920’s and into the 30’s, Hitler would not have risen to power; including, a notorious hyperinflation that destroyed life savings. That is the factor you missed in pointing to Horace Greeley Hjalmar Schacht’s quantity theory of money based recovery that then fed into massive industrial mobilisation for war; which led to his clashes and eventual dismissal. Absent the ruin of the German middle classes, Hitler’s rise would be inexplicable. Do me the courtesy of recognising that I will have a reason behind a brief remark on a history-loaded policy issue relevant to the threat of tyranny. KF

  56. 56
    kairosfocus says:

    RH7, according to 2500 CT scans on 500 patients — something a head of an institute connected to a cluster of 4 hospitals with 3500 beds can order up, by the time symptoms emerge there is lung damage. This is consistent with the puzzling report of a lot of patients who seem not to be distressed but are oxygen deprived per assessments. KF

  57. 57
    jerry says:

    Zelenko said his next project is lung scans of his patients, obviously the one that agree, to see what damage was done

    By the way Zelenko is very ill. He has just one lung, and severe heart issues. He had a biopsy of hip yesterday and heart surgery scheduled on Thursday. He is a survivor of a rare cancer that is terminal for nearly everyone who gets it

    Meanwhile he just pointed to doctors from Yale and Harvard that endorsed his protocol. https://internetprotocol.co/covid-19/2020/07/21/yale-harvard-professors-support-zelenkos-protocol/

    Maybe the critics should read their ebook just published to see what they are criticizing. It’s free and at link just above.

    When I see what Zelenko has been doing what comes into my mind is

    By the living Gawd that made you,
    You’re a better man than I am, Gunga Din!

  58. 58
    rhampton7 says:

    “ Until those are decisively discredited”

    First, the goal isn’t to discredit HCQ but to test HCQ beyond observational studies, which have more flaws and are more subjective than RCTs.

    Second, science doesn’t operate on the presume innocent until guilty principle. HCQ is in a gray area at the moment because of Raoult’s sloppy studies and the conflicting results of RCTs.

  59. 59
    rhampton7 says:

    The preliminary results of the country’s largest drug trial on the coronavirus — Pakistan Randomized and Observational Trial to Evaluate Coronavirus Treatment (PROTECT) — has not only established the safety of hydroxychloroquine, a drug generally used for malaria, in terms of mortality but has also shown significant recovery rates in Covid-19 patients when used in combination with two other drugs- azithromycin and oseltamivir.

    12 centres, including 10 universities from eight cities, were included in the study. The study enrolled Covid patients over the age of 18 who were divided into eight groups. The patients included in the research were 60pc male and 40pc female. The three medicines were given to seven groups, each consisting of 60 to 65 patients, alone and in different combinations, while one control group was given nothing.

    Prof Javed Akram disclosed that the rate of recovery from the combination of the three drugs was the highest at 86pc. The second highest recovery rate was 75pc from azithromycin. The overall recovery rate of the patients, who were given medicines, was 73.1pc while the rate of recovery without medicines was 67pc.

    https://www.dawn.com/news/1570211

  60. 60
    rhampton7 says:

    Recovery Rate – from the study above

    without meds: 67%
    with meds: 73%
    with HCQ and azithromycin: 75%

    Notice that the Raoult regimen (HCQ + azithromycin) was statistically equivalent, or nearly so, with meds alone. Further, it wasn’t astonishingly better than no meds at all.

    It’s these kinds of RCTs that ought to make you question the studies that supposedly claim HCQ is a great treatment.

  61. 61
    jerry says:

    What happens when C19 starts to infect the most densely human area on the planet, Dharavi. https://bit.ly/2E1wmIh

    Dharavi is part of Mumbai and has more than a million people in about a square mile C19 hit and to the rescue was Dr. Zelenko’s protocol. They used his protocol and some other homeopathic remedies and relatively few died.

    No social distancing here or masks and my guess not much hand washing. They did keep those over 55 at home.

    https://bit.ly/39jfb0I

  62. 62
    jerry says:

    science doesn’t operate on the presume innocent until guilty principle. HCQ is in a gray area at the moment because of Raoult’s sloppy studies and the conflicting results of RCTs.

    A few things.

    First, HCQ is innocent and has been used for 50 years as a prophylactic. So there is no harm using it.

    Second, It has been associated with fighting viral infections for near 40 years. You have been provided with the references but I guess you didn’t look at them.

    are more subjective than RCTs

    No study including all the RCT (which are all irrelevant) has discredited it and several have shown it to be effective when used correctly. All those publicly saying that HCQ is not effective are fake news studies.

    Fourth, there are several studies and anecdotes on the effectiveness of it around the world. I just provided one in India. I can provide a hundred more. There is also the study you just provided where HCQ, Azithromycin and Tamiflu had 86% success.

    It would be malpractice not to prescribe it. Especially with zinc.

    So it’s a no brainer to use it instead of nothing for fighting the virus at the correct times. In the study above using nothing has 67% success. This is what would be expected with the normal population. Nearly all in the low risk have no problem and shouldn’t be treated with drugs. There is no data with this study, just a press release. It will be necessary to look at the data to understand more.

    Maybe eventually you will understand what is going on.

  63. 63
    kairosfocus says:

    RH7, kindly see the Tuskegee case to see just what kind of ethics-epistemology challenges face mislabelled placebos in the face of a fast moving killer, CV19. You continue to dismiss without proper consideration otherwise uncontroversial implications of decision theory. Bottomline, evidence is evidence and good enough in an inductive context is good enough. especially when so called gold standards are ethically dubious. KF
    PS: here’s the book https://files.internetprotocol.co/ebook-covid-19.pdf

  64. 64
    jerry says:

    Should be read by all who question HCQ

    White Paper on Hydroxychloroquine

    Dr. Simone Gold, MD, JD

    https://bit.ly/3eSfKiS

    Some quotes – First – Introduction

    This white paper is to draw the reader’s attention to the indisputable safety of hydroxychloroquine (HCQ), an analog of the same quinine found in tree barks that George Washington used to protect his troops. The modern version has been FDA approved for 65 years, has shown remarkable efficacy against SARS-CoV-2 and its use is being wrongly restricted despite the immediate danger to the American people and the rest of the world.

    We speak in support of immediately reversing the massive, irresponsible disinformation campaign that is literally preventing doctors from dispensing HCQ, advocating as well that it be made available over the counter in the United States. This is logistically easy to do in a manner that ensures the supply and appropriate dispensation.

    Second – Conclusion

    This white paper is to draw the reader’s attention to the indisputable safety of HCQ, remarkable efficacy of HCQ against SARS-CoV-2, and the worldwide political storm that has resulted in its use being restricted. We speak in support of it being made available over the counter in the USA due to the inability of Americans to access it, whether they need it for treatment or to manage their fear.

    The virus is known to be asymptomatic or mild the vast majority of the time, but in people with multiple co-morbid conditions, rarely it can be deadly. Because so much was unknown in the beginning, the most cautious approach was taken. However, now that we know the facts, it has proven impossible to dislodge the fear that was implemented.

    At this time, disinformation and therefore resultant fear have a firmer grip on Americans than reality. And thus Americans who need a life-saving medication cannot get it either due to their own physicians’ reluctance, their pharmacies regulating against the same, their state medical boards threats, the media disinformation, and/or due to certain sectors of the federal government’s own anti-HCQ statements.

  65. 65
    rhampton7 says:

    Compare the hype, the claims, the statements you, Raoult, Zelenko, et al made in April about the promise of HCQ with what is being said about it now.

    Go ahead, please do.

  66. 66
    rhampton7 says:

    Anti-malaria drug hydroxychloroquine has not proven efficient against the coronavirus and is likely to be excluded from the Russian Health Ministry’s recommendations on treatment, the ministry’s chief consultant pulmonologist, Sergey Avdeev, said on Wednesday.

    Ritonavir is also likely to be excluded due to lack of efficiency, the expert added.

    https://www.urdupoint.com/en/world/russia-health-ministry-likely-to-exclude-hydr-981661.html

  67. 67
    rhampton7 says:

    Uganda has halted the use of hydroxychloroquine as studies to determine the drug’s effectiveness in treating COVID-19 according to a news report by The Independent.

    The drug has been used to treat some positive cases of the disease at some treatment facilities like Entebbe General Hospital.

    It was used in combination with antibiotics like azithromycin and painkillers where needed.

    The new approach will now focus on the use of Vitamin C in combination with zinc and azithromycin to manage cases.

    Another drug that is being tested and has shown promise is a cholesterol-lowering drug Fenofibrate which researchers say helps the body burn carbohydrates, reducing the fat accumulating inside the lung cells and stopping the virus from reproducing.

    https://www.devdiscourse.com/article/health/1138851-uganda-halts-use-of-hydroxychloroquine-for-covid-19-treatment

  68. 68
    kairosfocus says:

    Folks, grab these papers while you can, lest they be disappeared. That is where we are. KF

  69. 69
    Retired Physicist says:

    @65 night and day.

  70. 70
    rhampton7 says:

    I keep coming back to Israel. Known for producing world class scientist and doctors, they jumped in with both feet when HCQ was being touted as the last word in COVID-19 treatment.

    Israel was/is not concerned about American political ramifications of HCQ. All they care about is something that works. So what are they doing now?

    >> Galia Rahav, head of the Infectious Disease Unit and Laboratories at Sheba Medical Center, Tel Hashomer, told The Jerusalem Post that at the onset of the coronavirus pandemic, her team treated some patients with hydroxychloroquine and enrolled others in a clinical trial that involved the drug.

    >> Rahav said that “summarizing the data, we don’t think it works [for COVID-19] and we are not using it.”

    >> Rahav said her team is exploring the benefits of other drugs, including Remdesivir, an antiviral medication developed by the biopharmaceutical company Gilead Sciences.

    https://www.jpost.com/health-science/israeli-specialist-hydroxychloroquine-ineffective-treatment-for-covid-19-629493

  71. 71
    jerry says:

    RHampton again post fake news.

    In the post just above he linked to a news report from 2 months ago which never described on whom HCQ was tested.

    Israel has one of the best records in the world for C19 and RHampton Keeps on coming back to it with negative reports. There is a non sequitur someplace.

    He also uses another fake news story from Uganda on HCQ’s use in hospital.

    The Russian report say next to nothing about when it was used or who on. So it’s hard to say what led them to their statement. If it was hospital usage then it is another fake news story.

    So everything RHampton has reported so far is bogus. Why?

    Does RHampton read?

  72. 72
    jerry says:

    Nothing has changed.

    Compare the hype, the claims, the statements you, Raoult, Zelenko, et al made in April about the promise of HCQ with what is being said about it now.

    Go ahead, please do.

    It is still has the best results out there and there are other promising approaches.

    Did you read the white paper linked to just above your comment? My guess not. Your comment would be even more absurd if you did. It’s absurd without the white paper mentioned but off the charts looney given where you posted your comment.

  73. 73
    jerry says:

    @65 night and day

    Why don’t you help RHampton out. He seems unable to justify any of the comments he writes but you seem to agree with him.

  74. 74
    Retired Physicist says:

    @rhampton 70

    Yeah, the whole reason we do replication etc., tedious as it is, is because often early results come along that are flimsy and overhyped, that evaporate with finer study. Pons and Fleischmann for instance. Decades later there is still a handful of crackpots who believe cold fusion happened, just as decades from now there will still be crockpots who believe HCQ cures COVID.

  75. 75
    kairosfocus says:

    RP and RH7, there are two significant documents on the table, both linked. I challenge you to address them specifically on the merits. This also goes for Dr Raoult’s papers and the Kennedy School paper on evidence and decisions. KF

  76. 76
    rhampton7 says:

    I gave you many links that provided reasoned criticism of Raoult’s papers. I think the last one was two days ago. Did you not read them?

  77. 77
    ET says:

    So the people being saved by the HCQ protocol aren’t being saved by the HCQ protocol?

    Is there any evidence that the virus can replicate in the presence of zinc?

  78. 78
    jerry says:

    there will still be crockpots who believe HCQ cures COVID.

    Do you read relevant material? My guess is not. Otherwise you would not be making the comments you do which have no basis in anything real. For example, I know no-one who says HCQ cures COVID either here or elsewhere. The highest success rate for eliminating the virus does come with HCQ mixed with some other ingredients.

    I know RHampton does not read. He never responds to the links or questions posed to him while we read his links and find they are fake news. It has been explained to him very carefully what would be valid and he continues to provide irrelevant news reports.

    I suggest you make the case that HCQ is not effective when used correctly. You would be the first one on the planet to do so.

  79. 79
    Bob O'H says:

    Should be read by all who question HCQ

    As well as the references. For example, the author states

    In the largest study to date on the subject, HCQ has been shown to not increase heart (cardiac) risk.

    He then give this quote:

    This is the largest ever analysis of the safety of such treatments worldwide,
    examining over 900,000 HCQ and more than 300,000 HCQ + azithromycin users respectively. The results on the risk of serious adverse events associated with short-term (1 month) HCQ treatment as proposed for COVID-19 therapy are reassuring, with no excess risk of any of the considered safety outcomes compared to an equivalent therapy.

    But strangely stops before the very next sentence:

    Worryingly, significant risks are identified for combination users of HCQ+AZM even in the short-term as proposed for COVID19 management, with a 15-20% increased risk of angina/chest pain and heart failure, and a two-fold risk of cardiovascular mortality in the first month of treatment.

    But a couple of pages on he concludes

    In plain English: Taking HCQ even in combination with the antibiotic azithromycin does
    not cause an increased risk of fatal heart rhythm problems.

    In plain English, the ‘white paper’ is rubbish.

  80. 80
    jerry says:

    Snowball fights in hell have just started. Bob O’H has just endorsed HCQ.

    By making an objection that is not related to HCQ efficacy, he has has supported HCQ for treating the virus.

    The question is will the incident rate for heart issues for HCQ and Azithromycin (used for 5 days at low amounts) be objectionable given the success rate especially with zinc and the alternative of no treatment. Let the obfuscation begin.

    I shouldn’t have said “begin” since it has been going on for quite some time.

  81. 81
    Bob O'H says:

    Snowball fights in hell have just started. Bob O’H has just endorsed HCQ.

    What sort of tortured logic lead you to conclude that?

    By making an objection that is not related to HCQ efficacy, he has has supported HCQ for treating the virus.

    Yep, that’s pretty tortured. And you must have some pretty warped ideas if you think that pointing out evidence that HCQ + AZ is more likely to kill you is supporting using it as a treatment.

    FWIW, the section on efficacy is just as bad. It simply ignores the studies that show no effect. it doesn’t even try to argue that they are flawed, it just ignores them.

  82. 82
    Retired Physicist says:

    @Bob people who are desperate will find anything to maintain their worldview.

  83. 83
    jerry says:

    What sort of tortured logic lead you to conclude that?

    Not tortured but common sense. Human nature or just nature in general. Part of my logical reasoning course in college.

    Irrelevant conclusion. An irrelevant conclusion, also known as ignoratio elenchi (Latin for ”ignoring refutation”) or missing the point, is the informal fallacy of presenting an argument that may or may not be logically valid and sound, but (whose conclusion) fails to address the issue in question

    You pick an essentially irrelevant issue and called the paper rubbish. When the paper was about the efficacy of HCQ, you pick a non issue to criticize the paper.

    This is best illustrated by the famous Sherlock Holmes short story, Silver Blaze. Where the dog barking in the night (there was no barking) indicated that there was nothing to bark at.

    You failed to bark!!

    You should learn logic, it is essential for anyone claiming to be a scientist.

    And by the way how much was the danger of using HCQ + Azithromycin? You did not state what was the level of danger.

  84. 84
    jerry says:

    people who are desperate will find anything to maintain their worldview

    Some day you are going to raise a valid/relevant issue.

  85. 85
    Bob O'H says:

    You pick an essentially irrelevant issue and called the paper rubbish.

    (a) if it’s irrelevant, why was it in the report? Indeed, why does it take up more of the report than the section on Efficacy Studies?
    (b) a key aspect of deciding if a treatment is worthwhile is finding out if it is killing people.

    And by the way how much was the danger of using HCQ + Azithromycin?

    I’ll let you check – find the reference in the white paper, and then read it. I didn’t say what it was because my purpose in quoting that section was to show that Dr. Simone Gold, MD, JD was quote-mining the literature, in a particularly obvious way, and thus one should be cautious in trusting what he had written.

  86. 86
    ET says:

    RP:

    people who are desperate will find anything to maintain their worldview.

    You just described evolutionists. Nice own goal.

  87. 87
    kairosfocus says:

    Folks,

    Let’s start from facts. It is now pretty well shown that HCQ etc are established drugs, i.e. their in vitro chemical activity is credibly going to carry over into the body. And, they are safe enough for side effects etc to be manageable. In fact until recently HCQ was an OTC in many parts of the world.

    Next, since 2005, HCQ has shown relevant in vitro antiviral effects as well as longstanding anti-inflammatory effects as are qhy it has been used for arthritis etc. In that context, it was recently specifically shown that it is active against SARS2 virus in plausible-for-body concentrations. Two plausible mechanisms, as MedCram discusses, are that it alters pH and shifts shape of receptors for the spike proteins and props open ionophores that enable Zn ions to get into cells in enhanced concentration; which inhibits viral replication. Azithro acts against secondary infection and also has some antiviral effects. Zn is well known for antiviral effects.

    So, we should not be surprised to find that there is significant experience showing that if administered early in the U/L trajectory of the disease, for people with significant risk . . . low risk people are not going to have much of a difference to make either way . . . it makes a good difference in outcomes. And it does so fast, viral loads drop sharply within a few days. This summary is from multiple sources over the past several months.

    That is what is being buried under an avalanche of irrelevant cases, built to fail studies [wrong age groups, too late in the disease process, not studying the cocktail etc are typical] and demands that unless an ethically and epistemologically challenged gold standard . . . please see the Tuskegee syphilis study . . . is applied results are worthless. Then there was the scare mongering about heart disorders, and yes, the risk — per people who were managing real cases and relevant cardiologists — was grossly exaggerated.

    It is such criticisms that are worse than worthless, they have fostered a climate of fear, misunderstanding and polarisation that has likely needlessly cost arguably hundreds of thousands their lives.

    Those who enabled that sort of disaster will never acknowledge the failure.

    Now, we see an attempt to snip-snipe against a summary paper. This is what the white paper they are trying to trash says, first:

    There is obviously a tremendous disinformation campaign going on in the United States of
    America claiming that HCQ is neither safe nor effective. This is quite remarkable for a
    medication that has been FDA approved for 65 years and having already been dispensed
    billions of times all across the world with only 57 serious adverse events (heart) noted by
    the FDA in their own database over the past fifty years. In many countries it is available
    over the counter, like aspirin and Tylenol.

    Nonetheless, with the negative pressure being applied, state Governors have ordered,
    through their state licensing boards that physicians stop using it, and pharmacists stop
    dispensing it. Their wording is often more cautious, but doctors are told that they could be
    charged with “unprofessional conduct” (a threat to their license) or be “sanctioned” if they
    prescribe. First we need to understand how prescriptions have been done for decades.

    Once approved by the FDA, any physician can prescribe any prescription medication in
    the USA, for any reason. 55 This is significant in that a drug is not approved for a specific
    diagnosis; a drug either makes it through the years-long approval process or it does not.
    That means a medication can be used “on-label” (the reason it was approved) or “off-
    label” (other reasons that have never received FDA approval.) It costs a lot of money for
    the pharmaceutical company to gain another “on-label” use, so once a drug is approved for
    any use, it is typically used for many reasons. Those additional reasons are called “off-
    label.”

    As a practical matter “off-label” use accounts for about 20% of prescriptions . . . .

    Exploiting the public’s understandable lack of focus on the non-distinction between off-
    label and on-label has contributed to the public’s confusion regarding HCQ for Covid-19.
    From the physician’s perspective if a drug is FDA approved and safe it is within the
    physician’s armamentarium. And from the physician’s perspective, is highly suspect that
    that rule should change in the middle of a pandemic and without any legislative discussion
    or regulation whatsoever, let alone sound science to support the same. It has never
    happened that a state has threatened a doctor for prescribing a universally accepted safe
    generic cheap drug off-label . . . .

    Hydroxychloroquine is safe as a matter of fact, as demonstrated above. It is also
    considered “legally” safe as a matter of law as it is FDA approved for 65 years and doctors
    have been freely prescribing it in all that time until Covid-19. Contradicting its own
    policy, we believe for the first time in its history, the FDA has made statements that have
    caused states to restrict its use. While the right to prescribe is granted by each state, the
    states are informed by the FDA, and in reliance on the FDA, here are examples of over-
    reaching by many states. [cases given] . . . . It bears repeating that to be FDA approved, a drug has to go through years of testing. To be FDA approved for 65 years is an overwhelming testimonial to a drug’s safety and efficacy. There is no need for additional government intrusion . . . .

    If the disinformation campaign regarding HCQ weren’t so complete, from the scientific
    journals, to the media, to the state medical boards to the FDA, this would not really
    matter. Individual physicians who are innovators and early adopters would have moved
    first, prescribing HCQ off-label, just as physicians already do 20% of the time, and it
    would have caught on rapidly. However, the disinformation campaign blocked off-label
    use, and now we are in a pandemic with a safe and effective drug that doctors inclined to
    prescribe and patients inclined to take, cannot access.

    As a result, not only are patients not being treated promptly, effectively, and safely, some
    patients die. And as the fear of the pandemic has overtaken the virus itself and it is
    impossible to change public and physician opinion quickly enough to save lives, we must
    make the medication available to the public directly . . . .

    Country by country data is also available and access to HCQ is strongly linked to lower
    mortality. 73 We can see that even very poor countries have much lower case fatality rates
    than wealthy countries, which of course, is typically the opposite of what we would expect
    of a respiratory disease that could end up in an ICU admission. Kazakhstan, Bangladesh,
    Senegal, Pakistan, Serbia, Nigeria, Turkey, Ukraine, Honduras … the list goes on.
    Wealthier democracies or countries with especially abusive HCQ protocols such as are
    doing terribly: Ireland, Canada, Spain, The Netherlands, UK, Belgium, France … Of note,
    Italy and Spain switched mid-stream and now HCQ is easily available . . . .

    The limitation or outright ban on HCQ worldwide has begun to crack. It will soon collapse
    because the evidence of its safety and efficacy is so overwhelming. The countries that
    have less flexibility to tolerate fatal policies have already reversed themselves. South of
    us, Honduras, Panama, Costa Rica have, or earlier had, made HCQ available. Brazil is
    trying but faces many of the same political problems as the USA. Some countries have
    started going door to door to facilitate its availability. 74

    In Honduras their national policy now is: “The patient that presents for the first time to a
    First Level of Care facility, if so, treatment should be started with: Acetaminophen,
    Hydroxychloroquine 400 every 12 hours, Ivermectin, Azithromycin, Zinc …” 75 . . . .

    Panama reversed course regarding HCQ and many countries in South and Central
    America are following suit: 76

    Evaluating new evidence around the therapeutic options for COVID-19,
    specifically the use of HCQ and the Lancet journal withdrawing its
    publication on this topic. The Ministry of Health communicates that Circular
    No. 118-DGSP is null and void, establishing directives for immediate
    compliance regarding the use of HCQ and / or azithromycin. Leaving the
    therapeutic option for prescription according to medical criteria. Soon we will
    be sending a treatment guide for Covid-19 patients . . . .

    In France, bewilderingly, the drug was banned outright. However esteemed virologist
    Professor Raoult continued his clinical trials and in his hospitals the mortality rate was
    0.52% compared to the rest of France 19.12%. Assemblee of France (equivalent to
    Congress) called Dr. Raoult in for an “inquiry” because he has been such an outspoken
    advocate for HCQ. It turns out that his statistics were so devastating to the official French
    anti-HCQ political leadership, that the inquiry resulted in the French Minister of Health
    being forced to resign and now he being investigated, in large part due to his obstructing
    HCQ, which caused/led/contributed to the deaths of so many French citizens. 77

    Former French Prime Minister, health ministers to be investigated for
    pandemic response” A French court will investigate former French Prime
    Minister Edouard Philippe and two health ministers following complaints
    about the government’s handling of the coronavirus pandemic, Prosecutor
    General François Molins said today. Philippe, former Health Minister Agnès
    Buzyn and outgoing Health Minister Olivier Véran will have to respond to
    accusations of abstaining from fighting a disaster.

    That’s what you would not learn from the avalanche of ill-founded critiques for months here at UD, and of course in our oh so wonderful major media.

    When this is over, there is going to be a terrible reckoning as part of the playout over the next 6 – 18 months.

    KF

  88. 88
    kairosfocus says:

    F/N:

    https://www.newsweek.com/key-defeating-covid-19-already-exists-we-need-start-using-it-opinion-1519535

    >>The Key to Defeating COVID-19 Already Exists. We Need to Start Using It | Opinion
    Harvey A. Risch, MD, PhD , Professor of Epidemiology, Yale School of Public Health
    On 7/23/20 at 7:00 AM EDT

    As professor of epidemiology at Yale School of Public Health, I have authored over 300 peer-reviewed publications and currently hold senior positions on the editorial boards of several leading journals. I am usually accustomed to advocating for positions within the mainstream of medicine, so have been flummoxed to find that, in the midst of a crisis, I am fighting for a treatment that the data fully support but which, for reasons having nothing to do with a correct understanding of the science, has been pushed to the sidelines. As a result, tens of thousands of patients with COVID-19 are dying unnecessarily. Fortunately, the situation can be reversed easily and quickly.

    I am referring, of course, to the medication hydroxychloroquine. When this inexpensive oral medication is given very early in the course of illness, before the virus has had time to multiply beyond control, it has shown to be highly effective, especially when given in combination with the antibiotics azithromycin or doxycycline and the nutritional supplement zinc.

    On May 27, I published an article in the American Journal of Epidemiology (AJE) entitled, “Early Outpatient Treatment of Symptomatic, High-Risk COVID-19 Patients that Should be Ramped-Up Immediately as Key to the Pandemic Crisis.” That article, published in the world’s leading epidemiology journal, analyzed five studies, demonstrating clear-cut and significant benefits to treated patients, plus other very large studies that showed the medication safety.

    Physicians who have been using these medications in the face of widespread skepticism have been truly heroic. They have done what the science shows is best for their patients, often at great personal risk. I myself know of two doctors who have saved the lives of hundreds of patients with these medications, but are now fighting state medical boards to save their licenses and reputations. The cases against them are completely without scientific merit.

    Since publication of my May 27 article, seven more studies have demonstrated similar benefit. In a lengthy follow-up letter, also published by AJE, I discuss these seven studies and renew my call for the immediate early use of hydroxychloroquine in high-risk patients. These seven studies include: an additional 400 high-risk patients treated by Dr. Vladimir Zelenko, with zero deaths; four studies totaling almost 500 high-risk patients treated in nursing homes and clinics across the U.S., with no deaths; a controlled trial of more than 700 high-risk patients in Brazil, with significantly reduced risk of hospitalization and two deaths among 334 patients treated with hydroxychloroquine; and another study of 398 matched patients in France, also with significantly reduced hospitalization risk. Since my letter was published, even more doctors have reported to me their completely successful use . . . .

    Beyond these studies of individual patients, we have seen what happens in large populations when these drugs are used. These have been “natural experiments.” In the northern Brazil state of Pará, COVID-19 deaths were increasing exponentially. On April 6, the public hospital network purchased 75,000 doses of azithromycin and 90,000 doses of hydroxychloroquine. Over the next few weeks, authorities began distributing these medications to infected individuals. Even though new cases continued to occur, on May 22 the death rate started to plummet and is now about one-eighth what it was at the peak.

    A reverse natural experiment happened in Switzerland. On May 27, the Swiss national government banned outpatient use of hydroxychloroquine for COVID-19. Around June 10, COVID-19 deaths increased four-fold and remained elevated. On June 11, the Swiss government revoked the ban, and on June 23 the death rate reverted to what it had been beforehand. People who die from COVID-19 live about three to five weeks from the start of symptoms, which makes the evidence of a causal relation in these experiments strong. Both episodes suggest that a combination of hydroxychloroquine and its companion medications reduces mortality and should be immediately adopted as the new standard of care in high-risk patients .>>

    What is being drowned out.

    KF

  89. 89
    kairosfocus says:

    PS: Prof Risch continues:

    >>Why has hydroxychloroquine been disregarded?

    First, as all know, the medication has become highly politicized. For many, it is viewed as a marker of political identity, on both sides of the political spectrum. Nobody needs me to remind them that this is not how medicine should proceed. We must judge this medication strictly on the science. When doctors graduate from medical school, they formally promise to make the health and life of the patient their first consideration, without biases of race, religion, nationality, social standing—or political affiliation. Lives must come first.

    Second, the drug has not been used properly in many studies. Hydroxychloroquine has shown major success when used early in high-risk people but, as one would expect for an antiviral, much less success when used late in the disease course. Even so, it has demonstrated significant benefit in large hospital studies in Michigan and New York City when started within the first 24 to 48 hours after admission.

    In fact, as inexpensive, oral and widely available medications, and a nutritional supplement, the combination of hydroxychloroquine, azithromycin or doxycycline, and zinc are well-suited for early treatment in the outpatient setting. The combination should be prescribed in high-risk patients immediately upon clinical suspicion of COVID-19 disease, without waiting for results of testing. Delays in waiting before starting the medications can reduce their efficacy.

    Third, concerns have been raised by the FDA and others about risks of cardiac arrhythmia, especially when hydroxychloroquine is given in combination with azithromycin. The FDA based its comments on data in its FDA Adverse Event Reporting System. This reporting system captured up to a thousand cases of arrhythmias attributed to hydroxychloroquine use. In fact, the number is likely higher than that, since the reporting system, which requires physicians or patients to initiate contact with the FDA, appreciably undercounts drug side effects.

    But what the FDA did not announce is that these adverse events were generated from tens of millions of patient uses of hydroxychloroquine for long periods of time, often for the chronic treatment of lupus or rheumatoid arthritis. Even if the true rates of arrhythmia are ten-fold higher than those reported, the harms would be minuscule compared to the mortality occurring right now in inadequately treated high-risk COVID-19 patients. This fact is proven by an Oxford University study of more than 320,000 older patients taking both hydroxychloroquine and azithromycin, who had arrhythmia excess death rates of less than 9/100,000 users, as I discuss in my May 27 paper cited above. A new paper in the American Journal of Medicine by established cardiologists around the world fully agrees with this.

    In the future, I believe this misbegotten episode regarding hydroxychloroquine will be studied by sociologists of medicine as a classic example of how extra-scientific factors overrode clear-cut medical evidence. But for now, reality demands a clear, scientific eye on the evidence and where it points . . . >>

    I think there are a few questions to be asked and answered.

  90. 90
    kairosfocus says:

    NB: On U/L trajectory, I suggest, fairly fast descent to a crisis; of course, early successful intervention may stop the descent and lead to early recovery from higher on the descending arm. If failed, flatline. The L modifies the simpler U I used before, to explicitly show this. Recovery on the ascending arm takes longer. Given evidence of significant, early lung damage, recovery may not restore former vitality. Other damage later in the course of this destructive disease may worsen that. That means, long term debilitation and vulnerability may be an onward result. KF

  91. 91
    rhampton7 says:

    Hydroxychloroquine with or without Azithromycin in Mild-to-Moderate Covid-19

    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.
    CONCLUSIONS
    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

  92. 92
    rhampton7 says:

    The new study was carried out by scientists in Germany who tested HCQ on a collection of different cell types. They found that it does not inhibit the virus in human lung cells – the primary site of infection for the SARS-CoV-2 virus.

    Their findings clearly show that that HQC can block the coronavirus from infecting kidney cells from the African green monkey. But it does not inhibit the virus in human lung cells – the primary site of infection for the SARS-CoV-2 virus.

    In order for the virus to enter a cell, it can do so by two mechanisms – one, when the SARS-CoV-2 spike protein attaches to the ACE2 receptor and inserts its genetic material into the cell. In the second mechanism, the virus is absorbed into some special compartments in cells called endosomes.

    Depending on the cell type, some, like kidney cells, need an enzyme called cathepsin L for the virus to successfully infect them. In lung cells, however, an enzyme called TMPRSS2 (on the cell surface) is necessary. Cathepsin L requires an acidic environment to function and allow the virus to infect the cell, while TMPRSS2 does not.

    In the green monkey kidney cells, both hydroxychloroquine and chloroquine decrease the acidity, which then disables the cathepsin L enzyme, blocking the virus from infecting the monkey cells.

    In human lung cells, which have very low levels of cathepsin L enzyme, the virus uses the enzyme TMPRSS2 to enter the cell. But because that enzyme is not controlled by acidity, neither HCQ and CQ can block the SARS-CoV-2 from infecting the lungs or stop the virus from replicating.

    https://nationalinterest.org/blog/reboot/study-suggests-hydroxychloroquine-doesnt-protect-lung-cells-coronavirus-165523

  93. 93
    kairosfocus says:

    RH7, it is clear you are spamming, not interacting with adequate evidence. KF

  94. 94
    rhampton7 says:

    KF,
    On April 23rd you presented this claim as the truth:

    “(Raoult) His growing results show a steady pattern of a contrast of some 0.5% or less fatality rate contrasting to about 5% otherwise, i.e. we see the sort of 90% reduction highlighted by Dr Zelenko.“

    Do you still stand by those remarkable recovery rate numbers given that current RCTs suggest something much more modest?

    Was this hype or carelessness or sloppiness on the part of Raoult, Zelenko?

  95. 95
    rhampton7 says:

    How is the study, “ Hydroxychloroquine with or without Azithromycin in Mild-to-Moderate Covid-19” spamming without evidence?

  96. 96
    kairosfocus says:

    RH7, scroll just up and kindly note, starting with the Yale prof of epidemiology in 88 above. When you come to grips with that there will be reason to further discuss. Beyond that we have seen far too much of snipping, sniping and spamming based on misframing the issue. And BTW, the tabulation of results as things wound down is in the Raoult Roars OP, look for yourself. You have been corrected any number of times on misframed studies and the ethics-epistemology challenges of giving people deliberately mislabelled sugar pills or the like. Notice, too, the sobering lesson of the Tuskegee syphilis/bad blood study that needs yet to be fully absorbed. The gold standard fallacy has destructive consequences. KF

  97. 97
    kairosfocus says:

    PS: I suspect I need to note those were the statistics as at April 23 or thereabouts. So, they are face value accurate. C jun 11, his demographics were given again and rate climbed to 0.9% overall. He further summarises:

    Treatment with HCQ-AZ was associated with a decreased risk of transfer to the ICU or death (HR 0.19 0.12-0.29), decreased risk of hospitalization ?10 days (odds ratios 95% CI 0.37 0.26-0.51) and shorter duration of viral shedding (time to negative PCR: HR 1.27 1.16-1.39). QTc prolongation (>60 ms) was observed in 25 patients (0.67%) leading to the cessation of treatment in 3 cases. No cases of torsade de pointe or sudden death were observed.

    These results are compatible with the point made by the Yale prof.

  98. 98
    kairosfocus says:

    PPS: Risch:

    Am J Epidemiol

    . 2020 May 27;kwaa093.
    doi: 10.1093/aje/kwaa093. Online ahead of print.
    Early Outpatient Treatment of Symptomatic, High-Risk Covid-19 Patients that Should be Ramped-Up Immediately as Key to the Pandemic Crisis
    Harvey A Risch 1
    Affiliations

    PMID: 32458969 DOI: 10.1093/aje/kwaa093

    Abstract

    More than 1.6 million Americans have been infected with SARS-CoV-2 and GT 10 times that number carry antibodies to it. High-risk patients presenting with progressing symptomatic disease have only hospitalization treatment with its high mortality. An outpatient treatment that prevents hospitalization is desperately needed. Two candidate medications have been widely discussed: remdesivir, and hydroxychloroquine+azithromycin. Remdesivir has shown mild effectiveness in hospitalized inpatients, but no trials have been registered in outpatients. Hydroxychloroquine+azithromycin has been widely misrepresented in both clinical reports and public media, and outpatient trials results are not expected until September. Early outpatient illness is very different than later hospitalized florid disease and the treatments differ. Evidence about use of hydroxychloroquine alone, or of hydroxychloroquine+azithromycin in inpatients, is irrelevant concerning efficacy of the pair in early high-risk outpatient disease. Five studies, including two controlled clinical trials, have demonstrated significant major outpatient treatment efficacy. Hydroxychloroquine+azithromycin has been used as standard-of-care in more than 300,000 older adults with multicomorbidities, with estimated proportion diagnosed with cardiac arrhythmias attributable to the medications 47/100,000 users, of which estimated mortality is LT 20%, 9/100,000 users, compared to the 10,000 Americans now dying each week. These medications need to be widely available and promoted immediately for physicians to prescribe.

  99. 99
    rhampton7 says:

    professors at the University of Rennes 1 and hospital practitioners at the Rennes University Hospital

    Matthieu Revest “On hydroxychloroquine, I think it’s an absolute disaster. On the one hand, Professor Raoult should not have communicated in the mainstream press before having published all the evaluation elements in the scientific press, which he never did with a sufficient level of proof.”

    “ Thus today, there is no solid data that validates the interest of treatment with hydroxychloroquine, whether it is to reduce deaths or intubations, for patients on oxygen or suffering from mild to moderate forms, or to prevent the appearance of symptoms following contamination.

    There is therefore an international scientific consensus which affirms the ineffectiveness of hydroxychloroquine in the fight against Covid-19. It was certainly a good idea to evaluate this treatment initially, but it should be done according to the standards used for this type of evaluation.”

    Vincent Thibault. “I do not understand how a person can waste so much energy, moreover in such a serious situation, from an unproven claim. If hydroxychloroquine had been effective, this demonstration could have been gained really very quickly, with a trial limited to the peak of the epidemic.”

    “ There has been a drift of politics, the media, and also social networks grappling with conspiracy theses. It’s worrying. The idea that hydroxychloroquine was the right treatment skyrocketed without a solid study to back it up, and those who challenged it faced backlash.”

    https://www.ouest-france.fr/europe/france/coronavirus-aucune-donnee-solide-n-a-valide-l-hydroxychloroquine-6917357

  100. 100
    rhampton7 says:

    A Cluster-Randomized Trial of Hydroxychloroquine as Prevention of Covid-19 Transmission and Disease

    We conducted an open-label, cluster-randomized trial including asymptomatic contacts exposed to a PCR-positive Covid-19 case in Catalonia, Spain. Clusters were randomized to receive no specific therapy (control arm) or HCQ 800mg once, followed by 400mg daily for 6 days (intervention arm). The primary outcome was PCR-confirmed symptomatic Covid-19 within 14 days. The secondary outcome was SARS-CoV-2 infection, either symptomatically compatible or a PCR-positive result regardless of symptoms. Adverse events (AEs) were assessed up to 28 days. Results The analysis included 2,314 healthy contacts of 672 Covid-19 index cases identified between Mar 17 and Apr 28, 2020. A total of 1,198 were randomly allocated to usual care and 1,116 to HCQ therapy. There was no significant difference in the primary outcome of PCR-confirmed, symptomatic Covid-19 disease (6.2% usual care vs. 5.7% HCQ; risk ratio 0.89 [95% confidence interval 0.54-1.46]), nor evidence of beneficial effects on prevention of SARS-CoV-2 transmission (17.8% usual care vs. 18.7% HCQ). The incidence of AEs was higher in the intervention arm than in the control arm (5.9% usual care vs 51.6% HCQ), but no treatment-related serious AEs were reported. Conclusions Postexposure therapy with HCQ did not prevent SARS-CoV-2 disease and infection in healthy individuals exposed to a PCR-positive case. Our findings do not support HCQ as postexposure prophylaxis for Covid-19.

    https://www.medrxiv.org/content/10.1101/2020.07.20.20157651v1

  101. 101
    rhampton7 says:

    Scientists across the globe are working on vaccines to prevent Covid-19 infection. But in the meanwhile, and even after initial vaccines are approved, there is an urgent need for effective treatments for the respiratory disease caused by the SARS-CoV-2 coronavirus.

    Israeli hospitals were among the first anywhere to use dexamethasone, a steroid drug, to stop cytokines storms and reduce lung inflammation in severely ill Covid-19 patients. However, steroids can suppress the immune response too strongly.

    Additionally, an Israeli hospital is among the first to do a randomized, double-blind, placebo-controlled clinical trial of ivermectin, a drug to treat parasitic infections in people and animals, to see if it can shorten the duration of the disease if given to Covid-19 patients immediately after diagnosis.

    Israelis are also formulating novel therapeutics of their own.

    Follow the link to read a summary of 13 potential Israeli treatments using a variety of approaches – such as placenta-derived cells, peptides, blood plasma of recovered patients, and the cannabis compound CBD.

    https://www.israel21c.org/13-promising-covid-treatments-emerging-from-israel/

  102. 102
    rhampton7 says:

    Ivermectin, a drug used to treat parasitic infections in people and animals, is being tested at Israel’s Sheba Medical Center to see if it reduces symptoms and duration of Covid-19 infection.

    Dr. Eli Schwartz, founder of Sheba’s Center for Geographic Medicine and Tropical Disease, is one of the first researchers to do a randomized, double-blind, placebo-controlled trial of ivermectin on Covid-19 patients.

    “There is no single good study about any efficacious drug for corona treatment yet,” Schwartz says.

    He notes that many countries decided to treat Covid-19 patients with hydroxychloroquine despite lack of proof of safety and efficacy. “Later on, the World Health Organization and other authorities said it might even be harmful, but that wasn’t based on scientific evidence either.”

    https://www.israel21c.org/israelis-testing-anti-parasite-drug-against-covid-19/

  103. 103
    kairosfocus says:

    Still trying to bury the inconvenient facts?

  104. 104
    Retired Physicist says:

    @rhampton I just ordered a pulse oximeter. You can get an FDA approved one for about 35 bucks. There are lots of people who don’t know they have this disease but it turns out their oxygen saturation is low because they have hidden lung damage. Hoping when it arrives Tuesday my O2 sat is normal—95-100%.

    Back in the day, hell, we used to smoke in the lab. I’d take a drag on a camel, and then spin-coat some polymethylmethacrylate/polystyrene blends onto SiOx wafers before annealing them on a heated stage under a microscope. Smokin’ the whole time. Probably got some lung damage from that, but my O2 sat should still be pretty good.

    (You haven’t lived until you’ve gone to SLAC and characterized thin films using synchrotron radiation. Well, at least if you’re a Solid State geek)

  105. 105
    rhampton7 says:

    Inconvenient for you that Israel does not consider HCQ to be an effective treatment.

  106. 106
    kairosfocus says:

    RH7, more drowning out.

    In answer, Risch of Yale on Covid19:

    https://www.newsweek.com/key-defeating-covid-19-already-exists-we-need-start-using-it-opinion-1519535

    >>The Key to Defeating COVID-19 Already Exists. We Need to Start Using It | Opinion
    Harvey A. Risch, MD, PhD , Professor of Epidemiology, Yale School of Public Health
    On 7/23/20 at 7:00 AM EDT

    As professor of epidemiology at Yale School of Public Health, I have authored over 300 peer-reviewed publications and currently hold senior positions on the editorial boards of several leading journals. I am usually accustomed to advocating for positions within the mainstream of medicine, so have been flummoxed to find that, in the midst of a crisis, I am fighting for a treatment that the data fully support but which, for reasons having nothing to do with a correct understanding of the science, has been pushed to the sidelines. As a result, tens of thousands of patients with COVID-19 are dying unnecessarily. Fortunately, the situation can be reversed easily and quickly.

    I am referring, of course, to the medication hydroxychloroquine. When this inexpensive oral medication is given very early in the course of illness, before the virus has had time to multiply beyond control, it has shown to be highly effective, especially when given in combination with the antibiotics azithromycin or doxycycline and the nutritional supplement zinc.

    On May 27, I published an article in the American Journal of Epidemiology (AJE) entitled, “Early Outpatient Treatment of Symptomatic, High-Risk COVID-19 Patients that Should be Ramped-Up Immediately as Key to the Pandemic Crisis.” That article, published in the world’s leading epidemiology journal, analyzed five studies, demonstrating clear-cut and significant benefits to treated patients, plus other very large studies that showed the medication safety.

    Physicians who have been using these medications in the face of widespread skepticism have been truly heroic. They have done what the science shows is best for their patients, often at great personal risk. I myself know of two doctors who have saved the lives of hundreds of patients with these medications, but are now fighting state medical boards to save their licenses and reputations. The cases against them are completely without scientific merit.

    Since publication of my May 27 article, seven more studies have demonstrated similar benefit. In a lengthy follow-up letter, also published by AJE, I discuss these seven studies and renew my call for the immediate early use of hydroxychloroquine in high-risk patients. These seven studies include: an additional 400 high-risk patients treated by Dr. Vladimir Zelenko, with zero deaths; four studies totaling almost 500 high-risk patients treated in nursing homes and clinics across the U.S., with no deaths; a controlled trial of more than 700 high-risk patients in Brazil, with significantly reduced risk of hospitalization and two deaths among 334 patients treated with hydroxychloroquine; and another study of 398 matched patients in France, also with significantly reduced hospitalization risk. Since my letter was published, even more doctors have reported to me their completely successful use . . . .

    Beyond these studies of individual patients, we have seen what happens in large populations when these drugs are used. These have been “natural experiments.” In the northern Brazil state of Pará, COVID-19 deaths were increasing exponentially. On April 6, the public hospital network purchased 75,000 doses of azithromycin and 90,000 doses of hydroxychloroquine. Over the next few weeks, authorities began distributing these medications to infected individuals. Even though new cases continued to occur, on May 22 the death rate started to plummet and is now about one-eighth what it was at the peak.

    A reverse natural experiment happened in Switzerland. On May 27, the Swiss national government banned outpatient use of hydroxychloroquine for COVID-19. Around June 10, COVID-19 deaths increased four-fold and remained elevated. On June 11, the Swiss government revoked the ban, and on June 23 the death rate reverted to what it had been beforehand. People who die from COVID-19 live about three to five weeks from the start of symptoms, which makes the evidence of a causal relation in these experiments strong. Both episodes suggest that a combination of hydroxychloroquine and its companion medications reduces mortality and should be immediately adopted as the new standard of care in high-risk patients .>>

    What is being drowned out.

    And, again:

    >>Why has hydroxychloroquine been disregarded?

    First, as all know, the medication has become highly politicized. For many, it is viewed as a marker of political identity, on both sides of the political spectrum. Nobody needs me to remind them that this is not how medicine should proceed. We must judge this medication strictly on the science. When doctors graduate from medical school, they formally promise to make the health and life of the patient their first consideration, without biases of race, religion, nationality, social standing—or political affiliation. Lives must come first.

    Second, the drug has not been used properly in many studies. Hydroxychloroquine has shown major success when used early in high-risk people but, as one would expect for an antiviral, much less success when used late in the disease course. Even so, it has demonstrated significant benefit in large hospital studies in Michigan and New York City when started within the first 24 to 48 hours after admission.

    In fact, as inexpensive, oral and widely available medications, and a nutritional supplement, the combination of hydroxychloroquine, azithromycin or doxycycline, and zinc are well-suited for early treatment in the outpatient setting. The combination should be prescribed in high-risk patients immediately upon clinical suspicion of COVID-19 disease, without waiting for results of testing. Delays in waiting before starting the medications can reduce their efficacy.

    Third, concerns have been raised by the FDA and others about risks of cardiac arrhythmia, especially when hydroxychloroquine is given in combination with azithromycin. The FDA based its comments on data in its FDA Adverse Event Reporting System. This reporting system captured up to a thousand cases of arrhythmias attributed to hydroxychloroquine use. In fact, the number is likely higher than that, since the reporting system, which requires physicians or patients to initiate contact with the FDA, appreciably undercounts drug side effects.

    But what the FDA did not announce is that these adverse events were generated from tens of millions of patient uses of hydroxychloroquine for long periods of time, often for the chronic treatment of lupus or rheumatoid arthritis. Even if the true rates of arrhythmia are ten-fold higher than those reported, the harms would be minuscule compared to the mortality occurring right now in inadequately treated high-risk COVID-19 patients. This fact is proven by an Oxford University study of more than 320,000 older patients taking both hydroxychloroquine and azithromycin, who had arrhythmia excess death rates of less than 9/100,000 users, as I discuss in my May 27 paper cited above. A new paper in the American Journal of Medicine by established cardiologists around the world fully agrees with this.

    In the future, I believe this misbegotten episode regarding hydroxychloroquine will be studied by sociologists of medicine as a classic example of how extra-scientific factors overrode clear-cut medical evidence. But for now, reality demands a clear, scientific eye on the evidence and where it points . . . >>

    I think there are a few questions to be asked and answered.

    The May 27, 2020 paper:

    >> Am J Epidemiol

    . 2020 May 27;kwaa093.
    doi: 10.1093/aje/kwaa093. Online ahead of print.
    Early Outpatient Treatment of Symptomatic, High-Risk Covid-19 Patients that Should be Ramped-Up Immediately as Key to the Pandemic Crisis
    Harvey A Risch 1
    Affiliations

    PMID: 32458969 DOI: 10.1093/aje/kwaa093

    Abstract

    More than 1.6 million Americans have been infected with SARS-CoV-2 and GT 10 times that number carry antibodies to it. High-risk patients presenting with progressing symptomatic disease have only hospitalization treatment with its high mortality. An outpatient treatment that prevents hospitalization is desperately needed. Two candidate medications have been widely discussed: remdesivir, and hydroxychloroquine+azithromycin. Remdesivir has shown mild effectiveness in hospitalized inpatients, but no trials have been registered in outpatients. Hydroxychloroquine+azithromycin has been widely misrepresented in both clinical reports and public media, and outpatient trials results are not expected until September. Early outpatient illness is very different than later hospitalized florid disease and the treatments differ. Evidence about use of hydroxychloroquine alone, or of hydroxychloroquine+azithromycin in inpatients, is irrelevant concerning efficacy of the pair in early high-risk outpatient disease. Five studies, including two controlled clinical trials, have demonstrated significant major outpatient treatment efficacy. Hydroxychloroquine+azithromycin has been used as standard-of-care in more than 300,000 older adults with multicomorbidities, with estimated proportion diagnosed with cardiac arrhythmias attributable to the medications 47/100,000 users, of which estimated mortality is LT 20%, 9/100,000 users, compared to the 10,000 Americans now dying each week. These medications need to be widely available and promoted immediately for physicians to prescribe. >>

    It is time to face responsibility for needless politicisation and polarisation of discussion over a manifestly effective treatment and needless deaths by at least tens of thousands. There will be a day of reckoning over such culpable irresponsibility.

    KF

  107. 107
    kairosfocus says:

    Just for fun:

    https://videos.whatfinger.com/2020/07/26/brazilian-president-bolsonaro-tests-negative-for-covid-19-thanks-hydroxy-which-can-save-hundreds-of-thousands-right-now/

    Brazilian President Bolsonaro Tests Negative for COVID-19. Thanks Hydroxy which can save hundreds of thousands right now

  108. 108
    ET says:

    Obviously something else saved the Brazilian President. 🙄

  109. 109
    rhampton7 says:

    ET,
    The Pakistani RCT showed a 67% recovery rate without any medication, 75% with HCQ. So it’s statistically more likely that Bolsonaro fought off the virus then did the HCQ.

    That’s the importance of RCTs — scientifically meaningful comparisons.

    It’s also why Israeli hospitals don’t consider HCQ to be a particularly effective treatment.

  110. 110
    rhampton7 says:

    More than three-quarters of recently recovered COVID-19 patients had heart muscle problems show up during magnetic resonance imaging (MRI) tests, German doctors reported on Monday in JAMA Cardiology.

    In some patients, the heart may be “in serious trouble as a part of COVID-19 disease,” Dr. Valentina Puntmann of University Hospital Frankfurt told Reuters.

    Among 100 patients ages 45 to 53, “a considerable majority” — 78 — had inflammation in the heart muscle and lining. Sixty-seven had recovered at home while 33 had required hospitalization.

    Half of the former patients were more than two months out since their diagnosis at the time of the MRI.

    https://www.stltoday.com/lifestyles/health-med-fit/health/new-heart-problems-seen-in-recovered-covid-19-patients/article_30ed9771-6c6d-59bf-a59e-a6b0093b4b82.html

  111. 111
    rhampton7 says:

    Dr. Steven Nissen, chief academic officer for the Cleveland Clinic Heart, Vascular and Thoracic Institute, calls the pursuit of hydroxychloroquine as a treatment strategy “sheer madness” and tells Yahoo Life that “there has never been any good solid scientific evidence that it does work.”

    In addition, Dr. Dean Winslow, an infectious disease physician at Stanford Health Care, tells Yahoo Life that he was “very concerned” about the drug combination used in the study, which can cause heart rhythm changes.

    “Both macrolide antibiotics [like azithromycin] and antimalarial drugs [like hydroxychloroquine] have the potential of prolonging the QT interval [the time between the heart muscle contracting and relaxing] in EKGs and can cause fatal arrhythmias and increased mortality,” he explains.

    Adds Winslow: “This is further evidence that this is not a winning strategy. I think we’ve studied it enough.”

    Nissen agrees, saying: “It’s time to stop pursuing this. It’s time to move on and study something that has a chance to help people.”

    https://www.yahoo.com/lifestyle/new-study-shows-limitations-risks-hydroxychloroquine-for-treating-covid-19-204819038.html

  112. 112
    rhampton7 says:

    Recently, some research publications have suggested that COVID-19 can affect an infected person’s hearing. They said that even asymptomatic patients could have problems in hearing.

    In the American Journal Otolaryngology by M.W.M. Mustafa of the Qena Faculty of Medicine at South Valley University in Egypt provided a more detailed link between the viral infection and hearing problems.

    In a hearing test Mustafa conducted on 20 asymptomatic patients aged 20 to 50 years old, all participants performed worse than normal on some parts of the tests. They performed badly on tests of transient evoked otoacoustic emissions (TEOAE) amplitudes and the high-frequency pure-tone thresholds.

    Another letter in Acta Otolaryngologica Italica described a case series of six patients aged 22 to 40 years old who had the typical symptoms of COVID-19: fever, cough, and shortness of breath. The participants also reported symptoms of hearing problems on one side, and four of them said they could hear ringing in their ears.

    But just because someone tested positive of COVID-19 and reported hearing problems, it does not mean that the former caused the latter.

    The letter published in the International Journal of Immunopathology and Pharmacology entitled “Don’t forget ototoxicity during the SARS-CoV-2 (COVID-19) pandemic!” warns health experts that several medications used in treating the patients can have ototoxicity.

    https://www.sciencetimes.com/articles/26620/20200727/covid-19-loss-hearing-asymptomatic-patients.htm

  113. 113
    ET says:

    Why is there still no word on the patients’ pH level when HCQ was being considered as a treatment?

    rhampton:

    The Pakistani RCT showed a 67% recovery rate without any medication, 75% with HCQ. So it’s statistically more likely that Bolsonaro fought off the virus then did the HCQ.

    Blood type plays a big role. As does the patients’ pH level. You know, with scientifically meaningful comparisons on the line, those should have been recorded.

    It could very well be the some people have a diet that has an effect on their pH level. That would be good to know. The vitamin D levels also seem to have a huge impact on who lives or dies. Scientifically meaningful comparisons should include all of that

  114. 114
    Mac McTavish says:

    Another sad milestone. 150,000 COVID-19 deaths. Might I suggest that everyone keep the family and friends of the victims in your thoughts and prayers during these trying times.

  115. 115
    kairosfocus says:

    Still more burial of inconvenient issues. Okay, again — underscoring just how much there is refusal to recognise and address inconvenient factors:

    https://www.newsweek.com/key-defeating-covid-19-already-exists-we-need-start-using-it-opinion-1519535

    >>The Key to Defeating COVID-19 Already Exists. We Need to Start Using It | Opinion
    Harvey A. Risch, MD, PhD , Professor of Epidemiology, Yale School of Public Health
    On 7/23/20 at 7:00 AM EDT

    As professor of epidemiology at Yale School of Public Health, I have authored over 300 peer-reviewed publications and currently hold senior positions on the editorial boards of several leading journals. I am usually accustomed to advocating for positions within the mainstream of medicine, so have been flummoxed to find that, in the midst of a crisis, I am fighting for a treatment that the data fully support but which, for reasons having nothing to do with a correct understanding of the science, has been pushed to the sidelines. As a result, tens of thousands of patients with COVID-19 are dying unnecessarily. Fortunately, the situation can be reversed easily and quickly.

    I am referring, of course, to the medication hydroxychloroquine. When this inexpensive oral medication is given very early in the course of illness, before the virus has had time to multiply beyond control, it has shown to be highly effective, especially when given in combination with the antibiotics azithromycin or doxycycline and the nutritional supplement zinc.

    On May 27, I published an article in the American Journal of Epidemiology (AJE) entitled, “Early Outpatient Treatment of Symptomatic, High-Risk COVID-19 Patients that Should be Ramped-Up Immediately as Key to the Pandemic Crisis.” That article, published in the world’s leading epidemiology journal, analyzed five studies, demonstrating clear-cut and significant benefits to treated patients, plus other very large studies that showed the medication safety.

    Physicians who have been using these medications in the face of widespread skepticism have been truly heroic. They have done what the science shows is best for their patients, often at great personal risk. I myself know of two doctors who have saved the lives of hundreds of patients with these medications, but are now fighting state medical boards to save their licenses and reputations. The cases against them are completely without scientific merit.

    Since publication of my May 27 article, seven more studies have demonstrated similar benefit. In a lengthy follow-up letter, also published by AJE, I discuss these seven studies and renew my call for the immediate early use of hydroxychloroquine in high-risk patients. These seven studies include: an additional 400 high-risk patients treated by Dr. Vladimir Zelenko, with zero deaths; four studies totaling almost 500 high-risk patients treated in nursing homes and clinics across the U.S., with no deaths; a controlled trial of more than 700 high-risk patients in Brazil, with significantly reduced risk of hospitalization and two deaths among 334 patients treated with hydroxychloroquine; and another study of 398 matched patients in France, also with significantly reduced hospitalization risk. Since my letter was published, even more doctors have reported to me their completely successful use . . . .

    Beyond these studies of individual patients, we have seen what happens in large populations when these drugs are used. These have been “natural experiments.” In the northern Brazil state of Pará, COVID-19 deaths were increasing exponentially. On April 6, the public hospital network purchased 75,000 doses of azithromycin and 90,000 doses of hydroxychloroquine. Over the next few weeks, authorities began distributing these medications to infected individuals. Even though new cases continued to occur, on May 22 the death rate started to plummet and is now about one-eighth what it was at the peak.

    A reverse natural experiment happened in Switzerland. On May 27, the Swiss national government banned outpatient use of hydroxychloroquine for COVID-19. Around June 10, COVID-19 deaths increased four-fold and remained elevated. On June 11, the Swiss government revoked the ban, and on June 23 the death rate reverted to what it had been beforehand. People who die from COVID-19 live about three to five weeks from the start of symptoms, which makes the evidence of a causal relation in these experiments strong. Both episodes suggest that a combination of hydroxychloroquine and its companion medications reduces mortality and should be immediately adopted as the new standard of care in high-risk patients .>>

    What is being drowned out.

    And, again:

    >>Why has hydroxychloroquine been disregarded?

    First, as all know, the medication has become highly politicized. For many, it is viewed as a marker of political identity, on both sides of the political spectrum. Nobody needs me to remind them that this is not how medicine should proceed. We must judge this medication strictly on the science. When doctors graduate from medical school, they formally promise to make the health and life of the patient their first consideration, without biases of race, religion, nationality, social standing—or political affiliation. Lives must come first.

    Second, the drug has not been used properly in many studies. Hydroxychloroquine has shown major success when used early in high-risk people but, as one would expect for an antiviral, much less success when used late in the disease course. Even so, it has demonstrated significant benefit in large hospital studies in Michigan and New York City when started within the first 24 to 48 hours after admission.

    In fact, as inexpensive, oral and widely available medications, and a nutritional supplement, the combination of hydroxychloroquine, azithromycin or doxycycline, and zinc are well-suited for early treatment in the outpatient setting. The combination should be prescribed in high-risk patients immediately upon clinical suspicion of COVID-19 disease, without waiting for results of testing. Delays in waiting before starting the medications can reduce their efficacy.

    Third, concerns have been raised by the FDA and others about risks of cardiac arrhythmia, especially when hydroxychloroquine is given in combination with azithromycin. The FDA based its comments on data in its FDA Adverse Event Reporting System. This reporting system captured up to a thousand cases of arrhythmias attributed to hydroxychloroquine use. In fact, the number is likely higher than that, since the reporting system, which requires physicians or patients to initiate contact with the FDA, appreciably undercounts drug side effects.

    But what the FDA did not announce is that these adverse events were generated from tens of millions of patient uses of hydroxychloroquine for long periods of time, often for the chronic treatment of lupus or rheumatoid arthritis. Even if the true rates of arrhythmia are ten-fold higher than those reported, the harms would be minuscule compared to the mortality occurring right now in inadequately treated high-risk COVID-19 patients. This fact is proven by an Oxford University study of more than 320,000 older patients taking both hydroxychloroquine and azithromycin, who had arrhythmia excess death rates of less than 9/100,000 users, as I discuss in my May 27 paper cited above. A new paper in the American Journal of Medicine by established cardiologists around the world fully agrees with this.

    In the future, I believe this misbegotten episode regarding hydroxychloroquine will be studied by sociologists of medicine as a classic example of how extra-scientific factors overrode clear-cut medical evidence. But for now, reality demands a clear, scientific eye on the evidence and where it points . . . >>

    I think there are a few questions to be asked and answered.

    The May 27, 2020 paper:

    >> Am J Epidemiol

    . 2020 May 27;kwaa093.
    doi: 10.1093/aje/kwaa093. Online ahead of print.
    Early Outpatient Treatment of Symptomatic, High-Risk Covid-19 Patients that Should be Ramped-Up Immediately as Key to the Pandemic Crisis
    Harvey A Risch 1
    Affiliations

    PMID: 32458969 DOI: 10.1093/aje/kwaa093

    Abstract

    More than 1.6 million Americans have been infected with SARS-CoV-2 and GT 10 times that number carry antibodies to it. High-risk patients presenting with progressing symptomatic disease have only hospitalization treatment with its high mortality. An outpatient treatment that prevents hospitalization is desperately needed. Two candidate medications have been widely discussed: remdesivir, and hydroxychloroquine+azithromycin. Remdesivir has shown mild effectiveness in hospitalized inpatients, but no trials have been registered in outpatients. Hydroxychloroquine+azithromycin has been widely misrepresented in both clinical reports and public media, and outpatient trials results are not expected until September. Early outpatient illness is very different than later hospitalized florid disease and the treatments differ. Evidence about use of hydroxychloroquine alone, or of hydroxychloroquine+azithromycin in inpatients, is irrelevant concerning efficacy of the pair in early high-risk outpatient disease. Five studies, including two controlled clinical trials, have demonstrated significant major outpatient treatment efficacy. Hydroxychloroquine+azithromycin has been used as standard-of-care in more than 300,000 older adults with multicomorbidities, with estimated proportion diagnosed with cardiac arrhythmias attributable to the medications 47/100,000 users, of which estimated mortality is LT 20%, 9/100,000 users, compared to the 10,000 Americans now dying each week. These medications need to be widely available and promoted immediately for physicians to prescribe. >>

    It is time to face responsibility for needless politicisation and polarisation of discussion over a manifestly effective treatment and needless deaths by at least tens of thousands. There will be a day of reckoning over such culpable irresponsibility.

    KF

  116. 116
    ET says:

    Mac, How many elderly were killed due to callous Governors sending sick people to nursing homes? The point being is that 150,000 would be many thousands fewer if not for them.

  117. 117
    jerry says:

    Alex Berenson reported one of the the most viral videos in the history of Facebook got taken down in a very short time. It was of a group of doctors touting the effectiveness of HCQ and zinc and Azithromycin. 14 million views in 6 hours.

    Facebook said it was communicating false information.

    Scott Adams has come out of nowhere to understand what has been going on with HCQ. A week ago he said he was skeptical but now nails the issue.

    Does it strengthen or weaken the HCQ conspiracy case to see experts continuously tweet the wrong kinds of studies (hospitalized patients) to show why the proposed use (outpatient) doesn’t work?

    We see that here as RHampton continually posting fake news with the wrong kinds of studies

    One has to ask the question, are they that dumb or do they have an agenda that entails hundreds of thousands dying for what they believe is a greater cause. Are those attacking HCQ an example of one of the most callous movements in the history of mankind?

    Are those pointing to the number of dead from the virus the same people who cheer on attacks on what is probably the most effective known treatment against the virus? And at the same time do not offer an alternative.

  118. 118
    Bob O'H says:

    A week ago he said he was skeptical but now nails the issue.

    Does it strengthen or weaken the HCQ conspiracy case to see experts continuously tweet the wrong kinds of studies (hospitalized patients) to show why the proposed use (outpatient) doesn’t work?

    We see that here as RHampton continually posting fake news with the wrong kinds of studies
    I guess he wants links to studies like this. Which RHampton linked to above (although he linked to the pre-print version). So unless an outpatient study is the wrong sort of study for a study of outpatients, you’re going to have to try harder to dismiss the study.

    Are those attacking HCQ an example of one of the most callous movements in the history of mankind?

    let’s be clear about this – the evidence says HCQ isn’t an effective treatment. This has been shown in several RCTs, for different stages of the disease, as well as high-quality retrospective studies (e.g. the VA study, and this one, on outpatients).

    We’d all love it if an effective treatment was found, but unfortunately the evidence is saying HCQ isn’t it. We’re not monsters, and I don’t think people pushing for HCQ are either.

  119. 119
    Mac McTavish says:

    ET

    The point being is that 150,000 would be many thousands fewer if not for them.

    Does that make them any less deserving of our thoughts and prayers?

    I honestly don’t understand what would make you respond in this way to a comment that is asking for people to give their thoughts and prayers to the people who have died of COVID.

  120. 120
    jerry says:

    Bob O’H again endorses HCQ. The curious incident of the dog in the night rationale.

    I guess he wants links to studies like this…

    e.g. the VA study, and this one, on outpatients

    Only references to irrelevant analyses. What is it when someone only points to valid but irrelevant analyses.

    No barking!!

    Tantamount to an endorsement.

  121. 121
    rhampton7 says:

    Reasons to be skeptical of HCQ promoters— hawking the treatment as a genuine cure:

    The video, a 45-minute livestream of the first day of a “White Coat” summit by the group, was posted to Facebook, Twitter and YouTube by Breitbart and quickly went viral.

    “The virus has a cure, it’s called hydroxychloroquine, zinc, and Zithromax,” says one of the doctors in the video.

    “You don’t need masks. There is a cure. I know they don’t want to open schools. No, you don’t need people to be locked down. There is prevention and there is a cure.”
    — Dr Stella Immanuel

    https://www.bbc.com/news/53559938

    There is no cure. Ask Raoult if you don’t believe me.

  122. 122
    kairosfocus says:

    Folks, some more need to remind.

    https://www.newsweek.com/key-defeating-covid-19-already-exists-we-need-start-using-it-opinion-1519535

    >>The Key to Defeating COVID-19 Already Exists. We Need to Start Using It | Opinion
    Harvey A. Risch, MD, PhD , Professor of Epidemiology, Yale School of Public Health
    On 7/23/20 at 7:00 AM EDT

    As professor of epidemiology at Yale School of Public Health, I have authored over 300 peer-reviewed publications and currently hold senior positions on the editorial boards of several leading journals. I am usually accustomed to advocating for positions within the mainstream of medicine, so have been flummoxed to find that, in the midst of a crisis, I am fighting for a treatment that the data fully support but which, for reasons having nothing to do with a correct understanding of the science, has been pushed to the sidelines. As a result, tens of thousands of patients with COVID-19 are dying unnecessarily. Fortunately, the situation can be reversed easily and quickly.

    I am referring, of course, to the medication hydroxychloroquine. When this inexpensive oral medication is given very early in the course of illness, before the virus has had time to multiply beyond control, it has shown to be highly effective, especially when given in combination with the antibiotics azithromycin or doxycycline and the nutritional supplement zinc.

    On May 27, I published an article in the American Journal of Epidemiology (AJE) entitled, “Early Outpatient Treatment of Symptomatic, High-Risk COVID-19 Patients that Should be Ramped-Up Immediately as Key to the Pandemic Crisis.” That article, published in the world’s leading epidemiology journal, analyzed five studies, demonstrating clear-cut and significant benefits to treated patients, plus other very large studies that showed the medication safety.

    Physicians who have been using these medications in the face of widespread skepticism have been truly heroic. They have done what the science shows is best for their patients, often at great personal risk. I myself know of two doctors who have saved the lives of hundreds of patients with these medications, but are now fighting state medical boards to save their licenses and reputations. The cases against them are completely without scientific merit.

    Since publication of my May 27 article, seven more studies have demonstrated similar benefit. In a lengthy follow-up letter, also published by AJE, I discuss these seven studies and renew my call for the immediate early use of hydroxychloroquine in high-risk patients. These seven studies include: an additional 400 high-risk patients treated by Dr. Vladimir Zelenko, with zero deaths; four studies totaling almost 500 high-risk patients treated in nursing homes and clinics across the U.S., with no deaths; a controlled trial of more than 700 high-risk patients in Brazil, with significantly reduced risk of hospitalization and two deaths among 334 patients treated with hydroxychloroquine; and another study of 398 matched patients in France, also with significantly reduced hospitalization risk. Since my letter was published, even more doctors have reported to me their completely successful use . . . .

    Beyond these studies of individual patients, we have seen what happens in large populations when these drugs are used. These have been “natural experiments.” In the northern Brazil state of Pará, COVID-19 deaths were increasing exponentially. On April 6, the public hospital network purchased 75,000 doses of azithromycin and 90,000 doses of hydroxychloroquine. Over the next few weeks, authorities began distributing these medications to infected individuals. Even though new cases continued to occur, on May 22 the death rate started to plummet and is now about one-eighth what it was at the peak.

    A reverse natural experiment happened in Switzerland. On May 27, the Swiss national government banned outpatient use of hydroxychloroquine for COVID-19. Around June 10, COVID-19 deaths increased four-fold and remained elevated. On June 11, the Swiss government revoked the ban, and on June 23 the death rate reverted to what it had been beforehand. People who die from COVID-19 live about three to five weeks from the start of symptoms, which makes the evidence of a causal relation in these experiments strong. Both episodes suggest that a combination of hydroxychloroquine and its companion medications reduces mortality and should be immediately adopted as the new standard of care in high-risk patients .>>

    What is being drowned out.

    And, again:

    >>Why has hydroxychloroquine been disregarded?

    First, as all know, the medication has become highly politicized. For many, it is viewed as a marker of political identity, on both sides of the political spectrum. Nobody needs me to remind them that this is not how medicine should proceed. We must judge this medication strictly on the science. When doctors graduate from medical school, they formally promise to make the health and life of the patient their first consideration, without biases of race, religion, nationality, social standing—or political affiliation. Lives must come first.

    Second, the drug has not been used properly in many studies. Hydroxychloroquine has shown major success when used early in high-risk people but, as one would expect for an antiviral, much less success when used late in the disease course. Even so, it has demonstrated significant benefit in large hospital studies in Michigan and New York City when started within the first 24 to 48 hours after admission.

    In fact, as inexpensive, oral and widely available medications, and a nutritional supplement, the combination of hydroxychloroquine, azithromycin or doxycycline, and zinc are well-suited for early treatment in the outpatient setting. The combination should be prescribed in high-risk patients immediately upon clinical suspicion of COVID-19 disease, without waiting for results of testing. Delays in waiting before starting the medications can reduce their efficacy.

    Third, concerns have been raised by the FDA and others about risks of cardiac arrhythmia, especially when hydroxychloroquine is given in combination with azithromycin. The FDA based its comments on data in its FDA Adverse Event Reporting System. This reporting system captured up to a thousand cases of arrhythmias attributed to hydroxychloroquine use. In fact, the number is likely higher than that, since the reporting system, which requires physicians or patients to initiate contact with the FDA, appreciably undercounts drug side effects.

    But what the FDA did not announce is that these adverse events were generated from tens of millions of patient uses of hydroxychloroquine for long periods of time, often for the chronic treatment of lupus or rheumatoid arthritis. Even if the true rates of arrhythmia are ten-fold higher than those reported, the harms would be minuscule compared to the mortality occurring right now in inadequately treated high-risk COVID-19 patients. This fact is proven by an Oxford University study of more than 320,000 older patients taking both hydroxychloroquine and azithromycin, who had arrhythmia excess death rates of less than 9/100,000 users, as I discuss in my May 27 paper cited above. A new paper in the American Journal of Medicine by established cardiologists around the world fully agrees with this.

    In the future, I believe this misbegotten episode regarding hydroxychloroquine will be studied by sociologists of medicine as a classic example of how extra-scientific factors overrode clear-cut medical evidence. But for now, reality demands a clear, scientific eye on the evidence and where it points . . . >>

    I think there are a few questions to be asked and answered.

    The May 27, 2020 paper:

    >> Am J Epidemiol

    . 2020 May 27;kwaa093.
    doi: 10.1093/aje/kwaa093. Online ahead of print.
    Early Outpatient Treatment of Symptomatic, High-Risk Covid-19 Patients that Should be Ramped-Up Immediately as Key to the Pandemic Crisis
    Harvey A Risch 1
    Affiliations

    PMID: 32458969 DOI: 10.1093/aje/kwaa093

    Abstract

    More than 1.6 million Americans have been infected with SARS-CoV-2 and GT 10 times that number carry antibodies to it. High-risk patients presenting with progressing symptomatic disease have only hospitalization treatment with its high mortality. An outpatient treatment that prevents hospitalization is desperately needed. Two candidate medications have been widely discussed: remdesivir, and hydroxychloroquine+azithromycin. Remdesivir has shown mild effectiveness in hospitalized inpatients, but no trials have been registered in outpatients. Hydroxychloroquine+azithromycin has been widely misrepresented in both clinical reports and public media, and outpatient trials results are not expected until September. Early outpatient illness is very different than later hospitalized florid disease and the treatments differ. Evidence about use of hydroxychloroquine alone, or of hydroxychloroquine+azithromycin in inpatients, is irrelevant concerning efficacy of the pair in early high-risk outpatient disease. Five studies, including two controlled clinical trials, have demonstrated significant major outpatient treatment efficacy. Hydroxychloroquine+azithromycin has been used as standard-of-care in more than 300,000 older adults with multicomorbidities, with estimated proportion diagnosed with cardiac arrhythmias attributable to the medications 47/100,000 users, of which estimated mortality is LT 20%, 9/100,000 users, compared to the 10,000 Americans now dying each week. These medications need to be widely available and promoted immediately for physicians to prescribe. >>

    It is time to face responsibility for needless politicisation and polarisation of discussion over a manifestly effective treatment and needless deaths by at least tens of thousands. There will be a day of reckoning over such culpable irresponsibility.

    KF

  123. 123
    rhampton7 says:

    Dr Stella Immanuel, Houston doctor who was part of a controversial viral video touting hydroxychloroquine as a “cure” for COVID-19, is a licensed pediatrician in the State of Texas, according to the Texas Medical Board.

    Her practice address is listed as 6278 Highway 6 South in Houston, which Google Maps data shows is also the location of Fire Power Ministries Christian Resource Center, a ministry which is headed by Immanuel.

    Immanuel claims that medical issues like endometriosis, cysts, infertility, and impotence are caused by sex with “spirit husbands” and “spirit wives”—a phenomenon Immanuel describes essentially as witches and demons having sex with people in a dreamworld.
    “They are responsible for serious gynecological problems,” Immanuel said. “We call them all kinds of names—endometriosis, we call them molar pregnancies, we call them fibroids, we call them cysts, but most of them are evil deposits from the spirit husband,” Immanuel said of the medical issues in a 2013 sermon. “They are responsible for miscarriages, impotence—men that can’t get it up.”

    The Daily Beast also found that Immanuel claimed in 2015 that an Illuminati plan had been concocted by “a witch” to destroy the world using abortion, gay marriage, and children’s toys. She also claimed that DNA from space aliens is currently being used in medicine.

    In the same sermon, Immanuel also claimed the Magic 8-Ball toy was a tool to get people into witchcraft.

    https://cbsaustin.com/news/local/report-texas-doctor-who-went-viral-with-unproven-covid-19-cure-believes-in-demon-sperm

  124. 124
    rhampton7 says:

    The Pennsylvania Department of Health on Tuesday released a report related to a June investigation of a complaint that officials at Brighton Rehabilitation and Wellness Center administered hydroxychloroquine and zinc to help treat and prevent residents from contracting COVID-19. According to the report, the facility administered the drug combination to 205 of 435 residents as part of an “Experimental Post-Exposure Prophylaxis” treatment.

    According to the report, facility officials were cited for not notifying the Department of Health about the “experimental research” that was being conducted.

    Interviews in May with Department of Health inspectors found that Brighton Rehab officials not only administered the drug to 205 residents, but also failed to report any medication errors and adverse event occurring during the treatment.

    The facility’s medical director and clinical leadership is required to undergo training on resident rights regarding experimental research and a consultant pharmacist will conduct random audits each month to make sure that hydroxychloroquine and zinc are not being prescribed.

    This isn’t the first time that the facility’s use of the drug has come into the spotlight.

    https://www.timesonline.com/news/20200728/brighton-rehab-cited-for-use-of-hydroxychloroquine

  125. 125
    rhampton7 says:

    “I go along with the FDA,” Fauci says of his position on use of hydroxychloroquine when treating coronavirus.

    The overwhelming prevailing clinical trials that have looked at the efficacy of hydroxychloroquine have indicated that it is not effective in coronavirus disease,” NIH infectious disease expert Anthony Fauci says in interview on ABC’s “Good Morning America.”

    https://news.bloomberglaw.com/health-law-and-business/fauci-agrees-with-fda-hydroxychloroquine-not-effective-in-covid

  126. 126
    rhampton7 says:

    This is a failure on the part of our President. It’s exactly the kinds of fake news he rails against:

    President Donald Trump shared a tweet from Melissa Tate, who describes herself as a “Trumpublican,” which claimed “6000 doctors surveyed across the world all said #Hydroxychloroquine works in Covid patients” and also referred to “Multiple Studies in France.”

    The tweet added that “here in America it is being suppressed to keep deaths high so the economy can be shut down ahead of the election. It’s sick!”

    Newsweek has contacted the White House, the Trump campaign, and the FDA for comment.

    Several other posts on Trump’s Twitter account were no longer available, amid various tweets about the use of hydroxychloroquine. Newsweek has contacted Twitter for comment on the removed posts.

    https://www.newsweek.com/donald-trump-hydroxychloroquine-election-1520878

  127. 127
    rhampton7 says:

    Kenya’s Ministry of Health also took the opportunity to distance itself from claims that COVID-19 is easily treatable using hydroxychloroquine.

    Speaking at Tuesday’s media briefing in Nairobi, Dr. Patrick Amoth, the Ag. Director General for Public Health at the Ministry of Health Kenya, dismissed the claims, saying “due to stigma, fear, hopelessness, it is easy to hawk than sell science.”

    “This video was based on an individual who apparently was addressing people somewhere without any scientific basis. The WHO has given very clear guidelines based on randomized clinical trials…which shows that the use of chloroquine in the management of COVID-19 does not add any value. To the contrary, it actually can cause a risk especially for those who have preexisting heart conditions,” said Dr Amoth.

    https://africa.cgtn.com/2020/07/28/kenyas-covid-19-cases-top-18000-as-health-ministry-dismisses-u-s-video-touting-use-of-hydroxychloroquine/

  128. 128
    rhampton7 says:

    Israeli medical professionals are struggling to cope with the second wave of the coronavirus outbreak as some hospitals are at more than 100% capacity.

    Four Israeli hospitals have reported that they are operating at capacity or are already overcrowded.

    The ministry is trying to help overcrowded hospitals by implementing an early release of patients suffering from mild symptoms and transferring elderly patients to geriatric centers for treatment.

    The ongoing health crisis has resulted in nearly daily protests against the government in Jerusalem and Tel Aviv.

    The unemployment rate in the country is still above 20 percent.

    https://www1.cbn.com/cbnnews/israel/2020/july/israel-rsquo-s-hospitals-overcrowded-as-doctors-struggle-to-keep-up-with-virus-demand

    Israel has taken a harder line than we have, and they have less deaths per capita. It’s not because PM Netenyahu wants to destroy the Israeli economy, but to stop the spread of COVID-19 so that the economy can be safely reopened.

  129. 129
    jerry says:

    There is no cure

    How do you know? I have seen no information that supports that.

    Certainly nothing in the several hundred comments you have made supports your claim. No one else anywhere on the planet has provided anything close to supporting the statement.

    More fake stuff by RHampton.

  130. 130
    rhampton7 says:

    There is no cure Jerry. You think the Israeli are dumb?

  131. 131
    jerry says:

    There is no cure Jerry. You think the Israeli are dumb?

    That’s not an answer. That’s actually a non sequitur. So I take it you cannot support your claim.

    Because there is dissent in Israel you believe that proves your claim. What about the countries who disagree with those who disagree in Israel?

    By the way Israel had a hard time electing a government so there are lots of differing opinions there. Maybe there is a large contingent that wants there to be no effective treatment as there appears to be here.

  132. 132
    rhampton7 says:

    No Jerry, it is an answer. Why is unemployment over 20% in Israel with protests growing every day? Because the Israeli government put the country on lockdown after an explosive 2nd wave.

    Why would there be a 2nd wave if Israel had a cure? Why would they intentionally withhold it from themselves?

    There is no cure Jerry. Not in Israel or anywhere else in this world.

  133. 133
    jerry says:

    There is no cure Jerry. Not in Israel or anywhere else in this world.

    Again a non answer. Why are some countries doing so much better than others?

    Why in over a thousand posts by you there is nothing you posted showing HCQ ineffective?

    By the way Israel has one of the highest success rates in the world against the virus. There has been a rise recently so we will see what happens.

    HCQ is not the only effective treatment out there. But all the evidence points to it as one that is effective if used correctly.

  134. 134
    rhampton7 says:

    Why is Israel on lockdown with unemployment over 20% Jerry? Why a lockdown if there is a cure? Can you actually try to logically think this through?

  135. 135
  136. 136
    rhampton7 says:

    Due to the soaring number of coronavirus cases in Israel in recent weeks, more and more coronavirus wards in Israeli hospitals are full or almost full and hospitals in Israel’s capital are no longer accepting coronavirus patients, Israeli media reported on Monday

    Hadassah Ein Kerem’s coronavirus ward is at 178% capacity and the hospital in general is at 119% capacity, according to a Ynet report.

    The coronavirus wards at Shaarei Tzedek Hospital in Jerusalem and Assaf HaRofeh in Be’er Yaakov are at 118% capacity and Sheba Hospital in Tel HaShomer is over 100% capacity. Many other hospitals across Israel are operating at close to 100% capacity .

    There are no more available beds for coronavirus patients in Jerusalem with Hadassah and Shaarei Tzedek already transferring patients to hospitals in central Israel.

    https://www.theyeshivaworld.com/news/headlines-breaking-stories/1886919/no-coronavirus-beds-left-in-jerusalem-were-transferring-patients-to-the-center.html

    Again, do you think Israelis are dumb?

    Jerry, why are several Israeli hospitals at or over capacity with Covid-19 cases if there is a cure?

  137. 137
    rhampton7 says:

    The “censored” doctor Stella Immanuel:

    https://heavy.com/news/2020/07/dr-stella-immanuel/

  138. 138
    rhampton7 says:

    KF, cat got your tongue on the cure?

    What is the moral cost of allowing a partisan lie to persist when you know it’s false? Allowing people to believe there is a conspiracy to withhold a cure?

  139. 139
    kairosfocus says:

    RH7, personalities are not an answer to a substantial fact. Enough has been shown that the efficacy of HCQ based cocktails, suitably used, is not in doubt. The issue is why the hostility. I have repeatedly highlighted a serious answer and will momentarily do so again. Let that speak. KF

  140. 140
    kairosfocus says:

    F/N: Again, what needs to be faced:

    https://www.newsweek.com/key-defeating-covid-19-already-exists-we-need-start-using-it-opinion-1519535

    >>The Key to Defeating COVID-19 Already Exists. We Need to Start Using It | Opinion
    Harvey A. Risch, MD, PhD , Professor of Epidemiology, Yale School of Public Health
    On 7/23/20 at 7:00 AM EDT

    As professor of epidemiology at Yale School of Public Health, I have authored over 300 peer-reviewed publications and currently hold senior positions on the editorial boards of several leading journals. I am usually accustomed to advocating for positions within the mainstream of medicine, so have been flummoxed to find that, in the midst of a crisis, I am fighting for a treatment that the data fully support but which, for reasons having nothing to do with a correct understanding of the science, has been pushed to the sidelines. As a result, tens of thousands of patients with COVID-19 are dying unnecessarily. Fortunately, the situation can be reversed easily and quickly.

    I am referring, of course, to the medication hydroxychloroquine. When this inexpensive oral medication is given very early in the course of illness, before the virus has had time to multiply beyond control, it has shown to be highly effective, especially when given in combination with the antibiotics azithromycin or doxycycline and the nutritional supplement zinc.

    On May 27, I published an article in the American Journal of Epidemiology (AJE) entitled, “Early Outpatient Treatment of Symptomatic, High-Risk COVID-19 Patients that Should be Ramped-Up Immediately as Key to the Pandemic Crisis.” That article, published in the world’s leading epidemiology journal, analyzed five studies, demonstrating clear-cut and significant benefits to treated patients, plus other very large studies that showed the medication safety.

    Physicians who have been using these medications in the face of widespread skepticism have been truly heroic. They have done what the science shows is best for their patients, often at great personal risk. I myself know of two doctors who have saved the lives of hundreds of patients with these medications, but are now fighting state medical boards to save their licenses and reputations. The cases against them are completely without scientific merit.

    Since publication of my May 27 article, seven more studies have demonstrated similar benefit. In a lengthy follow-up letter, also published by AJE, I discuss these seven studies and renew my call for the immediate early use of hydroxychloroquine in high-risk patients. These seven studies include: an additional 400 high-risk patients treated by Dr. Vladimir Zelenko, with zero deaths; four studies totaling almost 500 high-risk patients treated in nursing homes and clinics across the U.S., with no deaths; a controlled trial of more than 700 high-risk patients in Brazil, with significantly reduced risk of hospitalization and two deaths among 334 patients treated with hydroxychloroquine; and another study of 398 matched patients in France, also with significantly reduced hospitalization risk. Since my letter was published, even more doctors have reported to me their completely successful use . . . .

    Beyond these studies of individual patients, we have seen what happens in large populations when these drugs are used. These have been “natural experiments.” In the northern Brazil state of Pará, COVID-19 deaths were increasing exponentially. On April 6, the public hospital network purchased 75,000 doses of azithromycin and 90,000 doses of hydroxychloroquine. Over the next few weeks, authorities began distributing these medications to infected individuals. Even though new cases continued to occur, on May 22 the death rate started to plummet and is now about one-eighth what it was at the peak.

    A reverse natural experiment happened in Switzerland. On May 27, the Swiss national government banned outpatient use of hydroxychloroquine for COVID-19. Around June 10, COVID-19 deaths increased four-fold and remained elevated. On June 11, the Swiss government revoked the ban, and on June 23 the death rate reverted to what it had been beforehand. People who die from COVID-19 live about three to five weeks from the start of symptoms, which makes the evidence of a causal relation in these experiments strong. Both episodes suggest that a combination of hydroxychloroquine and its companion medications reduces mortality and should be immediately adopted as the new standard of care in high-risk patients .>>

    What is being drowned out.

    And, again:

    >>Why has hydroxychloroquine been disregarded?

    First, as all know, the medication has become highly politicized. For many, it is viewed as a marker of political identity, on both sides of the political spectrum. Nobody needs me to remind them that this is not how medicine should proceed. We must judge this medication strictly on the science. When doctors graduate from medical school, they formally promise to make the health and life of the patient their first consideration, without biases of race, religion, nationality, social standing—or political affiliation. Lives must come first.

    Second, the drug has not been used properly in many studies. Hydroxychloroquine has shown major success when used early in high-risk people but, as one would expect for an antiviral, much less success when used late in the disease course. Even so, it has demonstrated significant benefit in large hospital studies in Michigan and New York City when started within the first 24 to 48 hours after admission.

    In fact, as inexpensive, oral and widely available medications, and a nutritional supplement, the combination of hydroxychloroquine, azithromycin or doxycycline, and zinc are well-suited for early treatment in the outpatient setting. The combination should be prescribed in high-risk patients immediately upon clinical suspicion of COVID-19 disease, without waiting for results of testing. Delays in waiting before starting the medications can reduce their efficacy.

    Third, concerns have been raised by the FDA and others about risks of cardiac arrhythmia, especially when hydroxychloroquine is given in combination with azithromycin. The FDA based its comments on data in its FDA Adverse Event Reporting System. This reporting system captured up to a thousand cases of arrhythmias attributed to hydroxychloroquine use. In fact, the number is likely higher than that, since the reporting system, which requires physicians or patients to initiate contact with the FDA, appreciably undercounts drug side effects.

    But what the FDA did not announce is that these adverse events were generated from tens of millions of patient uses of hydroxychloroquine for long periods of time, often for the chronic treatment of lupus or rheumatoid arthritis. Even if the true rates of arrhythmia are ten-fold higher than those reported, the harms would be minuscule compared to the mortality occurring right now in inadequately treated high-risk COVID-19 patients. This fact is proven by an Oxford University study of more than 320,000 older patients taking both hydroxychloroquine and azithromycin, who had arrhythmia excess death rates of less than 9/100,000 users, as I discuss in my May 27 paper cited above. A new paper in the American Journal of Medicine by established cardiologists around the world fully agrees with this.

    In the future, I believe this misbegotten episode regarding hydroxychloroquine will be studied by sociologists of medicine as a classic example of how extra-scientific factors overrode clear-cut medical evidence. But for now, reality demands a clear, scientific eye on the evidence and where it points . . . >>

    I think there are a few questions to be asked and answered.

    The May 27, 2020 paper:

    >> Am J Epidemiol

    . 2020 May 27;kwaa093.
    doi: 10.1093/aje/kwaa093. Online ahead of print.
    Early Outpatient Treatment of Symptomatic, High-Risk Covid-19 Patients that Should be Ramped-Up Immediately as Key to the Pandemic Crisis
    Harvey A Risch 1
    Affiliations

    PMID: 32458969 DOI: 10.1093/aje/kwaa093

    Abstract

    More than 1.6 million Americans have been infected with SARS-CoV-2 and GT 10 times that number carry antibodies to it. High-risk patients presenting with progressing symptomatic disease have only hospitalization treatment with its high mortality. An outpatient treatment that prevents hospitalization is desperately needed. Two candidate medications have been widely discussed: remdesivir, and hydroxychloroquine+azithromycin. Remdesivir has shown mild effectiveness in hospitalized inpatients, but no trials have been registered in outpatients. Hydroxychloroquine+azithromycin has been widely misrepresented in both clinical reports and public media, and outpatient trials results are not expected until September. Early outpatient illness is very different than later hospitalized florid disease and the treatments differ. Evidence about use of hydroxychloroquine alone, or of hydroxychloroquine+azithromycin in inpatients, is irrelevant concerning efficacy of the pair in early high-risk outpatient disease. Five studies, including two controlled clinical trials, have demonstrated significant major outpatient treatment efficacy. Hydroxychloroquine+azithromycin has been used as standard-of-care in more than 300,000 older adults with multicomorbidities, with estimated proportion diagnosed with cardiac arrhythmias attributable to the medications 47/100,000 users, of which estimated mortality is LT 20%, 9/100,000 users, compared to the 10,000 Americans now dying each week. These medications need to be widely available and promoted immediately for physicians to prescribe. >>

    It is time to face responsibility for needless politicisation and polarisation of discussion over a manifestly effective treatment and needless deaths by at least tens of thousands. There will be a day of reckoning over such culpable irresponsibility.

    KF

  141. 141
  142. 142
    rhampton7 says:

    Kansas City area doctors and public health professionals said a viral video published Monday and shared millions of times before being removed by social media companies is false and misleading.

    “It was disappointing to see our colleagues nationally get up on the steps in DC and say stuff that’s just so far off,” said Dr. Steve Stites, The University of Kansas Health System chief medical officer.
    “We’re building the airplane while we fly it, and sometimes we figure the parts don’t fit, and that’s hydroxychloroquine,” Stites said. “It looked theoretically like it was going to work, we even initiated a study here, the HERO study, trying to look at the use of hydroxychloroquine for front line workers. The reality is, it hasn’t worked, despite everybody’s trying to postulate that it should.”

    https://www.kmbc.com/article/kc-doctors-say-viral-video-makes-misleading-claims-about-covid-19/33449623

  143. 143
    rhampton7 says:

    “You want to open schools? Everybody get on hydroxychloroquine,” Dr. Immanuel says in the video. She recommends taking one tablet every other week as a safeguard against the disease.

    However, there is no scientific evidence indicating that hydroxychloroquine protects against the novel coronavirus, says Dr. Whyte, M.D., MPH, Chief Medical Officer of WebMD.

    In fact, people who took the medication still got sick after being exposed to someone with COVID-19, according to a double-blind, randomized, placebo-controlled trial published last month in The New England Journal of Medicine.

    Further, Dr Whyte questions the reasoning behind Dr. Immanuel’s dosing recommendation. Clinical trials reveal whether a medication is dangerous or effective in specific strengths. Those studies haven’t been done.

    “That’s why you do trials to come up with a dosing regimen,” says Dr. Whyte. Trial-and-error dosing is just dangerous.

    https://www.menshealth.com/health/a33446053/breitbart-stella-immanuel-video-fact-check/

  144. 144
    rhampton7 says:

    Less than one week after being appointed the country’s new coronavirus commissioner, Prof. Ronni Gamzu revealed his “Shield of Israel” strategic plan to save the country from the novel coronavirus.

    Earlier in the day, Gamzu met with the heads of local authorities and shared more about his plan, including that testing will be increased to 60,000 people per day within the next two months and ultimately up to 100,000 by winter. He said he wants to manage cities according to their rates of infection, designating them red, orange or green.

    The greener a city is, the more power the mayors will have to make decisions about what stores and activities to open. Red cities would be managed by Home Front Command in cooperation with the local authority.

    Shortly after sharing his plan, Gamzu told N12 he plans to open schools on September 1.

    “I expect all government ministers to back up this plan,” Netanyahu said. “I expect all Israeli citizens, without exception, to cooperate with it. Together, we will defeat coronavirus.”

    https://www.jpost.com/health-science/coronavirus-czar-debuts-defend-israel-strategic-plan-636656

    Even if KF won’t say it, there is no cure for Covid-19. Not in Israel. Not anywhere in this world.

  145. 145
    rhampton7 says:

    False claim that Israelis made COVID-19 remedy circulates on social media (JUNE 25, 2020)

    The claim has been circulating social media, having been retweeted on Twitter, and either been copy and pasted or re-shared multiple times on Facebook. It claims the remedy either cures or eliminates the virus, and that due to the remedy Israel has had none of its citizens succumb to the virus.

    While the claim that Israelis developed a working remedy is false, Israeli scientists and medical teams have made much progress in coronavirus research.

    https://www.jpost.com/israel-news/false-claim-that-israelis-created-covid-19-remedy-circulates-social-media-632704

  146. 146
    ET says:

    Again- the thing with HCQ is it’s supposed to change your pH which in turn has an effect of the ACE2 receptors. There are other ways to alter your body’s pH that doesn’t require HCQ. That’s why the patients’ pH values would have been a good indicator of what is going on.

  147. 147
    Bob O'H says:

    Jerry @ 120 –

    Only references to irrelevant analyses. What is it when someone only points to valid but irrelevant analyses.

    In what way is it irrelevant?

  148. 148
    JVL says:

    ET: Again- the thing with HCQ is it’s supposed to change your pH which in turn has an effect of the ACE2 receptors. There are other ways to alter your body’s pH that doesn’t require HCQ. That’s why the patients’ pH values would have been a good indicator of what is going on.

    How far from normal should the pH be to affect the ACE2 receptors?

  149. 149
    JVL says:

    From the BBC: where are the COVID-19 hotspots and which countries are experiencing second waves?

    https://www.bbc.co.uk/news/world-51235105

  150. 150
    kairosfocus says:

    F/N: Still being dodged by objectors aiming to drown out cogent and substantial reasons to accept the efficacy of HCQ+ cocktails:

    https://www.newsweek.com/key-defeating-covid-19-already-exists-we-need-start-using-it-opinion-1519535

    >>The Key to Defeating COVID-19 Already Exists. We Need to Start Using It | Opinion
    Harvey A. Risch, MD, PhD , Professor of Epidemiology, Yale School of Public Health
    On 7/23/20 at 7:00 AM EDT

    As professor of epidemiology at Yale School of Public Health, I have authored over 300 peer-reviewed publications and currently hold senior positions on the editorial boards of several leading journals. I am usually accustomed to advocating for positions within the mainstream of medicine, so have been flummoxed to find that, in the midst of a crisis, I am fighting for a treatment that the data fully support but which, for reasons having nothing to do with a correct understanding of the science, has been pushed to the sidelines. As a result, tens of thousands of patients with COVID-19 are dying unnecessarily. Fortunately, the situation can be reversed easily and quickly.

    I am referring, of course, to the medication hydroxychloroquine. When this inexpensive oral medication is given very early in the course of illness, before the virus has had time to multiply beyond control, it has shown to be highly effective, especially when given in combination with the antibiotics azithromycin or doxycycline and the nutritional supplement zinc.

    On May 27, I published an article in the American Journal of Epidemiology (AJE) entitled, “Early Outpatient Treatment of Symptomatic, High-Risk COVID-19 Patients that Should be Ramped-Up Immediately as Key to the Pandemic Crisis.” That article, published in the world’s leading epidemiology journal, analyzed five studies, demonstrating clear-cut and significant benefits to treated patients, plus other very large studies that showed the medication safety.

    Physicians who have been using these medications in the face of widespread skepticism have been truly heroic. They have done what the science shows is best for their patients, often at great personal risk. I myself know of two doctors who have saved the lives of hundreds of patients with these medications, but are now fighting state medical boards to save their licenses and reputations. The cases against them are completely without scientific merit.

    Since publication of my May 27 article, seven more studies have demonstrated similar benefit. In a lengthy follow-up letter, also published by AJE, I discuss these seven studies and renew my call for the immediate early use of hydroxychloroquine in high-risk patients. These seven studies include: an additional 400 high-risk patients treated by Dr. Vladimir Zelenko, with zero deaths; four studies totaling almost 500 high-risk patients treated in nursing homes and clinics across the U.S., with no deaths; a controlled trial of more than 700 high-risk patients in Brazil, with significantly reduced risk of hospitalization and two deaths among 334 patients treated with hydroxychloroquine; and another study of 398 matched patients in France, also with significantly reduced hospitalization risk. Since my letter was published, even more doctors have reported to me their completely successful use . . . .

    Beyond these studies of individual patients, we have seen what happens in large populations when these drugs are used. These have been “natural experiments.” In the northern Brazil state of Pará, COVID-19 deaths were increasing exponentially. On April 6, the public hospital network purchased 75,000 doses of azithromycin and 90,000 doses of hydroxychloroquine. Over the next few weeks, authorities began distributing these medications to infected individuals. Even though new cases continued to occur, on May 22 the death rate started to plummet and is now about one-eighth what it was at the peak.

    A reverse natural experiment happened in Switzerland. On May 27, the Swiss national government banned outpatient use of hydroxychloroquine for COVID-19. Around June 10, COVID-19 deaths increased four-fold and remained elevated. On June 11, the Swiss government revoked the ban, and on June 23 the death rate reverted to what it had been beforehand. People who die from COVID-19 live about three to five weeks from the start of symptoms, which makes the evidence of a causal relation in these experiments strong. Both episodes suggest that a combination of hydroxychloroquine and its companion medications reduces mortality and should be immediately adopted as the new standard of care in high-risk patients .>>

    What is being drowned out.

    And, again:

    >>Why has hydroxychloroquine been disregarded?

    First, as all know, the medication has become highly politicized. For many, it is viewed as a marker of political identity, on both sides of the political spectrum. Nobody needs me to remind them that this is not how medicine should proceed. We must judge this medication strictly on the science. When doctors graduate from medical school, they formally promise to make the health and life of the patient their first consideration, without biases of race, religion, nationality, social standing—or political affiliation. Lives must come first.

    Second, the drug has not been used properly in many studies. Hydroxychloroquine has shown major success when used early in high-risk people but, as one would expect for an antiviral, much less success when used late in the disease course. Even so, it has demonstrated significant benefit in large hospital studies in Michigan and New York City when started within the first 24 to 48 hours after admission.

    In fact, as inexpensive, oral and widely available medications, and a nutritional supplement, the combination of hydroxychloroquine, azithromycin or doxycycline, and zinc are well-suited for early treatment in the outpatient setting. The combination should be prescribed in high-risk patients immediately upon clinical suspicion of COVID-19 disease, without waiting for results of testing. Delays in waiting before starting the medications can reduce their efficacy.

    Third, concerns have been raised by the FDA and others about risks of cardiac arrhythmia, especially when hydroxychloroquine is given in combination with azithromycin. The FDA based its comments on data in its FDA Adverse Event Reporting System. This reporting system captured up to a thousand cases of arrhythmias attributed to hydroxychloroquine use. In fact, the number is likely higher than that, since the reporting system, which requires physicians or patients to initiate contact with the FDA, appreciably undercounts drug side effects.

    But what the FDA did not announce is that these adverse events were generated from tens of millions of patient uses of hydroxychloroquine for long periods of time, often for the chronic treatment of lupus or rheumatoid arthritis. Even if the true rates of arrhythmia are ten-fold higher than those reported, the harms would be minuscule compared to the mortality occurring right now in inadequately treated high-risk COVID-19 patients. This fact is proven by an Oxford University study of more than 320,000 older patients taking both hydroxychloroquine and azithromycin, who had arrhythmia excess death rates of less than 9/100,000 users, as I discuss in my May 27 paper cited above. A new paper in the American Journal of Medicine by established cardiologists around the world fully agrees with this.

    In the future, I believe this misbegotten episode regarding hydroxychloroquine will be studied by sociologists of medicine as a classic example of how extra-scientific factors overrode clear-cut medical evidence. But for now, reality demands a clear, scientific eye on the evidence and where it points . . . >>

    I think there are a few questions to be asked and answered.

    The May 27, 2020 paper:

    >> Am J Epidemiol

    . 2020 May 27;kwaa093.
    doi: 10.1093/aje/kwaa093. Online ahead of print.
    Early Outpatient Treatment of Symptomatic, High-Risk Covid-19 Patients that Should be Ramped-Up Immediately as Key to the Pandemic Crisis
    Harvey A Risch 1
    Affiliations

    PMID: 32458969 DOI: 10.1093/aje/kwaa093

    Abstract

    More than 1.6 million Americans have been infected with SARS-CoV-2 and GT 10 times that number carry antibodies to it. High-risk patients presenting with progressing symptomatic disease have only hospitalization treatment with its high mortality. An outpatient treatment that prevents hospitalization is desperately needed. Two candidate medications have been widely discussed: remdesivir, and hydroxychloroquine+azithromycin. Remdesivir has shown mild effectiveness in hospitalized inpatients, but no trials have been registered in outpatients. Hydroxychloroquine+azithromycin has been widely misrepresented in both clinical reports and public media, and outpatient trials results are not expected until September. Early outpatient illness is very different than later hospitalized florid disease and the treatments differ. Evidence about use of hydroxychloroquine alone, or of hydroxychloroquine+azithromycin in inpatients, is irrelevant concerning efficacy of the pair in early high-risk outpatient disease. Five studies, including two controlled clinical trials, have demonstrated significant major outpatient treatment efficacy. Hydroxychloroquine+azithromycin has been used as standard-of-care in more than 300,000 older adults with multicomorbidities, with estimated proportion diagnosed with cardiac arrhythmias attributable to the medications 47/100,000 users, of which estimated mortality is LT 20%, 9/100,000 users, compared to the 10,000 Americans now dying each week. These medications need to be widely available and promoted immediately for physicians to prescribe. >>

    It is time to face responsibility for needless politicisation and polarisation of discussion over a manifestly effective treatment and needless deaths by at least tens of thousands. There will be a day of reckoning over such culpable irresponsibility.

    KF

  151. 151
    BobRyan says:

    Sweden’s highest death for a single day was in April. It has been steadily declining ever since. Sweden did not lock down anything and has achieved heard immunity. By not shutting down, the projection was for millions to be dead by now, but there have only been a little over 5700.
    https://www.worldometers.info/coronavirus/country/sweden/

    The Diamond Princess should have been a floating morgue, but had 7 deaths. A US Navy ship had only 1 dead. Under the age of 65 with no preexisting conditions has a less than 0.02 percent chance of dying from SARS-COV-2, or COVID-19.

    Fear is being used to justify everything and the statistics do not support what is claimed. Suicides have increased, alcoholism and drug addition are becoming more rampant. ODs are on the rise. Spousal and child abuse are leading to loss of lives. Homelessness is increasing, since people who could afford their payments months ago no longer can.

    The US economy was finally on the right track after a decade of poor performance and will not recover any time soon. As many as a third of small businesses will never open their doors again.

  152. 152
    JVL says:

    BobRyan: Sweden’s highest death for a single day was in April. It has been steadily declining ever since. Sweden did not lock down anything and has achieved heard immunity. By not shutting down, the projection was for millions to be dead by now, but there have only been a little over 5700.

    Sweden has a population of about 10 million and had more than twice as many COVID-19 deaths than Romania (pop 19 million), more than three times as many deaths than Portugal (pop 10 million), more deaths than Poland (38 million), Ukraine (43 million), Austria (9 million), Hungary (9.5 million), and a lot of other countries of similar or larger populations. Compared to some of them Sweden messed up badly. In fact, the only European countries of populations 10 million or over with worse death rates are Belgium, UK, Spain and Italy. Swedens death rate (564 deaths per 1 million pop) is 7th on the list of all European countries, 8th on the list of all countries and is worse than the US death rate (so far) of 460 deaths per 1 million population.

    Sweden’s case rate and death rate have now dropped down to almost nothing but clearly they could have done much better compared to other countries whose economies are also not in the toilet. Denmark has about 6 million people, similar culture, language, etc and their death rate was 106 per 1 million. Finland, 5.5 million people, death rate 59 per 1 million. Norway, 5.4 million, death rate 47 per 1 million. Similar countries, similar cultures, similar economies, similar geography, and one had a much, much higher death rate.

    https://www.worldometers.info/coronavirus/

  153. 153
    jerry says:

    In what way is it irrelevant?

    I’m surprised you would ask such a question. You have been told many times and the answer was in my comments

    Studies done on wrong people. They picked extremely sick, wrong population. Or they picked low risk people, relatively young age people who are wrong population. First group not much helps except immune system. Second group will nearly 100% get well with no specific virus treatment.

    I’ve seen only one done so far that includes high risk patients shows no effect and about 40 that show a possible effect. And then there is the country wide efforts that support a positive effect for HCQ. For the one that showed no effect it’s hard to tell when in the virus progression they were at.

    A prime example of the disinformation is a Dr Deng whose tweets are wide spread and disparages HCQ with bogus information. There is a link above to one of his tweets. He is either clueless or has an agenda. My guess Is the latter and people are falling for his nonsense.

    I’ve seen plenty of positive analyses that show HCQ when used properly has a very positive effect.

  154. 154
    ET says:

    JVL:

    How far from normal should the pH be to affect the ACE2 receptors?

    I don’t know. That’s why we need the patients’ pH data.

  155. 155
    Bob O'H says:

    Jerry @ 153 –

    Studies done on wrong people. They picked extremely sick, wrong population.

    Not in the studies I cited. I specifically cited them because they were looking at prophylaxis, which is what you’ve been going on about.

    Or they picked low risk people, relatively young age people who are wrong population. First group not much helps except immune system. Second group will nearly 100% get well with no specific virus treatment.

    This would affect the power of the study, as you would need more subjects before you had a difference, but unless you’re suggesting HCQ has a different effect on the elderly than the middle aged, I don’t see why this would make the studies less relevant.

  156. 156
    Bob O'H says:

    kf – can you please stop spamming this thread with the full text of Risch’s article. You’ve put it up 6 times already, and I don’t think putting it up again will make a difference.

  157. 157
    BobRyan says:

    JVL

    As you said, Sweden has leveled off to almost nothing, which is what you want to see with heard immunity. Romania continues to have daily death spikes with their biggest day being July 21. There is no leveling off for them.
    https://www.worldometers.info/coronavirus/country/romania/

    Name the countries that have leveled off to almost nothing like Sweden has done.

  158. 158
    jerry says:

    Not in the studies I cited.

    Yes, all the studies you cited failed for the reasons I cited. Point to one that doesn’t. Specially the prophylactic study. Look at who was recruited, how they were analyzed and the results.

    I would bet if a study presented in support of HCQ was cited that used the procedures used in this study it would be denigrated everywhere. Given this, the study shows a small positive effect for HCQ. But uses the wrong population.

    My guess is that you didn’t read it or else you wouldn’t have made your comment.

  159. 159
    jerry says:

    Will we ever be allowed to use the expression “going viral” again since it means extremely wide spread of something. That is what viruses do.

    The original objectives was to limit the rate of viral infection to spare medical facilities. Didn’t happen as hospital ships and temporary hospitals went unused. Now people are going apocalyptic if a hospital has a high ICU rate but only a few are in such a situation.

    One hospital administrator said hospitals try to have a high ICU rate since that is where they make the most money. What percentage of hospital beds and ICU are C19 related? Some reports are relatively low.

    The current negative spin is on cases, which were supposed to happen everywhere eventually. It was even implied it was a good thing to have cases amongst those who are not susceptible to negative effects of virus. One report had increased homicides amongst those under 35 was higher than C19 deaths of those under 35.

    All has changed mainly because it might lead to election results not wanted. So emphasis is on prevention of cases which was not original objective.

  160. 160
    Bob O'H says:

    BobRyan @ 157 –

    As you said, Sweden has leveled off to almost nothing, which is what you want to see with heard [sic] immunity.

    But you also see it when other measures to reduce spread are used. The proportion infected has to be larger for herd immunity to be effective, which is why there is concern about a “second wave”, because measures are being relaxed.

    Name the countries that have leveled off to almost nothing like Sweden has done.

    Well, Norway, Finland, and Denmark for starters.

  161. 161
    Bob O'H says:

    Jerry @ 158 – but you haven’t shown why using a middle-aged rather than old population fails. Yes, fewer people might come down with the disease, but unless HCQ affects older people differently, that only mans you need a larger sample size to see an effect. So implicitly, you’re now moving the goalposts to it only having to be effective in the elderly.

  162. 162
    JVL says:

    ET: I don’t know. That’s why we need the patients’ pH data.

    I’m just wondering since the human body normally does a good job of keeping the body’s pH down to a narrow band between 7 and 8.

  163. 163
    JVL says:

    BobRyan: Name the countries that have leveled off to almost nothing like Sweden has done.

    We’re checking the same source/site! It’s really easy to check a few countries! New Zealond really stomped on infections, the other Scandinavian countries mentioned (and they are of particular interest because they all picked a different strategy, have had much lower death rates and their case loads dropped to zero much more quickly which meant they could instigate some more strigent border checks and get their economies going again. AND, again, Denmark, Norway and Finland are also like Sweden in many ways. It’s a fair comparison that makes Sweden efforts look severely lacking).

    If you bothered to check the data before making your statements you might get a more balanced outlook.

  164. 164
    ET says:

    Blood is not the body, JVL. A test of the patients’ saliva would be a better indicator.

  165. 165
    jerry says:

    Hard lockdowns vs Sweden. Top 10 deaths per million all had hard lockdowns except Sweden. And Sweden like others didn’t take care of elderly. So could have been better.

    https://twitter.com/AlexBerenson/status/1288476377528901632/photo/1

    By the way, link is to Alex Berenson who has tons of facts about cases, deaths, ICU usage etc. he has become target of left even though he is one of them. He just reports facts he finds and the left doesn’t like facts. They live on emotional arguments based on false narratives.

  166. 166
    jerry says:

    unless HCQ affects older people differently, that only mans you need a larger sample size to see an effect. So implicitly, you’re now moving the goalposts to it only having to be effective in the elderly.

    Have been 100% consistent since first Zelenko video. Apparently you never watched any but comment frequently on things you are not aware of.

    Issue was always on high risk vs low risk with evaluation of treatment based on hospitalization and death not on case prevention which was thought inevitable. Goal post in same place for over 4 months.

    My guess you read little about virus. My additional guess of 100+ links provided you apparently did not look at many if any.

  167. 167
    JVL says:

    ET: Blood is not the body, JVL. A test of the patients’ saliva would be a better indicator.

    But saliva doesn’t tend to interact with the pertinent systems does it? I suspect there are lab results demonstrating what you refer to regarding the affect of pH on such viruses; I’m just trying to figure out how that would work in the human body? Do the lab results indicate the pH value that is effective and can that value be created in the pertinent system in the human body without damaging the body overall?

  168. 168
    JVL says:

    Jerry: Hard lockdowns vs Sweden. Top 10 deaths per million all had hard lockdowns except Sweden. And Sweden like others didn’t take care of elderly.

    Hmm . . I live in the UK and let me tell you, our lockdown was not that hard and was late. In fact, it has been projected that if we had locked down sooner we might have saved 10 – 20,000 lives.

    Italy was also slow to respond to the crisis. That’s been well documented. Same with Spain. In fact, it was problems in Spain and Italy that first really got Europe worried

    Consider all the data. Not just one Twitter poster. One person rarely gets it all right. You have to consider everything. Also, it looks like he is referencing the same online site as I do.

  169. 169
    jerry says:

    Consider all the data. Not just one Twitter poster.

    So worldometer is not to be trusted? That is what you just said. Twitter poster is just reporting facts. Wrote a book on virus. Very short but second part coming soon. Book was suppressed by Amazon till Elon Musk went public about censorship.

    Maybe nobody locked down.

    In US the hardest lockdowns did the worse. Northeast (except Maine and New Hampshire which had less stringent rules) had worse results in world.

  170. 170
    JVL says:

    Jerry: So worldometer is not to be trusted? That is what you just said.

    No, I’m talking about one person’s interpretation of the data.

    Maybe nobody locked down.

    All evidence aside.

    In US the hardest lockdowns did the worse. Northeast (except Maine and New Hampshire which had less stringent rules) had worse results in world.

    Go and read analysis from other countries of how they got on top of the situation quickly. Don’t take my word for it, go and check. It’s not hard to do if you want to. Do you want to or do you want to stick to your all-ready decided opinion?

  171. 171
    jerry says:

    Do you want to or do you want to stick to your all-ready decided opinion?

    Incredible irony

    I believe I have literally provided hundreds of links. And reads almost any link provided.

    By the way I know the one link that has been provided by the critics here that is relevant and I am sure the one linking did not read the link in the link which is what is relevant. And it is only one.

  172. 172
    JVL says:

    JerrY: I believe I have literally provided hundreds of links. And reads almost any link provided.

    Please work on your typing. All I”m saying is that I know of evidence which contradicts your so you’re not considering all the data. Clearly.

    By the way I know the one link that has been provided by the critics here that is relevant and I am sure the one linking did not read the link in the link which is what is relevant. And it is only one.

    You know what, that is too hard to scan. I’ll wait ’til you clear it up.

  173. 173
    kairosfocus says:

    BO’H: can you kindly stop evading the force of what Dr Risch and others have to say, and their warranted conclusion that HCQ based cocktails, duly administered, credibly have good effect on the whole? I am protesting the repeated burial of that warranted conclusion that has become a clear tactic of choice across a large number of threads. KF

  174. 174
    rhampton7 says:

    Dr. Benjamin Neuman is a virus expert in the Texas A&M – Texarkana’s biology department. He’s been studying coronaviruses for decades and was part of the international committee that named the virus behind the COVID-19 pandemic.

    Dr. Neuman said back in March and April, researchers could legitimately say that hydroxychloroquine was unproven but had a chance. It was promising and they were waiting for more results.

    “And then the results came in and the results were not good. The results actually showed that hydroxychloroquine is no different than doing nothing in terms of protecting patients from dying and because of that the FDA actually took steps to remove it from the Emergency Use Authorization,” he said.

    “In science, the point is we have to be really, really careful. That is our job. And we can’t just answer questions based on what we think, scientific questions. They have to be answered with statistics and not statistics of the number of people that died or something like that. The branch of science that actually deals with uncertainty, you have to be able to prove beyond a reasonable doubt which is what juries are always supposed to do. But you have to do it with mathematics in order for something to be scientifically valid. And hydroxychloroquine, it is not,” Dr. Neuman said.

    https://www.fox4news.com/news/leading-coronavirus-expert-weighs-in-on-hydroxychloroquine-debate

  175. 175
    rhampton7 says:

    When studies released in June showed the drug did not help COVID-19 patients and even posed further risk, some of the conversation died out.

    However on Tuesday, posts on Twitter refueled the fire, so KSAT checked in with San Antonio hospitals and medical professionals to see if they’re using the drug.

    A Methodist Healthcare spokesperson the following statement regarding hydroxychloroquine: Treatment decisions about individual patients are made by the treating physician and not by the facility or system. Methodist Healthcare utilizes a physician-led, multidisciplinary work group to provide guidance on COVID-19 patient management. This work group does not endorse hydroxychloroquine based on the lack of evidence to support its use as an effective therapy; however, a small number of physicians practicing at Methodist Healthcare facilities have used the drug with a limited number of patients.”

    Baptist and University Hospitals used the malaria drug early on, but stopped around June, when the U.S. Food and Drug Administration revoked its emergency use authorization for hydroxychloroquine and the World Health Organization stalled its trials.

    “Here at University, we stopped using hydroxychloriquine after not only our own data, but data from other institutions around the world, showed that it does not benefit our patients clinically whatsoever. As a matter of fact, it increases adverse effects and can even increase mortality rate,” said Dr. Mohamed Hagahmed, a University Hospital emergency medicine physician and an associate professor at UT Health San Antonio.

    https://www.ksat.com/news/local/2020/07/28/are-san-antonio-hospitals-still-using-malaria-drug-for-covid-19/

  176. 176
    rhampton7 says:

    The video, which has since been removed from Facebook and Twitter due to the sites’ policies against misinformation about COVID-19, also suggested that Americans do not need to wear masks to stop the spread of the coronavirus.

    Dr. Anthony Fauci, the nation’s top infectious disease doctor, responded to the video Wednesday, telling MSNBC’s Andrea Mitchell it is “a bunch of people spouting something that isn’t true… The only recourse you have is to be very, very clear in presenting the scientific data that essentially contradicts that.”

    “The scientific data, the cumulative data on trials, clinical trials that were valid — namely, clinical trials that were randomized and controlled in the proper way — all of those trials show consistently that hydroxychloroquine is not effective in the treatment of coronavirus disease or COVID-19,” he added.

    An investigation from the Daily Beast published Tuesday found that Immanuel has made a wide variety of false or otherwise unfounded claims, including that the government is working on a secret vaccine with the intent of preventing people from being religious. She has also stated that the federal government is run by reptilian aliens, not humans.

    https://thehill.com/homenews/administration/509567-trump-on-promoting-doctor-who-defended-hydroxchloroquine-all-i-want

  177. 177
    rhampton7 says:

    Education Minister Yoav Galant revealed the plan for reopening of schools on September 1 under the coronavirus restrictions.

    “This is a groundbreaking plan on an international scale that was designed with the understanding that schools and educational facilities must be open and operational despite the coronavirus pandemic,” Galant said.

    According to the plan, kindergartners as well as first and second grade students, will continue to study in their regularly assigned classrooms without major adjustments. Students in third grade and up will be studying in groups of no more than 18 children. Older kids will switch to remote studies done from home or in a combination of in-school and distance learning.

    The minister said children from fifth and sixth grades should have in-class studies at least two days a week. Galant added that his plan, which he called “Learning Safely,” has the support of the government but will be officially approved only in the coming days.

    https://www.ynetnews.com/article/rk00vHxJ11w

  178. 178
    rhampton7 says:

    New research from the Hebrew University of Yerushalayim indicates that since the government reinstated bans on public gatherings approximately 10 days ago, Israel is seeing a drop in the number of coronavirus patients in moderate and serious condition, with another decrease expected over the next few days.

    Additionally, the study indicates that the attack rate in Israel has dropped below one, which means that coronavirus carriers are infecting one person or fewer, and indicates that the spread of the virus is being checked.

    Professor Yinon Ashkenazy of the Racah Institute of Physics, one of the authors of the report, said, “Our measurements, compiled from an analysis of the numbers of moderately and seriously ill patients, show a significant slowdown in the spread of the virus.

    “Our conclusion is that the steps taken on July 17, including limiting the number of people allowed to gather to 10 in enclosed spaces and 20 people outdoors, has actually worked. The spread of the virus has been slowing for some time, and the conclusion from that is that it is possible to open the economy, but there is no need to be severe. The existing restrictions have worked, and we need to think about how to live life in accordance with them.

    https://hamodia.com/2020/07/29/study-shows-restrictions-might-working-israel-hits-record-2093-new-cases/

  179. 179
    Bob O'H says:

    Jerry @ 166 –

    unless HCQ affects older people differently, that only mans you need a larger sample size to see an effect. So implicitly, you’re now moving the goalposts to it only having to be effective in the elderly.

    Have been 100% consistent since first Zelenko video. Apparently you never watched any but comment frequently on things you are not aware of.

    I’m sorry, are you saying that HCQ affects older people differently or not?

  180. 180
    Bob O'H says:

    BO’H: can you kindly stop evading the force of what Dr Risch and others have to say, and their warranted conclusion that HCQ based cocktails, duly administered, credibly have good effect on the whole?

    I have been – basically, their conclusion isn’t warranted. There are several studies that are simply ignored that show no effect, and the studies Risch cite are not high quality (e.g. the original Raoult paper, his follow-up without a control group, and the Brazilian tele-medicine “study”, and the Zelenko study where we know nothing about the control group, so we don’t know if it’s at all similar to the treated patients).

  181. 181
    BobRyan says:

    Heard immunity takes time and Sweden knew they would get some spikes early, but the leveling off to almost nothing was what they were going for. The projections were not 5,000 dead by this time, but 5,000,000. The projections claimed that half of Sweden’s population would die as a result of not locking down. They did not succumb to fear and handled this coronavirus the same way as they have all others.

    Spreading fear costs lives through increased suicide and ODs. Shutting down an economy costs people their livelihoods and increases the homeless rate. There has been an increase in abuse, which has cost lives. Anyone who believes shutting down an economy and spreading fear does not care about loss of life. They want a reduction of the population and any excuse is as good as the next. If the elderly really mattered, they would not be shutting them inside with others for long periods of time, since that increases the risk of getting sick.

  182. 182
    Bob O'H says:

    Bob – it’s herd immunity, not heard.

    Also, where does this 5m deaths come from? Even the worst case scenario for the US was suggesting only about 2m deaths? And what projections suggested a 50% mortality rate?

  183. 183
    kairosfocus says:

    BO’H, see what I am saying? Now, Twitter has been locking people down for the thought crime of simply pointing out that credible sources are reaching a different conclusion from the partyline. CENSORSHIP AND SLANDER. So, I have every right to point out what could credibly have averted at least tens of thousands of needless deaths:

    ********

    https://www.newsweek.com/key-defeating-covid-19-already-exists-we-need-start-using-it-opinion-1519535

    >>The Key to Defeating COVID-19 Already Exists. We Need to Start Using It | Opinion
    Harvey A. Risch, MD, PhD , Professor of Epidemiology, Yale School of Public Health
    On 7/23/20 at 7:00 AM EDT

    As professor of epidemiology at Yale School of Public Health, I have authored over 300 peer-reviewed publications and currently hold senior positions on the editorial boards of several leading journals. I am usually accustomed to advocating for positions within the mainstream of medicine, so have been flummoxed to find that, in the midst of a crisis, I am fighting for a treatment that the data fully support but which, for reasons having nothing to do with a correct understanding of the science, has been pushed to the sidelines. As a result, tens of thousands of patients with COVID-19 are dying unnecessarily. Fortunately, the situation can be reversed easily and quickly.

    I am referring, of course, to the medication hydroxychloroquine. When this inexpensive oral medication is given very early in the course of illness, before the virus has had time to multiply beyond control, it has shown to be highly effective, especially when given in combination with the antibiotics azithromycin or doxycycline and the nutritional supplement zinc.

    On May 27, I published an article in the American Journal of Epidemiology (AJE) entitled, “Early Outpatient Treatment of Symptomatic, High-Risk COVID-19 Patients that Should be Ramped-Up Immediately as Key to the Pandemic Crisis.” That article, published in the world’s leading epidemiology journal, analyzed five studies, demonstrating clear-cut and significant benefits to treated patients, plus other very large studies that showed the medication safety.

    Physicians who have been using these medications in the face of widespread skepticism have been truly heroic. They have done what the science shows is best for their patients, often at great personal risk. I myself know of two doctors who have saved the lives of hundreds of patients with these medications, but are now fighting state medical boards to save their licenses and reputations. The cases against them are completely without scientific merit.

    Since publication of my May 27 article, seven more studies have demonstrated similar benefit. In a lengthy follow-up letter, also published by AJE, I discuss these seven studies and renew my call for the immediate early use of hydroxychloroquine in high-risk patients. These seven studies include: an additional 400 high-risk patients treated by Dr. Vladimir Zelenko, with zero deaths; four studies totaling almost 500 high-risk patients treated in nursing homes and clinics across the U.S., with no deaths; a controlled trial of more than 700 high-risk patients in Brazil, with significantly reduced risk of hospitalization and two deaths among 334 patients treated with hydroxychloroquine; and another study of 398 matched patients in France, also with significantly reduced hospitalization risk. Since my letter was published, even more doctors have reported to me their completely successful use . . . .

    Beyond these studies of individual patients, we have seen what happens in large populations when these drugs are used. These have been “natural experiments.” In the northern Brazil state of Pará, COVID-19 deaths were increasing exponentially. On April 6, the public hospital network purchased 75,000 doses of azithromycin and 90,000 doses of hydroxychloroquine. Over the next few weeks, authorities began distributing these medications to infected individuals. Even though new cases continued to occur, on May 22 the death rate started to plummet and is now about one-eighth what it was at the peak.

    A reverse natural experiment happened in Switzerland. On May 27, the Swiss national government banned outpatient use of hydroxychloroquine for COVID-19. Around June 10, COVID-19 deaths increased four-fold and remained elevated. On June 11, the Swiss government revoked the ban, and on June 23 the death rate reverted to what it had been beforehand. People who die from COVID-19 live about three to five weeks from the start of symptoms, which makes the evidence of a causal relation in these experiments strong. Both episodes suggest that a combination of hydroxychloroquine and its companion medications reduces mortality and should be immediately adopted as the new standard of care in high-risk patients .>>

    What is being drowned out.

    And, again:

    >>Why has hydroxychloroquine been disregarded?

    First, as all know, the medication has become highly politicized. For many, it is viewed as a marker of political identity, on both sides of the political spectrum. Nobody needs me to remind them that this is not how medicine should proceed. We must judge this medication strictly on the science. When doctors graduate from medical school, they formally promise to make the health and life of the patient their first consideration, without biases of race, religion, nationality, social standing—or political affiliation. Lives must come first.

    Second, the drug has not been used properly in many studies. Hydroxychloroquine has shown major success when used early in high-risk people but, as one would expect for an antiviral, much less success when used late in the disease course. Even so, it has demonstrated significant benefit in large hospital studies in Michigan and New York City when started within the first 24 to 48 hours after admission.

    In fact, as inexpensive, oral and widely available medications, and a nutritional supplement, the combination of hydroxychloroquine, azithromycin or doxycycline, and zinc are well-suited for early treatment in the outpatient setting. The combination should be prescribed in high-risk patients immediately upon clinical suspicion of COVID-19 disease, without waiting for results of testing. Delays in waiting before starting the medications can reduce their efficacy.

    Third, concerns have been raised by the FDA and others about risks of cardiac arrhythmia, especially when hydroxychloroquine is given in combination with azithromycin. The FDA based its comments on data in its FDA Adverse Event Reporting System. This reporting system captured up to a thousand cases of arrhythmias attributed to hydroxychloroquine use. In fact, the number is likely higher than that, since the reporting system, which requires physicians or patients to initiate contact with the FDA, appreciably undercounts drug side effects.

    But what the FDA did not announce is that these adverse events were generated from tens of millions of patient uses of hydroxychloroquine for long periods of time, often for the chronic treatment of lupus or rheumatoid arthritis. Even if the true rates of arrhythmia are ten-fold higher than those reported, the harms would be minuscule compared to the mortality occurring right now in inadequately treated high-risk COVID-19 patients. This fact is proven by an Oxford University study of more than 320,000 older patients taking both hydroxychloroquine and azithromycin, who had arrhythmia excess death rates of less than 9/100,000 users, as I discuss in my May 27 paper cited above. A new paper in the American Journal of Medicine by established cardiologists around the world fully agrees with this.

    In the future, I believe this misbegotten episode regarding hydroxychloroquine will be studied by sociologists of medicine as a classic example of how extra-scientific factors overrode clear-cut medical evidence. But for now, reality demands a clear, scientific eye on the evidence and where it points . . . >>

    I think there are a few questions to be asked and answered.

    The May 27, 2020 paper:

    >> Am J Epidemiol

    . 2020 May 27;kwaa093.
    doi: 10.1093/aje/kwaa093. Online ahead of print.
    Early Outpatient Treatment of Symptomatic, High-Risk Covid-19 Patients that Should be Ramped-Up Immediately as Key to the Pandemic Crisis
    Harvey A Risch 1
    Affiliations

    PMID: 32458969 DOI: 10.1093/aje/kwaa093

    Abstract

    More than 1.6 million Americans have been infected with SARS-CoV-2 and GT 10 times that number carry antibodies to it. High-risk patients presenting with progressing symptomatic disease have only hospitalization treatment with its high mortality. An outpatient treatment that prevents hospitalization is desperately needed. Two candidate medications have been widely discussed: remdesivir, and hydroxychloroquine+azithromycin. Remdesivir has shown mild effectiveness in hospitalized inpatients, but no trials have been registered in outpatients. Hydroxychloroquine+azithromycin has been widely misrepresented in both clinical reports and public media, and outpatient trials results are not expected until September. Early outpatient illness is very different than later hospitalized florid disease and the treatments differ. Evidence about use of hydroxychloroquine alone, or of hydroxychloroquine+azithromycin in inpatients, is irrelevant concerning efficacy of the pair in early high-risk outpatient disease. Five studies, including two controlled clinical trials, have demonstrated significant major outpatient treatment efficacy. Hydroxychloroquine+azithromycin has been used as standard-of-care in more than 300,000 older adults with multicomorbidities, with estimated proportion diagnosed with cardiac arrhythmias attributable to the medications 47/100,000 users, of which estimated mortality is LT 20%, 9/100,000 users, compared to the 10,000 Americans now dying each week. These medications need to be widely available and promoted immediately for physicians to prescribe. >>

    It is time to face responsibility for needless politicisation and polarisation of discussion over a manifestly effective treatment and needless deaths by at least tens of thousands. There will be a day of reckoning over such culpable irresponsibility.

    ***************

    I think astute readers will be able to see for themselves — on evidence just summarised and from other similarly serious sources — that something is very wrong with the partyline narrative.

    KF

  184. 184
    kairosfocus says:

    RH7, there is another suppressed side, there is now reason to believe deaths of despair are topping deaths actually due to — as opposed to merely with — CV19. This reflects the decision challenge of dismal calculus. Large losses are inevitable once a pandemic breaks out, so the issue is the tradeoff between pandemic losses and losses due to destabilisation of economy and society with further global losses . . . including from famine . . . if deep sustained recession is triggered, i.e. depression. It is the partyline onesidedness that is telling us that something is deeply wrong. On lockdowns, the technocrat advocates who were jumping all over orderly protests triggered by dislocation losses and were clamping down on going to church SUDDENLY were making an exception for protests that rapidly turned into Red Guard riots. Then, there was the outright lying on efficacy of masks. In short the technocrats shattered their credibility. Resort to censorship and outright slander on Dr Risch, Dr Raoult, Dr Zelenko and ever so many others simply underscores that situation. Enabling behaviour for censorship, slander, ideological inconsistency and more simply tells us that we are not dealing with soundness but ill-founded ideology. KF

  185. 185
    kairosfocus says:

    BO’H: your implicit appeal to the gold standard fallacy to dismiss evidence that is cumulatively solid, brings up the issue of the pivotal case on ethics-epistemological failure for epidemiology and related disciplines, the Tuskegee syphilis atrocity. Wikipedia, against interest:

    The U.S. Public Health Service Syphilis Study at Tuskegee was a clinical study conducted between 1932 and 1972 by the United States Public Health Service.[1][2] [–> 40 years of sustained wrong, which had to be enforced through a warped understanding of ethics and epistemology, with overtones of racism similar to medical experiments on concentration camp inmates] The purpose of this study was to observe the natural history of untreated syphilis [–> decades after effective treatments were routinised by the late 1940’s] ; the African-American men in the study were only told they were receiving free health care from the Federal government of the United States.[3]

    [–> evil under false colour, robes and ceremonies of medicine and science; with calculated misleading as pivot, extracting manipulated consent that caused improper exposure to diseases treated ineffectively when ADEQUATE evidence . . . adequacy is not perfection . . . existed that better alternatives were available.]

    The United States Public Health Service started the study in 1932 in collaboration with Tuskegee University (then the Tuskegee Institute), a historically black college in Alabama. [–> misuse of credibility] Investigators enrolled in the study a total of 600 impoverished, African-American sharecroppers from Macon County, Alabama.[3] Of these men, 399 had latent syphilis, with a control group of 201 men who were not infected.[2] [–> oh, yes, the gold standard was applied within the study and the study as a whole was itself a control on efficacy of other treatments: natural, untreated course] As an incentive for participation in the study, the men were promised free medical care, but were deceived by the PHS

    [–> deception, a key to seeing the ethics failure and don’t tell us oh deliberately mislabelled sugar pills etc are not deception under colour, robes and ceremonies of medicine and science]

    , who disguised placebos, ineffective methods, and diagnostic procedures as treatment.[4]

    [–> REPEAT: “who disguised placebos, ineffective methods, and diagnostic procedures as treatment”]

    The men who had syphilis were never informed of their diagnosis, despite the risk of infecting others, and the fact that the disease could lead to blindness, deafness, mental illness, heart disease, bone deterioration, collapse of the central nervous system, and death.[5][6][7][8]

    [–> are people being told that as you are high risk and CV19 is fast moving with damage already in lungs per Raoult’s 2000+ CT scans on 500+ patients, when symptoms emerge? That death is a significant, rapid potential outcome on placebos? that HCQ+ cocktails have several lines of evidence pointing to likely rapidly acting efficacy?]

    According to the Centers for Disease Control and Prevention, the men were told that they were being treated for “bad blood,” a colloquialism that described various conditions such as syphilis, anemia and fatigue. “Bad blood”—specifically the collection of illnesses the term included—was a leading cause of death within the southern African-American community.[2] The men were initially told that the study was only going to last six months, but it was extended to 40 years.[2] After funding for treatment was lost, the study was continued without informing the men that they would never be treated. None of the infected men were treated with penicillin despite the fact that by 1947, the antibiotic had become the standard treatment for syphilis.[9]

    [–> so, what about the cumulative body of evidence since 2005 on likely efficacy of HCQ+ cocktails? Or, is that to be branded with a scarlet letter, dismissed as not meeting the gold standard that rests on deceptive practice . . . MISLABELLED, ineffective pseudo treatments in the face of life/death are deceptive . . . then marginalised and censored?]

    Study clinicians could have chosen to treat all syphilitic subjects and close the study, or split off a control group for testing with penicillin. Instead, they continued the study without treating any participants; they withheld treatment and information about it from the subjects.

    [–> So, how much more is it to be challenged when in the face of cumulative evidence of efficacy, treatments are sidelined and it is demanded that people subject themselves to life/death situations to “prove” what is already readily shown, save where studies are fail-by-design: too late in the U/L trajectory, wrong demographic, dubious statistics like Lancet, etc?]

    In addition, scientists prevented participants from accessing syphilis treatment programs available to other residents in the area.[10] The study continued, under numerous Public Health Service supervisors, until 1972, when a leak to the press resulted in its termination on November 16 of that year.[11] The victims of the study, all African-American, included numerous men who died of syphilis, 40 wives who contracted the disease and 19 children born with congenital syphilis.[12]

    The 40-year Tuskegee Study of Untreated Syphilis in the African American Male study was a major violation of ethical standards. [–> ethical failure] Researchers knowingly failed to treat participants appropriately [–> oh, how familiar] after penicillin was proven [–> empirical investigations cannot prove but can warrant a prudent conclusion] to be an effective treatment for syphilis and became widely available.[9] [–> how widely accessible are elements of HCQ cocktails? I submit, quite widely] Moreover, participants remained ignorant of the study clinicians’ true purpose, which was to observe the natural course of untreated syphilis.[3] [–> deception, deception, deception is deception] The revelation in 1972 of study failures by a whistleblower, Peter Buxtun, [–> So, how are whistleblowers currently being treated? see how it pinches when the shoe is on the other foot?] led to major changes in U.S. law and regulation concerning the protection of participants in clinical studies. Now studies require informed consent [–> what, really, is properly informed consent given what we are seeing now?],[13] communication of diagnosis and accurate reporting of test results.[14] [–> what about the right to access the best evidence and accessible treatments in the face of emerging pandemic?]

    The U.S. Public Health Service Syphilis Study at Tuskegee, cited as “arguably the most infamous biomedical research study in U.S. history,”

    You are forcing me to draw some unpalatable but warranted conclusions.

    KF

  186. 186
    jerry says:

    Kf,

    Bob O’H has endorsed HCQ several times. By pointing to fake studies, which he knows are fake he essentially has said there is no evidence against HCQ. Otherwise he would present the evidence.

    By not being able to cite evidence against HCQ, one is essentially endorsing it.

  187. 187

    Institutions such as the government, the medical community, health organizations, think tanks, research groups, academia and the news media have been caught in countless lies and deceptions for decades – honestly, since forever. It surprises me that anyone finds such sources credible, especially when there is so much money and power on the line.

  188. 188
    jerry says:

    Hundreds of links and a long discussion on C19 by a Swiss medical organization. https://swprs.org/a-swiss-doctor-on-covid-19/

    People should look at for their answers. It was posted before.

  189. 189
    kairosfocus says:

    Jerry, I find points 1 – 8, 19 and 25 ff particularly interesting given parallel developments:

    According to the latest immunological studies, the overall lethality of Covid-19 (IFR) is about 0.1% and thus in the range of a severe influenza (flu). For people at high risk or high exposure (including health care workers), early or prophylactic treatment is essential.
    In countries like the US, the UK, and also Sweden (without a lockdown), overall mortality since the beginning of the year is in the range of a strong influenza season; in countries like Germany, Austria and Switzerland, overall mortality is in the range of a mild influenza season.
    Even in global “hotspots”, the risk of death for the general population of school and working age is typically in the range of a daily car ride to work. The risk was initially overestimated because many people with only mild or no symptoms were not taken into account.
    Up to 80% of all test-positive persons remain symptom-free. Even among 70-79 year olds, about 60% remain symptom-free. About 95% of all people develop at most moderate symptoms.
    Up to 60% of all persons may already have a certain cellular background immunity to the new coronavirus due to contact with previous coronaviruses (i.e. common cold viruses). The initial assumption that there was no immunity against the new coronavirus was not correct.
    The median age of the deceased in most countries (including Italy) is over 80 years (e.g. 86 years in Sweden) and only about 4% of the deceased had no serious preconditions. The age and risk profile of deaths thus essentially corresponds to normal mortality.
    In many countries, up to two thirds of all extra deaths occurred in nursing homes, which do not benefit from a general lockdown. Moreover, in many cases it is not clear whether these people really died from Covid-19 or from weeks of extreme stress and isolation.
    Up to 30% of all additional deaths may have been caused not by Covid-19, but by the effects of the lockdown, panic and fear. For example, the treatment of heart attacks and strokes decreased by up to 60% because many patients no longer dared to go to hospital. . . . .

    Several media were caught trying to dramatize the situation in hospitals, sometimes even with manipulative images and videos. In general, the unprofessional reporting of many media maximized fear and panic in the population . . . .

    A global respiratory disease pandemic can indeed extend over several seasons, but many studies of a “second wave” are based on very unrealistic assumptions, such as a constant risk of illness and death across all age groups.
    In places like New York City, nurses described an oftentimes fatal medical mis­manage­ment of Covid patients due to questionable financial incentives or inappropriate medical protocols. On the other hand, early treatment with zinc and HCQ turned out to be effective after all.
    The number of people suffering from unemployment, depressions and domestic violence as a result of the measures has reached historic record levels. Several experts predict that the measures will claim far more lives than the virus itself. According to the UN 1.6 billion people around the world are at immediate risk of losing their livelihood.
    NSA whistleblower Edward Snowden warned that the “corona crisis” will be used for the permanent expansion of global surveillance. Renowned virologist Pablo Goldschmidt spoke of a “global media terror” and “totalitarian measures”. Leading British virologist Professor John Oxford spoke of a “media epidemic”.
    More than 600 scientists have warned of an “unprecedented surveillance of society” through problematic apps for “contact tracing”. In some countries, such “contact tracing” is carried out directly by the secret service. In several parts of the world, the population is being monitored by drones and facing serious police overreach during lockdowns.
    A 2019 WHO study on public health measures against pandemic influenza found that from a medical perspective, “contact tracing” is “not recommended in any circumstances”. Nevertheless, contact tracing apps have already become partially mandatory in several countries.

    We need to ask, who hope to benefit from panic, and what is the source of the concept, never let a crisis go to waste, i/l/o thesis-antithesis-synthesis. KF

    PS: What are you prepared to bet that background data were not available to players in the power games long since? Mix in the big exception on lockdown.

  190. 190
    jerry says:

    I have no idea where people get their news but there are several sites that have just the facts of the virus not the spin. Some are medical sites.

    Here is something I wrote several days ago about the virus.
    ————
    Several things. Probably more.

    1) C19 is very infectious. Probably a lot of other viruses are equally infectious. H1N1 was extremely infectious less than 10 years ago. Many common colds seem to spread quickly.

    2) Like other infectious viruses the immune system eventually defeats the virus in most cases. However, it seems that a significant portion of the population’s immune system does not defeat C19 very quickly. They seem mostly to be older people.

    Most new cases are much younger so less likely to become serious. Doing research on people not likely to have the virus progress is worthless research even if designed well.

    3) The C19 virus attacks an important enzyme on certain cell types that has at least two effects. It enables entry to cell and mass replication which destroys the cell. It also inhibits the function of the enzyme which leads to disruption of several processes that lead to clotting and cardiovascular problems. Maybe more effects but these two alone will cause lasting issues and death if immune system does not kill it.

    4) there are drugs that interfere with these two effects of the virus when used appropriately. One is HCQ and another is zinc. Remdesivir and ivermectin are two others. They are finding several others that also interfere with the virus’s actions. So there are potential cures available and more coming.

    5) Opposition to the use of these drugs seems to be political as opposed to medical. There also seems to be financial reasons to oppose or promote certain treatments/drugs. The opposition continually brings up irrelevant research which means either they are not conversant on the virus or have an agenda. Most likely the latter.

    Doing research on these drugs after the virus progressed to where they are unlikely to work is also worthless research. But people everywhere continually cite these irrelevant and thus worthless research. Why?

    6) there seems to be no one in world who has a complete grasp on what to do. So blaming Trump is fatuous who is essentially taking advice from government officials who have been publicly inconsistent.

    For example, no one in authority has a grasp on how to treat the virus since even today there is no official treatment other than palliative or what is called standard care despite the drugs mentioned above being available.

    7) no one has a good grasp on the cost benefits of any of the social and economic recommendations being put forward. Obviously people are dying from the virus but maybe far more will or have died from the economic consequences of trying to contain the virus. So no doctor or expert in infectious diseases or economist or politician can have any reliable understanding of what trying to contain the virus will do either medically, socially or economically.

    More and more statistics are coming out that are damning. One is the increase in homicides on men under 35 is higher than deaths due to C19 amongst this age group.

    8) people want answers but in reality no one on Earth has the answers.

  191. 191
    rhampton7 says:

    KF,

    No one wants to be the person that says, screw it, let it happen and **when** it overwhelms the hospitals and burns out the medical professionals, then those that die (or develop long term organ damage) are just part of “our” sacrifice.

    Do you have the guts to do that? President Trump doesn’t and neither does PM Netenyahu.

  192. 192
    rhampton7 says:

    A leader in the fight against COVID-19 in Nashville is debunking claims made in a since deleted viral video that touted hydroxychloroquine as a COVID-19 “cure” and said “you don’t need to wear a mask.”

    Dr. Alex Jahangir, the chair of the Metro Coronavirus Task Force, has urged the importance of wearing masks and reports daily virus cases and trends in the city.

    “I honestly don’t even want to speak any more about those statements because they’re just 15 minutes of fame seeking,” Dr. Jahangir said.

    “Regarding hydroxychloroquine, listen, all trials have shown it not to be an effective treatment for COVID-19,” Dr. Jahangir said. “In fact, if I’m not mistaken, the FDA actually pulled any approval they had given for that trial. So, it’s not an effective drug. It’s not an effective trial.”

    As Dr. Jahangir said trials have shown that not to be correct, Nashville will continue to use science and date in response to coronavirus.

    “We are approaching this with science with data, that is how the medical community is approaching how the mayor is approaching it, how the governor is approaching it, it’s how others are approaching it,” Dr. Jahngir said.

    http://fox17.com/news/local/na.....rce-leader

  193. 193
    rhampton7 says:

    “What I think about that video, to be perfectly honest, as someone who does not usually say very judgmental things, is I think it is very irresponsible and despicable,” said UAB Dr. Marazzo, who attended both Harvard and Yale.

    Two main claims were made in the video, one that hydroxychloroquine is a “cure” for COVID-19 and that mask-wearing is unnecessary.

    “Getting up there and distributing information with the badge of their white coats and their degrees behind them, to me, it’s one of the few things that really, really upsets me,” she said.

    She added that it violates the oath they took as doctors, the first part of which is “do no harm.”

    As for hydroxychloroquine, she says she wishes there were a cure, but there is not one yet.

    “We have excellent high level evidence from clinical trials showing that it doesn’t work,” said Dr. Marazzo.

    https://www.wtvy.com/2020/07/30/uab-doctor-calls-viral-video-claiming-hydroxychloroquine-is-a-cure-despicable/

  194. 194
    rhampton7 says:

    Prevea Health President and CEO Dr. Ashok Rai:

    “I think it’s really important for us to make sure we have good scientific knowledge and basis for our recommendations in health care because people do listen to us, and it’s dangerous if we say the wrong things.

    “The physicians there were saying things about hydroxychloroquine in specific that made the medical community uncomfortable because there are dangers associated with it. The way the drug was being recommended, the way that it was being talked about, really wasn’t based on the research.

    Some there may quote the recent study through Henry Ford Health System in Detroit where it talks about how it did decrease mortality. But it’s important to understand when you read that study, it’s talking about they use it in the hospital. They did not randomize their patients. And they specifically in that study say you need another study to prove its safety and that it works. And that’s what we saw in the New England Journal of Medicine where they actually did randomize people in different pools. They showed it didn’t work and it could cause harm. That’s how we base our medical decisions. You can’t just base it on what you’ve observed, because there is long-term harm. And that’s why those videos were pulled.”

    https://www.wbay.com/2020/07/30/dr-rai-talks-hydroxychloroquine-and-new-technology-on-tracking-covid-19/

  195. 195
    rhampton7 says:

    The economic crisis spawned by the coronavirus pandemic has hit Israel’s lower-middle class the hardest, according to a new analysis by the Bank of Israel.

    Beyond the culture and entertainment industries, which have not yet reopened, or hospitality, which has been placed under strict limitations, many of the jobs lost are in usually solid fields such as real estate, banking, insurance and financial services, information and communication.

    The people least affected by the crisis are upper-middle and upper-class Israelis — those in the ninth and 10th income deciles, found the report.

    https://www.haaretz.com/israel-news/business/.premium-lower-middle-class-israelis-hardest-hit-financially-by-virus-crisis-report-says-1.9031369

  196. 196
    rhampton7 says:

    Everything that Ronni Gamzu, the new coronavirus “czar,” said at his news conference in Jerusalem on Monday made sense. He unveiled what he called a “Shield of Israel” strategic plan, calling for a new social contract between those managing the coronavirus crisis and the public, ordering the IDF to take over testing and tracing, and pledging more oversight while gathering and presenting data logically and transparently.

    Speaking after Prime Minister Benjamin Netanyahu and Alternate Prime Minister and Defense Minister Benny Gantz, Gamzu urged citizens to always wear protective face masks, showing on a graph that countries that have enforced mask-wearing rules have seen a decline in their infection rates.

    Although we and others, including President Reuven Rivlin, have been saying this repeatedly ever since the national-unity government was established in May, let’s say it again: Now is the time to put politics aside for the sake of the whole country and its citizens. Our government should from now on listen closely to Prof. Gamzu and we should all follow his instructions. Gamzu himself said he is putting past mistakes aside and looking ahead to concentrate on creating a better future for us all.

    https://www.jpost.com/opinion/for-gamzu-to-win-govt-needs-to-get-politics-out-of-the-way-636957

  197. 197
    rhampton7 says:

    Setting aside the politics, Spectrum News asked two University at Buffalo doctors if hydroxychloroquine was effective in fighting coronavirus.

    “It’s been probably more researched than any other drug that we’ve been evaluating for COVID,” UB Division of Infectious Disease Chief Dr. Thomas Russo said.

    Russo said the medical community was rooting for hydroxychloroquine to work because it’s a generic drug, widely available, and can be taken in pill form.

    “It held tremendous promise and we were all excited about the possibility that this could really help us in this battle against COVID. Unfortunately the preponderance of evidence to this date does not support that,” he said.

    UB Senior Associate Dean for Clinical Affairs Dr. Kevin Gibbons said early on doctors were treating patients with the drug, but they’ve since learned more and studies that have suggested it does not work have been more scientifically sound than any that suggest the opposite.

    “The best evidence we have is that it’s not of benefit. Now the good news is although there are side effects to this medication and there is a cardiac risk factor for sudden death from arrhythmias, the incidents of that actually appear to be quite low,” Gibbons said.

    Russo said the study also doesn’t support hydroxychloroquine as a preventive drug. He said people should be cynical of testimonials from doctors or patients they see online.

    “Anecdotal and testimonial medicine is medicine of the 50s and 60s,” he said. “That is no longer the way we practice medicine.”

    https://spectrumlocalnews.com/nys/central-ny/politics/2020/07/29/ub-doctors-give-facts-about-hydroxychloroquine-and-covid

  198. 198
    jerry says:

    We now know that HCQ is safe. We also know there Is zero evidence that shows it does not work when used appropriately. We also know that there are studies where it has a positive effect on lowering hospitalization and death. We know several countries that have used it and have low death rates. We have research studies both currently and from the past that says it works.

    Given this it would be insane not to use it especially with zinc.

    Those who propose it as a treatment for C19 appropriately used are offering hope based on a ton of information. Those against it are offering despair and sure death for tens of thousands who are infected by the virus based on bogus information.

    So we have hope vs despair. We have people living vs people dying by the tens of thousands. Decide which side you are on.

  199. 199
    kairosfocus says:

    RH7, it is clear that you have simply dismissed inconvenient but cumulatively decisive evidence and continue to try to drown it out. That tells us a lot, not so much about one commenter but about the effect of what has been done. It is clear the models were drastically wrong (think about why a “need” for 30k ventilators was projected for NY state and how a hospital ship ended up sitting essentially empty, or how patients were sent into nursing homes), the Chinese lied and so did senior officials with responsibility, most notably on the masks issue. Likewise the riots exemption shatters credibility of the technocrats. Their behaviour with HCQ+ has been deeply ill advised ethically and epistemologically and it is plain the lessons of the Tuskegee Syphilis atrocity have not been adequately learned. KF

    PS: As a reminder, Tuskegee, just so it won’t be buried:

    The U.S. Public Health Service Syphilis Study at Tuskegee was a clinical study conducted between 1932 and 1972 by the United States Public Health Service.[1][2] [–> 40 years of sustained wrong, which had to be enforced through a warped understanding of ethics and epistemology, with overtones of racism similar to medical experiments on concentration camp inmates] The purpose of this study was to observe the natural history of untreated syphilis [–> decades after effective treatments were routinised by the late 1940’s] ; the African-American men in the study were only told they were receiving free health care from the Federal government of the United States.[3]

    [–> evil under false colour, robes and ceremonies of medicine and science; with calculated misleading as pivot, extracting manipulated consent that caused improper exposure to diseases treated ineffectively when ADEQUATE evidence . . . adequacy is not perfection . . . existed that better alternatives were available.]

    The United States Public Health Service started the study in 1932 in collaboration with Tuskegee University (then the Tuskegee Institute), a historically black college in Alabama. [–> misuse of credibility] Investigators enrolled in the study a total of 600 impoverished, African-American sharecroppers from Macon County, Alabama.[3] Of these men, 399 had latent syphilis, with a control group of 201 men who were not infected.[2] [–> oh, yes, the gold standard was applied within the study and the study as a whole was itself a control on efficacy of other treatments: natural, untreated course] As an incentive for participation in the study, the men were promised free medical care, but were deceived by the PHS

    [–> deception, a key to seeing the ethics failure and don’t tell us oh deliberately mislabelled sugar pills etc are not deception under colour, robes and ceremonies of medicine and science]

    , who disguised placebos, ineffective methods, and diagnostic procedures as treatment.[4]

    [–> REPEAT: “who disguised placebos, ineffective methods, and diagnostic procedures as treatment”]

    The men who had syphilis were never informed of their diagnosis, despite the risk of infecting others, and the fact that the disease could lead to blindness, deafness, mental illness, heart disease, bone deterioration, collapse of the central nervous system, and death.[5][6][7][8]

    [–> are people being told that as you are high risk and CV19 is fast moving with damage already in lungs per Raoult’s 2000+ CT scans on 500+ patients, when symptoms emerge? That death is a significant, rapid potential outcome on placebos? that HCQ+ cocktails have several lines of evidence pointing to likely rapidly acting efficacy?]

    According to the Centers for Disease Control and Prevention, the men were told that they were being treated for “bad blood,” a colloquialism that described various conditions such as syphilis, anemia and fatigue. “Bad blood”—specifically the collection of illnesses the term included—was a leading cause of death within the southern African-American community.[2] The men were initially told that the study was only going to last six months, but it was extended to 40 years.[2] After funding for treatment was lost, the study was continued without informing the men that they would never be treated. None of the infected men were treated with penicillin despite the fact that by 1947, the antibiotic had become the standard treatment for syphilis.[9]

    [–> so, what about the cumulative body of evidence since 2005 on likely efficacy of HCQ+ cocktails? Or, is that to be branded with a scarlet letter, dismissed as not meeting the gold standard that rests on deceptive practice . . . MISLABELLED, ineffective pseudo treatments in the face of life/death are deceptive . . . then marginalised and censored?]

    Study clinicians could have chosen to treat all syphilitic subjects and close the study, or split off a control group for testing with penicillin. Instead, they continued the study without treating any participants; they withheld treatment and information about it from the subjects.

    [–> So, how much more is it to be challenged when in the face of cumulative evidence of efficacy, treatments are sidelined and it is demanded that people subject themselves to life/death situations to “prove” what is already readily shown, save where studies are fail-by-design: too late in the U/L trajectory, wrong demographic, dubious statistics like Lancet, etc?]

    In addition, scientists prevented participants from accessing syphilis treatment programs available to other residents in the area.[10] The study continued, under numerous Public Health Service supervisors, until 1972, when a leak to the press resulted in its termination on November 16 of that year.[11] The victims of the study, all African-American, included numerous men who died of syphilis, 40 wives who contracted the disease and 19 children born with congenital syphilis.[12]

    The 40-year Tuskegee Study of Untreated Syphilis in the African American Male study was a major violation of ethical standards. [–> ethical failure] Researchers knowingly failed to treat participants appropriately [–> oh, how familiar] after penicillin was proven [–> empirical investigations cannot prove but can warrant a prudent conclusion] to be an effective treatment for syphilis and became widely available.[9] [–> how widely accessible are elements of HCQ cocktails? I submit, quite widely] Moreover, participants remained ignorant of the study clinicians’ true purpose, which was to observe the natural course of untreated syphilis.[3] [–> deception, deception, deception is deception] The revelation in 1972 of study failures by a whistleblower, Peter Buxtun, [–> So, how are whistleblowers currently being treated? see how it pinches when the shoe is on the other foot?] led to major changes in U.S. law and regulation concerning the protection of participants in clinical studies. Now studies require informed consent [–> what, really, is properly informed consent given what we are seeing now?],[13] communication of diagnosis and accurate reporting of test results.[14] [–> what about the right to access the best evidence and accessible treatments in the face of emerging pandemic?]

    The U.S. Public Health Service Syphilis Study at Tuskegee, cited as “arguably the most infamous biomedical research study in U.S. history,”

  200. 200
    kairosfocus says:

    F/N: Dr Birx now adds face shields to the list https://thehill.com/homenews/coronavirus-report/509752-birx-recommends-face-shields-to-protect-against-covid-19 Goggles as with gas masks would work similarly. I have for months worn fairly close fitting glasses. Of course, the huge hole in all of this was the special exemption made for riots, which shatters credibility of the technocrats. If face shields are advisable, the uncontrolled public gatherings were seriously dangerous and if they were not then the whole system collapses. KF

  201. 201
    Bob O'H says:

    Jerry –

    We now know that HCQ is safe.

    Aside from the side effects, of course. And (admittedly rare) sudden death from arrhythmias.

    We also know there Is zero evidence that shows it does not work when used appropriately.

    Where “used appropriately” seems to be “used in a context that hasn’t been studied rigorously”. Which would explain why there’s zero evidence for it not not working, if there’s zero evidence either way.

    We also know that there are studies where it has a positive effect on lowering hospitalization and death.

    And there are also studies showing no positive effect. The higher quality studies tend to show no positive effect.

    We know several countries that have used it and have low death rates.

    And several countries have not and have low death rates.

    We have research studies both currently and from the past that says it works.

    For lupus, yes. A rather different disease.

  202. 202
    jerry says:

    Bob O’H has just again endorsed HCQ. He made several comments about HCQ, all bogus or irrelevant. Again failure to provide a relevant valid objection is tantamount to an endorsement for its use in treating the C19 virus when used appropriately.

  203. 203
    kairosfocus says:

    BO’H, you were in the room when ever so many times I described how the old pharmaco prof in my uni would open his course: Pharmacology is the study of poisons in small doses. That means, the issue is to manage the balance of therapeutic and toxic effects through managed dosage. It is obvious you have paid scant attention to Prof Risch’s warranted remarks on toxicity and their context. That is itself a lesson as you have tried to dismiss his remarks without serious response. You have thus made yourself a case study on what is going wrong. FYI, I gather perhaps 2500 people per year may die from Aspirin, where have you put on record your stringent objection to this drug, demanding that it be tightly restricted? Are you aware that, with 65 years of use, HCQ has in fact been OTC in many jurisdictions? What does that tell you? Do you understand how the pattern of your objections shows the breakdown of credibility in our public discourse on key issues? KF

  204. 204
    Bob O'H says:

    FYI, I gather perhaps 2500 people per year may die from Aspirin, where have you put on record your stringent objection to this drug, demanding that it be tightly restricted?

    I haven’t, because we also have good evidence that it works. And because the risks and benefits can be assessed, and that can change prescription practice.

    Are you aware that, with 65 years of use, HCQ has in fact been OTC in many jurisdictions? What does that tell you?

    That different jurisdictions have different standards for what can be sold OTC. I could imagine it being sold OTC in countries with high incidence of malaria, because that might be the most effective way of getting malaria treatments to the people who need it.

    Do you understand how the pattern of your objections shows the breakdown of credibility in our public discourse on key issues?

    You mean Jerry trashing his credibility by repeatedly lying about me advocating for HCQ?

  205. 205
    jerry says:

    You mean Jerry trashing his credibility by repeatedly lying about me advocating for HCQ?

    No lying. I’m saying you are endorsing by your actions.

    In college in a philosophy course on logic that was about a third on argumentation, one of the topics we covered was how when someone presents false arguments, the motivation is nearly always because there was no legitimate argument on their side. It’s called distraction and diversion.

    The implications of such an approach is that the other side is correct. So your words per se did not endorse HCQ but your actions have. An old English expression is that actions speak louder than words.

    So no lying and no lost of credibility due to that.

  206. 206
    jerry says:

    HCQ or not HCQ

    What is going on is something like Pascal’s wager except this time we know that hell exists. The hell in this case is death due to the C19 virus. The wager is HCQ + zinc works or doesn’t. The outcome is nearly always continued life If it works. If it doesn’t work, the outcome is frequently death often painful. On the other side of the wager is only frequent death often painful.

    One side is let’s try and save hundreds of thousands of lives. The other side says let them die. That is the logic that is being argued by both sides.

    Let the distractions and diversions begin.

  207. 207
    kairosfocus says:

    BO’H: refusal to acknowledge the cumulative force of evidence of efficacy of HCQ+ cocktails for treating CV19 on your part does not overthrow the weight of that evidence. The Tuskegee syphilis atrocity should suffice to show the ethics-epistemology issues involved. KF

  208. 208
    Bob O'H says:

    Jerry @ 206 –

    HCQ or not HCQ

    Seeing as the preponderance of evidence is that it doesn’t work, this is easy to answer. Really, when you’re reduced to “[w]e also know there Is zero evidence that shows it does not work when used appropriately.” without responding to the argument “Where “used appropriately” seems to be “used in a context that hasn’t been studied rigorously”” it’s probably time to give up.

    kf – I have “acknowledge[d] the cumulative force of evidence of efficacy of HCQ+ cocktails for treating CV19”. That’s why I’ve been arguing that it shouldn’t be used.

  209. 209
    ET says:

    What evidence, Bob? Have you seen the data on the patients’ pH? Has anyone demonstrated that HCQ is not an ionophore? Has anyone demonstrated that the virus continues to replicate in the presence of zinc?

    Where is the data and science, Bob?

  210. 210

    Bob O’h,

    I’ve seen reported research that falls on both sides of this issue. Also, it’s well known that this treatment has been used for decades for various coronavirus strains as well as other uses, and the potential side effects are about as well-known as any drug treatment for anything.

    Given that, shouldn’t this be a decision left up to the specific situation and relationship between a patient and his doctor?

    It seems to me that the politics surrounding this issue, especially since Trump mentioned the treatment, has made this far too politically divisive and problematic to sort through at any governmental, bureaucratic, political level. Why not just knock the treatment ball back into the court where it should have been left in the first place: a decision made by the patient and his or her doctor?

    That treatment was never controversial until Trump mentioned it. IMO, it’s far less likely that an individual doctor is going to give treatment advice based on politics.

  211. 211
    Bob O'H says:

    WJM –

    Also, it’s well known that this treatment has been used for decades for various coronavirus strains

    Really? I wasn’t aware that it had been used in clinical practice for corona viruses. I know there were one or two trials a few years ago, but they were negative (basically, it wasn’t possible to get a high enough dose to the right place).

    Given that, shouldn’t this be a decision left up to the specific situation and relationship between a patient and his doctor?

    No, because doctors don’t have time to look at and assess all of the studies of all of the drugs and treatments they might be using. So having an organisation to do this (e.g. the FDA, or NICE in the UK9 is vital. Also remember that someone has to pay for the treatments, so they will also want some assurance that the treatment will be effective (and cost effective).

    I do agree that the decision should be left to the medical profession, but leaving the decision to individual doctors makes the decision very political (with a very small p!): individual decisions can be influenced by a lot of non-scientific factors, including Politics (with a big P), money, and other forms of persuasion. Ben Goldacre’s book “Bad Pharma” is a good read about the whole pharma industry.

  212. 212
    jerry says:

    Seeing as the preponderance of evidence is that it doesn’t work, this is easy to answer.

    This is easy to answer because none has ever been presented. It is why I say you essentially endorse HCQ. You have made several links to irrelevant research which means it is bogus. You have been told this several times but continue to make them. You have had the opportunity to provide disconfirming information and have failed to do so.

    Really, when you’re reduced to “[w]e also know there Is zero evidence that shows it does not work when used appropriately.”

    There is lots of evidence to show it works and zero evidence to show it doesn’t work. That not “reduced to” but extremely good logic. Showing something is true is done by affirmative evidence as well as a lack of negative information. Part of basic logic.

    If someone reported a study where several people took HCQ and zinc and died that would be disconfirming evidence. I suspect some will die. Zelenko had a couple but an overwhelming number who did well and were from the same group of high risk patients.

  213. 213
    asauber says:

    What do youse guys think about this:

    “The CDC has instructed hospitals, medical examiners, coroners and physicians to collect and report COVID-19 data by significantly different standards than all other infectious diseases and causes of death.”

    https://childrenshealthdefense.org/news/if-covid-fatalities-were-90-2-lower-how-would-you-feel-about-schools-reopening/

    Andrew

  214. 214
    jerry says:

    A new study that came out yesterday from Lombardy

    https://www.ijidonline.com/article/S1201-9712(20)30600-7/fulltext#.XyRR931FtZ4.twitter

    Effectiveness of Hydroxychloroquine in COVID-19 disease: A done and dusted situation?

  215. 215
    kairosfocus says:

    BO’H: You again show why what you dismissed is highly relevant. Accordingly,

    ********
    https://www.newsweek.com/key-defeating-covid-19-already-exists-we-need-start-using-it-opinion-1519535

    >>The Key to Defeating COVID-19 Already Exists. We Need to Start Using It | Opinion
    Harvey A. Risch, MD, PhD , Professor of Epidemiology, Yale School of Public Health
    On 7/23/20 at 7:00 AM EDT

    As professor of epidemiology at Yale School of Public Health, I have authored over 300 peer-reviewed publications and currently hold senior positions on the editorial boards of several leading journals. I am usually accustomed to advocating for positions within the mainstream of medicine, so have been flummoxed to find that, in the midst of a crisis, I am fighting for a treatment that the data fully support but which, for reasons having nothing to do with a correct understanding of the science, has been pushed to the sidelines. As a result, tens of thousands of patients with COVID-19 are dying unnecessarily. Fortunately, the situation can be reversed easily and quickly.

    I am referring, of course, to the medication hydroxychloroquine. When this inexpensive oral medication is given very early in the course of illness, before the virus has had time to multiply beyond control, it has shown to be highly effective, especially when given in combination with the antibiotics azithromycin or doxycycline and the nutritional supplement zinc.

    On May 27, I published an article in the American Journal of Epidemiology (AJE) entitled, “Early Outpatient Treatment of Symptomatic, High-Risk COVID-19 Patients that Should be Ramped-Up Immediately as Key to the Pandemic Crisis.” That article, published in the world’s leading epidemiology journal, analyzed five studies, demonstrating clear-cut and significant benefits to treated patients, plus other very large studies that showed the medication safety.

    Physicians who have been using these medications in the face of widespread skepticism have been truly heroic. They have done what the science shows is best for their patients, often at great personal risk. I myself know of two doctors who have saved the lives of hundreds of patients with these medications, but are now fighting state medical boards to save their licenses and reputations. The cases against them are completely without scientific merit.

    Since publication of my May 27 article, seven more studies have demonstrated similar benefit. In a lengthy follow-up letter, also published by AJE, I discuss these seven studies and renew my call for the immediate early use of hydroxychloroquine in high-risk patients. These seven studies include: an additional 400 high-risk patients treated by Dr. Vladimir Zelenko, with zero deaths; four studies totaling almost 500 high-risk patients treated in nursing homes and clinics across the U.S., with no deaths; a controlled trial of more than 700 high-risk patients in Brazil, with significantly reduced risk of hospitalization and two deaths among 334 patients treated with hydroxychloroquine; and another study of 398 matched patients in France, also with significantly reduced hospitalization risk. Since my letter was published, even more doctors have reported to me their completely successful use . . . .

    Beyond these studies of individual patients, we have seen what happens in large populations when these drugs are used. These have been “natural experiments.” In the northern Brazil state of Pará, COVID-19 deaths were increasing exponentially. On April 6, the public hospital network purchased 75,000 doses of azithromycin and 90,000 doses of hydroxychloroquine. Over the next few weeks, authorities began distributing these medications to infected individuals. Even though new cases continued to occur, on May 22 the death rate started to plummet and is now about one-eighth what it was at the peak.

    A reverse natural experiment happened in Switzerland. On May 27, the Swiss national government banned outpatient use of hydroxychloroquine for COVID-19. Around June 10, COVID-19 deaths increased four-fold and remained elevated. On June 11, the Swiss government revoked the ban, and on June 23 the death rate reverted to what it had been beforehand. People who die from COVID-19 live about three to five weeks from the start of symptoms, which makes the evidence of a causal relation in these experiments strong. Both episodes suggest that a combination of hydroxychloroquine and its companion medications reduces mortality and should be immediately adopted as the new standard of care in high-risk patients .>>

    What is being drowned out.

    And, again:

    >>Why has hydroxychloroquine been disregarded?

    First, as all know, the medication has become highly politicized. For many, it is viewed as a marker of political identity, on both sides of the political spectrum. Nobody needs me to remind them that this is not how medicine should proceed. We must judge this medication strictly on the science. When doctors graduate from medical school, they formally promise to make the health and life of the patient their first consideration, without biases of race, religion, nationality, social standing—or political affiliation. Lives must come first.

    Second, the drug has not been used properly in many studies. Hydroxychloroquine has shown major success when used early in high-risk people but, as one would expect for an antiviral, much less success when used late in the disease course. Even so, it has demonstrated significant benefit in large hospital studies in Michigan and New York City when started within the first 24 to 48 hours after admission.

    In fact, as inexpensive, oral and widely available medications, and a nutritional supplement, the combination of hydroxychloroquine, azithromycin or doxycycline, and zinc are well-suited for early treatment in the outpatient setting. The combination should be prescribed in high-risk patients immediately upon clinical suspicion of COVID-19 disease, without waiting for results of testing. Delays in waiting before starting the medications can reduce their efficacy.

    Third, concerns have been raised by the FDA and others about risks of cardiac arrhythmia, especially when hydroxychloroquine is given in combination with azithromycin. The FDA based its comments on data in its FDA Adverse Event Reporting System. This reporting system captured up to a thousand cases of arrhythmias attributed to hydroxychloroquine use. In fact, the number is likely higher than that, since the reporting system, which requires physicians or patients to initiate contact with the FDA, appreciably undercounts drug side effects.

    But what the FDA did not announce is that these adverse events were generated from tens of millions of patient uses of hydroxychloroquine for long periods of time, often for the chronic treatment of lupus or rheumatoid arthritis. Even if the true rates of arrhythmia are ten-fold higher than those reported, the harms would be minuscule compared to the mortality occurring right now in inadequately treated high-risk COVID-19 patients. This fact is proven by an Oxford University study of more than 320,000 older patients taking both hydroxychloroquine and azithromycin, who had arrhythmia excess death rates of less than 9/100,000 users, as I discuss in my May 27 paper cited above. A new paper in the American Journal of Medicine by established cardiologists around the world fully agrees with this.

    In the future, I believe this misbegotten episode regarding hydroxychloroquine will be studied by sociologists of medicine as a classic example of how extra-scientific factors overrode clear-cut medical evidence. But for now, reality demands a clear, scientific eye on the evidence and where it points . . . >>

    I think there are a few questions to be asked and answered.

    The May 27, 2020 paper:

    >> Am J Epidemiol

    . 2020 May 27;kwaa093.
    doi: 10.1093/aje/kwaa093. Online ahead of print.
    Early Outpatient Treatment of Symptomatic, High-Risk Covid-19 Patients that Should be Ramped-Up Immediately as Key to the Pandemic Crisis
    Harvey A Risch 1
    Affiliations

    PMID: 32458969 DOI: 10.1093/aje/kwaa093

    Abstract

    More than 1.6 million Americans have been infected with SARS-CoV-2 and GT 10 times that number carry antibodies to it. High-risk patients presenting with progressing symptomatic disease have only hospitalization treatment with its high mortality. An outpatient treatment that prevents hospitalization is desperately needed. Two candidate medications have been widely discussed: remdesivir, and hydroxychloroquine+azithromycin. Remdesivir has shown mild effectiveness in hospitalized inpatients, but no trials have been registered in outpatients. Hydroxychloroquine+azithromycin has been widely misrepresented in both clinical reports and public media, and outpatient trials results are not expected until September. Early outpatient illness is very different than later hospitalized florid disease and the treatments differ. Evidence about use of hydroxychloroquine alone, or of hydroxychloroquine+azithromycin in inpatients, is irrelevant concerning efficacy of the pair in early high-risk outpatient disease. Five studies, including two controlled clinical trials, have demonstrated significant major outpatient treatment efficacy. Hydroxychloroquine+azithromycin has been used as standard-of-care in more than 300,000 older adults with multicomorbidities, with estimated proportion diagnosed with cardiac arrhythmias attributable to the medications 47/100,000 users, of which estimated mortality is LT 20%, 9/100,000 users, compared to the 10,000 Americans now dying each week. These medications need to be widely available and promoted immediately for physicians to prescribe. >>

    It is time to face responsibility for needless politicisation and polarisation of discussion over a manifestly effective treatment and needless deaths by at least tens of thousands. There will be a day of reckoning over such culpable irresponsibility.

    *********

    Likewise, on the Tuskegee atrocity and its significance for so called gold standards,

    The U.S. Public Health Service Syphilis Study at Tuskegee was a clinical study conducted between 1932 and 1972 by the United States Public Health Service.[1][2] [–> 40 years of sustained wrong, which had to be enforced through a warped understanding of ethics and epistemology, with overtones of racism similar to medical experiments on concentration camp inmates] The purpose of this study was to observe the natural history of untreated syphilis [–> decades after effective treatments were routinised by the late 1940’s] ; the African-American men in the study were only told they were receiving free health care from the Federal government of the United States.[3]

    [–> evil under false colour, robes and ceremonies of medicine and science; with calculated misleading as pivot, extracting manipulated consent that caused improper exposure to diseases treated ineffectively when ADEQUATE evidence . . . adequacy is not perfection . . . existed that better alternatives were available.]

    The United States Public Health Service started the study in 1932 in collaboration with Tuskegee University (then the Tuskegee Institute), a historically black college in Alabama. [–> misuse of credibility] Investigators enrolled in the study a total of 600 impoverished, African-American sharecroppers from Macon County, Alabama.[3] Of these men, 399 had latent syphilis, with a control group of 201 men who were not infected.[2] [–> oh, yes, the gold standard was applied within the study and the study as a whole was itself a control on efficacy of other treatments: natural, untreated course] As an incentive for participation in the study, the men were promised free medical care, but were deceived by the PHS

    [–> deception, a key to seeing the ethics failure and don’t tell us oh deliberately mislabelled sugar pills etc are not deception under colour, robes and ceremonies of medicine and science]

    , who disguised placebos, ineffective methods, and diagnostic procedures as treatment.[4]

    [–> REPEAT: “who disguised placebos, ineffective methods, and diagnostic procedures as treatment”]

    The men who had syphilis were never informed of their diagnosis, despite the risk of infecting others, and the fact that the disease could lead to blindness, deafness, mental illness, heart disease, bone deterioration, collapse of the central nervous system, and death.[5][6][7][8]

    [–> are people being told that as you are high risk and CV19 is fast moving with damage already in lungs per Raoult’s 2000+ CT scans on 500+ patients, when symptoms emerge? That death is a significant, rapid potential outcome on placebos? that HCQ+ cocktails have several lines of evidence pointing to likely rapidly acting efficacy?]

    According to the Centers for Disease Control and Prevention, the men were told that they were being treated for “bad blood,” a colloquialism that described various conditions such as syphilis, anemia and fatigue. “Bad blood”—specifically the collection of illnesses the term included—was a leading cause of death within the southern African-American community.[2] The men were initially told that the study was only going to last six months, but it was extended to 40 years.[2] After funding for treatment was lost, the study was continued without informing the men that they would never be treated. None of the infected men were treated with penicillin despite the fact that by 1947, the antibiotic had become the standard treatment for syphilis.[9]

    [–> so, what about the cumulative body of evidence since 2005 on likely efficacy of HCQ+ cocktails? Or, is that to be branded with a scarlet letter, dismissed as not meeting the gold standard that rests on deceptive practice . . . MISLABELLED, ineffective pseudo treatments in the face of life/death are deceptive . . . then marginalised and censored?]

    Study clinicians could have chosen to treat all syphilitic subjects and close the study, or split off a control group for testing with penicillin. Instead, they continued the study without treating any participants; they withheld treatment and information about it from the subjects.

    [–> So, how much more is it to be challenged when in the face of cumulative evidence of efficacy, treatments are sidelined and it is demanded that people subject themselves to life/death situations to “prove” what is already readily shown, save where studies are fail-by-design: too late in the U/L trajectory, wrong demographic, dubious statistics like Lancet, etc?]

    In addition, scientists prevented participants from accessing syphilis treatment programs available to other residents in the area.[10] The study continued, under numerous Public Health Service supervisors, until 1972, when a leak to the press resulted in its termination on November 16 of that year.[11] The victims of the study, all African-American, included numerous men who died of syphilis, 40 wives who contracted the disease and 19 children born with congenital syphilis.[12]

    The 40-year Tuskegee Study of Untreated Syphilis in the African American Male study was a major violation of ethical standards. [–> ethical failure] Researchers knowingly failed to treat participants appropriately [–> oh, how familiar] after penicillin was proven [–> empirical investigations cannot prove but can warrant a prudent conclusion] to be an effective treatment for syphilis and became widely available.[9] [–> how widely accessible are elements of HCQ cocktails? I submit, quite widely] Moreover, participants remained ignorant of the study clinicians’ true purpose, which was to observe the natural course of untreated syphilis.[3] [–> deception, deception, deception is deception] The revelation in 1972 of study failures by a whistleblower, Peter Buxtun, [–> So, how are whistleblowers currently being treated? see how it pinches when the shoe is on the other foot?] led to major changes in U.S. law and regulation concerning the protection of participants in clinical studies. Now studies require informed consent [–> what, really, is properly informed consent given what we are seeing now?],[13] communication of diagnosis and accurate reporting of test results.[14] [–> what about the right to access the best evidence and accessible treatments in the face of emerging pandemic?]

    The U.S. Public Health Service Syphilis Study at Tuskegee, cited as “arguably the most infamous biomedical research study in U.S. history,”

    KF

  216. 216
    kairosfocus says:

    Jerry, I clip:

    Letter to the Editor|Articles in Press

    PDF [771 KB]
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    Effectiveness of Hydroxychloroquine in COVID-19 disease: A done and dusted situation?

    Antonella d’Arminio Monforte
    Alessandro Tavelli
    Francesca Bai
    Giulia Marchetti
    Alessandro Cozzi-Lepri

    Open Access Published:July 29, 2020 DOI: https://doi.org/10.1016/j.ijid.2020.07.056

    Dear Sir,
    Arshad et al show evidence for a reduced mortality in Covid-19 patients taking hydroxychloroquine alone or with azithromycin in an observational study in USA (Arshad et al., 2020
    ). Data on effectiveness and toxicity of hydroxychloroquine are controversial (Liu et al., 2020
    , Devaux et al., 2020
    , Gautret et al., 2020
    , Tang et al., 2020
    , Geleris et al., 2020
    ).
    A total of 539 COVID-19 hospitalised patients were included in our cohort in Milan, from February 24 to May 17,2020 of whom 174 died in hospital (day 14 probability of death: 29.5%–95%CI: 25.5–34.0). We divided a subset of our cohort in three groups who started treatment a median of 1 day after admission: those receiving hydroxycholoroquine alone (N?=?197), those receiving hydroxycholoroquine?+?azithromycin (N?=?94), and those receiving neither (controls) (N?=?92). Of the latter group, 10 started HIV antivirals (boosted-lopinavir or –darunavir), 1 teicoplanin, 12 immunomodulatory drugs or corticosteroids, 23 heparin and 46 remained untreated. The percent of death in the 3 groups was 27%, 23% and 51%. Mechanical ventilation was used in 4.3% of hydoxychloroquine, 14.2% of hydroxycholoroquine?+?azithromycin and 26.1% of controls. Unweighted and weighted relative hazards of mortality are shown in Table 1. After adjusting for a number of key confounders (see table), the use of hydroxycholoroquine?+?azithromycin was associated with a 66% reduction in risk of death as compared to controls; the analysis also suggested a larger effectiveness of hydroxychloroquine in patients with less severe COVID-19 disease (PO2/FiO2?>?300, interaction p-value<.0001). Our results are remarkably similar to those shown by Arshad et al.

    Note, this is for usage fairly late in the U/L trajectory and it seems to be with highly vulnerable patients. So, this is not optimal use.

    I would suggest adding Ivermectin in such cases.

    KF

  217. 217
    rhampton7 says:

    Researchers on Wednesday published scathing critiques of a study President Trump repeatedly touted on Twitter. That study, published earlier this month in the International Journal of Infectious Diseases, claimed to show that hydroxychloroquine saved lives.

    In a letter to the editor titled “Clarifying the record on hydroxychloroquine for the treatment of patients hospitalized with COVID-19,” researchers at the University at Albany said the group that received hydroxychloroquine might have fared better because they were healthier to begin with and received more aggressive treatment.

    For example, the patients in the Henry Ford study who were given hydroxychloroquine had fewer risk factors for heart disease, the Albany researchers, Eli Rosenberg, David Holtgrave and Tomoko Udo, wrote in their letter.

    Also, the hydroxychloroquine patients were more than twice as likely to be given steroids, a treatment known to be effective against Covid-19.

    The Detroit study was not a randomized clinical trial, which is considered the gold standard in medicine and helps avoid these potential biases. In such trials, patients are randomly assigned to take a drug or not take it, which means the two groups should be very similar.

    “We’ve acknowledged the varying conclusions multiple studies have reached, along with the limitations of our retrospective [hydroxychloroquine] study as well as those of other published studies on the topic,” according to a statement on Wednesday from Tammy Battaglia, a spokeswoman for Henry Ford.

    https://www.cnn.com/2020/07/31/health/hydroxychloroquine-study-henry-ford-letters/index.html

  218. 218
    rhampton7 says:

    Dr. Anthony Fauci is among the experts who are critical of a study by Detroit’s Henry Ford Health System that found the drug hydroxychloroquine lowered the death rate in COVID-19 patients.

    But the issue, Fauci said, is that the study was not a randomized, double-blind study — which is considered “the gold standard” in science. In other words, doctors carefully selected who received the treatment, which could skew the results.

    Fauci said that some of the patients were also receiving corticosteroids, which could have influenced the results further.

    When Rep. Blaine Luetkemeyer, a Republican from Missouri, interrupted Fauci, saying the study had been peer-reviewed, Fauci reiterated the importance of randomized, double-blind studies.

    “It doesn’t matter, you can peer-review something that’s a bad study,” Fauci said. “The fact is it is not a randomized placebo-controlled trial. The point that I think is important, because we all want to keep an open mind, any and all of the randomized placebo-controlled trials, which is the gold standard of determining if something is effective, none of them have shown any efficacy for hydroxychloroquine.”

    https://www.metrotimes.com/news-hits/archives/2020/07/31/dr-fauci-says-henry-ford-hydroxychloroquine-study-touted-by-trump-is-flawed

  219. 219
    rhampton7 says:

    another expert frequently toeing that line is Harvey Risch, MD, PhD, an epidemiologist at Yale University in New Haven, Connecticut.

    Risch authored a Newsweek editorial on July 23 calling on doctors to immediately start treating patients with HCQ.

    Risch points readers to his review — he is the only author — published in late May in the American Journal of Epidemiology that cites five studies in support of HCQ, particularly when used early in the course of COVID-19.

    None are randomized controlled trials. One is the heavily publicized and now discredited French study by Didier Raoult, MD, and colleagues in March that sparked initial hopes for HCQ. Two have no corresponding data or publications.

    Risch asserts his own re-analysis of the French study suggests a stronger benefit for HCQ plus azithromycin when started earlier in the illness compared with standard of care. But researchers have called the original data involving only 42 patients “uninterpretable.”

    A second study from Raoult’s group published in May involved 973 patients all of whom got HCQ; there was no randomization or control.

    For his third study, Risch links to a two-page Google document by Vladimir Zelenko, MD. Risch cites data from Zelenko on 405 outpatients who were treated with HCQ, azithromycin, and zinc, of whom six were hospitalized and two died. There was no control group, and the Google document doesn’t provide more detail on the data.

    The fourth citation is a controlled, but not randomized, study from Brazil with a total of 636 patients; 412 were treated with HCQ and azithromycin, with 224 who declined treatment serving as controls. Fewer of those on the drugs had to be hospitalized, but with no randomization, the treatment’s role is uncertain.

    Finally, Risch cites a small ongoing study in a long-term care facility on Long Island in New York that gave HCQ plus doxycycline to about 200 high-risk COVID patients, again with no control group. Only nine died, suggesting a treatment benefit, but Risch gave no source for the data nor other details.

    Risch published a follow-up to that paper — again in the American Journal of Epidemiology, on July 20, and again as sole author — that outlined an additional seven studies that he said support HCQ early in disease. None appear to be large randomized controlled trials, though some have comparator groups. Some lack any citation at all. One study is additional data from Zelenko, on another 400 patients, but again unpublished and without full data.

    https://www.medpagetoday.com/infectiousdisease/covid19/87844

  220. 220
    rhampton7 says:

    In the Newsweek editorial and in the later journal submission, both of which were published following three highly publicized randomized trials that reported no benefit from HCQ, Risch did not address or even acknowledge them.

    In a statement posted on Yale’s website, Sten Vermund, MD, PhD, dean of the Yale School of Public Health, distanced himself from Risch’s papers.

    “My role as Dean is not to suppress the work of the faculty, but rather, to support the academic freedom of our faculty, whether it is in the mainstream of thinking or is contrarian,” Vermund wrote.

    “Yale-affiliated physicians used HCQ early in the response to COVID-19, but it is only used rarely at present due to evidence that it is ineffective and potentially risky.”

    https://www.medpagetoday.com/infectiousdisease/covid19/87844

    Shall I post this six times?

  221. 221
    jerry says:

    Countries using HCQ successively

    https://techstartups.com/2020/07/23/countries-using-hydroxychloroquine-low-coronavirus-fatality-rate-compared-countries-dont-association-american-physicians-surgeons-says/

    Countries using hydroxychloroquine have low coronavirus fatality rate compared to countries that don’t, Association of American Physicians and Surgeons says

    Website taken down as part of tech purge of HCQ https://americasfrontlinedoctorsummit.com/

  222. 222
    rhampton7 says:

    Children under five years of age may harbor up to 100 times as much of the coronavirus in their noses and throats as infected adults and older children, according to a study out of Chicago.

    “Our analyses suggest children younger than 5 years with mild to moderate COVID-19 have high amounts of SARS-CoV-2 viral RNA in their nasopharynx compared with older children and adults,” the researchers stated in the study published in JAMA Pediatrics on Thursday.

    “Young children can potentially be important drivers of SARS-CoV-2 spread in the general population, as has been demonstrated with respiratory syncytial virus, where children with high viral loads are more likely to transmit,” they wrote.

    https://www.foxnews.com/health/young-children-coronavirus-carry-more-virus-adults-study

  223. 223
    ET says:

    OT- My wife was showing symptoms, so her doctor had her tested. It came back negative. I would think that should clear the entire house.

  224. 224
    Mac McTavish says:

    ET

    OT- My wife was showing symptoms, so her doctor had her tested. It came back negative. I would think that should clear the entire house.

    Unfortunately it is not as simple as that. There is still a high false negative with respect to the commonly used tests. If anyone in the house is showing any symptoms, you are advised to isolate the entire household.

  225. 225
    ET says:

    The symptoms she is showing have nothing to do with covid-19 and everything to do with a pre-existing condition. It is just that every symptom seems to be enough to trigger testing. It doesn’t matter if those symptoms also cover your well-known, pre-existing condition that requires immediate attention when it flares up.

  226. 226
    jerry says:

    An up to date analysis of Sweden on Twitter. https://twitter.com/JacobGudiol/status/1283308801043636231

  227. 227
    jerry says:

    A very interesting video on a HCQ.

    https://www.youtube.com/watch?time_continue=787&v=6xqCg12rOPM&feature=emb_logo

    By Dr. David L. Katz

  228. 228
    kairosfocus says:

    Jerry (& attn RH7, BO’H et al):

    Dr Katz is of course on the whole quite good. He is well worth the watching.

    That noted, I find he has not fully addressed the gold standard ethics-epistemology challenge, but that is a commonplace. It is why I have annotated a Wiki clip’s admissions regarding the infamous 40-year Tuskegee Syphilis study. There are serious questions about placing placebo based trials on a pedestal related to the inherent issue of giving high risk people facing a fast-moving deadly disease deliberately mislabelled sugar pills or other similarly known ineffective treatments under false colours of the ceremonies, robes and credibility of medicine and science: first, do no harm. No “consent form” can eliminate that issue.

    Such is compounded by the decision theory, epistemological question of adequacy of warrant in the face of urgent action in a life and death crisis. Dr Katz lets a cat out of the bag when he speaks of how Medical Doctors and other relevant professionals are trained to set up randomised, placebo control studies as gold standard and to isolate particular components of a system in order to see if individual or combination effects count for more in an outcome. Where, again, instantly, the do no harm/deception issue cannot rightly be neglected, especially with a decision theory result on the table.

    For, there is a natural baseline that exists almost automatically, namely, flu-like, common cold-like respiratory tract illness treatments (and treatments for complications including pneumonia and cytokine storms), which are a general standard approach in absence of a generally accepted specific remedy. Such a baseline creates natural records thus readily harvestable statistics, as I have pointed out for months now. So, we have a [near-] Business as usual arm, which provides a natural control or cluster of similar tracks. One that does not involve deception or unjustifiably heightened risk.

    Now, urgency in the face of time and effort to develop and test novel treatments is a further factor. A highly contagious disease triggered pandemic, by its nature, creates a crisis in weeks to months, it does not lend itself to many months to years for idealised research procedures to wend their way to results, or for heavily bureaucratic and highly costly drug certification protocols to work their way to final on label approvals. So, automatically, we face a prudence issue, how to so direct reason, investigation, ethical considerations to gain a responsible, credibly reliable result with inevitably noisy and less than idealised information or procedure.

    Decisions under such circumstances are always going to be vulnerable to accusations of weak evidence coming from those who have put a gold standard on a pedestal and who refuse to address consequences and costs of delay in face of rapidly mounting crisis and/or of systematically breaking ethical strictures regarding deception and harm. The Tuskegee Syphilis study atrocity highlights such considerations. I pause, noting that I clip and comment on Wiki in a PS here, below. The obvious conclusion is that paralysis of rapid action on credible alternatives and/or advocacy of doing evils [deception, undue exposure to harm] for an idealised good to come is itself an evil. In extreme cases such as the Tuskegee study or the Nazi death camp medical experiments, an atrocity. One that in the end will destroy the credibility of disciplines, technocrats and statesmen alike.

    Now, fairly standard decision theory treats BAU as a baseline, against which credible alternatives are examined and on which a plausible structure of alternative oucomes can be composed or projected or inferred or modelled. Then, on gap analysis, we can motivate a change strategy towards a better, more prudent choice informed by considerations of relevant issues up to and including black swan events. Which, arguably, we are facing.

    The issue is, how do we get to credible alternatives?

    In this context, on cumulative evidence that exploits a factor that is so common that it is estimated that it covers 20% of all US prescriptions; off-label use of established drugs. Where, that a drug is established implies its known ability to enter and work in the body, with manageable safety. Drugs, being poisons in small doses. Here, in vitro studies in plausible concentrations, more or less plausible action mechanisms, animal analogues and results from effectively experimental off label use all count.

    HCQ, in fact, has been shifted to arthritis and auto immune disease treatments based on precisely that background. So, those who have challenged further shifted use on grounds of earlier successful shifts and shortages are in an ethical self-referential conundrum. Past off label success warrants future off label use on credible evidence, it does not warrant casting one group of patients against another, despite dislocations due to sudden shifts in demand.

    As for safety, Dr Risch’s notes on the low incidence, long term use situation and manageability inherent in the doctor-patient relationship as well as expressed opinions of those familiar with extensive use count. The conclusion is, highly manageable so justifiable on relative risks of BAU and alt for relevant target groups. All of this is of course being studiously ignored or batted aside in race to denounce as unsafe, unsafe or to demand an ethically questionable, likely to be too late alleged gold standard. Here, failure to listen and reasonably consider relevant decision theory results is itself a further ethics issue, duty to prudence.

    Now, there is a specific focus for HCQ based cocktails. Where, as a set of plausible mechanisms is on the table, synergy is an expected feature warranting working with a cocktail, HCQ +azithromycin or doxycycline + Zn + vits C, D, possibly Ivermectin, etc. Messy relative to purist demands to isolate but we do not have that luxury. That’s why plausible mechanisms count. Similarly, in vitro results, which do point to credible antiviral action. So far, I have not heard of animal analogues, and humans must not be treated as lab rats.

    So, we are left to prudence and judiciousness.

    Physician prescribed and supervised treatment of the vulnerable (60+, cancer, asthma etc as we well know) who show early symptoms is justified and on preponderance shows credible effectiveness early in the U/L trajectory. If hospitalisation is indicated, onward issues come up. Here, Remdesivir has some evidence of moderate success, and Ivermectin may be a good possibility too. Other treatments are indicated as good possibilities. The point is, disease dynamics shift as damage is done and different phases present different challenges. I have serious doubts on achievability of long term effective vaccines for Corona Virus caused diseases. In which context, studies directed to general populations or the not at high risk or to those too far down the U/L trajectory should not be used to discredit utility at the proper locus.

    Similarly, on increased risk due to high exposure, preventive use has some evidential support, esp. coming out of India.

    Unfortunately, we will not get this decision theory supported balance from the over-polarised situation and i/l/o the gold standard fallacy that has been used to create a public panic. That is shameful and may well be responsible for needless loss of life of at least tens of thousands.

    Surely, we can do better, and we can avoid burying the balance under an avalanche of largely irrelevant, one sided, distractive commentary.

    With the stipulations given, Katz obviously has a serious point. Unfortunately, it means there is a significant likelihood that he will be censored.

    KF

    PS: The Tuskegee Syphilis study atrocity:

    The U.S. Public Health Service Syphilis Study at Tuskegee was a clinical study conducted between 1932 and 1972 by the United States Public Health Service.[1][2] [–> 40 years of sustained wrong, which had to be enforced through a warped understanding of ethics and epistemology, with overtones of racism similar to medical experiments on concentration camp inmates] The purpose of this study was to observe the natural history of untreated syphilis [–> decades after effective treatments were routinised by the late 1940’s] ; the African-American men in the study were only told they were receiving free health care from the Federal government of the United States.[3]

    [–> evil under false colour, robes and ceremonies of medicine and science; with calculated misleading as pivot, extracting manipulated consent that caused improper exposure to diseases treated ineffectively when ADEQUATE evidence . . . adequacy is not perfection . . . existed that better alternatives were available.]

    The United States Public Health Service started the study in 1932 in collaboration with Tuskegee University (then the Tuskegee Institute), a historically black college in Alabama. [–> misuse of credibility] Investigators enrolled in the study a total of 600 impoverished, African-American sharecroppers from Macon County, Alabama.[3] Of these men, 399 had latent syphilis, with a control group of 201 men who were not infected.[2] [–> oh, yes, the gold standard was applied within the study and the study as a whole was itself a control on efficacy of other treatments: natural, untreated course] As an incentive for participation in the study, the men were promised free medical care, but were deceived by the PHS

    [–> deception, a key to seeing the ethics failure and don’t tell us oh deliberately mislabelled sugar pills etc are not deception under colour, robes and ceremonies of medicine and science]

    , who disguised placebos, ineffective methods, and diagnostic procedures as treatment.[4]

    [–> REPEAT: “who disguised placebos, ineffective methods, and diagnostic procedures as treatment”]

    The men who had syphilis were never informed of their diagnosis, despite the risk of infecting others, and the fact that the disease could lead to blindness, deafness, mental illness, heart disease, bone deterioration, collapse of the central nervous system, and death.[5][6][7][8]

    [–> are people being told that as you are high risk and CV19 is fast moving with damage already in lungs per Raoult’s 2000+ CT scans on 500+ patients, when symptoms emerge? That death is a significant, rapid potential outcome on placebos? that HCQ+ cocktails have several lines of evidence pointing to likely rapidly acting efficacy?]

    According to the Centers for Disease Control and Prevention, the men were told that they were being treated for “bad blood,” a colloquialism that described various conditions such as syphilis, anemia and fatigue. “Bad blood”—specifically the collection of illnesses the term included—was a leading cause of death within the southern African-American community.[2] The men were initially told that the study was only going to last six months, but it was extended to 40 years.[2] After funding for treatment was lost, the study was continued without informing the men that they would never be treated. None of the infected men were treated with penicillin despite the fact that by 1947, the antibiotic had become the standard treatment for syphilis.[9]

    [–> so, what about the cumulative body of evidence since 2005 on likely efficacy of HCQ+ cocktails? Or, is that to be branded with a scarlet letter, dismissed as not meeting the gold standard that rests on deceptive practice . . . MISLABELLED, ineffective pseudo treatments in the face of life/death are deceptive . . . then marginalised and censored?]

    Study clinicians could have chosen to treat all syphilitic subjects and close the study, or split off a control group for testing with penicillin. Instead, they continued the study without treating any participants; they withheld treatment and information about it from the subjects.

    [–> So, how much more is it to be challenged when in the face of cumulative evidence of efficacy, treatments are sidelined and it is demanded that people subject themselves to life/death situations to “prove” what is already readily shown, save where studies are fail-by-design: too late in the U/L trajectory, wrong demographic, dubious statistics like Lancet, etc?]

    In addition, scientists prevented participants from accessing syphilis treatment programs available to other residents in the area.[10] The study continued, under numerous Public Health Service supervisors, until 1972, when a leak to the press resulted in its termination on November 16 of that year.[11] The victims of the study, all African-American, included numerous men who died of syphilis, 40 wives who contracted the disease and 19 children born with congenital syphilis.[12]

    The 40-year Tuskegee Study of Untreated Syphilis in the African American Male study was a major violation of ethical standards. [–> ethical failure] Researchers knowingly failed to treat participants appropriately [–> oh, how familiar] after penicillin was proven [–> empirical investigations cannot prove but can warrant a prudent conclusion] to be an effective treatment for syphilis and became widely available.[9] [–> how widely accessible are elements of HCQ cocktails? I submit, quite widely] Moreover, participants remained ignorant of the study clinicians’ true purpose, which was to observe the natural course of untreated syphilis.[3] [–> deception, deception, deception is deception] The revelation in 1972 of study failures by a whistleblower, Peter Buxtun, [–> So, how are whistleblowers currently being treated? see how it pinches when the shoe is on the other foot?] led to major changes in U.S. law and regulation concerning the protection of participants in clinical studies. Now studies require informed consent [–> what, really, is properly informed consent given what we are seeing now?],[13] communication of diagnosis and accurate reporting of test results.[14] [–> what about the right to access the best evidence and accessible treatments in the face of emerging pandemic?]

    The U.S. Public Health Service Syphilis Study at Tuskegee, cited as “arguably the most infamous biomedical research study in U.S. history,”

  229. 229
    kairosfocus says:

    PPS: Here is an example of the sort of irresponsible, ultimately self-defeating censorship, abuse of authority and needless polarisation in the face of more than adequate warrant by abusive scarlet letter labelling that I am pointing out: https://www.facebook.com/263129423748523/posts/3361757900552311/?d=n

  230. 230
    jerry says:

    A doctor successfully treats his patients With HCQ and zinc. Gets banned by Facebook for posting so. His stats are on photo posted so click to read.

    https://twitter.com/ProcterMd/status/1289065806886776832

  231. 231
    ET says:

    It is very telling that those poo-poo’ing HCQ and zinc cannot provide any answers to the relevant questions:

    Did the studies demonstrate that HCQ is not an ionophore? Did the studies demonstrate that the virus continues to replicate in the presence of zinc?

  232. 232
    jerry says:

    It is very telling that those poo-poo’ing HCQ and zinc cannot provide any answers to the relevant questions

    And they keep pointing to bogus information to support their points of view. That’s because there is nothing anywhere on the internet that is relevant to support their attitudes.

    They have chosen to support a invalid premise that is letting hundreds of thousand die than one that provides hope for recovery. I wonder why?

    Humanity has progressed technically in amazing ways but behaviorally a large percentage are no different from any era in history.

  233. 233
    jerry says:

    The Lockdown’s Destruction

    From Wall Street Journal – behind a paywall https://www.wsj.com/articles/the-lockdowns-destruction-11596150889

    Democrats and their media allies have trapped themselves in a contradiction. They are deploring Thursday’s grim second-quarter GDP report even as they demand a repeat of the lockdown that caused the economic catastrophe…

    That’s the main message from the 32.9% decline in GDP, the worst ever recorded… The fall in transportation, recreation, food services and hotels was brutal… plunge in health-care spending during a health-care crisis… subtracted 9.5 percentage points from GDP… It was also a terrible public-health blunder.

    the continuing unemployment claims rate was highest in states like New York (16.3%) and California (15.5%) that have been slow to reopen; Nevada (22%) and Hawaii (21%) that rely on tourism; and Louisiana (16.6%) and Georgia (16%) that offer among the most generous unemployment benefits for low-wage workers. Arizona (7.9%), Florida (8.6%) and Texas (10.1%) haven’t experienced a spike in claims.

    And the Democrats want more of this misery. Is it because the rich and elites (press, academia, pop culture) who vote for Democrats in the US are not affected that much by the lockdown.

  234. 234
    jerry says:

    Posting more Hope.

    Advancement of covid may result from stopping hydroxychloroquine

    Translation of article about how deaths from C19 increased dramatically when HCQ was stopped being used. Hope is HCQ is now reinstated.

    https://translate.google.com/translate?hl=&sl=es&tl=en&u=https%3A%2F%2Fensegundos.com.pa%2F2020%2F07%2F24%2Favance-del-covid-puede-ser-resultado-de-suspender-la-hidroxicloroquina%2F&sandbox=1

    They do not want to use the drugs,” adds the doctor, citing the example of Guayaquil in Ecuador where the virus has been controlled, “moving from 500 deaths per day to none, because they are using hydroxychloroquine and azithromycin,” the doctor argued…

    Finally, on July 22, 56 days after the suspension and after Panama exceeded the threshold of 1,000 deaths, with more than 50,000 cases and an average of 1,000 new cases per day, the government announced the use of hydroxychloroquine under criteria of each doctor. “Each doctor will decide according to the symptomatology, age and progress of the patient,” said the director of the Social Security Fund, Enrique Lau Cortés.

    .

    Meanwhile in Costa Rica, right next door, they have been using HCQ and have one of the best records in the world.

  235. 235

    From The Association of American Physicians & Surgeons July 22 2020:
    https://aapsonline.org/more-evidence-presented-for-why-hydroxychloroquine-should-be-made-available-in-a-new-court-filing-by-aaps/

    ““The mortality rate from COVID-19 in countries that allow access to HCQ is only one-tenth the mortality rate in countries where there is interference with this medication, such as the United States,” explains Andrew Schlafly.”

    From 2005 NCBI virology journal:
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1232869/

    Conclusion: Chloroquine is effective in preventing the spread of SARS CoV in cell culture. Favorable inhibition of virus spread was observed when the cells were either treated with chloroquine prior to or after SARS CoV infection. In addition, the indirect immunofluorescence assay described herein represents a simple and rapid method for screening SARS-CoV antiviral compounds.

  236. 236

    In terms of risk management. HCQ+Z treatments are safe, dirt cheap, and we have good reason to believe it at least might be effective both as a prophylactic and as early-stage treatment and there is no current reason NOT to use it as such. The risk is a few dollars; the potential reward is it might save your life.

    Those who are advocating against widespread use of HCQ+Z in this manner are making a very poor risk-management decision; if you are right – that HCQ+Z is ineffective, nothing has been lost except a few dollars; if you are wrong and it is at least to some degree effective, you may have contributed to the deaths of potentially 10’s of thousands of people.

  237. 237
    jerry says:

    HCQ +zinc – safe, effective and cheap.

    One extremely large negative. It has been recommended by a Trump so guaranteed not to cure TDS.

  238. 238
    ET says:

    That’s the rub. Had Trump never uttered a word about it, HCQ and zinc would be seen as “the” cure. And people would be getting on him for not making a National announcement in favor of it.

  239. 239
    rhampton7 says:

    Problem was with Raoult’s sloppy research and hyped promises of returns, and then the President piling on and calling it a cane changer without any evidence.

    Had both men told the scientific truth – it may have some benefit but we won’t know for sure until there are RCTs to confirm our suspicions, the whole mess could have been avoided.

    But both Raoult and President Trump are very much self promoters and are not familiar with humble pronouncementS.

  240. 240
    ET says:

    Wow. The MedCram videos alone, provide the evidence.

  241. 241
    rhampton7 says:

    A doctor with Ochsner Health explained how the anti-malaria drug hydroxychloroquine has been successful in treating patients with Lupus after the debate over the drug’s effectiveness in treating COVID-19 played out on the national stage this week.

    Dr. Saravanan Thiagaranjan, head of the Rheumatology department at Ochsner Health in Baton Rouge says hydroxycloroquine could provide some benefit in treating COVID-19 patients because it is used to treat infections like malaria.

    However, Thiagaranjan says it has been proven repeatedly that hydroxycloroquine, also known as plaquenil, does not work in treating patients with COVID-19.
    “Plaquenil is used in lupus, but it’s not the only medicine used for lupus,” Thiagaranjan said. “It’s used in mild lupus and skin lupus. But when lupus is affecting your heart, lungs and kidneys, you’re not going to spend your money on plaquenil.”
    Thiagarajan said he has patients who are prescribed hydroxychloroquine and have tested positive for the coronavirus.
    “[COVID-19 patients] may see some minor symptoms improve on plaqunil,” Thiagaranjan said. “But if COVID is affecting your lungs, you’re not going to bet your money on plaqunil, because it’s not showing effectiveness.”

    https://www.wafb.com/2020/07/31/ochsner-rheumatologist-breaks-down-hydroxychloroquine-amid-national-debate/

  242. 242
    rhampton7 says:

    In a new Yahoo! News/YouGov survey, respondents were asked “Do you think the drug hydroxychloroquine is a cure for COVID-19?”

    The vast majority — 83 percent — either correctly said it is not (52%) or said they didn’t know (31%), and only 17 percent mistakenly said it is a cure. The drug has not even been proven an effective treatment for the virus, and some studies have shown it to be potentially harmful. There is currently no cure for the coronavirus illness.

    But among Trump supporters, a whopping 44 percent say Hydroxychloroquine is a cure for coronavirus, and less than a quarter of them correctly said that it is not.

    Those numbers could grow, as the poll was taken between July 28 and July 30, while Trump was promoting the drug as a cure using a video that was subsequently deleted across social media platforms

    https://www.mediaite.com/news/almost-half-of-trump-fans-think-hydroxychloroquine-is-cure-for-coronavirus-it-is-not/

  243. 243
    rhampton7 says:

    A New Zealand Covid-19 study looking at the efficacy of weekly prophylactic hydroxychloroquine regimes for high risk frontline healthcare workers has been abandoned.

    Based on the lack of evidence around the effectiveness of the anti-malaria drug – which was controversially promoted by US President Donald Trump and Brazilian President Jair Bolsonaro – the study won’t move onto recruitment and trials.

    “ Given the rapidly emerging evidence on potential Covid-19 treatments from other international trials, all three trials have adapted significantly and have removed hydroxychloroquine as a candidate for treatment or prevention,” the council spokesperson said.

    https://www.stuff.co.nz/national/health/coronavirus/122318977/coronavirus-hydroxychloroquine-studies-in-new-zealand-abandoned-due-to-lack-of-evidence-and-covid19-cases

  244. 244
    rhampton7 says:

    Right-wing Texas state Rep. Tony Tinderholt, who pushed for reopening the state amid the coronavirus pandemic and compared the shutdown to “socialism,” says he thought he was going to die after recently testing positive for COVID-19.

    “ Though I am not quite back to 100% health, I am feeling much better and continue to self isolate and heal inside my home,” Tinderholt wrote on Facebook on Friday afternoon. “I praise the Lord for keeping my family safe and for sending an excellent medical professional who was not afraid to practice the medicine he felt was in the best interest of his patients.”

    According to the Fort Worth Star-Telegram, Tinderholt’s treatment did not include hydroxychloroquine because doctors thought it would be too risky given that he has a titanium heart valve.

    The Texas Tribune reports: “I truly thought last Friday was gonna be my last,” Tinderholt, an Arlington Republican, said in a text message to the Tribune. Tinderholt said his wife and two of his children also tested positive for the virus, though their symptoms were less severe. … Tinderholt is a member of the hardline conservative House Freedom Caucus, which has frequently criticized Gov. Greg Abbott’s response to the pandemic — shutting down businesses and requiring masks in public — as government overreach.

    https://www.towleroad.com/2020/07/right-wing-texas-lawmaker-who-compared-coronavirus-restrictions-to-socialism-nearly-dies-from-covid-19/https://www.towleroad.com/2020/07/right-wing-texas-lawmaker-who-compared-coronavirus-restrictions-to-socialism-nearly-dies-from-covid-19/

  245. 245
    jerry says:

    And now for the truth after a series of fake news irrelevant posts. There is zero evidence that HCQ does not work in early treatment especially when used with zinc. There is $200,000 to the first person who can show it doesn’t work

    No one has presented a study anywhere in the world to show otherwise. But yet everyday we get fake stories saying HCQ doesn’t work. There is plenty of studies by doctors showing it does work. It is the most recommended drug in the world for C19.

    Then there is the choice being made by those who say it doesn’t work who condemn to death tens of thousands who are high risk and contact the disease. Saying don’t use a safe, effective inexpensive drug because it was recommended by politicians they don’t like.

    Don’t take this, it won’t do you any harm, it costs almost nothing. It has been recommended by tens of thousands of doctors. But some who don’t like certain politicians don’t want you to take it.

  246. 246
    rhampton7 says:

    The West Bengal government has issued a new set of guidelines on treating COVID-19 patients with comorbidities, usage of repurposed drugs and post-discharge care. The new protocols, issued by the health department, was prepared following recommendations of experts who have been visiting several private and state-run COVID facilities, officials said.

    It is aimed at ensuring uniformity in the treatment of coronavirus patients, they said. On the usage of drugs to treat COVID-19, the guidelines said hydroxychloroquine has no effect on clinical recovery, and it has been clinically beneficial in select cases, but with significant limitations.

    Remdesivir can only be used in case of emergencies keeping in mind the side effects like anaemia, liver function test anomalies and acute kidney injury, it said. For patients having moderate symptoms but showing an increase in oxygen requirement, the guidelines suggested the use of methylprednisolone and dexamethasone, preferably within 48 hours of admission.

    https://www.financialexpress.com/lifestyle/health/west-bengal-govt-issues-new-guidelines-on-treating-covid-19-patients-with-comorbidities/2042111/

  247. 247
    rhampton7 says:

    In Uganda, Dr. William Worodria, the chairperson case management committee, said during the onset of the virus, some treatment centers were using hydroxychloroquine, a medication used in treatment of malaria, lupus and rheumatoid arthritis, to treat COVID-19.

    “In our first guidelines we did include the use of hydroxychloroquine under experimental medication but when we looked at the evidence including local evidence of the two sides; one which used hydroxychloroquine and one which did not, there was no difference. So in our second guideline, we have removed it from therapy,” he said.

    According to Worodria, Uganda’s treatment regimen now targets to boost one’s immunity to fight off the virus. He said the treatment depends on the stage of the disease.

    “If it’s mild you don’t need a lot of therapies. We give routine Vitamin C. if they have respiratory syndrome we give zinc,” he said.

    He noted that in case a patient develops pneumonia, they give antibiotics and if the disease becomes severe, a combination of other medicines including remdesivir is given.

    However, he said, remdesivir has also not shown much effectiveness in patients under intensive care.

    https://www.newvision.co.ug/news/1523847/hydroxychloroquine-removed-covid-19-treatment-experts

  248. 248
    rhampton7 says:

    Dr Stella Immanuel, the Texas-based doctor, who claimed she has cured COVID-19 patients with hydroxychloroquine, has made another claim as a ‘demon buster’.

    ‘I’m a demon buster. Yes, demons sleep with people. Yes, if you pray for them they get better,’ she told the Houston Chronicle.

    https://www.pmnewsnigeria.com/2020/08/01/covid-doctor-stella-immanuel-makes-new-claim-as-demon-buster/

  249. 249
    rhampton7 says:

    247 “If it’s mild you don’t need a lot of therapies. We give routine Vitamin C. if they have respiratory syndrome we give zinc,” he said.

    — sounds like the over the counter vitamins are doing all the work and HCQ is stealing the credit. It’s not even needed!

  250. 250
    ET says:

    HCQ is not needed. Quercetin is also an ionophore. Quercetin, zinc, vitamin C (should be liposomal), vitamin D and melatonin are all on the prophylaxis list of the EVMS.

    That said, HCQ (or Quercetin) and zinc, @ the onset of symptoms, is the cure. Vitamin D you need to already be taking- meaning take it before you get any symptoms. And liposomal C is by far more effective than regular water soluble C.

  251. 251
    rhampton7 says:

    ET, There is no cure. None. Nowhere. Not even the high-priest of HCQ, Raoult, has declared it a cure.

  252. 252
    ET says:

    rhampton7- There is a cure and it has worked. Perhaps you are playing semantic games with the word “cure”. But there is a treatment that makes sick people healthy again. And there is an effective prophylaxis that will prevent the virus from taking hold- ie keep you from getting sick.

  253. 253
    kairosfocus says:

    RH7,

    we see the same pattern of burial under an avalanche of irrelevancies yet again.

    Where, you — an anonymous Internet commenter — have the gall to blanket dismiss a world-class leading researcher and head of a major research institute in France who has successfully done and published the work to substantiate why HCQ+ cocktails are a credible, effective treatment for CV19, once we are early enough in the U/L trajectory. Nor have you ever been able to substantially and cogently address the ethics-epistemology and decision theory issues tied to the Tuskegee syphilis atrocity. With lives needlessly on the line.

    So, as a reminder of what is being suppressed:

    ********
    https://www.newsweek.com/key-defeating-covid-19-already-exists-we-need-start-using-it-opinion-1519535

    >>The Key to Defeating COVID-19 Already Exists. We Need to Start Using It | Opinion
    Harvey A. Risch, MD, PhD , Professor of Epidemiology, Yale School of Public Health
    On 7/23/20 at 7:00 AM EDT

    As professor of epidemiology at Yale School of Public Health, I have authored over 300 peer-reviewed publications and currently hold senior positions on the editorial boards of several leading journals. I am usually accustomed to advocating for positions within the mainstream of medicine, so have been flummoxed to find that, in the midst of a crisis, I am fighting for a treatment that the data fully support but which, for reasons having nothing to do with a correct understanding of the science, has been pushed to the sidelines. As a result, tens of thousands of patients with COVID-19 are dying unnecessarily. Fortunately, the situation can be reversed easily and quickly.

    I am referring, of course, to the medication hydroxychloroquine. When this inexpensive oral medication is given very early in the course of illness, before the virus has had time to multiply beyond control, it has shown to be highly effective, especially when given in combination with the antibiotics azithromycin or doxycycline and the nutritional supplement zinc.

    On May 27, I published an article in the American Journal of Epidemiology (AJE) entitled, “Early Outpatient Treatment of Symptomatic, High-Risk COVID-19 Patients that Should be Ramped-Up Immediately as Key to the Pandemic Crisis.” That article, published in the world’s leading epidemiology journal, analyzed five studies, demonstrating clear-cut and significant benefits to treated patients, plus other very large studies that showed the medication safety.

    Physicians who have been using these medications in the face of widespread skepticism have been truly heroic. They have done what the science shows is best for their patients, often at great personal risk. I myself know of two doctors who have saved the lives of hundreds of patients with these medications, but are now fighting state medical boards to save their licenses and reputations. The cases against them are completely without scientific merit.

    Since publication of my May 27 article, seven more studies have demonstrated similar benefit. In a lengthy follow-up letter, also published by AJE, I discuss these seven studies and renew my call for the immediate early use of hydroxychloroquine in high-risk patients. These seven studies include: an additional 400 high-risk patients treated by Dr. Vladimir Zelenko, with zero deaths; four studies totaling almost 500 high-risk patients treated in nursing homes and clinics across the U.S., with no deaths; a controlled trial of more than 700 high-risk patients in Brazil, with significantly reduced risk of hospitalization and two deaths among 334 patients treated with hydroxychloroquine; and another study of 398 matched patients in France, also with significantly reduced hospitalization risk. Since my letter was published, even more doctors have reported to me their completely successful use . . . .

    Beyond these studies of individual patients, we have seen what happens in large populations when these drugs are used. These have been “natural experiments.” In the northern Brazil state of Pará, COVID-19 deaths were increasing exponentially. On April 6, the public hospital network purchased 75,000 doses of azithromycin and 90,000 doses of hydroxychloroquine. Over the next few weeks, authorities began distributing these medications to infected individuals. Even though new cases continued to occur, on May 22 the death rate started to plummet and is now about one-eighth what it was at the peak.

    A reverse natural experiment happened in Switzerland. On May 27, the Swiss national government banned outpatient use of hydroxychloroquine for COVID-19. Around June 10, COVID-19 deaths increased four-fold and remained elevated. On June 11, the Swiss government revoked the ban, and on June 23 the death rate reverted to what it had been beforehand. People who die from COVID-19 live about three to five weeks from the start of symptoms, which makes the evidence of a causal relation in these experiments strong. Both episodes suggest that a combination of hydroxychloroquine and its companion medications reduces mortality and should be immediately adopted as the new standard of care in high-risk patients .>>

    What is being drowned out.

    And, again:

    >>Why has hydroxychloroquine been disregarded?

    First, as all know, the medication has become highly politicized. For many, it is viewed as a marker of political identity, on both sides of the political spectrum. Nobody needs me to remind them that this is not how medicine should proceed. We must judge this medication strictly on the science. When doctors graduate from medical school, they formally promise to make the health and life of the patient their first consideration, without biases of race, religion, nationality, social standing—or political affiliation. Lives must come first.

    Second, the drug has not been used properly in many studies. Hydroxychloroquine has shown major success when used early in high-risk people but, as one would expect for an antiviral, much less success when used late in the disease course. Even so, it has demonstrated significant benefit in large hospital studies in Michigan and New York City when started within the first 24 to 48 hours after admission.

    In fact, as inexpensive, oral and widely available medications, and a nutritional supplement, the combination of hydroxychloroquine, azithromycin or doxycycline, and zinc are well-suited for early treatment in the outpatient setting. The combination should be prescribed in high-risk patients immediately upon clinical suspicion of COVID-19 disease, without waiting for results of testing. Delays in waiting before starting the medications can reduce their efficacy.

    Third, concerns have been raised by the FDA and others about risks of cardiac arrhythmia, especially when hydroxychloroquine is given in combination with azithromycin. The FDA based its comments on data in its FDA Adverse Event Reporting System. This reporting system captured up to a thousand cases of arrhythmias attributed to hydroxychloroquine use. In fact, the number is likely higher than that, since the reporting system, which requires physicians or patients to initiate contact with the FDA, appreciably undercounts drug side effects.

    But what the FDA did not announce is that these adverse events were generated from tens of millions of patient uses of hydroxychloroquine for long periods of time, often for the chronic treatment of lupus or rheumatoid arthritis. Even if the true rates of arrhythmia are ten-fold higher than those reported, the harms would be minuscule compared to the mortality occurring right now in inadequately treated high-risk COVID-19 patients. This fact is proven by an Oxford University study of more than 320,000 older patients taking both hydroxychloroquine and azithromycin, who had arrhythmia excess death rates of less than 9/100,000 users, as I discuss in my May 27 paper cited above. A new paper in the American Journal of Medicine by established cardiologists around the world fully agrees with this.

    In the future, I believe this misbegotten episode regarding hydroxychloroquine will be studied by sociologists of medicine as a classic example of how extra-scientific factors overrode clear-cut medical evidence. But for now, reality demands a clear, scientific eye on the evidence and where it points . . . >>

    I think there are a few questions to be asked and answered.

    The May 27, 2020 paper:

    >> Am J Epidemiol

    . 2020 May 27;kwaa093.
    doi: 10.1093/aje/kwaa093. Online ahead of print.
    Early Outpatient Treatment of Symptomatic, High-Risk Covid-19 Patients that Should be Ramped-Up Immediately as Key to the Pandemic Crisis
    Harvey A Risch 1
    Affiliations

    PMID: 32458969 DOI: 10.1093/aje/kwaa093

    Abstract

    More than 1.6 million Americans have been infected with SARS-CoV-2 and GT 10 times that number carry antibodies to it. High-risk patients presenting with progressing symptomatic disease have only hospitalization treatment with its high mortality. An outpatient treatment that prevents hospitalization is desperately needed. Two candidate medications have been widely discussed: remdesivir, and hydroxychloroquine+azithromycin. Remdesivir has shown mild effectiveness in hospitalized inpatients, but no trials have been registered in outpatients. Hydroxychloroquine+azithromycin has been widely misrepresented in both clinical reports and public media, and outpatient trials results are not expected until September. Early outpatient illness is very different than later hospitalized florid disease and the treatments differ. Evidence about use of hydroxychloroquine alone, or of hydroxychloroquine+azithromycin in inpatients, is irrelevant concerning efficacy of the pair in early high-risk outpatient disease. Five studies, including two controlled clinical trials, have demonstrated significant major outpatient treatment efficacy. Hydroxychloroquine+azithromycin has been used as standard-of-care in more than 300,000 older adults with multicomorbidities, with estimated proportion diagnosed with cardiac arrhythmias attributable to the medications 47/100,000 users, of which estimated mortality is LT 20%, 9/100,000 users, compared to the 10,000 Americans now dying each week. These medications need to be widely available and promoted immediately for physicians to prescribe. >>

    It is time to face responsibility for needless politicisation and polarisation of discussion over a manifestly effective treatment and needless deaths by at least tens of thousands. There will be a day of reckoning over such culpable irresponsibility.

    ********
    The U.S. Public Health Service Syphilis Study at Tuskegee was a clinical study conducted between 1932 and 1972 by the United States Public Health Service.[1][2] [–> 40 years of sustained wrong, which had to be enforced through a warped understanding of ethics and epistemology, with overtones of racism similar to medical experiments on concentration camp inmates] The purpose of this study was to observe the natural history of untreated syphilis [–> decades after effective treatments were routinised by the late 1940’s] ; the African-American men in the study were only told they were receiving free health care from the Federal government of the United States.[3]

    [–> evil under false colour, robes and ceremonies of medicine and science; with calculated misleading as pivot, extracting manipulated consent that caused improper exposure to diseases treated ineffectively when ADEQUATE evidence . . . adequacy is not perfection . . . existed that better alternatives were available.]

    The United States Public Health Service started the study in 1932 in collaboration with Tuskegee University (then the Tuskegee Institute), a historically black college in Alabama. [–> misuse of credibility] Investigators enrolled in the study a total of 600 impoverished, African-American sharecroppers from Macon County, Alabama.[3] Of these men, 399 had latent syphilis, with a control group of 201 men who were not infected.[2] [–> oh, yes, the gold standard was applied within the study and the study as a whole was itself a control on efficacy of other treatments: natural, untreated course] As an incentive for participation in the study, the men were promised free medical care, but were deceived by the PHS

    [–> deception, a key to seeing the ethics failure and don’t tell us oh deliberately mislabelled sugar pills etc are not deception under colour, robes and ceremonies of medicine and science]

    , who disguised placebos, ineffective methods, and diagnostic procedures as treatment.[4]

    [–> REPEAT: “who disguised placebos, ineffective methods, and diagnostic procedures as treatment”]

    The men who had syphilis were never informed of their diagnosis, despite the risk of infecting others, and the fact that the disease could lead to blindness, deafness, mental illness, heart disease, bone deterioration, collapse of the central nervous system, and death.[5][6][7][8]

    [–> are people being told that as you are high risk and CV19 is fast moving with damage already in lungs per Raoult’s 2000+ CT scans on 500+ patients, when symptoms emerge? That death is a significant, rapid potential outcome on placebos? that HCQ+ cocktails have several lines of evidence pointing to likely rapidly acting efficacy?]

    According to the Centers for Disease Control and Prevention, the men were told that they were being treated for “bad blood,” a colloquialism that described various conditions such as syphilis, anemia and fatigue. “Bad blood”—specifically the collection of illnesses the term included—was a leading cause of death within the southern African-American community.[2] The men were initially told that the study was only going to last six months, but it was extended to 40 years.[2] After funding for treatment was lost, the study was continued without informing the men that they would never be treated. None of the infected men were treated with penicillin despite the fact that by 1947, the antibiotic had become the standard treatment for syphilis.[9]

    [–> so, what about the cumulative body of evidence since 2005 on likely efficacy of HCQ+ cocktails? Or, is that to be branded with a scarlet letter, dismissed as not meeting the gold standard that rests on deceptive practice . . . MISLABELLED, ineffective pseudo treatments in the face of life/death are deceptive . . . then marginalised and censored?]

    Study clinicians could have chosen to treat all syphilitic subjects and close the study, or split off a control group for testing with penicillin. Instead, they continued the study without treating any participants; they withheld treatment and information about it from the subjects.

    [–> So, how much more is it to be challenged when in the face of cumulative evidence of efficacy, treatments are sidelined and it is demanded that people subject themselves to life/death situations to “prove” what is already readily shown, save where studies are fail-by-design: too late in the U/L trajectory, wrong demographic, dubious statistics like Lancet, etc?]

    In addition, scientists prevented participants from accessing syphilis treatment programs available to other residents in the area.[10] The study continued, under numerous Public Health Service supervisors, until 1972, when a leak to the press resulted in its termination on November 16 of that year.[11] The victims of the study, all African-American, included numerous men who died of syphilis, 40 wives who contracted the disease and 19 children born with congenital syphilis.[12]

    The 40-year Tuskegee Study of Untreated Syphilis in the African American Male study was a major violation of ethical standards. [–> ethical failure] Researchers knowingly failed to treat participants appropriately [–> oh, how familiar] after penicillin was proven [–> empirical investigations cannot prove but can warrant a prudent conclusion] to be an effective treatment for syphilis and became widely available.[9] [–> how widely accessible are elements of HCQ cocktails? I submit, quite widely] Moreover, participants remained ignorant of the study clinicians’ true purpose, which was to observe the natural course of untreated syphilis.[3] [–> deception, deception, deception is deception] The revelation in 1972 of study failures by a whistleblower, Peter Buxtun, [–> So, how are whistleblowers currently being treated? see how it pinches when the shoe is on the other foot?] led to major changes in U.S. law and regulation concerning the protection of participants in clinical studies. Now studies require informed consent [–> what, really, is properly informed consent given what we are seeing now?],[13] communication of diagnosis and accurate reporting of test results.[14] [–> what about the right to access the best evidence and accessible treatments in the face of emerging pandemic?]

    The U.S. Public Health Service Syphilis Study at Tuskegee, cited as “arguably the most infamous biomedical research study in U.S. history,”
    ********

    KF

  254. 254
    kairosfocus says:

    F/N: The inimitable Dr Stella (of Cameroun* and Texas) in her own voice, with transcript: https://www.click2houston.com/news/local/2020/07/31/full-interview-houston-doctor-in-viral-video-touting-hydroxychloroquine-as-virus-cure-doubles-down-on-claims/ KF

    *PS: Some attempts to discredit her have targetted her views on demonology,

    (and in particular incubus and succubus demons targetting our current cultural obsession with sexuality and ever more bizarre perversities and transgressivity . . . if I ever doubted such awful realities, the rise of this shocking trend and associated billion dollar industries of exploitation and human trafficking that feed obsessive, addictive, ethically and mentally debasing fantasies that clearly will open demonic portals into lives would make me reconsider . . . )

    which are doubtless shaped by her background and experiences. Without blanket endorsing her remarks or how her views are worded, if you have never dealt with the reality of demonisation, I would counsel prudent restraint from empty dismissive talk. There are more — and horrifically worse — things in this world than are dreamed of in your oh so comfortable philosophy dressed up in a lab coat, dear Horatio.

  255. 255
    BobRyan says:

    For anyone paying attention, it is common knowledge that goggles are now being advised to be worn with masks. Those who have been washing their hands a lot, using social distancing and wearing masks, are still getting sick. Rather than acknowledge the obvious, which is it was bad advice from the beginning, they are doubling down. Washing your hands constantly and social distancing work against the immune system, which leads to greater risk of health problems.

    Cloth masks create a moist, hot and dark environment, which does not make for a healthy environment. Anything being exhaled is, to at least some extent, being inhaled. We are not supposed to inhale what we exhale. The masks do not keep everything from escaping, which is the reason people with glasses notice just how much they fog up when they exhale. Part of what is being exhaled is getting into the eyes, which is not healthy, There is a reason masks used in serious outbreaks of anything include eye covering and filters to clean the air prior to inhaling.

    No matter which country you look at, the statistics remain the same. The chances of someone under the age of 65 with no preexisting conditions dying from SARS-CoV-2 are extremely low. Those countries with aging populations are seeing a higher rate of death, since it impacts the elderly far more than anyone else.

    Sweden did what all countries should have done. They went for heard immunity and their rate of death leveled off a while ago to almost nothing. Had other countries done what has always been done with coronaviruses, you would not have the same level of suicides, ODs, murder at the hands of abusers, increased unemployment, increased alcoholism, increased homelessness, increased hunger, etc. Those are real lives that have been lost and impacted by government overreach.

  256. 256
    kairosfocus says:

    PPS: Pardon a controversial observation. I am going to borrow a thought or two from the White Rose Martyrs, tract IV, and suggest that “we must conduct a struggle against the National Socialist terrorist [–> de-Christianising, anti-Christian] state with rational means; but whoever today still doubts the reality, the existence of demonic powers, has failed by a wide margin to understand the metaphysical background of this [4th generation civilisational] war.” In particular, I am stirred in my spirit to suggest that Dr Stella has put her finger on an issue that needs to be soberly pondered, the very issue on which those who seek to discredit her on HCQ+ cocktails used to treat CV19 have fastened to portray her as a loony or near loony. Namely, this: in a culture where increasingly bizarre sexual obsessions and perversities seek to brazenly walk in broad daylight and are supported by billion dollar industries of exploitation and human trafficking, if we imagine that incubi and succubi are confined to nightmare visits [and guess where the word mare comes from in this context], we are gravely mistaken. Such minions of the prince of darkness grim are manifestly influencing policy, regulation and law, so too are driving whole markets of evil. I dare to add into this witches’ brew, the rise of a linked industry that has sustained the actual worst holocaust in history, the 800+ million victims of the mass destruction of our living posterity in the womb under false colours of law and reproductive health care; mounting up at another just under a million further victims per week. (And yes, the marxist trail of 100 million graves is only the second worst holocaust, the worst ideological mass killing in history.) We desperately need deep mindset change and purification, if we are to find true liberation from such demonic debasement of our whole civilisation. Dr Stella has a sobering point.

  257. 257
    jerry says:

    Are most people immune to the virus?

    Came across this article published today in India.

    Not everyone in coronavirus-hit family prone to disease: Study

    https://www.newindianexpress.com/nation/2020/aug/02/not-everyone-in-coronavirus-hit-family-prone-to-disease-study-2178165.html

    Remember the earliest possible information was from Diamond Princess where everyone was in close proximity. And only a few elderly died and most did not contract disease.

    Brings up interesting proposition: Are there 4 types of people. First, those not susceptible in any way to virus. Second, those who get it and show few if any symptoms. Third, those who get it and exhibit symptoms but defeat the virus with their immune systems. Fourth, those who get it and exhibit symptoms which progress to hospitalization.

    Of the last group some will die and are mostly elderly. So it may indicate five groups. Maybe more. The percentage in each group is unknown but the first three could be over 90% of the population.

    The target for treatments such as HCQ and zinc are for group 4 but fairly early in the process. All we hear about is group 4 since they could proceed to death or serious damage from the virus.

  258. 258
    jerry says:

    Zelenko protocol not about HCQ.

    Zelenko protocol is

    1) identify high risk patients; those in group 4 in previous post.

    2) treat asap – within first couple days of developing symptoms.

    3) use ZINC, hcq, azithromycin or doxycycline

    Objective is no hospitalization and no deaths.
    ————————-

    Came across new European site on C19. https://unherd.com/author/freddie-sayers/

    If you go there you can see an interview with Anders Tegnell, man who guided Sweden’s response to virus.

  259. 259
    jerry says:

    More hope:
    Four weeks and 300,000 #SARSCoV2 positive tests later, Florida has more hospital beds available than it did on July 5. How ‘bout them apples? – From Alex Berenson

    https://twitter.com/AlexBerenson/status/1289975186909884417

  260. 260
    rhampton7 says:

    “Where, you — an anonymous Internet commenter — have the gall to blanket dismiss a world-class leading researcher and head of a major research institute”

    I have posted perhaps a dozen different critiques of Raoult’s work by the scientific/medical community, which have ignored.

    I have posted dozens of hospitals, research institutions, even entire nations that have looked within and found that HCQ does not work, or has minimal effect. Again you have steadfastly ignored it all.

    To top it off, you refuse to say what is true – that there is no cure for Covid. Raoult never made such a claim. Yet when confronted with this fact you ramble on, avoiding the other issue.

    Really, all you need to say to this forum is, “You all know how strongly I feel about the effectiveness of HCQ, but on this singular point RH7 is correct. There is no cure.”

    So you quit moral grand standing. It’s a unbecoming.

  261. 261
    rhampton7 says:

    The Henry Ford Health System has issued an open letter about a study it published in July that found hydroxychloroquine cut the death rate by 50% in certain sick patients hospitalized with COVID-19.

    Saying “the political climate that has persisted has made any objective discussion about this drug impossible,” the Henry Ford Health System said in the letter that it will no longer comment outside the medical community on the use of hydroxychloroquine to treat novel coronavirus.

    “Like all observational research, these studies are very difficult to analyze and can never completely account for the biases inherent in how doctors make different decisions to treat different patients. Furthermore, it is not unusual that results from such studies vary in different populations and at different times, and no one study can ever be considered all by itself.”

    The letter comes after Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Disease, called the Henry Ford study flawed in his testimony Friday at a Congressional hearing on the federal government’s efforts to control the pandemic.

    https://www.freep.com/story/news/health/2020/08/03/henry-ford-fauci-trump-hydroxychloroquine-covid-19/5573656002/

  262. 262
    rhampton7 says:

    The saga continues: 3 White House experts say hydroxychloroquine ineffective as a COVID-19 treatment

    On July 29, for instance, Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases and a member of the White House Coronavirus Task Force, discussed the topic with the BBC:

    “We know that every single good study—and by good study, I mean randomized control study in which the data are firm and believable—has shown that hydroxychloroquine is not effective in the treatment of COVID-19,” Fauci said.

    Deborah Birx, MD, another prominent member of the White House Coronavirus Task Force, shared similar sentiments in an interview with Fox News on July 30.

    “We know in the randomized controlled trials to date—and there’s been several of them—that there’s not evidence that it improves those patients’ outcomes,” she said. “Whether they have mild, moderate disease or whether they’re seriously ill in the hospital.”

    On Sunday, August 2, another voice joined in: Admiral Brett Giroir, MD, assistant secretary for health at the U.S. Department of Health and Human Services (HHS). Giroir, in charge of coordinating the Trump administration’s COVID-19 testing response, spoke with NBC’s Meet the Press and made it clear that he does not recommend the medication as a treatment.

    “Most physicians and prescribers are evidence-based and they’re not influenced by whatever is on Twitter or anything else,” Giroir said. “And the evidence just doesn’t show that hydroxychloroquine is effective right now.”

    https://www.cardiovascularbusiness.com/topics/healthcare-economics/saga-continues-3-white-house-experts-say-hydroxychloroquine-ineffective

  263. 263
    rhampton7 says:

    In an apparent warning shot at Dr. Stella Immanuel, the Texas agency that regulates the practice of medicine has advised physicians it can take action against those who promise a cure for COVID-19.

    The Texas Medical Board issued a statement about such claims Friday, just a few days after Immanuel, a Houston pastor-doctor, very publicly touted hydroxychloroquine as a cure for the disease. Numerous studies have found the drug does not show any benefit against COVID-19 and the Food and Drug Administration has cautioned about its use because of reports linking it with heart problems and other injuries and disorders.

    “A physician must provide full disclosure of treatment options, side effects, obtain informed consent, and there cannot be false, misleading or deceptive advertising or statements made regarding any therapies, including a cure for COVID-19,” says the medical board’s statement.

    The statement said if the board were to receive a complaint for false, misleading or deceptive advertising, it would be reviewed following its standard enforcement process. It did not say the complaint had to involve harm to a patient.

    https://www.houstonchronicle.com/news/health/article/Medical-board-warns-Dr-Immanuel-others-touting-15455333.php

  264. 264
    kairosfocus says:

    RH7, I repeat, you have improperly impugned the person and work of Dr Raoult, as has been pointed out any number of times with adequate details. You have been consistently unresponsive to reasonable correction and facts that warrant the conclusion that HCQ+ based cocktails are an effective treatment if administered appropriately and early enough in the U/L trajectory of CV19. That may be politically incorrect but it is empirically well warranted. I suggest, you need to do serious rethinking. KF

  265. 265
    kairosfocus says:

    RH7,

    has it occurred to you that something is very wrong with the personal attacks, censorship and threats by officialdom that have targetted almost any sufficiently strong personality who has stood up in the face of a politically correct partyline attitude to HCQ+ cocktails?

    In the current case, a Cameroun immigrant doctor (so, English is 3rd or 4th language, French would have been official language), who stood up with a circle of other frontline doctors, Dr Immanuel. Her specific claim has been that she has successfully treated 350 (now evidently 400+) patients with HCQ+ cocktails, early in the U/L trajectory and that she is in process of publication. Further, that in her lifetime familiarity with HCQ (Malaria –> W Africa, a major debilitating problem), it is reasonably safe and manageable as a drug. Indeed, so much so that it has been freely available over the counter, i.e. it is a drug that is sufficiently manageable that ordinary people can be trusted to self-administer safely.

    Now, such claims are readily checkable. The OTC status is in fact correct, and blows up the extreme danger suggestion in the PC narrative used to deconstruct credibility. A key point telling us that something is very wrong here. And BTW, there has been sufficient testimony by doctors and specialists (including Dr Risch of Yale) to confirm that the risks are manageable.

    Note, here, Dr Immanuel has also highlighted that others have made and even published similar claims as to effectiveness but are being sidelined and dismissed. This too is correct. (I have already, many times, pointed to the ethics-epistemology challenge tied to the error of erecting mistreatment using deliberately mislabelled sugar pills or the equivalent in the face of a fast-acting, deadly disease into a “gold standard” of evidence. Your unresponsiveness to say the implications of the Tuskegee syphilis atrocity speaks volumes.)

    As for “cure” language apparently being used to threaten her with her licence, she has plainly stated that threats against licence will not move her from testifying to what she knows from practice. My inference is that to strip her on such grounds will lead to a serious lawsuit. I suspect, that issues of tortious interference and other considerations will apply. It is a serious thing to interfere with the professional integrity of the physician and the duty implicit in the very name we commonly use in English, doctor. That is, literally, recognised TEACHER.

    Let’s highlight “cure” using AMHD:

    cure (kyo?or)
    n.
    1.
    a. A drug or course of medical treatment used to restore health: discovered a new cure for ulcers.
    b. Restoration of health; recovery from disease: the likelihood of cure.
    c. Something that corrects or relieves a harmful or disturbing situation: The cats proved to be a good cure for our mouse problem . . .
    v. cured, cur·ing, cures

    The issue is that “cure” is linguistically a functional term, not an official one. But of course, it conveys high confidence and so there will be bureaucratic attempts to capture the word to mean OFFICIALLY APPROVED treatment; dismissing usage otherwise as quackery. HCQ+ cocktails are arguably functionally effective under certain conditions when antivirals will be effective. They do not have official stamp of approval, due to a deeply polarised, needless controversy, which is exactly what Dr Immanuel and a significant number of other doctors are using rights and freedoms of association, expression and publication as well as petition to address.

    Indeed, the rally in front of the US Supreme Court was an actual peaceful protest — something, that many who are rioting or enabling same would do well to heed.

    Another disturbing feature of the personal attacks I have seen is the trend to dismiss her on her views on a fairly common phenomenon, incubus/succubus. She has used terms commonly used in W Africa to describe such. They have been trolled up and are used distractively to discredit and dismiss without serious consideration of her claims as physician. Without endorsing how W Africans often colourfully describe the phenomenon, I would suggest — as one who among many others has had to deal with demonic phenomena and has seen demonic levitation (along with dozens of other witnesses) — that there are more horrors in this world than are dreamed of in a priori evolutionary materialistic scientism. That’s what the White Rose Martyrs pointed out regarding Hitler in their Tract IV. And, thankfully, more hopes such as the reality of God and of salvation that includes successful deliverance from spiritual oppression and bondage. Including demonised sexual bondages. (And if one has not made the connexion between the sex trafficking, porn-perversion industries, the mass holocaust of our living posterity in the womb and the warping of public policy in ways that facilitate billion dollar evil industries and the demonic, s/he has not begun to truly understand the root realities of the ongoing corruption of our civilisation.)

    When will we wake up to our folly and peril?

    KF

  266. 266
    jerry says:

    Posted by Dr. Todaro, one of HCQ zinc doctors.

    If your plan is to blindly trust and obey every word out of Dr. Fauci’s mouth, then just say so.

    It will save everyone countless twitter debates.

    Fauci has been caught pushing bogus studies that undermine HCQ

  267. 267
    jerry says:

    When will we wake up to our folly and peril?

    Someone said it will be November 3rd after the polls close.

  268. 268
    jerry says:

    Why was Dr Immanuel singled out? Several other doctors spoke at that conference. It reveals more about those who have highlighted her testimony than it does about her.

    Saving lives is not important to them. That is obvious to anyone who watches them trying to undermine HCQ with logically invalid approaches. They know it yet they continue on in their rhetoric which if others were using for something they did not advocate they would be the first to attack as irresponsible. But impugning Dr Immanuel is beyond the pale. The hypocrisy is amazing.

  269. 269
    kairosfocus says:

    Dr Raoult, Dr Zelenko, Dr Rasch, Dr Immanuel . . .

  270. 270
    jerry says:

    Dr Simone Gold who was spokesperson for press conference got fired and other doctors got censored. Dr. Todaro’s documents got deleted by Google. Dr Palmers patient results were taken down by Facebook.

    Comment on “cure” by Dr Palmer

    Clarification: There is no “cure” for COVID-19. However, I believe there is treatment available that substantially alleviates symptoms and reduces the severity of the disease and shortens it’s course which when used early on in the disease (<7days) is much more effective—Dr. P.

  271. 271
    jerry says:

    Science says liberals, not conservatives, are psychotic. This probably explains their intransigence against HCQ and use of illogical arguments in support of their claims.

    The American Journal of Political Science published a correction this year saying that the 2012 paper has “an error” — and that liberal political beliefs, not conservative ones, are actually linked to psychoticism.

    “The interpretation of the coding of the political attitude items in the descriptive and preliminary analyses portion of the manuscript was exactly reversed,” the journal said in the startling correction.

    https://nypost.com/2016/06/09/science-says-liberal-beliefs-are-linked-to-pyschotic-traits/?utm_source=twitter_sitebuttons&utm_medium=site%20buttons&utm_campaign=site%20buttons

  272. 272
    Bob O'H says:

    Jerry – of course if your level of science education rises above that of a tabloid newspaper you’ll know that psychoticism does not mean psychotic.

  273. 273
    ET says:

    Yeah, cuz psychology is a science- BWAAAAAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHA

  274. 274
    jerry says:

    From Wikipedia. Maybe about the same trustworthiness as a tabloid.

    Psychoticism is a personality pattern typified by aggressiveness and interpersonal hostility. High levels of this trait were believed by Eysenck to be linked to increased vulnerability to psychosis such as in schizophrenia.

    One of the reasons a conservative doesn’t like debating a liberal he knows is the almost immediate hostility that arises in the liberal. I know many, many nice liberals but learned many years ago that their beliefs are almost always based on emotions. One doesn’t like their emotions contradicted.

    On the internet with essential anonymity as here it is easier to maintain one’s demeanor.

    As Scott Adams has recently said about how some people’s response to other’s valid points

    I stopped using good arguments because sarcasm works better

    Often sarcasm replaces good arguments because there really aren’t any good arguments.

  275. 275
    rhampton7 says:

    After two weeks battling COVID-19, State Rep. Randy Fine (R-Palm Bay) posted on Facebook that he needed his lungs X-rayed as his symptoms now included a recurring fever and a hacking chest cough. He remarked that the hydroxychloroquine therapy he had been on proved ineffective.

    “I’ve had a cold who knows how many times. I have never had to deal with anything like this. And for those who want to believe that (hydroxychloroquine) is some kind of magic solution, I’ve been taking that too (I don’t oppose it, but I am tired of people pretending it is magic),” he wrote in the post.

    “Was given it the day my test came back,” Fine replied. “Sorry to burst the magic bubble.”

    “I’m over it,” Fine texted FLORIDA TODAY from his Holmes Regional Medical Center hospital bed on Monday. “People should be able to use it if they want. But people should stop pretending it is some kind of magic potion as well. If they need proof, look at me.”

    https://www.floridatoday.com/story/news/2020/08/04/not-magic-says-rep-fine-hydroxychloroquine-therapy-covid-19/5573368002/

  276. 276
    rhampton7 says:

    Statement From Yale Faculty on Hydroxychloroquine and Its Use in COVID-19

    We write with grave concern that too many are being distracted by the ardent advocacy of our Yale colleague, Dr. Harvey Risch, to promote the assertion that hydroxychloroquine (HCQ) when given with antibiotics is effective in treating COVID-19, in particular as an early therapeutic intervention for the disease. As his colleagues, we defend the right of Dr. Risch, a respected cancer epidemiologist, to voice his opinions. But he is not an expert in infectious disease epidemiology and he has not been swayed by the body of scientific evidence from rigorously conducted clinical trials, which refute the plausibility of his belief and arguments. Over the last few weeks, all of us have spent considerable time explaining the evidence behind HCQ research, as it applies to early and late stage COVID-19 patients to the scientific community and general public, and now are compelled to detail the evidence in this open letter.

    We are seriously alarmed for the safety of patients and the coherence and effectiveness of our national COVID-19 emergency response when misinformation about HCQ is spread and when rigorous scientific evidence and consensus produced by the community of expert researchers in infectious diseases, federal agencies and national and global health organizations are not heeded. Let us be clear: we are unanimous in our desire to see the development of therapies to treat COVID-19 and to prevent the transmission or acquisition of SARS-CoV-2. If HCQ was shown to be effective, even among subgroups of patients with COVID-19 in ongoing high quality trials, we would join our colleagues in promoting access to it for all who need it. However, the evidence thus far has been unambiguous in refuting the premise that HCQ is a potentially effective early therapy for COVID-19.

    https://www.counterpunch.org/2020/08/04/statement-from-yale-faculty-on-hydroxychloroquine-and-its-use-in-covid-19/

  277. 277
    rhampton7 says:

    Doctors at Henry Ford Health System penned an opened letter on the hospital’s study of hydroxychloroquine being used to treat COVID-19.

    The most well-accepted and definitive method to determine the efficacy of a treatment is a double-blind, randomized clinical trial. However, this type of study takes a long time to design, execute and analyze. Therefore, a whole scientific field exists in which scientists examine how a drug is working in the real world to get as best an answer as they can as soon as possible. These types of studies can be done much more rapidly with data that is already available, usually from medical records.

    Like all observational research, these studies are very difficult to analyze and can never completely account for the biases inherent in how doctors make different decisions to treat different patients. Furthermore, it is not unusual that results from such studies vary in different populations and at different times, and no one study can ever be considered all by itself.

    Our promising Henry Ford treatment study should be considered as another important contribution to the other studies of hydroxychloroquine that describes what the authors found in our patient population. We – along with all doctors and scientists – eagerly support the need for randomized clinical trials.

    https://www.wxyz.com/news/coronavirus/henry-ford-docs-pen-open-letter-on-hydroxychloroquine-study

  278. 278
    rhampton7 says:

    The claim appeared in a video posted to YouTube on August 1, 2020, titled, “Studies show countries using hydroxychloroquine have far fewer COVID-19 deaths” (archived here), which opened:

    While the media continues to slam the use of hydroxychloroquine, numerous studies have revealed countries that used the drug are doing much better than those that haven’t. One America’s Pearson Sharp has the details.

    This One America News video makes several claims that either cannot be substantiated or have been rejected by the U.S. Food & Drug Administration, the World Health Organization and the Center for Disease Control.

    The video refers to “numerous studies,” but does not provide the author nor title of any specific study.

    Although Dr. David Nazarian of Los Angeles, California, is not interviewed on camera and the time and place of his comments is not provided by the narrator, the One America News video says (at time code 1:00) that Nazarian says patients taking hydroxychloroquine are doing better than those who aren’t.

    Board certified in internal medicine, Nazarian operates My Concierge MD, Executive Health in Los Angeles, California. On his website, he says he has worked as an emergency room doctor, as a doctor providing medical service on movie production sites and as a hospitalist. As a medical student, his website says, he served a one-month rotation in 2008 in epidemiology, the study of how diseases spread. He lists one scholarly publication, a 2004 journal article about stroke medication. Lead Stories reached out to Nazarian by phone and email on August 3, 2020, to check the research and statements attributed to him. This story will be updated, if appropriate, when Nazarian replies.

    https://leadstories.com/hoax-alert/2020/08/fact-check-no-evidence-that-countries-using-hydroxychloroquine-have-far-fewer-covid-19-deaths.html

  279. 279
    rhampton7 says:

    The Trump administration in May donated approximately 2 million doses of hydroxychloroquine (HCQ) to Brazil in an effort to help the country treat victims of the pandemic. But as research on the anti-malarial drug revealed it was ineffective against the novel coronavirus, those doses have gone virtually untouched.

    Now, more than two months later, as the virus ravages the Brazilian population, most of the 2 million doses have remained in a storage facility near the airport where they were unloaded, Health Ministry spokesman Renato Strauss told CNN.

    https://lawandcrime.com/high-profile/trump-admin-donated-2-million-doses-of-hydroxychloroquine-to-brazil-most-of-which-may-end-up-being-destroyed/

  280. 280
    rhampton7 says:

    The Nigeria Centre for Disease Control (NCDC) has said that there is no specific cure for COVID-19, adding however that some trial drugs showed promising results, but were yet to be validated for use, according to a news report by Today.

    The Centre said this at it announced the increase of the number of COVID-19 cases in the country by 288 on Monday, thus bringing the total number of infections in the country to 44,129.

    https://www.devdiscourse.com/article/health/1156147-nigeria-ncdc-does-not-approve-hydroxychloroquine-for-covid-19-treatment

  281. 281
    ET says:

    There is a medically recommended OTC prophylaxis. It’s kind of stupid that it isn’t made widely known.

  282. 282
    rhampton7 says:

    Israeli leaders are considering reinstating a full lockdown in August as the country continues to battle a second wave of the coronavirus.

    Chevy Levy, the director-general of Israel’s Health Ministry, told Army Radio on Tuesday that “a partial or complete lockdown are still options.”

    Prime Minister Benjamin Netanyahu said on Monday that “a general lockdown of the entire country” is a “possibility” the government wants to avoid.

    “We must lower the morbidity. We simply must,” Netanyahu said during a meeting with the government’s corona cabinet. “We cannot allow it to remain as it is. There is also great importance to the IDF joining this action, especially regarding cutting the morbidity, locating people with the virus and quarantining them, etc. This is important; we must deal with this wave.”

    https://www1.cbn.com/cbnnews/israel/2020/august/israel-mulls-imposing-another-lockdown-to-fight-virus

  283. 283
    kairosfocus says:

    The bury the inconvenient balance of evidence game continues

    ***************
    https://www.newsweek.com/key-defeating-covid-19-already-exists-we-need-start-using-it-opinion-1519535

    >>The Key to Defeating COVID-19 Already Exists. We Need to Start Using It | Opinion
    Harvey A. Risch, MD, PhD , Professor of Epidemiology, Yale School of Public Health
    On 7/23/20 at 7:00 AM EDT

    As professor of epidemiology at Yale School of Public Health, I have authored over 300 peer-reviewed publications and currently hold senior positions on the editorial boards of several leading journals. I am usually accustomed to advocating for positions within the mainstream of medicine, so have been flummoxed to find that, in the midst of a crisis, I am fighting for a treatment that the data fully support but which, for reasons having nothing to do with a correct understanding of the science, has been pushed to the sidelines. As a result, tens of thousands of patients with COVID-19 are dying unnecessarily. Fortunately, the situation can be reversed easily and quickly.

    I am referring, of course, to the medication hydroxychloroquine. When this inexpensive oral medication is given very early in the course of illness, before the virus has had time to multiply beyond control, it has shown to be highly effective, especially when given in combination with the antibiotics azithromycin or doxycycline and the nutritional supplement zinc.

    On May 27, I published an article in the American Journal of Epidemiology (AJE) entitled, “Early Outpatient Treatment of Symptomatic, High-Risk COVID-19 Patients that Should be Ramped-Up Immediately as Key to the Pandemic Crisis.” That article, published in the world’s leading epidemiology journal, analyzed five studies, demonstrating clear-cut and significant benefits to treated patients, plus other very large studies that showed the medication safety.

    Physicians who have been using these medications in the face of widespread skepticism have been truly heroic. They have done what the science shows is best for their patients, often at great personal risk. I myself know of two doctors who have saved the lives of hundreds of patients with these medications, but are now fighting state medical boards to save their licenses and reputations. The cases against them are completely without scientific merit.

    Since publication of my May 27 article, seven more studies have demonstrated similar benefit. In a lengthy follow-up letter, also published by AJE, I discuss these seven studies and renew my call for the immediate early use of hydroxychloroquine in high-risk patients. These seven studies include: an additional 400 high-risk patients treated by Dr. Vladimir Zelenko, with zero deaths; four studies totaling almost 500 high-risk patients treated in nursing homes and clinics across the U.S., with no deaths; a controlled trial of more than 700 high-risk patients in Brazil, with significantly reduced risk of hospitalization and two deaths among 334 patients treated with hydroxychloroquine; and another study of 398 matched patients in France, also with significantly reduced hospitalization risk. Since my letter was published, even more doctors have reported to me their completely successful use . . . .

    Beyond these studies of individual patients, we have seen what happens in large populations when these drugs are used. These have been “natural experiments.” In the northern Brazil state of Pará, COVID-19 deaths were increasing exponentially. On April 6, the public hospital network purchased 75,000 doses of azithromycin and 90,000 doses of hydroxychloroquine. Over the next few weeks, authorities began distributing these medications to infected individuals. Even though new cases continued to occur, on May 22 the death rate started to plummet and is now about one-eighth what it was at the peak.

    A reverse natural experiment happened in Switzerland. On May 27, the Swiss national government banned outpatient use of hydroxychloroquine for COVID-19. Around June 10, COVID-19 deaths increased four-fold and remained elevated. On June 11, the Swiss government revoked the ban, and on June 23 the death rate reverted to what it had been beforehand. People who die from COVID-19 live about three to five weeks from the start of symptoms, which makes the evidence of a causal relation in these experiments strong. Both episodes suggest that a combination of hydroxychloroquine and its companion medications reduces mortality and should be immediately adopted as the new standard of care in high-risk patients .>>

    What is being drowned out.

    And, again:

    >>Why has hydroxychloroquine been disregarded?

    First, as all know, the medication has become highly politicized. For many, it is viewed as a marker of political identity, on both sides of the political spectrum. Nobody needs me to remind them that this is not how medicine should proceed. We must judge this medication strictly on the science. When doctors graduate from medical school, they formally promise to make the health and life of the patient their first consideration, without biases of race, religion, nationality, social standing—or political affiliation. Lives must come first.

    Second, the drug has not been used properly in many studies. Hydroxychloroquine has shown major success when used early in high-risk people but, as one would expect for an antiviral, much less success when used late in the disease course. Even so, it has demonstrated significant benefit in large hospital studies in Michigan and New York City when started within the first 24 to 48 hours after admission.

    In fact, as inexpensive, oral and widely available medications, and a nutritional supplement, the combination of hydroxychloroquine, azithromycin or doxycycline, and zinc are well-suited for early treatment in the outpatient setting. The combination should be prescribed in high-risk patients immediately upon clinical suspicion of COVID-19 disease, without waiting for results of testing. Delays in waiting before starting the medications can reduce their efficacy.

    Third, concerns have been raised by the FDA and others about risks of cardiac arrhythmia, especially when hydroxychloroquine is given in combination with azithromycin. The FDA based its comments on data in its FDA Adverse Event Reporting System. This reporting system captured up to a thousand cases of arrhythmias attributed to hydroxychloroquine use. In fact, the number is likely higher than that, since the reporting system, which requires physicians or patients to initiate contact with the FDA, appreciably undercounts drug side effects.

    But what the FDA did not announce is that these adverse events were generated from tens of millions of patient uses of hydroxychloroquine for long periods of time, often for the chronic treatment of lupus or rheumatoid arthritis. Even if the true rates of arrhythmia are ten-fold higher than those reported, the harms would be minuscule compared to the mortality occurring right now in inadequately treated high-risk COVID-19 patients. This fact is proven by an Oxford University study of more than 320,000 older patients taking both hydroxychloroquine and azithromycin, who had arrhythmia excess death rates of less than 9/100,000 users, as I discuss in my May 27 paper cited above. A new paper in the American Journal of Medicine by established cardiologists around the world fully agrees with this.

    In the future, I believe this misbegotten episode regarding hydroxychloroquine will be studied by sociologists of medicine as a classic example of how extra-scientific factors overrode clear-cut medical evidence. But for now, reality demands a clear, scientific eye on the evidence and where it points . . . >>

    I think there are a few questions to be asked and answered.

    The May 27, 2020 paper:

    >> Am J Epidemiol

    . 2020 May 27;kwaa093.
    doi: 10.1093/aje/kwaa093. Online ahead of print.
    Early Outpatient Treatment of Symptomatic, High-Risk Covid-19 Patients that Should be Ramped-Up Immediately as Key to the Pandemic Crisis
    Harvey A Risch 1
    Affiliations

    PMID: 32458969 DOI: 10.1093/aje/kwaa093

    Abstract

    More than 1.6 million Americans have been infected with SARS-CoV-2 and GT 10 times that number carry antibodies to it. High-risk patients presenting with progressing symptomatic disease have only hospitalization treatment with its high mortality. An outpatient treatment that prevents hospitalization is desperately needed. Two candidate medications have been widely discussed: remdesivir, and hydroxychloroquine+azithromycin. Remdesivir has shown mild effectiveness in hospitalized inpatients, but no trials have been registered in outpatients. Hydroxychloroquine+azithromycin has been widely misrepresented in both clinical reports and public media, and outpatient trials results are not expected until September. Early outpatient illness is very different than later hospitalized florid disease and the treatments differ. Evidence about use of hydroxychloroquine alone, or of hydroxychloroquine+azithromycin in inpatients, is irrelevant concerning efficacy of the pair in early high-risk outpatient disease. Five studies, including two controlled clinical trials, have demonstrated significant major outpatient treatment efficacy. Hydroxychloroquine+azithromycin has been used as standard-of-care in more than 300,000 older adults with multicomorbidities, with estimated proportion diagnosed with cardiac arrhythmias attributable to the medications 47/100,000 users, of which estimated mortality is LT 20%, 9/100,000 users, compared to the 10,000 Americans now dying each week. These medications need to be widely available and promoted immediately for physicians to prescribe. >>

    It is time to face responsibility for needless politicisation and polarisation of discussion over a manifestly effective treatment and needless deaths by at least tens of thousands. There will be a day of reckoning over such culpable irresponsibility.

    KF

  284. 284
    kairosfocus says:

    Further to this, we need to ponder the Tuskegee syphilis atrocity:

    **************

    The U.S. Public Health Service Syphilis Study at Tuskegee was a clinical study conducted between 1932 and 1972 by the United States Public Health Service.[1][2] [–> 40 years of sustained wrong, which had to be enforced through a warped understanding of ethics and epistemology, with overtones of racism similar to medical experiments on concentration camp inmates] The purpose of this study was to observe the natural history of untreated syphilis [–> decades after effective treatments were routinised by the late 1940’s] ; the African-American men in the study were only told they were receiving free health care from the Federal government of the United States.[3]

    [–> evil under false colour, robes and ceremonies of medicine and science; with calculated misleading as pivot, extracting manipulated consent that caused improper exposure to diseases treated ineffectively when ADEQUATE evidence . . . adequacy is not perfection . . . existed that better alternatives were available.]

    The United States Public Health Service started the study in 1932 in collaboration with Tuskegee University (then the Tuskegee Institute), a historically black college in Alabama. [–> misuse of credibility] Investigators enrolled in the study a total of 600 impoverished, African-American sharecroppers from Macon County, Alabama.[3] Of these men, 399 had latent syphilis, with a control group of 201 men who were not infected.[2] [–> oh, yes, the gold standard was applied within the study and the study as a whole was itself a control on efficacy of other treatments: natural, untreated course] As an incentive for participation in the study, the men were promised free medical care, but were deceived by the PHS

    [–> deception, a key to seeing the ethics failure and don’t tell us oh deliberately mislabelled sugar pills etc are not deception under colour, robes and ceremonies of medicine and science]

    , who disguised placebos, ineffective methods, and diagnostic procedures as treatment.[4]

    [–> REPEAT: “who disguised placebos, ineffective methods, and diagnostic procedures as treatment”]

    The men who had syphilis were never informed of their diagnosis, despite the risk of infecting others, and the fact that the disease could lead to blindness, deafness, mental illness, heart disease, bone deterioration, collapse of the central nervous system, and death.[5][6][7][8]

    [–> are people being told that as you are high risk and CV19 is fast moving with damage already in lungs per Raoult’s 2000+ CT scans on 500+ patients, when symptoms emerge? That death is a significant, rapid potential outcome on placebos? that HCQ+ cocktails have several lines of evidence pointing to likely rapidly acting efficacy?]

    According to the Centers for Disease Control and Prevention, the men were told that they were being treated for “bad blood,” a colloquialism that described various conditions such as syphilis, anemia and fatigue. “Bad blood”—specifically the collection of illnesses the term included—was a leading cause of death within the southern African-American community.[2] The men were initially told that the study was only going to last six months, but it was extended to 40 years.[2] After funding for treatment was lost, the study was continued without informing the men that they would never be treated. None of the infected men were treated with penicillin despite the fact that by 1947, the antibiotic had become the standard treatment for syphilis.[9]

    [–> so, what about the cumulative body of evidence since 2005 on likely efficacy of HCQ+ cocktails? Or, is that to be branded with a scarlet letter, dismissed as not meeting the gold standard that rests on deceptive practice . . . MISLABELLED, ineffective pseudo treatments in the face of life/death are deceptive . . . then marginalised and censored?]

    Study clinicians could have chosen to treat all syphilitic subjects and close the study, or split off a control group for testing with penicillin. Instead, they continued the study without treating any participants; they withheld treatment and information about it from the subjects.

    [–> So, how much more is it to be challenged when in the face of cumulative evidence of efficacy, treatments are sidelined and it is demanded that people subject themselves to life/death situations to “prove” what is already readily shown, save where studies are fail-by-design: too late in the U/L trajectory, wrong demographic, dubious statistics like Lancet, etc?]

    In addition, scientists prevented participants from accessing syphilis treatment programs available to other residents in the area.[10] The study continued, under numerous Public Health Service supervisors, until 1972, when a leak to the press resulted in its termination on November 16 of that year.[11] The victims of the study, all African-American, included numerous men who died of syphilis, 40 wives who contracted the disease and 19 children born with congenital syphilis.[12]

    The 40-year Tuskegee Study of Untreated Syphilis in the African American Male study was a major violation of ethical standards. [–> ethical failure] Researchers knowingly failed to treat participants appropriately [–> oh, how familiar] after penicillin was proven [–> empirical investigations cannot prove but can warrant a prudent conclusion] to be an effective treatment for syphilis and became widely available.[9] [–> how widely accessible are elements of HCQ cocktails? I submit, quite widely] Moreover, participants remained ignorant of the study clinicians’ true purpose, which was to observe the natural course of untreated syphilis.[3] [–> deception, deception, deception is deception] The revelation in 1972 of study failures by a whistleblower, Peter Buxtun, [–> So, how are whistleblowers currently being treated? see how it pinches when the shoe is on the other foot?] led to major changes in U.S. law and regulation concerning the protection of participants in clinical studies. Now studies require informed consent [–> what, really, is properly informed consent given what we are seeing now?],[13] communication of diagnosis and accurate reporting of test results.[14] [–> what about the right to access the best evidence and accessible treatments in the face of emerging pandemic?]

    The U.S. Public Health Service Syphilis Study at Tuskegee, cited as “arguably the most infamous biomedical research study in U.S. history,”

    KF

  285. 285
    Bob O'H says:

    There is a medically recommended OTC prophylaxis. It’s kind of stupid that it isn’t made widely known.

    actually, I think social distancing and the use of masks are quite well known.

  286. 286
    Bob O'H says:

    kf @ 283 – it might help if you actually responded to specific points, rather than just copy and paste again. rhampton7 has just posted a response to Risch, which you’ve ignored.

  287. 287
    kairosfocus says:

    BO’H: You have that wrong way around. For many weeks, Jerry has done so time and again and I have sometimes supported him. The pattern is, studies that fail to deal with vulnerability factors properly, fail to deal with the composite nature of the treatment, i.e. fail to recognise synergy, fail to recognise that an antiviral should address the early, viral multiplication stage, and fail to address implications of known ability to get into the body and so work multiplied by lab evidence of antiviral efficacy in plausible concentrations in tissue from 2005 to Raoult’s recent study. Fail, too, to reasonably address manageability of health risks. Again and again, the counter studies are fatally flawed, often signalled by reference to hospitalised patients. As a result, I will keep pointing to the summary by a Yale epidemiology professor, which points to the actual balance on merits, and to the critical issue on the ethics-epistemology failure of elevating tests constructing an artificial control by treating patients facing a fast moving deadly disease with deliberately mislabelled sugar pills or the like. Not to mention, fail to deal responsibly with manageability of risks. The implications of the Tuskegee syphilis atrocity are highly relevant. Once we remove this fallacy, we are able to see that empirical evidence is evidence and that we have good enough evidence to see efficacy if we are willing to acknowledge evidence. That is the real problem, irresponsible selective hyperskepticism, an issue very familiar from the baseline issues addressed in this blog. In the end, history will for cause judge us harshly on how we have mismanaged this issue through fallacious reasoning and undue politicisation because the “wrong” person suggested what then became unacceptable, multiplied by influence of interests of various kinds. RH7’s response was corrected somewhere above also. Rish has properly summarised. A big clue on the error in the critique most recently put up is its reference to the alleged gold standard, which is ethically and epistemologically fallacious as already noted. In short, the pivotal questions were begged to marginalise and dismiss a person who is — contrary to impressions given — “professor of epidemiology at Yale School of Public Health,” which implies enough familiarity with the issues . . . many epidemics are of infectious diseases . . . to speak with significant credibility. Besides, the evidence and logic are pretty clear in their own right. KF

  288. 288
    kairosfocus says:

    F/N: A reminder on a plausible mechanism for Z-Pac contribution to efficacy against CV19 . . . the issue is synergies:

    https://finance.townhall.com/columnists/davidgornoski/2020/04/07/how-zpak-could-slay-covid19-n2566476

    >>How Z-Pak Could Slay COVID-19

    David Gornoski
    |
    Posted: Apr 07, 2020 9:18 AM
    How Z-Pak Could Slay COVID-19

    Z-Pak, also known as azithromycin or Zithromax, could be a critical tool in preventing and treating COVID-19 coronavirus, according to Professor Michael P. Lisanti, MD-PhD and Chair of Translational Medicine at Salford University in the UK. I recently spoke with Professor Lisanti to unpack his hypothesis and call for immediate clinical trials of Z-pak and other extremely inexpensive, generic antibiotics for COVID-19 patients.

    . . . . Professor Lisanti has specialized in identifying FDA-approved generic antibiotics like Z-pak and doxycycline that are extremely effective in killing senescent cells at the heart of aging-related diseases.

    As the world is painfully aware, COVID-19 coronavirus is particularly dangerous for the elderly or those with aging-related senescent illnesses like diabetes, cancer, heart disease, and lung disease. As Professor Lisanti said in a statement on his new paper in the journal Aging, “If you look at the host receptors of COVID-19, they are related to senescence. Two proteins have been proposed to be the cellular receptors of COVID-19: one is CD26 – a marker of senescence, and the other, ACE-2, is also associated with senescence. So, older people would be predicted to be more susceptible to COVID-19, exactly as is observed clinically in patients. This could increase their probability of infection, and would explain the increased fatality of COVID-19 infection in older patients. All of this could be related to advanced chronological age and senescent cells.”

    Lisanti’s laboratory has previously demonstrated that Z-pak selectively removes 97% of senescent cells. Without those cells acting as host receptors, it may be harder for COVID-19 to take root in the body and cause serious damage.>>

    Relevant supportive evidence on the Zelenko protocol. Azithromycin is not just there to hit secondary infection. IIRC, this was raised earlier but has long since been buried under the avalanche of distractive, dismissive commentary.

    I assume no one responsibly doubts antiviral effects of Zn, and it is plausible that HCQ serves as ionophore that in effect props open cellular ports so Zn can come in in higher cellular concs. as well as helping to suppress undue immune system response (recall, antihistamines . . .).

    Then, there is the pH shift effect, which makes ACE-2 receptors shapeshift making it harder for the virus to grab a hold.

    So, on CUMULATIVE evidence, we have good causal suggestions that make the statistics make sense.

    This is not blind statistical correlation.

    KF

  289. 289
    jerry says:

    rather than just copy and paste again. rhampton7 has just posted a response to Risch, which you’ve ignored.

    Sort of ironic. All RHampton essentially does is copy and paste. I haven’t seen anything that shows he understands anything he posts. And he copy and pasted irrelevant comments by other Yale faculty that pointed to bogus studies. You then referenced this post of irrelevant comments.

  290. 290
    kairosfocus says:

    PS: If you reject the credible efficacy of such a cocktail, why, why on CAUSAL action grounds. Why should we dismiss Zn [ . . . have you watched MedCram?], or HCQ as ionophore and dampener of the immune system, or Azithro as hitting senescence tied cells likely to be found in lungs and heart tissue, or pH effects? Why are the lab results to be dismissed, that on plausible concentrations, HCQ has relevant antiviral effects? Why should we disregard 65 years of known ability of HCQ to act as a drug when taken orally, and to be manageable in regards to health risks (which seem to be rare and typically tied to long term use)? Why should we disregard so commonplace a result as that HCQ and family appear to have such broad spectrum activity against microbial forms that it was packaged and sold as fish tank cleaner? Why then should we be dismissive towards the clinical result patterns, including rapid relief of symptoms and tracked rapid decline in viral load per swab based tests? (Similar to how we test for the disease.)

  291. 291
    jerry says:

    Hope: The Swiss doctors are at it again

    https://swprs.org/on-the-treatment-of-covid-19/

    Treatment protocol

    Zinc (50mg to 100mg per day)º
    Hydroxychloroquine (400mg per day)*
    Quercetin (500mg to 1000mg per day)º
    Bromhexine (50mg to 100mg per day)º
    Azithromycin (up to 500mg per day)*
    Heparin (usual dosage)*

    Quercetin may be used in addition to or as a replacement of hydroxychloroquine (HCQ). Contraindications for HCQ (e.g. favism or heart disease) and azithromycin must be observed. Treatment duration is five to seven days. Prophylactic treatment requires lower doses.

  292. 292
    kairosfocus says:

    PPS: Zn as antiviral:
    https://pubmed.ncbi.nlm.nih.gov/31305906/

    >> Review
    Adv Nutr

    . 2019 Jul 1;10(4):696-710.
    doi: 10.1093/advances/nmz013.
    The Role of Zinc in Antiviral Immunity
    Scott A Read 1 2 , Stephanie Obeid 3 , Chantelle Ahlenstiel 3 , Golo Ahlenstiel 1 2
    Affiliations

    PMID: 31305906 PMCID: PMC6628855 DOI: 10.1093/advances/nmz013

    Free PMC article
    Abstract

    Zinc is an essential trace element that is crucial for growth, development, and the maintenance of immune function. Its influence reaches all organs and cell types, representing an integral component of approximately 10% of the human proteome, and encompassing hundreds of key enzymes and transcription factors. Zinc deficiency is strikingly common, affecting up to a quarter of the population in developing countries, but also affecting distinct populations in the developed world as a result of lifestyle, age, and disease-mediated factors. Consequently, zinc status is a critical factor that can influence antiviral immunity, particularly as zinc-deficient populations are often most at risk of acquiring viral infections such as HIV or hepatitis C virus. This review summarizes current basic science and clinical evidence examining zinc as a direct antiviral, as well as a stimulant of antiviral immunity. An abundance of evidence has accumulated over the past 50 y to demonstrate the antiviral activity of zinc against a variety of viruses, and via numerous mechanisms. The therapeutic use of zinc for viral infections such as herpes simplex virus and the common cold [–> mostly, corona viruses] has stemmed from these findings; however, there remains much to be learned regarding the antiviral mechanisms and clinical benefit of zinc supplementation as a preventative and therapeutic treatment for viral infections.>>

    Why — causally — should we dismiss the possibility or plausibility of synergy between Zn and HCQ?

  293. 293
    kairosfocus says:

    Jerry, expanding:

    The Swiss Doctors:

    >>On the treatment of Covid-19

    Published: July 2, 2020; Updated: August 5, 2020
    Languages: DE, EN; Share on: Twitter / Facebook

    Immunological and serological studies show that most people develop no symptoms or only mild symptoms when infected with the new coronavirus, while some people may experience a more pronounced or critical course of the disease.

    Based on the available scientific evidence and current clinical experience, the SPR Collaboration recommends that physicians and authorities consider the following Covid-19 treatment protocol for the early treatment of people at high risk or high exposure (see references below).

    Note: Patients are asked to consult a doctor.
    Treatment protocol

    Zinc (50mg to 100mg per day)º
    Hydroxychloroquine (400mg per day)*
    Quercetin (500mg to 1000mg per day)º
    Bromhexine (50mg to 100mg per day)º
    Azithromycin (up to 500mg per day)*
    Heparin (usual dosage)*

    *) Prescription only (in most countries)
    º) Also prophylactically (for high-risk persons)

    Note: Quercetin may be used in addition to or as a replacement of hydroxychloroquine (HCQ). Contraindications for HCQ (e.g. favism or heart disease) and azithromycin must be observed. Treatment duration is five to seven days. Prophylactic treatment requires lower doses.>>

    That’s a protocol.

    KF

  294. 294
    kairosfocus says:

    Further:

    >>Treatment successes

    Zinc/HCQ/AZ: US physicians reported an 84% decrease in hospitalization rates, a 50% decrease in mortality rates among already hospitalized patients (if treated early), and an improvement in the condition of patients within 8 to 12 hours. Italian doctors reported a decrease in deaths of 66%.

    Bromhexine: Iranian doctors reported in a study with 78 patients a decrease in intensive care treatments of 82%, a decrease in intubations of 89%, and a decrease in deaths of 100%. Chinese doctors reported a 50% reduction in intubations.
    Mechanisms of action

    Zinc inhibits RNA polymerase activity of coronaviruses and thus blocks virus replication. Hydroxychloroquine and quercetin support the cellular absorption of zinc and have additional anti-viral properties. Bromhexine inhibits the expression of the cellular TMPRSS2 protease and thus the entry of the virus into the cell. Azithromycin prevents bacterial superinfections. Heparin prevents infection-related thromboses and embolisms in patients at risk. (See scientific references below).

    See also: Illustration of the mechanisms of action of HCQ, quercetin and bromhexine
    Additional notes

    The early treatment of patients as soon as the first typical symptoms appear and even without a PCR test is essential to prevent progression of the disease. Zinc, HCQ, quercetin and bromhexin may also be used prophylactically for people at high risk or high exposure (e.g. for health care workers).

    In contrast, isolating infected high-risk patients at home and without early treatment until they develop serious respiratory problems, as often happened during lockdowns, may be detrimental.

    The alleged or actual negative results with hydroxychloroquine in some studies were based on delayed use (intensive care patients), excessive doses (up to 2400mg per day), manipulated data sets (the Surgisphere scandal), or ignored contraindications (e.g., favism or heart disease).

    Early treatment based on the above protocol is intended to avoid hospitalization. If hospitalization nevertheless becomes necessary, experienced ICU doctors recommend avoiding invasive ventilation (intubation) whenever possible and using oxygen therapy (HFNC) instead.

    It is conceivable that the above treatment protocol, which is simple, safe and inexpensive, could render more complex medications, vaccinations, and other measures largely obsolete.>>

    Now, if you object, kindly give valid causal reasons why not.

    KF

  295. 295
    Bob O'H says:

    kf @ 288 – OK, so rather than actually respond to specific criticisms, you’re just going to stick your fingers in your ears and copy and paste .

    kf @ 288 – HCQ + AZ has been tested in trials and doesn’t show an effect. So your plausible mechanism doesn’t work well enough I’m afraid.

    Jerry @ 289 – that’s a fair point about rhampton copying and pasting. But on the response to Risch, I think it is relevant, partly because it does give a substantive response, and also because it means you can’t just use his authority as a Yale epidemiologist – the signitories of that response include several Yale epidemiologists.

    kf @ 290 –

    Why are the lab results to be dismissed, that on plausible concentrations, HCQ has relevant antiviral effects?

    Because you learn in Drug Discovery 101 that most positive lab results don’t lead to an effective drug, for all sorts of reasons (e.g. the drug can’t be delivered at a high enough concentration, or there are side effects etc.).

    Jerry @ 291 – does it bother you that most of the studies the Swiss use to justify their protocol are of the sort you’ve dismissed as irrelevant?
    kf @ 294 –

    It is conceivable that the above treatment protocol, which is simple, safe and inexpensive, could render more complex medications, vaccinations, and other measures largely obsolete.>>

    Now, if you object, kindly give valid causal reasons why not.

    Yes, it is conceivable. But that doesn’t mean it’s true. So doctors would need evidence that it works, and for some components the evidence says that it doesn’t (e.g. these studies, but there are more).

  296. 296
    kairosfocus says:

    BO’H: really! You are in denial, that is clear. KF

  297. 297
    ET says:

    LoL! @ Bob- OK Bob, did someone demonstrate that cob=vid-19 continues to replicate in the presence of zinc? If you cannot answer that question then perhaps you should just shut up. Neither you nor rhampton has provided any relevant scientific data. And that is very telling.

  298. 298
    rhampton7 says:

    August 5, 2020 at 3:29 pm
    RE Dr Risch

    Statement From Yale Faculty on Hydroxychloroquine and Its Use in COVID-19

    We write with grave concern that too many are being distracted by the ardent advocacy of our Yale colleague, Dr. Harvey Risch, to promote the assertion that hydroxychloroquine (HCQ) when given with antibiotics is effective in treating COVID-19, in particular as an early therapeutic intervention for the disease. As his colleagues, we defend the right of Dr. Risch, a respected cancer epidemiologist, to voice his opinions. But he is not an expert in infectious disease epidemiology and he has not been swayed by the body of scientific evidence from rigorously conducted clinical trials, which refute the plausibility of his belief and arguments…

    (New material)
    The disproportionate focus on treatment with HCQ, in addition to the lack of a strong scientific rationale for its use and the risk of its potentially harmful effects, has major opportunity costs. In a recent analysis of COVID-19 clinical trials, one in every six studies of treatments against SARSCoV-2 was designed to study HCQ or chloroquine. We understand the desperation of many to see an effective treatment for COVID-19 emerge that will stop the pandemic in its tracks or slow its relentless spread in the US. But investing our resources in HCQ after multiple studies have not shown it to be effective for COVID-19 has serious implications for more than just individual patients. The continuing advocacy on behalf of HCQ distracts us from advancing the science on COVID-19 and seeking more effective interventions in a time when more than 1000 people are dying per day of this disease. There are multiple approaches to expedite the evaluation and approval of drugs for serious and life-threatening diseases in the US that have existed for decades now, but they all still rely on data from rigorous, well-conducted clinical trials to guide us. In addition, this ongoing promotion of HCQ has global implications as well, as many countries in the global South only have access to HCQ and use of HCQ is still common in this setting despite the lack of evidence and potential risks.

    It is critical that we follow the science and where the evidence leads us on a quest to treat and prevent COVID-19. In this climate, it’s important to rely on the data above all else when making clinical or regulatory decisions. Making these kinds of choices guided by personal endorsements outside of the context of the existing scientific evidence is medicine by testimonial and risks people’s lives. Randomized controlled trials are how we keep from fooling ourselves, test our assumptions about new drugs and new uses for old ones. For instance, flecainide was initially proposed as a drug to treat those at risk of severe arrhythmias after sudden myocardial infarction. However, the Cardiac Arrhythmia Suppression Trial showed for the first time that mortality was actually three times higher among persons receiving the drug for this purpose. Even though the drug was known to be effective in those experiencing severe arrhythmia, it ended up increasing mortality in those simply at risk. And no one noticed because sudden death after myocardial infarction was not a rare event and this tripling of the risk was not detected until a randomized, controlled trial was done. The FDA has rescinded the EUA for HCQ for a reason: the vast preponderance of the evidence suggests that the drug is without merit in clinical care for COVID-19 and presents real dangers to patients by its continued use.

    https://www.counterpunch.org/2020/08/04/statement-from-yale-faculty-on-hydroxychloroquine-and-its-use-in-covid-19/

  299. 299
    rhampton7 says:

    Dr F. Perry Wilson, from the Yale School of Medicine:

    Whenever I discuss hydroxychloroquine (HCQ), people come out of the woodwork to tell me what a bad doctor I am. Even when I made a video simply demonstrating how searching pubmed.gov works, I got some pretty rough replies.

    Now, before we get started:
    I am not paid by any pharmaceutical company, nor do I hold a patent on any drug or device. My grant funding comes from the National Institutes of Health (NIH) and the Department of Defense (DOD). My NIH studies have nothing to do with drugs.

    Now, when you look for HCQ studies in COVID-19, you will find a ton — roughly 900 published at last count. The vast majority of these are observational studies.

    Why do people like me put so much more weight in randomized controlled trials (RCTs) than observational studies? It’s simple.

    In an observational study, the observed effect of the exposure of interest (HCQ) on the outcome of interest is due to both its true causal effect and the characteristics of who was selected for treatment.

    In a randomized trial, because the selection is random, the observed effect is due solely to the true effect of the treatment.

    That’s why we put so much stock in RCTs. Before RCTs are available, observational data are okay; we can use them to generate hypotheses. But observational studies should be used to design RCTs, and RCTs should be used to guide therapy.

  300. 300
    rhampton7 says:

    COntinued…

    But to illustrate, I’ll give one observational example, since I think 100 people have emailed it to me in the past week.

    This is one of Didier Raoult’s studies, appearing in Travel Medicine and Infectious Disease. They report on 3737 patients with COVID-19. These were mostly outpatients, and the study states that, barring contraindications, they were prescribed 200 mg of HCQ three times a day for 10 days, with 5 days of azithromycin. They then compared the 3119 people who took that regimen for at least 3 days with 618 who didn’t.

    In the observational setting like this, the key question is, why did they not take the medications? Looking at Table 1 in the paper, we can see that at baseline, these groups are quite different.

    Table 1 https://img.medscapestatic.com/article/935/058/935058-fig12.png?interpolation=lanczos-none&resize=306:*

    Those who took the standard therapy tended to be younger; 53% were under age 44 compared with 36.4% who got the other treatments. They had less cancer, less diabetes, less chronic heart disease, and lower NEWS scores, which is a measure of disease severity. In other words, this was a group poised to do well. The treatment wasn’t assigned randomly; it was given to the healthiest. That’s not unethical or anything, by the way. It’s totally reasonable to be careful about who you give drugs to. It just makes it harder to interpret the results.

    And the results were better in the group who got the HCQ regimen: 0.5% death rate compared with 3.1% death rate.

    Table 2 https://img.medscapestatic.com/article/935/058/935058-fig13.png?interpolation=lanczos-none&resize=306:*
    From Lagier JC, et al. Travel Med Infect Dis. 2020;36:101791. doi:10.1016/j.tmaid.2020.101791

    Now, you can adjust for baseline differences. Here, they adjusted for that severity score and comorbidity score — not age or anything else — and still found significance. But let me highlight two issues with adjustment.

    First, adjustment isn’t magical. You have to adjust for all the factors that are different at baseline to get an unbiased estimate of treatment effect.

    Second, you don’t know all those factors. You can only adjust for what you measure. Unmeasured differences in the groups will always be present, with one exception.

    You guessed it. If you randomize, you will balance not only measured differences but even unmeasured differences between the groups.

    That’s why clinical epidemiologists like me get so psyched about randomization.

    https://www.medscape.com/viewarticle/935058

  301. 301
    rhampton7 says:

    The ???????? South African Department of Health says it does not recommend the use of the controversial anti-malarial drug hydroxychloroquine as a Covid-19 treatment.

    Popo Maja, a spokesperson for the Department of Health, said South Africa has never recommended hydroxychloroquine as a Covid-19 treatment, but it had been used as a clinical trial under conditions where patients were carefully monitored for any adverse effects.

    “The National Department of Health regularly reviews evidence from clinical trials and adjusts guidelines accordingly,” it said.

    The department, however, did advocate for the use of dexamethasone, which it said had reduced mortality rates among patients who were severely infected with Covid-19.

    “Dexamethasone has been shown to reduce mortality amongst patients with severe Covid-19 disease, and all patients requiring oxygen should receive a 10-day course of dexamethasone.

    https://www.iol.co.za/news/south-africa/sa-hospitals-stance-on-the-controversial-hydroxychloroquine-drug-as-covid-19-treatment-64ec87fc-6821-4b31-b631-d427b37919ac

  302. 302
    jerry says:

    the signitories of that response include several Yale epidemiologists.

    If the Yale academics had a valid objection, don’t you think they would pointed to it. But they didn’t because no one on the planet has done so. Maybe a little too emphatic but I have yet to have seen anyone. And you and no one else here has done so.

    does it bother you that most of the studies the Swiss use to justify their protocol are of the sort you’ve dismissed as irrelevant?

    I am sure there may be some. There about a hundred studies. Why don’t you point out the ones that are irrelevant. We can then examine each.

  303. 303
    jerry says:

    A comparison of 2,7 billion people in places with wide spread HCQ use vs limited or no use. https://hcqtrial.com/

    Many countries either adopted or declined early treatment with HCQ, forming a large country-randomized controlled trial. 2.0 billion people were assigned to the treatment group, and 663 million to the control group. As of August 5, 2020, an average of 37.8/million in the treatment group have died, and 438.5/million in the control group, relative risk 0.086. After adjustments, treatment and control deaths become 78.2/million and 626.6/million, relative risk 0.12. Confounding factors affect this estimate, including varying degrees of spread between countries. Accounting for predicted changes in spread, we estimate a relative risk of 0.21. The treatment group has 79.1% lower chance of death. We examined diabetes, obesity, hypertension, life expectancy, population density, urbanization, testing level, and intervention level, which do not account for the effect observed.

    Is this true? Very long analysis but how valid. I can see the nit pickers ready and willing.

  304. 304
    ET says:

    Here’s the confusing part with respect to science:

    1- It has been demonstrated, scientifically, that HCQ is an ionophore
    2- It has been so demonstrated that ionophores allow more zinc into cells than the regular zinc transportation system does
    3- And it has been so demonstrated that the extra cellular zinc prevents viruses from replicating

    Which of those 3 has been demonstrated to be not true in any of the studies conducted?

  305. 305
    rhampton7 says:

    At least five randomized controlled studies say hydroxychloroquine doesn’t help

    If you want to know if a drug works, ideally the only difference between a patient who gets it and one who doesn’t is — no surprise — the drug itself. That’s harder to do than meets the eye. People aren’t identical. You can weigh them, look at their medical histories, check their blood oxygen levels and temperature, and yet, you still might miss something.

    That’s where randomly assigning patients to treatment and non-treatment groups comes in.

    “You don’t know all the possible things going on in the background and all that noise is what randomizing helps filter out,” said Boston University infectious disease modeler Brooke Nichols. “It’s the best way to be sure that the only effect is the effect of the drug.”

    Letting a computer program assign patients also prevents any subconscious choices by doctors from distorting the results. The whole approach is designed to take human foibles out of the picture.

    To really minimize the human factor, not only do you randomly assign patients to groups, but the patients and the health care workers themselves don’t know what group they are in. So everyone gets a pill, but for half of them, the pill might be just sugar or something equally neutral. That neutral pill is a placebo.

    “That’s the gold-gold standard of research,” said Nichols. “And just one one small notch below that is the randomized controlled trial without a placebo.”

    1. A Cluster-Randomized Trial of Hydroxychloroquine as Prevention of Covid-19 Transmission and Disease, MedRxIV, July 26, 2020. No placebo.

    2. Hydroxychloroquine with or without Azithromycin in Mild-to-Moderate Covid-19, New England Journal of Medicine, July 23, 2020. No placebo.

    3. Hydroxychloroquine in Nonhospitalized Adults With Early COVID-19, Annals of Internal Medicine, July 16, 2020. Placebo used.

    4. No clinical benefit from use of hydroxychloroquine in hospitalised patients with COVID-19, Recovery Trial – University of Oxford, June 5, 2020. No placebo.

    5. A Randomized Trial of Hydroxychloroquine as Postexposure Prophylaxis for Covid-19, New England Journal of Medicine, June 3, 2020. Placebo used.

    https://www.politifact.com/factchecks/2020/aug/05/brett-giroir/yes-least-five-randomized-controlled-studies-say-h/

  306. 306
    rhampton7 says:

    After two weeks battling COVID-19, State Rep. Randy Fine (R-Palm Bay) posted on Facebook that he needed his lungs X-rayed as his symptoms now included a recurring fever and a hacking chest cough. He remarked that the hydroxychloroquine therapy he had been on proved ineffective.

    (New Material)
    … Despite this, believers in the treatment have persisted.

    “He didn’t use the HCQ correctly,” a comment said on Randy Fine’s page. “You must take zinc with the hydroxychloraquine. (sic) The zinc is the magic bullet and the hydroxychloraquine (sic) carries it so it can prevent viral replication. Just curious, did you take the zinc too?”

    “Yup. Sorry to burst the magic bubble,” Fine shot back.

    In fact Fine said he took the drugs on the recommendation and prescription of his doctor, and contrary to assertions that the public is being denied access to the drug, Fine said he had no problem filling his prescription at CVS.

    https://www.floridatoday.com/story/news/2020/08/04/not-magic-says-rep-fine-hydroxychloroquine-therapy-covid-19/5573368002/

  307. 307
    ET says:

    And we are still waiting on the science and the data

  308. 308
    rhampton7 says:

    ET, you are? I thought you had made up your mind.

  309. 309
    Bob O'H says:

    Jerry @ 302 – there’s a comprehensive takedown of Risch here. Feel free to ignore it or find it irrelevant.

  310. 310
    Bob O'H says:

    ET @ 304 – what we’re interested in is whether there is an effective treatment for patients, i.e. human beings. What you describe is in vitro activity. You may well be totally right, but it’s only relevant if the same activity occurs in patients at doses that can be safely prescribed. That’s why we need clinical trials.

  311. 311
    kairosfocus says:

    RH7 & BO’H:

    You are both off track. Perhaps, it has escaped you that in the above, I gave causal dynamics, starting with implicit antiviral action of Azithromycin and the functionality of Zn.

    In that context I pointed out the known role of HCQ as a drug and its demonstrated in vitro confirmation of effect on relevant viruses. I even pointed out that its biochemical activity is extremely broad spectrum to the point of use as fishtank cleaner (since the ’70’s IIRC), which means that among its attack modes are effects that target core cellular life processes common to several kingdoms of life. Obviously, some of these cross over into antiviral activity, indicating interference with D/RNA and/or protein replication mechanisms. Which points directly to the ionophore activity and promotion of higher Zn concentration in the cell, which as just that inhibitory power. It probably has other core process modes of attack.

    The logic, then, is that we are dealing with a cocktail pivoting on a drug known to be effectve when taken orally and to have manageable risks (Pharmacology, being the study of poisons in small doses, i.e. all drugs have toxicity. It is possible to have toxicity with water!)

    It has known core cellular life attack modes, from efficacy as fishtank cleaner, implying some attacks are on absolutely core cross-kingdom metabolism and/or key replication processes. Some of which intersect with viral pathways for replication, hitting from the literature both D and R type viruses.

    So, it can cross the gut into the body and in plausible conc will have biochemical effects. That is why it has significant observed effects during the actual viral stages of SARS2, CV19 infections. Though it is an anti-inflammatory, attacking therefore some elements of the cytokine storm, there is such a thing as too much damage, too little reserve capability to recover. System breakdown implies that once we are late in the U/L trajectory, flatlining — death — is a significantly likely outcome.

    That is why studies that are too late, in stages where damage is in place, secondary infections and out of control immune responses are liable to be in action, will produce marginal or negative results. Similarly, in population segments that are less vulnerable, effects will be marginal, there was no difference to be made. Misdirected studies will give misleading results. Which has clearly happened.

    The clinical results from research targetting early, viral stages before hospital admission and off label use targetting vulnerable populations early in the trajectory are thus likely to work. Which is precisely what we see, once guavas are not compared with coconuts or mushrooms. Here, we should also note asymptomatic damage so once symptoms manifest the 2500 CT scans on 500+ patients ordered by Dr Raoult make that clear. Which BTW underscores his position as a leading researcher.

    In that context, the responsible position is clear, it is plausible, on sufficient track record, that the Raoult-Zelenko-Swiss protocol will be effective if given early in the U/L trajectory of CV19, and likely other similar viral diseases. Side effects are manageable. No other treatment is comparably cost effective, especially the business as usual de facto standard flu like complaint response. Given ethics-epistemology issues and time lags to get through major studies, questions on effectiveness and timeliness of novel vaccines etc, It is therefore reasonable to use the protocol in the face of a fast spreading deadly pandemic.

    That is what several voices have argued only to be shunted aside, marginalised and even personally attacked, including with threat of loss of licence.

    History, for cause, is going to find us sorely wanting.

    KF

  312. 312
    kairosfocus says:

    BO’H, it is obvious that you did not seriously note that say Dr Raoult’s lab results targetted plausible in tissue concentrations when he demonstrated in lab effects. This was a key part of his results. Where, again, he is a major, distinguished researcher heading a relevant institute based in a 4-hospital cluster with what 3500 or so beds. I get the strong impression that he is being rhetorically belittled, marginalised, disregarded through deconstructionism. As I have noted, HCQ is known to be effective as a drug when taken orally and to have manageable side/toxic effects. Indeed the fish tank test is one of the key insights: the fish thrive, the crud dies, i.e. complex vertebrate life forms have manageable toxicity, the simpler crud life forms do not, for relevant zones of concentration. Other components of the cocktail are similarly dosed in reasonable ranges; you already know Zn is not in dispute as an antiviral and HCQ plausibly acts as a promoter by weakening mechanisms that normally suppress Zn conc in the cell. In the face of disease, some inhibition of cellular function is tolerable for a few days, to block a viral disease process. You also need to address the ethics-epistemology issues drawn out through the Tuskegee syphilis atrocity and highlighted above, the gold standard notion is fallacious ethically and epistemologically. Evidence is evidence and enough of it, esp. when convergent, is decisive. Placebos are sometimes unethical for cause as people are not lab rats, and are likely to take far too long in the face of exponentially growing epidemics. KF

  313. 313
    BobRyan says:

    India had one of the most stringent lock downs in the world. They had 2 single day spikes in June, but mostly shows an upward trend of daily deaths continuing today.
    https://www.worldometers.info/coronavirus/country/india/

    Sweden did not lock and their daily death rate continues to be close to nothing. The projections were for millions to be dead by June and the projections were wrong.
    https://www.worldometers.info/coronavirus/country/sweden/

    South Korea did not lock down and they had their spike in early March. They are another country projected to have millions dead, but have a daily death rate close to nothing.
    https://www.worldometers.info/coronavirus/country/south-korea/

    There are 2 other countries who did not lock down, Turkmenistan and Tajikistan, both of which are about as reliable as China for information.

    A United States navel ship had an outbreak and 1 sailor died. Cruise ships with outbreaks were not floating morgues, even though the passengers were mostly older and overweight.

  314. 314
    kairosfocus says:

    PS: A reminder on the significance of the Tuskegee atrocity, once a fortiori logic is applied, by way of marking up what W/pedia was forced to acknowledge:

    ********

    The U.S. Public Health Service Syphilis Study at Tuskegee was a clinical study conducted between 1932 and 1972 by the United States Public Health Service.[1][2] [–> 40 years of sustained wrong, which had to be enforced through a warped understanding of ethics and epistemology, with overtones of racism similar to medical experiments on concentration camp inmates] The purpose of this study was to observe the natural history of untreated syphilis [–> decades after effective treatments were routinised by the late 1940’s] ; the African-American men in the study were only told they were receiving free health care from the Federal government of the United States.[3]

    [–> evil under false colour, robes and ceremonies of medicine and science; with calculated misleading as pivot, extracting manipulated consent that caused improper exposure to diseases treated ineffectively when ADEQUATE evidence . . . adequacy is not perfection . . . existed that better alternatives were available.]

    The United States Public Health Service started the study in 1932 in collaboration with Tuskegee University (then the Tuskegee Institute), a historically black college in Alabama. [–> misuse of credibility] Investigators enrolled in the study a total of 600 impoverished, African-American sharecroppers from Macon County, Alabama.[3] Of these men, 399 had latent syphilis, with a control group of 201 men who were not infected.[2] [–> oh, yes, the gold standard was applied within the study and the study as a whole was itself a control on efficacy of other treatments: natural, untreated course] As an incentive for participation in the study, the men were promised free medical care, but were deceived by the PHS

    [–> deception, a key to seeing the ethics failure and don’t tell us oh deliberately mislabelled sugar pills etc are not deception under colour, robes and ceremonies of medicine and science]

    , who disguised placebos, ineffective methods, and diagnostic procedures as treatment.[4]

    [–> REPEAT: “who disguised placebos, ineffective methods, and diagnostic procedures as treatment”]

    The men who had syphilis were never informed of their diagnosis, despite the risk of infecting others, and the fact that the disease could lead to blindness, deafness, mental illness, heart disease, bone deterioration, collapse of the central nervous system, and death.[5][6][7][8]

    [–> are people being told that as you are high risk and CV19 is fast moving with damage already in lungs per Raoult’s 2000+ CT scans on 500+ patients, when symptoms emerge? That death is a significant, rapid potential outcome on placebos? that HCQ+ cocktails have several lines of evidence pointing to likely rapidly acting efficacy?]

    According to the Centers for Disease Control and Prevention, the men were told that they were being treated for “bad blood,” a colloquialism that described various conditions such as syphilis, anemia and fatigue. “Bad blood”—specifically the collection of illnesses the term included—was a leading cause of death within the southern African-American community.[2] The men were initially told that the study was only going to last six months, but it was extended to 40 years.[2] After funding for treatment was lost, the study was continued without informing the men that they would never be treated. None of the infected men were treated with penicillin despite the fact that by 1947, the antibiotic had become the standard treatment for syphilis.[9]

    [–> so, what about the cumulative body of evidence since 2005 on likely efficacy of HCQ+ cocktails? Or, is that to be branded with a scarlet letter, dismissed as not meeting the gold standard that rests on deceptive practice . . . MISLABELLED, ineffective pseudo treatments in the face of life/death are deceptive . . . then marginalised and censored?]

    Study clinicians could have chosen to treat all syphilitic subjects and close the study, or split off a control group for testing with penicillin. Instead, they continued the study without treating any participants; they withheld treatment and information about it from the subjects.

    [–> So, how much more is it to be challenged when in the face of cumulative evidence of efficacy, treatments are sidelined and it is demanded that people subject themselves to life/death situations to “prove” what is already readily shown, save where studies are fail-by-design: too late in the U/L trajectory, wrong demographic, dubious statistics like Lancet, etc?]

    In addition, scientists prevented participants from accessing syphilis treatment programs available to other residents in the area.[10] The study continued, under numerous Public Health Service supervisors, until 1972, when a leak to the press resulted in its termination on November 16 of that year.[11] The victims of the study, all African-American, included numerous men who died of syphilis, 40 wives who contracted the disease and 19 children born with congenital syphilis.[12]

    The 40-year Tuskegee Study of Untreated Syphilis in the African American Male study was a major violation of ethical standards. [–> ethical failure] Researchers knowingly failed to treat participants appropriately [–> oh, how familiar] after penicillin was proven [–> empirical investigations cannot prove but can warrant a prudent conclusion] to be an effective treatment for syphilis and became widely available.[9] [–> how widely accessible are elements of HCQ cocktails? I submit, quite widely] Moreover, participants remained ignorant of the study clinicians’ true purpose, which was to observe the natural course of untreated syphilis.[3] [–> deception, deception, deception is deception] The revelation in 1972 of study failures by a whistleblower, Peter Buxtun, [–> So, how are whistleblowers currently being treated? see how it pinches when the shoe is on the other foot?] led to major changes in U.S. law and regulation concerning the protection of participants in clinical studies. Now studies require informed consent [–> what, really, is properly informed consent given what we are seeing now?],[13] communication of diagnosis and accurate reporting of test results.[14] [–> what about the right to access the best evidence and accessible treatments in the face of emerging pandemic?]

    The U.S. Public Health Service Syphilis Study at Tuskegee, cited as “arguably the most infamous biomedical research study in U.S. history,”

  315. 315
    jerry says:

    there’s a comprehensive takedown of Risch here. Feel free to ignore it or find it irrelevant.

    Why don’t you take the two or most three most relevant things from this guys rant and present it. It would be interesting to see what is actually the best argument against HCQ used appropriately.

    So far I haven’t seen anything from you or anyone else. But maybe you could focus in on a few given this source.

  316. 316
    kairosfocus says:

    Jerry, guess why I have focused on the cumulative evidence on plausible causal processes and linked context of actual clinical results across thousands of cases? Including, the surprisingly relevant point that use as fish tank cleaner points to significant cross-kingdom bio activity thus attacks on core cellular processes, and to — for a reasonable dosage range — significant differential effects on simple vs complex life forms. KF

  317. 317
    jerry says:

    Here is a list of 67 studies done on HCQ. I am not pointing to any specific study at the moment but am willing to look at each individually for discussion purposes. https://c19study.com/

    So anyone who wants to dispute the relevance or non-relevance of any particular study feel free to do so. It may prove educational.

    The main reason I am commenting here at this time is to learn about the virus, clarify my understanding and to improve this understanding by articulating It through comments So far I have learned a lot from the comments made by others both supporting and challenging this understanding and links provided. I assume others have too.

    Just found this report on a study in Italy on over 3000 C19 patients. https://translate.google.com/translate?depth=1&pto=aue&rurl=translate.google.com&sl=auto&sp=nmt4&tl=en&u=http://www.francesoir.fr/opinions-entretiens/interview-exclusive-une-etude-italienne-sur-3-451-patients-confirme-lefficacite

    It’s a translation. My guess is that this will not make RHampton’s top 40 list. But I am sure he will find someone who will criticize it.

  318. 318
    ET says:

    Bob O’H:

    what we’re interested in is whether there is an effective treatment for patients, i.e. human beings.

    The data I am asking for will tell us why there is or isn’t. Or do you not understand how the science works?

  319. 319
    ET says:

    rhampton:

    ET, you are? I thought you had made up your mind.

    YOU are the one who has made up their mind- all without the scientific data.

  320. 320
    Bob O'H says:

    ET – what you’re asking for won’t tell us, for the reasons I’ve indicated. Yes, I do know how science works, because it’s what I do.

    I’ve also read about drug development and discussed it with people in the business, and this is a common theme: even if a drug works in vitro that doesn’t mean it’ll work in practice.

  321. 321
    jerry says:

    Just found out the source for the opposition to HCQ in the United States. It is both financial and legal. If HCQ is designated an appropriate drug for the Virus, then by law no other drug can get emergency use authorization and is prevented from being pushed to the head of the line.

    Thus, there is big financial reasons for disparaging HCQ. I don’t know if this affects other drugs that also may be effective such as ivermectin.

    It would prevent Remdesivir and vaccines from quick approval and require more testing for each. It sounds like the law should be modified at least for this instance and it would stop the disparagement of HCQ and allow other drugs to proceed.

  322. 322
    Bob O'H says:

    kf @ 316 –

    Jerry, guess why I have focused on the cumulative evidence on plausible causal processes and linked context of actual clinical results across thousands of cases?

    Because simply focusing on the results of the clinical trials, i.e. direct tests of whether HCQ works, undermines your argument?

  323. 323
    jerry says:

    Because simply focusing on the results of the clinical trials, i.e. direct tests of whether HCQ works, undermines your argument?

    Is this true? I’m not aware of anything that shows this. Why don’t you present it?

    Another doctor with almost 100% success against C19. There are several others.

    https://www.bitchute.com/video/Nuw30f6a4A2A/

    This was made a month ago. His current stats are 325 treated. Two hospitalized and one death.

    So if caution is advised, what do you do if you get it? Answer, there is an effective treatment that works a lot of the time.

  324. 324
    ET says:

    Earth to Bob- That is why we need the data I was asking for. The data that would show us how much zinc is in the patients’ cells. What science do you do, Bob? You didn’t know squat about the chimpanzee anatomy. You think blind watchmaker evolution is science and yet it is untestable trope.

  325. 325
    ET says:

    And was does zinc therapy work with colds and flus?

  326. 326
    kairosfocus says:

    BO’H: How in denial you are. You have swept away the evidence of successful treatment, have elevated critiques and misdirected or outright fraudulent studies –think how so many responded to Lancet! — to a pedestal and now wish to dismiss the evidence of not just correlation but causal mechanisms. Then, you project a mirror image to me. Sad. KF

    PS: Start from the point that Zn is a recognised antiviral and that what promotes it in the cell will thus have associated antiviral properties. Then think about what happens if you do not understand a system with synergistic effects and try to play around component by component. Then, go look at the papers by Raoult et al, and specifically the study that reports on antiviral effects at plausible in-body concentrations. Then, figure out that a drug with 65 year track record has manageable toxicity and that it is able to move into the body when taken orally. That already shows that it is plausible that the in lab result will be mirrored in tissue. Then, look again at the facts from thousands of cases that show rapid, effective action when taken by the right people at the right time. Sharp progressive decline in virus load is a key result. But then, what we are seeing is the crooked yardstick effect in action. Once a crooked yardstick is taken as standard of straight, accurate, upright, whatever disagrees with the particular crookedness will be rejected — including, what is actually straight, accurate and plumb. Not even a plumb line will move some locked into a crooked standard.

  327. 327
    JVL says:

    BobRyan: Sweden did not lock and their daily death rate continues to be close to nothing. The projections were for millions to be dead by June and the projections were wrong.

    Look at Denmark, Norway and Finland: similar countries culturally, geographically, politically and economically. They did lock down, they hit almost zero deaths far earlier than Sweden and their deaths rates are far, far below Swedens. Their economies are doing just fine because they were able to open things back up again fairly quickly.

  328. 328
    JVL says:

    Jerry: Just found out the source for the opposition to HCQ in the United States. It is both financial and legal. If HCQ is designated an appropriate drug for the Virus, then by law no other drug can get emergency use authorization and is prevented from being pushed to the head of the line.

    Thus, there is big financial reasons for disparaging HCQ. I don’t know if this affects other drugs that also may be effective such as ivermectin.

    Which does nothing to explain all the clinical trials from other countries around the world saying that HCQ is ineffective against COVID-19.

    It would prevent Remdesivir and vaccines from quick approval and require more testing for each. It sounds like the law should be modified at least for this instance and it would stop the disparagement of HCQ and allow other drugs to proceed.

    You do realise that the US bought three months of the world supply of Remdesivir?

  329. 329
    Bob O'H says:

    Jerry @ 323 –
    Is this true? I’m not aware of anything that shows this. Why don’t you present it?
    I and others have done. Repeatedly. But you keep on dismissing the evidence as irrelevant.
    ET @ 324 –

    Earth to Bob- That is why we need the data I was asking for. The data that would show us how much zinc is in the patients’ cells.

    But who cares if the same trials show no clinical benefit? Why send a lot of effort to get a secondary endpoint when the primary endpoint, the one that matters, is easier to obtain? And if the primary endpoint shows no benefit, who cares about the secondary endpoint?
    kf @ 326 – you can wave your arms all you want, but you’re going to have to explain why there are several RCTs that show no effect of HCQ (e.g. see the second paragraph here for a list). What RCTs are there that show a positive effect?

  330. 330
    Mac McTavish says:

    KF

    BO’H: How in denial you are.

    To be fair, Bob and R7 have provided links numerous studies, many of them double blind and randomized, that fail to show efficacy for HCQ as a prophylactic, in early stages of infection, in mid stages of infection or in late stages of infection. Trump was so certain of the benefits of HCQ that he took a course of treatments, yet he insists that everyone who he meets wear masks and be tested.

    Everybody was hoping that HCQ would be an effective treatment but it just hasn’t proven to be so.

  331. 331
    JVL says:

    I think this is a fairly balanced discussion of using Zinc as an antiviral from an advocate. Worth a read.

    https://chrismasterjohnphd.com/covid-19/what-is-the-best-dose-of-zinc-for-covid-19-prevention

  332. 332
    kairosfocus says:

    MMT, the studies have consistently been misdirected: too late (often, hospitalised), wrong population (age, preconditions, risk factors), cutting apart elements of a synergy. They are also side stepping evidence on mechanisms and evidence that shows working as advertised, vulnerable groups, early in the U/L trajectory, based on synergies in a cocktail. Further to this, serious ethical, epistemological and “too late” issues surrounding turning use of deliberately mis labelled sugar pills or the like into artificial controls and treating that as a gold standard to dismiss valid evidence that better fits ethics-epistemology constraints in the face of deadly pandemic also need to be soberly faced. KF

  333. 333
  334. 334
    kairosfocus says:

    PS: Another article on Zn, sowing longstanding baseline knowledge:

    https://pubmed.ncbi.nlm.nih.gov/10499817/

    >>Med Hypotheses

    . 1999 Jul;53(1):6-16.
    doi: 10.1054/mehy.1999.0867.

    Modern diets and diseases: NO-zinc balance. Under Th1, zinc and nitrogen monoxide (NO) collectively protect against viruses, AIDS, autoimmunity, diabetes, allergies, asthma, infectious diseases, atherosclerosis and cancer

    J E Sprietsma 1
    Affiliations

    PMID: 10499817 DOI: 10.1054/mehy.1999.0867

    Abstract

    Thanks to progress in zinc research, it is now possible to describe in more detail how zinc ions (Zn++) and nitrogen monoxide (NO), together with glutathione (GSH) and its oxidized form, GSSG, help to regulate immune responses to antigens. NO appears to be able to liberate Zn++ from metallothionein (MT), an intracellular storage molecule for metal ions such as zinc (Zn++) and copper (Cu++). Both Zn++ and Cu++ show a concentration-dependent inactivation of a protease essential for the proliferation of the AIDS virus HIV-1, while zinc can help prevent diabetes complications through its intracellular activation of the enzyme sorbitol dehydrogenase (SDH). A Zn++ deficiency can lead to a premature transition from efficient Th1-dependent cellular antiviral immune functions to Th2-dependent humoral immune functions. Deficiencies of Zn++, NO and/or GSH shift the Th1/Th2 balance towards Th2, as do deficiencies of any of the essential nutrients (ENs) – a group that includes methionine, cysteine, arginine, vitamins A, B, C and E, zinc and selenium (Se) – because these are necessary for the synthesis and maintenance of sufficient amounts of GSH, MT and NO. Via the Th1/Th2 balance, Zn++, NO, MT and GSH collectively determine the progress and outcome of many diseases. Disregulation of the Th1/Th2 balance is responsible for autoimmune disorders such as diabetes mellitus. Under Th2, levels of interleukin-4 (II-4), II-6, II-10, leukotriene B4 (LTB4) and prostaglandin E2 (PGE2) are raised, while levels of II-2, Zn++, NO and other substances are lowered. This makes things easier for viruses like HIV-1 which multiply in Th2 cells but rarely, if ever, in Th1 cells. AIDS viruses (HIVs) enter immune cells with the aid of the CD4 cell surface receptor in combination with a number of co-receptors which include CCR3, CCR5 and CXCR4. Remarkably, the cell surface receptor for LTB4 (BLTR) also seems to act as a co-receptor for CD4, which helps HIVs to infect immune cells. The Th2 cytokine II-4 increases the number of CXCR4 and BLTR co-receptors, as a result of which, under Th2, the HIV strains that infect immune cells are precisely those that are best able to accelerate the AIDS disease process. The II-4 released under Th2 therefore not only promotes the production of more HIVs and the rate at which they infect immune cells, it also stimulates selection for the more virulent strains. Zn++ inhibit LTB4 production and numbers of LTB4 receptors (BLTRs) in a concentration-dependent way. Zn++ help cells to keep their LTB4 ‘doors’ shut against the more virulent strains of HIV. Moreover, a sufficiency of Zn++ and NO prevents a shift of the Th1/Th2 balance towards Th2 and thereby slows the proliferation of HIV, which it also does by inactivating the HIV protease. Research makes it look likely that deficiencies of ENs such as zinc promote the proliferation of Th2 cells at the expense of Th1 cells. Zinc deficiency also promotes cancer. Under the influence of Th1 cells, zinc inhibits the growth of tumours by activating the endogenous tumour-suppressor endostatin, which inhibits angiogenesis. The modern Western diet, with its excess of refined products such as sugar, alcohol and fats, often contains, per calorie, a deficiency of ENs such as zinc, selenium and vitamins A, B, C and E, which results in disturbed immune functions, a shifted Th1/Th2 balance, chronic (viral) infections, obesity, atherosclerosis, autoimmunity, allergies and cancer. In view of this, an optimization of dietary composition [–> clearly, including appropriate Zn] would seem to give the best chance of beating (viral) epidemics and common (chronic) diseases at a realistic price.>>

    This is on general functionality of Zn.

    The article linked from 292 includes:

    >>Zinc is an essential trace element that is crucial for growth, development, and the maintenance of immune function . . . Zinc deficiency is strikingly common, affecting up to a quarter of the population in developing countries, but also affecting distinct populations in the developed world as a result of lifestyle, age, and disease-mediated factors. Consequently, zinc status is a critical factor that can influence antiviral immunity, particularly as zinc-deficient populations are often most at risk of acquiring viral infections such as HIV or hepatitis C virus . . . An abundance of evidence has accumulated over the past 50 y to demonstrate the antiviral activity of zinc against a variety of viruses, and via numerous mechanisms. The therapeutic use of zinc for viral infections such as herpes simplex virus and the common cold [–> Mostly, corona viruses] has stemmed from these findings; however, there remains much to be learned regarding the antiviral mechanisms and clinical benefit of zinc supplementation as a preventative and therapeutic treatment for viral infections. >>

    An over emphasis on what remains to be learned can lead to failing to note what we do know.

  335. 335
    ET says:

    Earth to Bob O’H- It isn’t enough to say the trials failed. Scientists would want to know why, especially given what I said in 304.

  336. 336
    ET says:

    JVL’s article appears to be from April or before. We should have the data by now telling us if zinc interferes with covid-19’s ability to replicate.

  337. 337
    ET says:

    kairosfocus- it is well known that the western diet isn’t a diet anyone should imitate. I wouldn’t doubt if the underlying cause for the bulk of the covid-19 fatalities are due to our unhealthy lifestyle. We are a nutritionally deficient people, generally speaking.

  338. 338
    Bob O'H says:

    ET – it is enough if the purpose is to find a treatment, which is what we ultimately want. I’ve no idea if scientists would actually be that interested or not – many may well think there are more interesting problems.

  339. 339
    JVL says:

    Kairosfocus: JVL, kindly see 292 above and the onward linked:

    Did you even read the article I linked to. It was from an advocate of using zinc!

    Maybe you’re not arguing against what I posted (which I think you would agree with) but it sure seems like it.

  340. 340
    kairosfocus says:

    JVL, it is precisely because of what I read that I gave specifics, highlighting things that have been learned, noting “over emphasis on what remains to be learned can lead to failing to note what we do know.” In short, yes we would love to know a lot more, but it is not balanced to say “Actually, we know neither of these things,” WRT Zelenko’s “hydroxychloroquine helps Zinc enter the cell . . . . Zinc slows viral replication within the cell.” And in the face of fast moving pandemic, we do not have the luxury of time, one fights a war of strategic level surprise with the army one has, not the one one would like to have. KF

  341. 341
    jerry says:

    To be fair, Bob and R7 have provided links numerous studies, many of them double blind and randomized, that fail to show efficacy for HCQ as a prophylactic, in early stages of infection, in mid stages of infection or in late stages of infection.

    To be fair, this not entirely true. Yes, they have presented late stage trials. But these are irrelevant. I’m unaware of either person providing anything relevant for other stages.

    The goal of the treatment should be prevention of hospitalization and death amongst high risk people who are infected at an early stage of virus. So this is what any study and analysis should be about. Why provide a study on low risk patients since they will fight the virus off with their immune system alone quickly.

    Someone presents a study and are then told why the study is not relevant. They then say they presented studies showing HCQ not effective which is not true. If they disagree then they should point to the study in question.

    One of the ironies is that there are some studies showing HCQ + having a positive effect with hospitalized patients.

  342. 342
    kairosfocus says:

    BO’H, maybe that is one of our core problems, we don’t have the luxury of time, 1 – 3 years to explore possibilities, we are forced to use what we have now or can achieve quickly in the face of strategic surprise and massive dislocation and loss. By the time a conventional search is done, the results will be of academic interest. We need good enough treatments that buy time for immune system response without fatal runaway, turning a killer into a bad cold. That points to looking among existing drugs for action that is broad spectrum enough to slow the viral multiplication trend and dampen down runaway. HCQ-based cocktails and other similar drugs have shown that sort of effectiveness if given early enough in the U/L trajectory. KF

  343. 343
    rhampton7 says:

    320 – Bob is correct. Just because it works in a Petri dish doesn’t mean it will work in the human body. You can google.

  344. 344
    rhampton7 says:

    By now there’s little doubt about hydroxychloroquine: It doesn’t work for treating Covid-19. But there’s a bigger, more important lesson hidden in the story of its failure—a rarely-mentioned, but altogether crucial, error baked into the early research. The scientists who ran the first, promising laboratory experiments on the drug had used the wrong kind of cells: Instead of testing its effects on human lung cells, they relied on a supply of mass-produced, standardized cells made from a monkey’s kidney. In the end, that poor decision made their findings more or less irrelevant to human health. Worse, it’s possible that further research into novel Covid-19 cures will end up being compromised by the same mistake.

    https://www.wired.com/story/scientists-may-be-using-the-wrong-cells-to-study-covid-19/

  345. 345
    rhampton7 says:

    Dr. Anthony Fauci is rejecting Yale epidemiologist Dr. Harvey Risch’s arguments about randomized placebo-controlled studies of hydroxychloroquine.

    “New Day” host brought up the issue with Fauci. Berman said: “However we did have Dr Harvey Risch from Yale on Monday, and he suggested what you have been saying, that random controlled trials, placebo-controlled trials, you say they’re the gold standards. He says that’s not so.”

    Berman asked Fauci why he felt so strongly about the trials.

    “Well, because it is the gold standard,” Fauci said. “You have to compare your intervention with something. Because the medical literature and experience is full of situations of anecdotal retrospective cohort studies that have proven to be wrong.”

    “I might add, agreeing with me is virtually every scientist who is competent in clinical trials, that will say that the randomized placebo-controlled trial is in fact the gold standard. So I would have to respectfully totally disagree with him.”

    https://www.newsmax.com/newsfront/fauci-risch-hydroxychloroquine-trials/2020/08/06/id/980862/

  346. 346
    JVL says:

    Jerry: To be fair, this not entirely true. Yes, they have presented late stage trials. But these are irrelevant. I’m unaware of either person providing anything relevant for other stages.

    Then you have really not been paying attention. There’s not much point in bringing things up if you’re just going to ignore them.

  347. 347
    rhampton7 says:

    The Oxford University-led study, known as Copcov, is aiming to enrol 40,000 healthcare workers from across the world to determine whether the drug is effective at fighting Covid-19.

    the researchers behind Copcov have stressed that, while the drug has been ruled out as a method to treat infections, it may still be able to prevent them.

    One of the trial’s lead investigators Dr Will Schilling said: “We really don’t know if hydroxychloroquine works or not in prevention or very early treatment. That question remains unanswered.

    “The benefits found in small post-exposure treatment trials, although modest, could be very valuable if they were confirmed.”

    https://www.standard.co.uk/news/health/hydroxychloroquine-coronavirus-treatment-dismissed-donald-trump-a4518031.html

  348. 348
    ET says:

    No, Bob, it isn’t. Because that data may show that they are doing something wrong.

  349. 349
    kairosfocus says:

    RH7, half the truth as usual. No one has seriously suggested that what works in lab must work in wild. Notice, first, that mechanisms of cellular action at plausible concs were identified and it was noted on 65 years of use that inevitable toxicity is manageable and oral form does make transfer to body. In that context, identifying plausible mechanisms is a part of a cumulative empirical case. It lends credibility to use experimentally in absence of known strongly effective treatments, so that comparison to the baseline can be made. In this case, thousands of cases of success and testing that points to rapid, early reduction of virus load [typ across 2 – 6 days once started early enough in the U/L trajectory], showing reason to be confident something is working. Zn is credible as an inhibitor of replication, but one whose conc in cells is tightly regulated. HCQ seems to relax that, increasing access, multiplied by other mechanisms. Such would promote breaking the in-body viral multiplication and cell destruction chain that starts the dangerous cascade that can lead to flatlining. Given tendency to Zn etc deficiencies, supplements make sense. And more, but this is enough to highlight the point. KF

  350. 350
    kairosfocus says:

    PS, on the ethics-epistemology challenge, here is the ghost in the room that exposes the fallacies in gold standard thinking on empirical evidence and linked ethical dilemmas that in the end I am dismayed to see an unresponsiveness to that would never have been so decades ago. It used to be widely recognised that placebo controls face serious ethical challenges:

    ********

    The U.S. Public Health Service Syphilis Study at Tuskegee was a clinical study conducted between 1932 and 1972 by the United States Public Health Service.[1][2] [–> 40 years of sustained wrong, which had to be enforced through a warped understanding of ethics and epistemology, with overtones of racism similar to medical experiments on concentration camp inmates] The purpose of this study was to observe the natural history of untreated syphilis [–> decades after effective treatments were routinised by the late 1940’s] ; the African-American men in the study were only told they were receiving free health care from the Federal government of the United States.[3]

    [–> evil under false colour, robes and ceremonies of medicine and science; with calculated misleading as pivot, extracting manipulated consent that caused improper exposure to diseases treated ineffectively when ADEQUATE evidence . . . adequacy is not perfection . . . existed that better alternatives were available.]

    The United States Public Health Service started the study in 1932 in collaboration with Tuskegee University (then the Tuskegee Institute), a historically black college in Alabama. [–> misuse of credibility] Investigators enrolled in the study a total of 600 impoverished, African-American sharecroppers from Macon County, Alabama.[3] Of these men, 399 had latent syphilis, with a control group of 201 men who were not infected.[2] [–> oh, yes, the gold standard was applied within the study and the study as a whole was itself a control on efficacy of other treatments: natural, untreated course] As an incentive for participation in the study, the men were promised free medical care, but were deceived by the PHS

    [–> deception, a key to seeing the ethics failure and don’t tell us oh deliberately mislabelled sugar pills etc are not deception under colour, robes and ceremonies of medicine and science]

    , who disguised placebos, ineffective methods, and diagnostic procedures as treatment.[4]

    [–> REPEAT: “who disguised placebos, ineffective methods, and diagnostic procedures as treatment”]

    The men who had syphilis were never informed of their diagnosis, despite the risk of infecting others, and the fact that the disease could lead to blindness, deafness, mental illness, heart disease, bone deterioration, collapse of the central nervous system, and death.[5][6][7][8]

    [–> are people being told that as you are high risk and CV19 is fast moving with damage already in lungs per Raoult’s 2000+ CT scans on 500+ patients, when symptoms emerge? That death is a significant, rapid potential outcome on placebos? that HCQ+ cocktails have several lines of evidence pointing to likely rapidly acting efficacy?]

    According to the Centers for Disease Control and Prevention, the men were told that they were being treated for “bad blood,” a colloquialism that described various conditions such as syphilis, anemia and fatigue. “Bad blood”—specifically the collection of illnesses the term included—was a leading cause of death within the southern African-American community.[2] The men were initially told that the study was only going to last six months, but it was extended to 40 years.[2] After funding for treatment was lost, the study was continued without informing the men that they would never be treated. None of the infected men were treated with penicillin despite the fact that by 1947, the antibiotic had become the standard treatment for syphilis.[9]

    [–> so, what about the cumulative body of evidence since 2005 on likely efficacy of HCQ+ cocktails? Or, is that to be branded with a scarlet letter, dismissed as not meeting the gold standard that rests on deceptive practice . . . MISLABELLED, ineffective pseudo treatments in the face of life/death are deceptive . . . then marginalised and censored?]

    Study clinicians could have chosen to treat all syphilitic subjects and close the study, or split off a control group for testing with penicillin. Instead, they continued the study without treating any participants; they withheld treatment and information about it from the subjects.

    [–> So, how much more is it to be challenged when in the face of cumulative evidence of efficacy, treatments are sidelined and it is demanded that people subject themselves to life/death situations to “prove” what is already readily shown, save where studies are fail-by-design: too late in the U/L trajectory, wrong demographic, dubious statistics like Lancet, etc?]

    In addition, scientists prevented participants from accessing syphilis treatment programs available to other residents in the area.[10] The study continued, under numerous Public Health Service supervisors, until 1972, when a leak to the press resulted in its termination on November 16 of that year.[11] The victims of the study, all African-American, included numerous men who died of syphilis, 40 wives who contracted the disease and 19 children born with congenital syphilis.[12]

    The 40-year Tuskegee Study of Untreated Syphilis in the African American Male study was a major violation of ethical standards. [–> ethical failure] Researchers knowingly failed to treat participants appropriately [–> oh, how familiar] after penicillin was proven [–> empirical investigations cannot prove but can warrant a prudent conclusion] to be an effective treatment for syphilis and became widely available.[9] [–> how widely accessible are elements of HCQ cocktails? I submit, quite widely] Moreover, participants remained ignorant of the study clinicians’ true purpose, which was to observe the natural course of untreated syphilis.[3] [–> deception, deception, deception is deception] The revelation in 1972 of study failures by a whistleblower, Peter Buxtun, [–> So, how are whistleblowers currently being treated? see how it pinches when the shoe is on the other foot?] led to major changes in U.S. law and regulation concerning the protection of participants in clinical studies. Now studies require informed consent [–> what, really, is properly informed consent given what we are seeing now?],[13] communication of diagnosis and accurate reporting of test results.[14] [–> what about the right to access the best evidence and accessible treatments in the face of emerging pandemic?]

    The U.S. Public Health Service Syphilis Study at Tuskegee, cited as “arguably the most infamous biomedical research study in U.S. history,”

  351. 351
    rhampton7 says:

    Dr F. Perry Wilson, from the Yale School of Medicine: I am showing this because this study, appearing (for now) on medRxiv , is from the RECOVERY trial group. They are the ones who published the randomized trial showing that dexamethasone (a cheap, widely available drug) reduced mortality in severe COVID-19. It’s a talented group. They want to find cures. Anyway, they randomized 4716 hospitalized patients with COVID-19 to 800 mg of HCQ at entry and 6 hours, followed by 400 mg every 12 hours for the next 9 days or until discharge vs placebo. The groups were well balanced because this was a randomized trial. The primary outcome was all-cause mortality at 28 days.

    https://img.medscapestatic.com/article/935/058/935058-fig30.png?interpolation=lanczos-none&resize=306:*

    From Horby P, et al. medRxiv 2020.07.15.20151852. doi: https://doi.org/10.1101/2020.07.15.20151852

    At 28 days, 26.8% of the patients in the HCQ arm and 25% of those in the usual-care arm had died, a nonsignificant difference with a P value of .18.

    Let’s put these together:

    https://img.medscapestatic.com/article/935/058/935058-fig31.png?interpolation=lanczos-none&resize=306:*

    I am not going to say that HCQ has no effect on COVID-19. We can never be 100% sure of that. But I am sure that if it has an effect, it is quite small. Think of a world where HCQ was a miracle cure for COVID-19. Think how different all of these randomized trials would look. It would be immediately obvious.

    https://www.medscape.com/viewarticle/935058

  352. 352
    rhampton7 says:

    Dr F. Perry Wilson, from the Yale School of Medicine (2): First, we know that many individuals take zinc supplements, so if, as the argument goes, HCQ is a miracle cure when given with zinc, you’d still see a benefit in an HCQ trial because a subset of people — maybe 25% — are taking zinc.

    The zinc issue falls into this “no true Scotsman” land of HCQ studies. Any negative study can be dismissed: “Oh, you didn’t give it early enough, or late enough, or with zinc, or with azithromycin, or on Sunday,” or whatever. That’s not how science works.

    I’m not saying that any of these studies are perfect, just that they are the best evidence we have right now. The burden of proof is to show that the drug works. Though I’m sure that pharma would be stoked to be able to argue that their latest negative trial can be ignored because their billion-dollar drug wasn’t given in concert with vitamin C or whatever.

  353. 353
    rhampton7 says:

    Rep. Randy Fine (R-Palm Bay) sounds like himself again two weeks after he says he first tested positive for COVID-19.

    Fine said about 30% of his lungs are covered with damage from COVID-19.

    “It’s not getting worse, but it’s going to take a while to get better. And certainly the notion of how long is it going to take? Is it possibly permanent? That’s certainly scary,” Fine said.

    On his Facebook livestreams, Fine is getting a lot of questions about hydroxychloroquine. Fine said he took it up until Sunday when he got to the hospital.

    https://www.clickorlando.com/news/local/2020/08/06/state-rep-randy-fine-set-to-leave-hospital-after-covid-19-diagnosis/

  354. 354
    Mac McTavish says:

    KF, we have been over the ethical issue multiple times. There is no ethical issue. You keep referring to “intentionally mislabeled sugar pills”. The patients and doctors involved are fully informed that neither will know who is receiving the drug or the placebo. The patients can back out at any time. And during the study they still receive symptom related treatments.

    It is called the “gold standard” for a very good reason. It is the best procedure we have for determining the efficacy of a treatment.

    At the beginning of the pandemic all of the experts said that it would persist for a very long time. Plenty of time for your pet doctors to have conducted proper clinical trials. But they didn’t. Do you ever wonder how many lives they could have saved if they had done so?

  355. 355
    kairosfocus says:

    MMT, your denial does not make the reality go away. A generation ago, my essential point would have been a commonplace. Now, we are so benumbed that we cannot feel its force. It is pain, pain and sorrow that will have to teach us, broken backed at the foot of a cliff, the first lessons of civilisation that we have spurned and forgotten. A gold standard that reduces human beings to deceived lab rats deliberately mistreated in the face of deadly disease under false colours, rituals and solemn ceremonies of medicine and science is a standard only for fool’s gold. Especially, when it induces us to discard competent, adequate, cumulative evidence. History will judge us harshly indeed, for cause. 6 – 18 months to the foot of the cliff. KF

  356. 356
    jerry says:

    This whole discussion is getting or has been comical but really tragic. I personally could care a rat’s rear end about HCQ. Nor do I think anyone else here recommending it do either. What we care about is a treatment for the virus that is effective.

    I and several others have put forth other drugs as possible treatments. At the moment HCQ + zinc seems the best protocol for early treatment. It has the distinct advantage of being dirt cheap.

    When something comes along that is better HCQ is history as far I am concerned.

    What I find amazing is that no one who is disparaging HCQ has offered an alternative. Nada nothing zilch. The only objective is to find reasons why nothing will help especially HCQ.

    Those who support HCQ are offering hope and life. Those who denigrate HCQ are offering despair and death. Those who denigrate HCQ seem more interested in winning a semantics and gotcha game.

  357. 357
    kairosfocus says:

    Jerry, the point is, there is one serious, cost effective, adequately evidence based treatment. It is what they do not want. KF

  358. 358
    Mac McTavish says:

    KF

    MMT, your denial does not make the reality go away.

    Is this the reality that I am alive today because of the prior use of double blind, randomized, placebo control clinical trials? And, I dare say, that a person of your age has probably benefitted from them as well?

    Health care is much better today because of the “gold standard” you so despise. Even the vaccines that are being developed are relying on the “gold standard” clinical trials. This process, that you think is unethical, has delayed the use of a vaccine by many months, possibly more than a year. During this time, thousands have died. Should we bypass these trials?

  359. 359
    ET says:

    No Mac, the reality that HCQ and zinc are saving lives. Why do you quote-mine and then harp on that quote-mine?

  360. 360
    jerry says:

    Is this the reality that I am alive today because of the prior use of double blind, randomized, placebo control clinical trials? And, I dare say, that a person of your age has probably benefitted from them as well?

    Health care is much better today because of the “gold standard” you so despise. Even the vaccines that are being developed are relying on the “gold standard” clinical trials. This process, that you think is unethical, has delayed the use of a vaccine by many months, possibly more than a year. During this time, thousands have died. Should we bypass these trials?

    Just about everything in this comment is nonsense. The world existed for thousands of years without double blind randomized placebo studies. The modern world is not dependent on them. That does not mean they are not useful sometimes. But definitely not all the time.

    They are used to ensure something is safe and more effective. That is not relevant in this case. The alternative is doing nothing. Hence they are not necessary in the short run.

    Nobody despises or is against these types of studies. It is just they are not necessary here. The delays caused by their use has led hundreds of thousands to die unnecessarily. Insisting on them here is killing people. The RCT in this case is not a safe procedure because the outcome in one of the groups is definitely death for some of the subjects. You are recommending a study in which some in the placebo group are expected to die.

    About a vaccine, they are dealing with something brand new so there is a very large question of safety. Vaccines could have unknown long term effects.

    It appears from your comment that you do not understand the issues. You would be better off just asking questions.

  361. 361
    kairosfocus says:

    MMT, all you just did is to underscore the point that there is an ethics-epistemology gap. People are not lab rats to be manipulated under false colours of medicine, science, research and knowledge, especially when that manipulation exposes them to harm or even death. That was why the Nazi medical experiments and the Tuskegee atrocity were condemned. It is why a deliberate effort was made to more ethically reproduce actual advances in medical knowledge created through the Nazi experiments (which, med students would tell us, their profs told them, saved many more lives than were taken). Linked, empirical evidence never amounts to rationally undeniable proof, it can produce adequate, reliable, trustworthy warrant. Which is often cumulative and collectively far stronger than individual parts. A comparison is that while a chain cannot be stronger than its weakest link, short, weak fibres can be twisted into strands, cumulatively counter twisted into long strong ropes. That is why in vitro/lab exercises count, it is why plausible mechanisms count, it is why animal analogues (if available) count, it is why well-founded modelling and simulation count, it is why case experiences and records count. It ids why decision theory pivoting on gap analysis between business as usual outcomes and cumulatively credible alternatives can ethically, with good warrant, motivate change from BAU to ALT, or even show that no alternative is superior. And more. Such has been discussed for months, both from me in my own right and from others cited, as encountered. Of course, it does not fit a preferred narrative, so it has been repeatedly discounted. That speaks telling volumes. KF

  362. 362
    Mac McTavish says:

    KF

    People are not lab rats to be manipulated under false colours of medicine, science, research and knowledge, especially when that manipulation exposes them to harm or even death.

    You do realize that lab rats have no choice and humans bravely and altruistically volunteer for clinical trials with full knowledge that they may receive a placebo.

    That was why the Nazi medical experiments and the Tuskegee atrocity were condemned.

    Equating clinical trials, where patients volunteer, to Nazi medical experiments is deplorable. Even suggesting such a link speaks volumes, and not in your favor.

    The next time your doctor recommends a drug, or a procedure, for you or anyone in your family, I expect you to decline it if they were developed through the use of your despised “gold standard” clinical trials. Keep in mind, this would include blood pressure medication, cholesterol medication, most antibiotics, pain killers, heart medications, Viagra, etc. etc. etc.

  363. 363
    kairosfocus says:

    MMT, I suggest you read the Tuskegee case to see the fundamentally corrosive nature of deception in medical research. Next, I advise you to ponder what Medicine did for decades after WW2, use the knowledge created through the Nazi atrocities to save lives as knowledge is knowledge. Third, kindly ponder the decision theory issue as put on the table, so that you will see that there is generally no need to create an artificial baseline dependent on deception. In this case all the gold standard fallacy has achieved is to inject a doorway to selectively hyperskeptical rejection of adequate empirical evidence, in a context where by the time the cumbersome and ethically dubious procedure is completed, the disease will have run a far more deadly course than on an alternative where force of cumulative evidence was respected. The cost is liable to be, cumulatively tens to over 100 thousand needless deaths. Which is itself a sobering aspect of the ethics-epistemology breakdown. But of course, thanks to the self-reinforcing effect of a crooked yardstick, that point will itself be shunted aside. KF

  364. 364
    Bob O'H says:

    Jerry @ 341 –

    To be fair, this not entirely true. Yes, they have presented late stage trials. But these are irrelevant. I’m unaware of either person providing anything relevant for other stages.

    If that’s true, you need to see a doctor, as your memory is impaired. At comment 118 I linked to two studies, with the titles “Hydroxychloroquine for Early Treatment of Adults with Mild Covid-19: A Randomized-Controlled Trial” and “A Randomized Trial of Hydroxychloroquine as Postexposure Prophylaxis for Covid-19”. So neither are late-stage.

    One might think it’s possible that you hadn’t seen them, except you responded to my comment @ 120.

  365. 365
    Bob O'H says:

    Jerry @356 –

    This whole discussion is getting or has been comical but really tragic. I personally could care a rat’s rear end about HCQ. Nor do I think anyone else here recommending it do either. What we care about is a treatment for the virus that is effective.

    I’d hope that’s true for everyone here.

    I and several others have put forth other drugs as possible treatments. At the moment HCQ + zinc seems the best protocol for early treatment. It has the distinct advantage of being dirt cheap.

    When something comes along that is better HCQ is history as far I am concerned.

    Right, but the evidence is not giving HCQ is as effective, cheaper, and doesn’t have side effects.

    Unfortunately there’s no cure yet. There are some treatments, e.g. dexamethasone in patients with severe covid-19. It would be great if a general cure could be found, but life often isn’t that simple. A prophylaxis that didn’t involve shunning civilisation (e.g. by moving to New Zealand) would be nice too.

    Those who support HCQ are offering hope and life.

    The problem is that the evidence now strongly suggests it’s a false hope and no more life than not taking HCQ.

  366. 366
    kairosfocus says:

    BO’H: The cumulative, on balance evidence — once selective hyperskepticism is set aside as fallacious — does support the effectiveness of HCQ based cocktails as administered in the early viral stages of the U/L trajectory of CV19, with plausible mechanisms. That is reason enough to support their use under pandemic circumstances. This is supported by related evidence that a serious cluster of ethical and epistemological errors are at work that have opened a gateway to selective hyperskepticism through the gold standard fallacy. There is no good reason to project emotional or ideological adherence driving support, that seems to be a projection. For instance, there is modest evidence of moderate effectiveness of remdesivir, which must be tempered by dosage costs weighed down by development costs etc. Ivermectin is promising, with indication that it can extend effectiveness down the descending arm, in conjunction with the HCQ cocktail. Other possibilities are reasonable. What is argued for is respect for cumulative empirical evidence and not unduly hampering the professional freedom and judgement of the physician, up to and including threatened loss of licence. Similarly, far too much of opposition is based on inappropriate studies . . . too late on U/L (often signalled by “hospital-based”), wrong population [not at risk]. wrong dosages [toxic] etc . . . and scare mongering over an exaggerated estimate of toxicity. Which last is present with all drugs of consequence: poisons in small doses. Actually, water, salt and sugar can have toxic effects. At this stage, fairly late in the pandemic, it is the judgement of sound history that is at stake, and for cause it will be quite harsh. KF

  367. 367
    Bob O'H says:

    kf –

    What is argued for is respect for cumulative empirical evidence and not unduly hampering the professional freedom and judgement of the physician, up to and including threatened loss of licence.

    Right, so don’t then ignore the “cumulative empirical evidence” that HCQ doesn’t work. If there is a “gold standard fallacy” then it’s that one can only use the gold standard, not that the gold standard is useless. We now have several gold standard trials, including use at an early stage and as a prophylaxis, and they show no positive effect of HCQ.

    We’d all love it if HCQ did work to treat covid-19, but I’m afraid the evidence in its favour is not of good quality. For example, retrospective studies (e.g. the reports of Raoult and Zelenko) suffer because there may be several differences between the control and treatment groups that are not in the analysis. At the very least, the study needs to either control for these differences.

  368. 368
    ET says:

    There must be a cure as not everyone who has had covid-19 has died nor still has it. And there is a medically recommended prophylaxis that can save hundreds of thousands of lives, or more.

    There are medical papers touting the efficacy of vitamin D, no less

  369. 369
    ET says:

    Dr. Zelenko still has a $200,000 challenge. Strange that no one has been able to collect it.

  370. 370
    ET says:

    Bob- your links in 118 are for HCQ alone. Clearly you haven’t been following along.

  371. 371
    ET says:

    kairosfocus nailed the problem earlier. It’s our diet. It is killing us even without covid-19. C19 is just helping it get it done faster. We are a nutritionally deficient people. And viruses can and do take advantage of that.

  372. 372
    ET says:

    Newly Published Outpatient Study Finds that Early Use of Zinc, Hydroxychloroquine and Azithromycin Is Associated with Less Hospitalizations and Death:

    The study reports a survival rate of over 99% in patients with confirmed positive cases of COVID-19

    Flail away, Bob and RH…

  373. 373
    jerry says:

    I’ve asked for studies to discuss. I get my memory is failing and irrelevant studies. Traveling today so I will repeat my reasons why they are irrelevant later. But they have been given above.

    In the meantime provide links to make it easier.

  374. 374
    Bob O'H says:

    ET – yes, yes. We’ve all seen that. A survival rate over 99% is in line with the estimated IFR, and with a sample of 141 it’s not too unlikely to have 0 or 1 cases (even with a 2% IFR, there’s still about a 20% probability).

    Seriously, when over 99% of people infected with SARS-Cov-2 survive, I don’t think a treatment it that impressive if over 99% of the people who are given it survive.

  375. 375
    Bob O'H says:

    ET @ 370 – take that up with Jerry. He was discussing HCQ on its own.

  376. 376
    kairosfocus says:

    BO’H: No, Jerry has consistently spoken to the HCQ+ cocktail protocol. KF

  377. 377
    Mac McTavish says:

    KF

    MMT, I suggest you read the Tuskegee case to see the fundamentally corrosive nature of deception in medical research.

    Completely irrelevant to the ethical issues around clinical trials. There is no deception involved with clinical trials. Patients must give informed consent, knowing that they may receive a placebo. You keep harping on the “deliberately mislabelled Sugar pills red herring” . Given that patients are informed that they may be sugar, where is the deception?

  378. 378
    Bob O'H says:

    kf @ 376 – Not when he wrote “When something comes along that is better HCQ is history as far I am concerned.”, and “What I find amazing is that no one who is disparaging HCQ has offered an alternative.” and “The only objective is to find reasons why nothing will help especially HCQ.” and “Those who support HCQ are offering hope and life.” and “Those who denigrate HCQ are offering despair and death.” and “Those who denigrate HCQ seem more interested in winning a semantics and gotcha game.”

    Yes, he does mention HCQ + Zn, but clearly he’s mostly interested in discussing HCQ.

  379. 379
    Bob O'H says:

    Jerry @ 373 –

    Traveling today so I will repeat my reasons why they are irrelevant later.

    Last time you moved the goalposts, and the studies weren’t in the elderly. If you try that again, you’ll have to explain why you didn’t mention them in 341 when you wrote “To be fair, this not entirely true. Yes, they have presented late stage trials. But these are irrelevant. I’m unaware of either person providing anything relevant for other stages.”.

    Anyway, happy travels!

  380. 380
    kairosfocus says:

    MMT, you are quite wrong as has been shown any number of times, you cleasrly did not read with care. Here we go:

    The U.S. Public Health Service Syphilis Study at Tuskegee was a clinical study conducted between 1932 and 1972 by the United States Public Health Service.[1][2] [–> 40 years of sustained wrong, which had to be enforced through a warped understanding of ethics and epistemology, with overtones of racism similar to medical experiments on concentration camp inmates] The purpose of this study was to observe the natural history of untreated syphilis [–> decades after effective treatments were routinised by the late 1940’s] ; the African-American men in the study were only told they were receiving free health care from the Federal government of the United States.[3]

    [–> evil under false colour, robes and ceremonies of medicine and science; with calculated misleading as pivot, extracting manipulated consent that caused improper exposure to diseases treated ineffectively when ADEQUATE evidence . . . adequacy is not perfection . . . existed that better alternatives were available.]

    The United States Public Health Service started the study in 1932 in collaboration with Tuskegee University (then the Tuskegee Institute), a historically black college in Alabama. [–> misuse of credibility] Investigators enrolled in the study a total of 600 impoverished, African-American sharecroppers from Macon County, Alabama.[3] Of these men, 399 had latent syphilis, with a control group of 201 men who were not infected.[2] [–> oh, yes, the gold standard was applied within the study and the study as a whole was itself a control on efficacy of other treatments: natural, untreated course] As an incentive for participation in the study, the men were promised free medical care, but were deceived by the PHS

    [–> deception, a key to seeing the ethics failure and don’t tell us oh deliberately mislabelled sugar pills etc are not deception under colour, robes and ceremonies of medicine and science]

    , who disguised placebos, ineffective methods, and diagnostic procedures as treatment.[4]

    [–> REPEAT: “who disguised placebos, ineffective methods, and diagnostic procedures as treatment”]

    The men who had syphilis were never informed of their diagnosis, despite the risk of infecting others, and the fact that the disease could lead to blindness, deafness, mental illness, heart disease, bone deterioration, collapse of the central nervous system, and death.[5][6][7][8]

    [–> are people being told that as you are high risk and CV19 is fast moving with damage already in lungs per Raoult’s 2000+ CT scans on 500+ patients, when symptoms emerge? That death is a significant, rapid potential outcome on placebos? that HCQ+ cocktails have several lines of evidence pointing to likely rapidly acting efficacy?]

    According to the Centers for Disease Control and Prevention, the men were told that they were being treated for “bad blood,” a colloquialism that described various conditions such as syphilis, anemia and fatigue. “Bad blood”—specifically the collection of illnesses the term included—was a leading cause of death within the southern African-American community.[2] The men were initially told that the study was only going to last six months, but it was extended to 40 years.[2] After funding for treatment was lost, the study was continued without informing the men that they would never be treated. None of the infected men were treated with penicillin despite the fact that by 1947, the antibiotic had become the standard treatment for syphilis.[9]

    [–> so, what about the cumulative body of evidence since 2005 on likely efficacy of HCQ+ cocktails? Or, is that to be branded with a scarlet letter, dismissed as not meeting the gold standard that rests on deceptive practice . . . MISLABELLED, ineffective pseudo treatments in the face of life/death are deceptive . . . then marginalised and censored?]

    Study clinicians could have chosen to treat all syphilitic subjects and close the study, or split off a control group for testing with penicillin. Instead, they continued the study without treating any participants; they withheld treatment and information about it from the subjects.

    [–> So, how much more is it to be challenged when in the face of cumulative evidence of efficacy, treatments are sidelined and it is demanded that people subject themselves to life/death situations to “prove” what is already readily shown, save where studies are fail-by-design: too late in the U/L trajectory, wrong demographic, dubious statistics like Lancet, etc?]

    In addition, scientists prevented participants from accessing syphilis treatment programs available to other residents in the area.[10] The study continued, under numerous Public Health Service supervisors, until 1972, when a leak to the press resulted in its termination on November 16 of that year.[11] The victims of the study, all African-American, included numerous men who died of syphilis, 40 wives who contracted the disease and 19 children born with congenital syphilis.[12]

    The 40-year Tuskegee Study of Untreated Syphilis in the African American Male study was a major violation of ethical standards. [–> ethical failure] Researchers knowingly failed to treat participants appropriately [–> oh, how familiar] after penicillin was proven [–> empirical investigations cannot prove but can warrant a prudent conclusion] to be an effective treatment for syphilis and became widely available.[9] [–> how widely accessible are elements of HCQ cocktails? I submit, quite widely] Moreover, participants remained ignorant of the study clinicians’ true purpose, which was to observe the natural course of untreated syphilis.[3] [–> deception, deception, deception is deception] The revelation in 1972 of study failures by a whistleblower, Peter Buxtun, [–> So, how are whistleblowers currently being treated? see how it pinches when the shoe is on the other foot?] led to major changes in U.S. law and regulation concerning the protection of participants in clinical studies. Now studies require informed consent [–> what, really, is properly informed consent given what we are seeing now?],[13] communication of diagnosis and accurate reporting of test results.[14] [–> what about the right to access the best evidence and accessible treatments in the face of emerging pandemic?]

    The U.S. Public Health Service Syphilis Study at Tuskegee, cited as “arguably the most infamous biomedical research study in U.S. history,”

    Quite relevant.

    And deliberately mislabelled sugar pills or the like are inherently deceptive, that too is highly relevant despite your dismissals. Indeed, deception is one of the major ethical concerns regarding placebos in general.

    KF

  381. 381
    kairosfocus says:

    PS: An oldie but goodie:

    ********

    https://www.hks.harvard.edu/centers/mrcbg/news-events/COVID_Zeckhauser

    >>Unleash the Data on COVID-19

    By Maryaline Catillon and Richard Zeckhauser*

    Given the lethality of the COVID-19 pandemic, the urgent need is for actionable information directing care towards treatments offering higher probabilities of improving outcomes and preventing death. In normal times, randomized control trials (RCTs) would be the gold standard for determining whether innovative medical treatments are safe and effective. But with 1,500 Americans dying every day, these are hardly normal times.

    There is an urgent need for high quality studies based on real world experience, which has already accumulated for many thousands of patients. Dr. Anthony Fauci, the nation’s pandemic physician in chief, said that RCT results will not be available “for months”. The disease will not wait.

    RCTs, which randomly assign patients to a treatment or a control group, are only ethically acceptable when the safety and performance of a treatment is unknown. When ample data exists, as now, that criterion is not met.

    Analyzing real world data on actual outcomes, when it exists in abundance, offers an alternative approach to learn almost immediately. Moreover, it avoids the ethical challenge of an RCT, given that available data could predict outcomes. Massive numbers of COVID-19 patients are currently being administered “unproven” drugs based on medical decisions made by doctors. Massive numbers are not receiving any such drugs. Thus, carefully designed case control studies could leverage differences between ongoing protocols at large hospital systems and detailed information from patients’ electronic medical records. That could determine whether widely employed hydroxychloroquine, with or without azithromycin, provides significant benefits, and at which stages to which patients, and could provide similar information on the risks it imposes. It could yield the same information about remdesivir, and about many other drug treatments currently in use.

    For each patient, doctors strive to optimize treatment in the current, uncertain environment. These drug versus non-drug decisions constitute an ongoing large observational study, in which the allocation to treatment and control groups varies widely. The large numbers of patients treated eliminates concerns that random variation might lead to misleading results. Those large numbers also yield results by demographic, comorbidities, and stage of disease. Leveraging real world evidence is more acceptable ethically when extensive information is already available.

    As decision theorists who have studied the methodological quality of vast numbers of RCTs, we are enthusiasts for well-conducted RCTs. But delaying public health recommendations till RCTs are completed is not appropriate in the present circumstance. Imminent threats are enormous and widespread data is easily at hand. The outcomes of the thousands of individuals who have already received drug therapies on an ad hoc basis should inform practice now.

    We make this recommendation recognizing that President Trump, having taken his own counsel, is cheerleader in chief for hydroxychloroquine. He might be right. He might be wrong. Let’s assemble the data as quickly as possible. Saving lives, like the ocean’s edge, is where politics should stop.

    High quality case control studies based on thousands of cases, the silver standard we recommend, are immensely faster than RCTs. Recent articles in the world’s leading medical journals show that they consistently yield the same major findings. Experience with the recommendations of antiretroviral therapy (ART) for HIV provides an instructive warning. Even though 20 years of observational studies demonstrated its enormous benefits, the World Health Organization waited until 2015 and the publication of the first set of RCT results (which reached the same conclusions) to make a “treat all” recommendation. Many lives were lost as the world waited for its recommendation.

    COVID-19 presents its own example. Through late March, medical authorities recommended the general public not employ masks to protect against it. In early April, that all switched: masks became strongly recommended. No RCT supported this reversal; little evidence was mounted. Yet officials applauded, the public widely complied, and the world was better off.

    We support the well-intentioned RCTs already underway in many medical centers. But tens of thousands will die before we have their results. In the meantime, anecdotal success stories, physicians’ highly personal experiences, and informal information networks are serving as the basis for widespread adoption of treatment protocols. The treatment for COVID-19 would be much more responsibly informed, hence appropriately deployed, if we were just willing to unleash the data.

    *Maryaline Catillon, formerly a hospital director in France, recently completed her Ph.D. in Health Policy at Harvard. Richard Zeckhauser is a professor of economics and decision theory at Harvard Kennedy School.>>

  382. 382
    kairosfocus says:

    PPS: On Dr Raoult’s in vitro test:

    https://www.mediterranee-infection.com/wp-content/uploads/2020/03/La-Scola-et-al-V1.pdf

    >>[ABSTRACT]

    13 Human coronaviruses SARS-CoV-2 appeared at the end of 2019 and led to a pandemic with 14 high morbidity and mortality. As there are currently no effective drugs targeting this virus, 15 drug repurposing represents a short-term strategy to treat millions of infected patients at low 16 costs. Hydroxychloroquine showed an antiviral effect in vitro. In vivo it also showed efficacy, 17especially when combined with azithromycin in a preliminary clinical trial. Here we 18 demonstrate that the combination of hydroxychloroquine and azithromycin has a synergistic 19 effect in vitro on SARS-CoV -2 at concentrations compatible with that obtained in human 20 lung >>

  383. 383
    ET says:

    Bob, you are obviously clueless. Just leave it at that

  384. 384
    ET says:

    Earth to Mac & Cheese- every patient should be treated equally and given the same chance to survive the virus. That is what kairosfocus is referring to. Shotgun the cure if you have to and then go back to determine what worked.

  385. 385
    kairosfocus says:

    PPPS: Lancet back in 2003:

    https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(03)00806-5/fulltext

    >>Effects of chloroquine on viral infections: an old drug against today’s diseases

    Dr Adrea Savarino
    John R Boelaert
    Antonio Cassone
    Giancario Majori
    Roberto Cauda

    Published:November, 2003DOI: https://doi.org/10.1016/S1473-3099(03)00806-5
    PlumX Metrics

    Summary
    Chloroquine is a 9-aminoquinoline known since 1934. Apart from its well-known antimalarial effects, the drug has interesting biochemical properties that might be applied against some viral infections. Chloroquine exerts direct antiviral effects, inhibiting pH-dependent steps of the replication of several viruses including members of the flaviviruses, retroviruses, and coronaviruses. Its best-studied effects are those against HIV replication, which are being tested in clinical trials. Moreover, chloroquine has immunomodulatory effects, suppressing the production/release of tumour necrosis factor ? and interleukin 6, which mediate the inflammatory complications of several viral diseases. We review the available information on the effects of chloroquine on viral infections, raising the question of whether this old drug may experience a revival in the clinical management of viral diseases such as AIDS and severe acute respiratory syndrome, which afflict mankind in the era of globalisation.>>

    HCQ of course is closely related.

  386. 386
    kairosfocus says:

    F/N: More from the Raoult paper:

    >>Chloroquine, a decades-old antimalarial agent,33 an analog of quinine , was known to inhibit the acidification of intracellular compartments 34 (10)and has shown in vitro and in vivo (mice models) activity against different subtypes of 35 Coronaviruses: SARS-CoV-1, MERS-CoV, HCoV-229E and HCoV-OC43 (11-16). In 2004 it 36 was tested in vitro against SARS-CoV1 (17) and caused a 99% reduction of viral replication 37after 3 days at 16 [micro]M. Moreover, tests in vitro have shown inhibition of viral replication on 38 SARS-CoV2 detected by PCR and by CCK-8 assay(18). hydroxychloroquine39(hydroxychloroquinesulfate; 7-Chloro-4[4-(N-ethyl-N-b-hydroxyethylamino)–methylbutylamino]quinoline sulfate)has shown activity against SARS-CoV2 in vitro and 41 exhibited a less toxic profile(19)>>

    BTW, notice, some use of model animals.

  387. 387
    Bob O'H says:

    kf @ 381 – ah, thanks. I was looking for that. It didn’t age well, did it?

    They wrote

    Massive numbers of COVID-19 patients are currently being administered “unproven” drugs based on medical decisions made by doctors. Massive numbers are not receiving any such drugs. Thus, carefully designed case control studies could leverage differences between ongoing protocols at large hospital systems and detailed information from patients’ electronic medical records.

    and

    High quality case control studies based on thousands of cases, the silver standard we recommend, are immensely faster than RCTs.

    So where are these studies?

  388. 388
    Mac McTavish says:

    KF

    MMT, you are quite wrong as has been shown any number of times, you cleasrly did not read with care. Here we go

    Yes, I read that, and it is horrible. But you are comparing apples and armadillos. Modern clinical trials are highly regulated and informed patient consent is at the top of the list. Patients are not required to volunteer for a clinical trial, and they will continue to receive the best that medicine has to offer in their treatment.

    ET

    Earth to Mac & Cheese

    Please stop being so childish. If you can’t respond in a mature fashion maybe you should just not comment.

  389. 389
    RHolt says:

    I see that there has been a great deal of emphasis on in vitro data so much so that I feel it has led some astray from being able to evaluate the evidence for HCQ efficacy. For example many of the presented links are for virus research that is not COVID-19. When we look at the COVID-19 specific iin vitro data we see a different story. For example a recent publication presented data that HCQ does not prevent COVID-19 replication in lung tissue culture. The authors also present a mechanism describing why this data differs from the green monkey kidney cell data which should be addressed and not ignored. From a recent publication in Nature:

    https://theconversation.com/why-hydroxychloroquine-and-chloroquine-dont-block-coronavirus-infection-of-human-lung-cells-143234

    Their findings clearly show that that HQC can block the coronavirus from infecting kidney cells from the African green monkey. But it does not inhibit the virus in human lung cells – the primary site of infection for the SARS-CoV-2 virus.

    In order for the virus to enter a cell, it can do so by two mechanisms – one, when the SARS-CoV-2 spike protein attaches to the ACE2 receptor and inserts its genetic material into the cell. In the second mechanism, the virus is absorbed into some special compartments in cells called endosomes.

    Depending on the cell type, some, like kidney cells, need an enzyme called cathepsin L for the virus to successfully infect them. In lung cells, however, an enzyme called TMPRSS2 (on the cell surface) is necessary. Cathepsin L requires an acidic environment to function and allow the virus to infect the cell, while TMPRSS2 does not.

    [Deep knowledge, daily. Sign up for The Conversation’s newsletter.]

    In the green monkey kidney cells, both hydroxychloroquine and chloroquine decrease the acidity, which then disables the cathepsin L enzyme, blocking the virus from infecting the monkey cells. In human lung cells, which have very low levels of cathepsin L enzyme, the virus uses the enzyme TMPRSS2 to enter the cell. But because that enzyme is not controlled by acidity, neither HCQ and CQ can block the SARS-CoV-2 from infecting the lungs or stop the virus from replicating.

    Additionally, I’ve read some comments that suggest it is pH changes, via HCQ administration, that change the shape of the ACE receptor and prevents viral infection. On several fronts this is mistaken. To believe that HCQ can affect the tightly controled blood/plasma pH is to suggest that HCQ can overwhelm the bicarbonate buffer system (with dire consequences). This is simply mistaken. Recent cell culture work has elucidated the mechanism by which HCQ might affect the ACE receptor and it is through the mechanism of inhibiting terminal glycosylation of the ACE receptor that prevents COVID-19 infection. This has been demonstrated in cell culture but has not been confirmed in vivo.

  390. 390
    kairosfocus says:

    BO’H, laughably wrong by way of selective hyperskepticism, yet again. KF

  391. 391
    kairosfocus says:

    MMT, the relevance is highlighted step by step. After this fiasco the protocols are going to have to be redone again. KF

  392. 392
    Bob O'H says:

    kf @ 389 – Thanks. If it’s “laughably wrong by way of selective hyperskepticism” to simply ask for what the article asks for, I guess you might want to think twice before touting it again.

  393. 393
    Mac McTavish says:

    KF@390, I read your clip in detail. And, yes, it is a textbook example of medical malfeasance. Withholding a diagnosis and not providing effective treatments when they are discovered is medical malpractice. None of that is comparable to the modern clinical trials being conducted on HCQ. Patients are informed of their diagnosis and their prognosis. They are clearly informed that they may or may not receive the drug being tested and that neither they nor the doctor will know. It is the patient who makes the decision whether to be part of the trial.

    While the trial is proceeding they are still being treated according to best known practices. And they can opt out of the study at any time. That is a far cry from the case study you presented.

  394. 394
    RHolt says:

    While the trial is proceeding they are still being treated according to best known practices. And they can opt out of the study at any time. That is a far cry from the case study you presented.

    I agree that today’s clinical trials are a far cry from the Tuskagee fiasco that started 80 years ago. Progress has been made over those 80 years. Additionally, patients in clinical trials are often being treated with an experimental drug and compared to the accepted standard of care. If the trial is ended prematurely, e.g., toxicity of obvious lack of efficacy in the experimental. treatment, the patient is immediately treated with the accepted standard. I participated in a clinical trial and I was completely informed of what the treatment arms were comprised of and how I would be treated (not which treatment arm I would be assigned) throughout the trial. Randomized controlled trials, either with placebo or not, are the gold standard for reasons that have previously outlined. Retrospective studies are quite weak in informative power and are oftened riddled with biases that cannot be accounted for in these types of studies.

    I’d also point out that the plural of anecdote is not data. Anecdotal information is the weakest of all evidence in the medical literature and useless when gleaned from sources on the internet.

  395. 395
    ET says:

    Mac & Cheese:

    If you can’t respond in a mature fashion maybe you should just not comment.

    You should heed your own advice.

  396. 396
    RHolt says:

    We review the available information on the effects of chloroquine on viral infections, raising the question of whether this old drug may experience a revival in the clinical management of viral diseases such as AIDS and severe acute respiratory syndrome, which afflict mankind in the era of globalisation.

    One of the first things taught in cell culture, i.e., in vitro, research methodology is that cells in a dish on a bench top are not the same as an intact organism. Following that there is, typically, a great emphasis that in vitro results need to be considered very carefully and not to over-extrapolate these cell culture results to what actually happens with administration of the drug to a living organism.

    To underscore the need for such cautionary interpretations there were several invitro studies with HIV and HCQ treatment. One study (linked below) demonstrated a robust inhibition of HIV viral replication.

    Inhibition of Human Immunodeficiency Virus Type 1 Replication by Hydroxychloroquine in T Cells and Monocytes
    https://www.liebertpub.com/doi/abs/10.1089/aid.1993.9.91

    However, when the drug was tested in people to see if HCQ might be used to treat, or suppress, HIV the results demonstrated that in the HCQ treatment arm viral replication in these patients increased across the board. These data demonstrate that in vitro research results are useful in elucidating potential mechanisms of action and that these in vitro results cannot be assumed to ocurr in a living patient/animal.

    Effects of Hydroxychloroquine on Immune Activation and Disease Progression Among HIV-Infected Patients Not Receiving Antiretroviral Therapy A Randomized Controlled Trial
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3821003/

    Conclusion

    Among HIV-infected patients not taking antiretroviral therapy, the use of hydroxychloroquine compared with placebo did not reduce CD8 cell activation but did result in a greater decline in CD4 cell count and increased viral replication.

  397. 397
    kairosfocus says:

    BO’H: lo mismo. You insist on not attending to the cumulative body of evidence. Duly noted. KF

  398. 398
    kairosfocus says:

    MMT, “do no harm” goes back more or less to Hippocrates. Guess why placebos are “blind,” if not to create a false impression, clipping my comment and cite: “REPEAT: ‘who disguised placebos, ineffective methods, and diagnostic procedures as treatment’.” Further to such, leaving patients in one’s care facing a fast-moving deadly disease without reasonably accessible and credible treatments using a measure of deception is indefensible. Using the insistence on such an approach to hyperskeptically lock out recognising cumulative and even otherwise compelling evidence while ignoring that a pandemic is inherently a matter of urgency so too late implies never is even more indefensible. But then, at this point, I suspect almost nothing would persuade yo;, at least, we can see live what is going seriously wrong with our thinking. KF

  399. 399
    rhampton7 says:

    KF said “ there is one serious, cost effective, adequately evidence based treatment.

    You forgot Dexamethasone. I think it’s even cheaper and more widely available than HCQ

  400. 400
    rhampton7 says:

    Covid-19 patients in Slovenia are primarily treated with support measures that target symptoms, meaning they receive oxygen and fever-reducing drugs if necessary. Those with severe symptoms are given remdesivir, favipiravir and dexamethasone, drugs that research shows can be potentially effective.

    “These are drugs that multiple studies have shown to be potentially effective while also having a relatively favourable safety profile,” Logar added.

    Slovenian doctors do not use hydroxychloroquine, an arthritis medicine that also can be used to prevent malaria, nor do they use the antibiotic azithromycin or drugs for HIV, as these have been proven ineffective in multiple studies.

    https://www.total-slovenia-news.com/politics/6723-remdesivir-favipiravir-dexamethasone-the-main-covid-19-drugs-in-slovenia

  401. 401
    rhampton7 says:

    South African Health Minister Zweli Mkhize says a study has shown that the use of a steroid called dexamethasone on COVID-19 patients in ICU, has resulted in a decline of 25% in South Africa’s mortality rate among the critically ill.

    A clinical trial led by researchers at Oxford University found that when administrated intravenously, in small doses, dexamethasone reduced death rates by around a third among severely ill coronavirus patients.

    Local doctors have been using dexamethasone to treat critically ill COVID-19 patients for almost two months now.

    Mkhize said the steroid has already shown remarkable results.

    “Since the introduction of dexamethasone on 16 June, other studies show that there has been dramatic improvement at 30%-40%. The ICU mortality at the beginning of the pandemic was around 80%.”

    https://ewn.co.za/2020/08/05/dexamethasone-use-sees-25-drop-in-mortality-rate-of-critical-covid-patients-study

  402. 402
    rhampton7 says:

    we need to be realistic: A vaccine is not a silver bullet. Even if one (or more) is proven safe and effective, vaccines are notoriously difficult to make and distribute. People will continue to contract the virus because some won’t get vaccinated and because the vaccine may not be effective for everyone, particularly older populations at higher risk for illness and death. The annual flu vaccine, for example, reduces the risk for illness by only 40% to 60%, even in years when the vaccine is well matched to the circulating virus strain.

    So far, only two drugs have demonstrated a therapeutic effect against Covid-19 in randomized clinical trials: the antiviral remdesivir and the common steroid dexamethasone. Remdesivir reduced the recovery time for infected patients and dexamethasone reduced mortality for the sickest patients.

    The search for more effective drugs is belatedly underway. As of late July, scientists were examining nearly 300 potential treatments. The National Institutes of Health is preparing to launch large clinical trials of some of the most promising approaches, including studies of antiviral monoclonal antibodies, drugs that minimize out of control immune systems, and blood thinners to prevent problems caused by blood clots.

    An economic model that we and colleagues at the USC Schaeffer Center for Health Policy and Economics developed shows the importance of treatments in preserving hospital capabilities while reducing the number of deaths and the costs of care. A hypothetical treatment modeled loosely after Tamiflu, an antiviral medication used to treat the flu, that can cut the need for hospitalization by 50% would result in 285,000 fewer admissions for Covid-19 and up to 71,000 fewer deaths by the end of 2021, assuming that 20% of the population becomes infected and half of those with symptoms get the treatment.

    A hospital-based treatment for Covid-19 that can reduce the length of stay and mortality by 30% could save up to 85,000 lives.

    https://www.statnews.com/2020/08/05/we-need-a-covid-19-vaccine-but-we-need-new-treatments-too/

  403. 403
    jerry says:

    A hospital-based treatment for Covid-19 that can reduce the length of stay and mortality by 30% could save up to 85,000 lives.

    A treatment So far, only two drugs have demonstrated a therapeutic effect against Covid-19 in randomized clinical trials: the antiviral remdesivir and the common steroid dexamethasone used early in the progress of the disease could have save over a half million lives.

    So far, only two drugs have demonstrated a therapeutic effect against Covid-19 in randomized clinical trials: the antiviral remdesivir and the common steroid dexamethasone

    Have you looked at the testing for these two drugs? I have. They show a positive effect in certain situations but it is small.

    Instead of cutting and pasting try to learn about the virus. You might make meaningful comments. My guess is that you are not a natural English speaker and have trouble understanding the content of what you post.

  404. 404
    jerry says:

    A long but very interesting discussion by a doctor who has prescribed HCQ in the past and Scott Adams.

    https://www.youtube.com/watch?v=dZsxe5OruO0

    They discuss HCQ in detail and vaccines as well as the US politics involved.

    Comment by Scott Adams on a video He made which is discussed in the YouTube interview linked to

    Well, it’s been a day since the
    @FakeNews
    mocked Peter Navarro for referring to a video I made about the arguments for and against HCQ.

    Yet, not one criticism of the video itself.

    Not one.

    Just . . . personal attacks.

    Think about that.

  405. 405
    Mac McTavish says:

    KF, I guess me and the vast majority of the medical profession will just have to agree to disagree with you as it pertains to the ethics of clinical trials.

  406. 406
    jerry says:

    The Scott Adams video that the press denigrated but never linked to. https://twitter.com/ScottAdamsSays/status/1288910299643273217

    I tell you why Trump is medically correct and CNN might be killing tens-of-thousands

  407. 407
    jerry says:

    Who is lying and who is telling the truth about HCQ? An article by a experienced virologist.

    https://www.realclearpolitics.com/articles/2020/08/04/an_effective_covid_treatment_the_media_continues_to_besmirch_143875.html

    There is still $200,000 for anyone who can show HCQ and zinc don’t work to extremely reduce the effects of the virus when taken early.

  408. 408
    kairosfocus says:

    MMT, kindly go look at the history of eugenics, where its intellectual support was all but complete among educated elites across the board. Numbers count for nothing, only warrant. And it is clear something is seriously wrong here, evidently tied to the sort of ethical breakdown that is enabling the worst holocaust in history, that of our living posterity in the womb; directly implying gross breakdown of respect for life by the very profession most directly charged to defend it. In short, things are so bad with professional ethics that we should expect gross evils and errors. Next, I think there is a breakdown of understanding cumulative force of empirical evidence and there are clear decision theory shaped holes. The relativism of numbers fails, and with it your attempt to marginalise and dismiss. KF

  409. 409
    kairosfocus says:

    PS: A reminder, from earlier OP’s, showing that it is not just some contributor to a blog against the solid phalanx of the medical profession and medical research:

    ********
    https://www.mediterranee-infection.com/wp-content/uploads/2020/06/RCT-and-Outbreaks-main-manuscript-BMJ-v5.pdf

    Assay
    Randomised Controlled Trials during epidemic

    Philippe Brouqui, Pierre Verger, Didier Raoult
    Aix Marseille Université, IRD, MEPHI, VITROME,
    ORS Paca, IHU-Méditerranée Infection, Marseille,
    France

    In epidemics there is an urgent need for new knowledge on drug efficacy to help policymakers fight the crisis. Yet the best research methodology to do this is a matter of debate, write Philippe Brouqui, Pierre Verger and Didier Raoult .

    The outbreak of an emerging infectious agent needs the rapid involvement of research to bring new knowledge. Past experience with Ebola virus outbreaks and, more recently SARS-CoV 2, have raised a question over the place of randomised controlled trials (RCTs) as the methodology of choice to answer clinical questions in an novel epidemic situation. Drug safety and effectiveness is a long process which can take years. For antimicrobials, just 25% of drugs submitted to phase 1 succeed to Phase 3 and further licensing (1). This is why, in an epidemic, drug repurposing is often looked at, because drug toxicity has already been evaluated (2). [–> this also points to off-label use]

    An RCT is designed to attempt to reduce bias, particularly in trials evaluating new drugs. The principle is to random assign volunteers into two or more treatment options and then compare them against a measured outcome. As RCTs reduce causality and spurious bias, they are considered to be the most reliable form of scientific evidence. For these reasons, they are required for market authorisation of a new pharmaceutical drug and cited by healthcare policies as a mandatory means for decision -making about treatments.

    When gold standard becomes unethical

    In emerging disease outbreaks, there is an urgent lack of treatments for the new pathogen. When a particular therapeutic option is supported by scientifically demonstrated efficacy in vitro and or in animal model, and supported further by clinical case reports and/or pilot series in humans, it is ethically difficult to argue that the data still needs to be confirmed in an RCT before it can be made available to patients. Especially if it seems “obvious” that control (untreated) subjects will have poorer outcomes than those receiving treatment. [–> sounds familiar?] As one study mocked, there would be few volunteers for the placebo group in an RCT on the parachute’s effectiveness in avoiding death by jumping out of an airplane, unless the jump had an average height of 0.6 m (3).

    When even imperfect scientific data show a particularly obvious effect, it is no longer ethical to perform an RCT since it forces patients to accept either not to be treated (in the control arm), or to be treated with a molecule known to be effective. Consider the advent of penicillin. It took five
    patients before Sir Edward Abraham could definitively demonstrate that penicillin saved 100% of patients with staphylococcus or streptococcus infections. Nobody today would dare to test the efficacy of penicillin on pneumococcal pneumonia compared to placebo . . . >>

    And more can be said. I just note, this is essentially what was being brushed aside above over the past few days.

    KF

  410. 410
    ET says:

    Interesting Stats from Massachusetts roughly 6.9 million people:

    8709 deaths(from the MA web site)
    70+years old =7351 deaths
    69 and younger group with 1358 deaths
    No one under 19 has died from covid.
    98% of the deaths had a pre-existing condition ie, cancer asthma, Pneumonia .

    Doesn’t seem like something we need to shut down for…

  411. 411
    rhampton7 says:

    Michael Waxman, a pulmonary critical care physician who has worked at Research Medical Center (Kansas City) since 1985, said that one of the problems with the hydroxychloroquine story is that “people have been reporting next to everything they’ve been seeing, they’ve been experiencing, and there’s been an utter lack of really great research that’s been reported.”

    “In fact, probably a large amount of what you’re looking at is just simply observational data, assuming that it’s not bogus, as unfortunately there’s been a bit of. But even the other things are very observational and … you really need good science to try to differentiate.”

    “Large, randomized controlled trials” are the only way to find out whether hydroxychloroquine can prevent COVID-19 in people who are at risk of exposure to the infection, Duke’s researchers say.

    Pulmonologist Mario Castro, vice chair for clinical and translational research at the University of Kansas School of Medicine, and principal investigator of the HERO HCQ study site at KU, said that’s key about this study.

    “That’s one of the things that HERO has been combating, is that there’s very little prophylaxis information” about hydroxychloroquine, Castro said. “We are hoping now … that we’ll be able to answer this definitely with an adequate sample size.”

    https://www.kansascity.com/news/coronavirus/article244685792.html

  412. 412
    jerry says:

    Doesn’t seem like something we need to shut down for…

    People forget the perfect Petri dish. The Diamond Princess. My guess is over 2000 high risk subjects. I believe 14 died, all passengers.

    About 20% became infected but everyone was exposed. This gives credence to the hypothesis that a high percentage of the people are not susceptible to the virus.

  413. 413
    rhampton7 says:

    Hydroxychloroquine should not be used to treat or prevent coronavirus, the Australian government’s official COVID-19 evidence taskforce has recommended.

    The Walter and Eliza Hall Institute-led Covid Shield trial, which is testing whether hydroxychloroquine can protect healthcare workers from catching COVID-19, will still go ahead.

    “The question around using hydroxychloroquine as a preventative has still got substantial merit,” said Professor Marc Pellegrini, one of the study’s lead investigators.

    “There is an absence of evidence to support it, and an absence of evidence to suggest it does not work. Therefore it still has merit within the guise of clinical trials.”

    Associate Professor Julian Elliott, executive director of the National COVID-19 Clinical Evidence Taskforce , said the evidence was starting to point to the drug not working for prevention either.

    Two studies, with a combined 3135 patients, showed the drug did not prevent COVID-19 infections. But that is not enough data to conclusively show the drug does not work for prevention.

    “It looks like the effect is close to zero. But it is only two trials and 3135 patients,” Professor Elliot said.

    https://www.smh.com.au/national/thumbs-down-for-hydroxychloroquine-from-government-virus-taskforce-20200806-p55j76.html

  414. 414
    rhampton7 says:

    The Uttar Pradesh government has approved the use of Ivermectin as a new medication for the treatment and prevention of Covid-19. The drug will replace hydroxychloroquine.

    Dr Navneet Kumar Verma, treasurer IMA (Ghaziabad chapter), while explaining the difference between the two drugs, said that hydroxychloroquine is essentially an anti-malarial drug while Ivermectin is an anti-parasitic drug — which has been found to be more effective in the treatment of Covid -19.

    “Ivermectin blocks entry of virus at multiple points thereby acting as an inhibitor for covid-19 causative virus (SARS-CoV-2), it has little side effect as compared to hydroxychloroquine which has found to be causing cardiac-related ailments in the long run,” said Verma.

    The Ghaziabad DM, meanwhile, said use of Ivermectin is prevalent in the district and after state government’s direction hydroxychloroquine will be replaced. “We have enough stock of Ivermectin in the district” informed Ajay Shankar Pandey, district magistrate, Ghaziabad.

    https://timesofindia.indiatimes.com/city/noida/ivermectin-to-be-used-for-covid-treatment-in-up-to-replace-hcq/articleshow/77423417.cms

  415. 415
    rhampton7 says:

    HCQ replacement…

    Sources in the government said that the decision to replace Hydroxychloroquine (HCQ) with Ivermectin was taken after encouraging results in Agra, where it was used on an experimental basis.
    Sources said that the medicine proved effective in not only in the treatment of Covid-19 patients but also in preventing large scale infection among frontline health workers engaged in the treatment and handling of Covid-19 patients.

    “There were a lot of issues with HCQ. Therefore, we have now been instructed to instead use Ivermectin as per the prescribed doses. We will start distribution of the medicine among frontline health workers and also during contact tracing from Saturday onwards,” said Lucknow Chief Medical Officer Dr RP Singh.

    https://indianexpress.com/article/india/up-new-protocol-ivermectin-to-replace-hcq-in-treatment-of-covid-patients-6545236/

  416. 416
    kairosfocus says:

    RH7,

    the one sided bury the inconvenient evidence story continues.

    (Which, BTW, is revealing on deeper patterns of ideological thinking that are relevant to, say, why so many are so resistant to the well warranted inference that on reliable observable signs, design is best causal explanation of various phenomena such as C-Chem, aqueous medium cell based life that uses alphanumeric, 4-state per element digital code in algorithms carried out through molecular nanotech. Language and goal directed processes with functionally specific complex systems and well matched components are pretty strong signs of intelligent design. But there is an old saying that there’s none so blind as he who will not see. This wider issue in the news, how treatments for CV19 are responded to in centres of influence then by more or less ordinary people, is a part of a far wider and deeper problem that is leading our ship of civilisation towards needless shipwreck. But then, Plato’s warning on that is nearly 2400 years old but is hardly present in our collective consciousness. And people by and large are too unaware to ask pointed questions as to why, and as to who would benefit from the current business as usual.)

    Back on focal issue, FYI Dr Didier Raoult is at least comparable to Dr Fauci, and there are such things as natural regularities that are strong enough to be observable on reasonable encounter. That’s why the sciences in general go well beyond being merely applied statistics. It is also why there is such a thing as insightful, prudential informed judgement leading to foresight and to general competence in strategic level decision making etc.

    Recall, he heads a research institute with 80+ researchers, based in a hospital complex of 4, with 3500 or so beds. Recall, as just one part of his investigation he ordered up 2000+ CT scans for 500+ patients, itself a million dollar exercise given what such scans require in equipment, facilities, staff, infrastructure. It is in that context that he has clustered preliminary evidence from labs etc that have established adequate credibility to warrant the HCQ-Azithro core of the cocktail protocol, to which Dr Zelenko has added Zn supplementation. And on the strength of this, he has given results on now a base of 3,000+ patients regarding differential results of BAU vs ALT. ALT is clearly cost-effective.

    That can be taken as reasonably established, adequately warranted. The issue going forward is not really whether such cocktails, suitably targetted are a cost effective treatment that could have averted needless loss in the 10’s of thousands or more range, but why the entrenched objections to both the protocol and to what would otherwise be a straightforward application of decision theory on evaluation of cost, effectiveness and risk assessed outcomes.

    A key part of that is that we habitually look to authorities we are comfortable and familiar with, for thought, policy and action leadership. In that, we often fail to do due diligence on the actual strength of cases, but instead cheer on one’s preferred team. And here, Dr Raoult is not a familiar voice in the Anglophone world.

    Now, too, one of the issues in strategic change is that there is no end of rhetoric/argument with clever people who view things this way or that.

    For example in the 1920’s von Mises showed the critical issue that central planners could not calculate values [and by extension could not process enough information of adequate quality to plan an economy]. It took to the turn of the 90’s for critical breakdown to show empirically that he was right and that therefore most planning of an economy should be by households and firms interacting through reasonably free markets supported by good law and order.

    (Thirty years later, astonishingly, many clever people are still trying to bring back in central, ideologically driven planning. Never mind the ongoing, utterly needless fiasco in oil-rich Venezuela and the associated tyranny and oppression. The culture-form marxists and their critical theories, identity group resentment politics, deconstructionist tactics, agit prop — including now Red Guards rioting in the streets — a riding a wave of hopes to seize power in the geostrategic centre of our civilisation, through a 4GW, media amplified insurgency pivoting on discredit and demonise the symbolic centres of leadership and influence defending the despised legacy order. They obviously have never heard of what happened to the dog that chased the car only to be invited to drive. It couldn’t. And frankly, some of what is going on with the pandemic is related. A group of drunks unable to stand up on their own, can come together in a shaky stability and make seeming progress. Until the house of cards comes tumbling down; here, predictably over the next 6 – 18 months.)

    Coming back to the particular focal issue for this thread i/l/o that context, there have clearly been adequate observations to show that for vulnerable people early enough in the U/L trajectory of CV19, HCQ-based cocktails can and often do rapidly suppress viral replication and suppress onward complications such as secondary bacterial infections [azithro], leading to drastically shifted outcomes for those groups. That’s been strongly shown since March, complete with an iconic, widely shared plot of the trend of treatment results. The groups that can have CASE — nobody knows enough to estimate actual INFECTION values — fatality rates of several percent to double digit percent have a viable option. That is what Dr Zelenko and others up to the Frontline Doctors and Swiss Doctors have run with in what is now clearly an insurgency of frontline doctors against the establishment.

    In short, there have been enough reasonable investigations, with thousands of cases, to substantiate a credible alternative to the implicit baseline business as usual treatment as flu-like illnesses prone to complications.

    In addition, as I again remind from Dr Raoult and have taken time to highlight for several days now, that there is a background of plausible causal mechanisms shown through lab investigations and even some animal modelling. We are dealing with a fairly broad spectrum antiviral action. Where, the ability of HCQ to work as fish tank cleaner is actually a significant sign: complex animals thrive, the crud dies, crud from across several kingdoms of life. That means HCQ attacks core biochemical life processes tied to metabolism and/or replication. Which is what is recognised from the lab.

    So, the sort of statistical outcomes Dr Raoult identified are not an isolated surprise with no connexions to our relevant knowledge base. And, on 65 years of practice, HCQ has readily managed toxicity, the agit prop scare on that was grossly unjustified and irresponsible, with life on the line.

    Of course, other treatments are emerging to complement or supplement or to adapt the protocol. Of these ivermectin and doxycycline are perhaps the most common. The latter gets away from the cardio toxicity issues for Azithro. The former seems able to extend the reach of the protocol down the descending arm of the U/L trajectory. Doubtless, further investigations will bring up further possibilities. Fine.

    What is not so fine is the cost in lives and needless disruption over the past four months tracing to stubborn, interested resistance to the simple expedient of acknowledging the Raoult results. That is where, for cause, history will judge us harshly.

    KF

  417. 417
    ET says:

    Personally, I would use quercetin instead of HCQ, anyway. Quercetin, liposomal vitamin C, vitamin D along w/ Omegas 3-6-9, and zinc. And Cell Power to top it all off.

    Take that cocktail and survive the virus

  418. 418
    jerry says:

    There are several potential treatments for the C19 virus. Ivermectin mentioned above was first introduced here 2 1/2 months ago.

    https://uncommondescent.com/medicine/doctor-ivette-lozano-from-dallas-texas-on-treating-patients-with-hcq-cocktails/#comment-702505

    Remdesivir was mentioned here over 3 months ago. The interesting thing about this drug is that is has only a small advantage but since a RCT has been conducted showing this small advantage it is lionized. This shows the shallowness of the support for a RCT.

    https://uncommondescent.com/medicine/the-worlds-physicians-weigh-in-they-want-hydroxychloroquine-and-azithromycin/#comment-697488

    dexamethasone popped up as a result of the Recovery trial as a late stage treatment.

    https://uncommondescent.com/medicine/dr-raoult-roars-new-articles-on-findings-and-issues-about-hcq-cocktails-for-covid-19/#comment-704446

    Vitamin D deficiency has been linked to high increased likelihood of severe results to C19 infection. Referenced here almost 4 months ago. This has become a hot topic around world as possible preventive for C19 severe infection.

    https://uncommondescent.com/intelligent-design/inference-review-devotes-issue-to-covid-19/#comment-698682

    RHampton actually pointed to Tamiflu as helpful in treating C19. See #59 in this thread. The drug name for it is Oseltamivir. He also pointed to HCQ being effective in the same comment.

    Pepcid or famotidine came up here almost 3 months ago
    https://uncommondescent.com/medicine/doctor-ivette-lozano-from-dallas-texas-on-treating-patients-with-hcq-cocktails/#comment-702301

    As mentioned just above quercetin and zinc may prove extremely beneficial. In the interview with Scott Adams above the doctor said he was taking it. Dr. Zelenko recommends it too. Recommended by Eastern Virginia Medical School here four months ago.

    https://uncommondescent.com/intelligent-design/inference-review-devotes-issue-to-covid-19/#comment-698682

    There are several others. No one is arguing against any of these except some have use only in late stages of the infection during hospitalization and not for early use and prevention of hospitalization. Some are extremely expensive. Some are over the counter and extremely cheap. For example, Vitamin D, quercetin and zinc. HCQ is extremely cheap as the list price in drug stores a couple months ago was about 20 cents per pill.

  419. 419
    jerry says:

    Hope:
    Korean study on HCQ

    Early Hydroxychloroquine Administration for Rapid Severe Acute Respiratory Syndrome Coronavirus 2 Eradication

    There are no proven therapeutics for Coronavirus disease 2019 (COVID-19) pneumonia outbreak. We observed and analyzed the clinical efficacy of the most used hydroxychloroquine (HCQ) for 30 days. In this study, administration of HCQ <5 days from diagnosis (odds ratio: 0.111, 95% confidence interval: 0.034 – 0.367, P = 0.001) was the only protective factor for prolonging of viral shedding in COVID-19 patients. Early administration of HCQ significantly ameliorates inflammatory cytokine secretion by eradicating COVID-19, at discharge. Our findings suggest that patients confirmed of COVID-19 infection should be administrated HCQ as soon as possible.

    https://bit.ly/2Pxw4eO

    I found this posted by a doctor in McKinney Texas who has treated 5% of the patients in his county of 780,000. The county (Collin) for McKinney has a death rate of 113 per million while Texas has 288 deaths per million and the United States has 487 deaths per million and NY state has 1687 deaths per million. Maybe one of the reasons McKinney has such a low death rate is that some of the doctors are using HCQ and zinc. This particular doctor has treated 333 C19 patients with 1 death.

    Recommended diet and supplements for boosting immune system

    https://bit.ly/2XGnMpy

  420. 420
    jerry says:

    Truth -Why HCQ doesn’t work

    A retweet by Ilan Swartz MD who said he Just learned precisely why hydroxychloroquine doesn’t work

    tweet from Kulvinder Kaur MD a Canadian doctor – You may have noticed extreme anti-#HCQ #COVID19 rhetoric/biases of some Cdn academics-esp in Toronto, Montreal, Edmonton Reminder: #Remdesivir patented by #Gilead: $100 M+ Edmonton manufacturing plant & has given LARGE research/education grants to Cdn hosps &academic institutions

    Could other investments in the US explain the US medical community’s attitude toward HCQ?

    This would explain why HCQ works in most of the world but not in the US or Canada?

  421. 421
    jerry says:

    Hope

    Is the secret to beating the virus T-cell immunity.

    https://bit.ly/2PBLrmy

    Is this the reason why most exposed never get the virus? Study from Karolinska Institute – https://bit.ly/2F9207z

  422. 422
    rhampton7 says:

    Susceptibility to COVID-19 in patients treated with antimalarials: a population based study in Emilia-Romagna, Northern Italy

    OBJECTIVES: To evaluate the susceptibility of coronavirus disease 2019 (COVID-19) in patients with autoimmune conditions treated with antimalarials in a population-based study.

    METHODS: All residents treated with chloroquine/hydroxychloroquine (CQ/HCQ) from July through December 2019 and living in 3 provinces of Regione Emilia-Romagna were identified by drug prescription registries and matched with the registry containing all residents, living in the same areas, who have had swabs and positive swabs for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

    RESULTS: 4,408 patients were identified. The prevalence of antimalarial users was 0.85/1000 in males and 3.3/1000 in females. The cumulative incidence of being tested during the study period was 2.7% in the general population and 3.8% in CQ/HCQ users, while the cumulative incidence of testing positive was 0.55% in the general population and 0.70% in users. Multivariate models showed that CQ/HCQ users had a slightly higher probability of being tested compared to general population (OR 1.09, 95%CI 0.94-1.28), the same probability of being diagnosed with COVID-19 (OR 0.94, 95%CI 0.66-1.34), and a slightly lower probability of being positive once tested (OR 0.83, 95%CI 0.56-1.23). All three differences were not statistically significant.

    CONCLUSIONS: Our study did not support the prophylactic use of antimalarials for COVID-19.

    https://www.docwirenews.com/abstracts/susceptibility-to-covid-19-in-patients-treated-with-antimalarials-a-population-based-study-in-emilia-romagna-northern-italy/

  423. 423
    rhampton7 says:

    State Rep. Randy Fine, R-Palm Bay, was released from the hospital after a five-day stay related to severe COVID-19 symptoms and lung damage.

    Fine said that his lungs could be damaged for weeks, months or even indefinitely and that he will have to continue to see a lung specialist for checkups and possible treatment even as the worst of his symptoms have been treated.

    “It ain’t the flu. When the flu’s over, it’s over,” he said. “You’re typically not dealing with this.”

    Other than the residual effects on his lungs, Fine said he’s feeling largely healthy and is taking several prescriptions to help with the healing process.

    https://www.floridatoday.com/story/news/2020/08/08/rep-randy-fine-released-after-covid-19-hospitalization/3326104001/

  424. 424
    rhampton7 says:

    In mid-July, the Trump administration instructed hospitals to change the way they reported data on their coronavirus patients, promising the new approach would provide better, more up-to-the-minute information about the virus’s toll and allow resources and supplies to be quickly dispatched across the country.

    Instead, the move has created widespread confusion, leaving some states in the dark about their hospitals’ remaining bed and intensive care capacity and, at least temporarily, removing this information from public view. As a result, it has been unclear how many people are in hospitals being treated for COVID-19.

    Hospitalizations for COVID-19 have been seen as a key metric of both the coronavirus’s toll and the health care system’s ability to deal with it.

    Asked about the lack of timely data on its public website, HHS said it will update the site to “make it clear that the estimates are only updated weekly.” HHS is now posting a date file each day on healthdata.gov with aggregate information on hospitalizations by state.

    But unlike the prior releases from CDC, which provided estimates on hospital capacity based on the responses, this file only gives totals for the hospitals that reported data. It’s unclear which hospitals did not report, how large they are, or whether the reported data is representative.

    It’s also unclear if it’s accurate.

    Louisiana says more than 1,500 people are currently hospitalized with COVID-19. The federal data puts the figure at fewer than 700.

    Nationally, The COVID Tracking Project reports that more than 56,000 people were hospitalized around the country with the virus, as of Thursday.

    The data released by HHS on Friday puts the figure at more than 70,000.

    https://www.dailyherald.com/news/20200808/how-many-people-in-the-us-are-hospitalized-with-covid-19-who-knows-

  425. 425
    rhampton7 says:

    What is Ivermectin?

    Ivermectin is an inhibitor of the COVID-19 causative virus (SARS-CoV-2) in vitro. (remember in vitro success does not equal success within the human body)

    A single treatment able to effect ~5000-fold reduction in virus at 48 h in cell culture

    Ivermectin is FDA-approved for parasitic infections, and therefore has a potential for repurposing.

    Ivermectin is widely available, due to its inclusion on the WHO model list of essential medicines.

    https://www.indiatvnews.com/fyi/ivermectin-new-drug-to-treat-covid-19-coronavirus-to-be-used-in-uttar-pradesh-640473

  426. 426
    kairosfocus says:

    RH7,

    it is almost amusing to see how you managed to side-step the very first exchange in this blog on ivermectin once it was linked just above, in the Dr Lozano thread of discussion:

    196, May 23, 2020 at 6:49 pm, jerry: >> . . . Another doctor with success stories using HCQ plus. Adding Ivermectin to zinc and azithromycin

    https://www.nbcmiami.com/news/local/local-doctor-tries-new-coronavirus-drug-treatment/2219465/ >>

    Then, KF, 197: >>I clip from Jerry’s linked:

    [Dr. Jean-Jacques Rajter] and his wife, who is also a pulmonologist, are pioneering the use of an anti-parasitic drug called Ivermectin to fight the novel coronavirus.

    “If we get to these people early, and what I mean by that is if their oxygen requirements are less than 50%, I’ve had nearly a 100% response rate, they all improve, if they’re on more oxygen than that, then it becomes a little more varied, some people, they don’t respond anymore because they are too far advanced,” explained Dr. Rajter.

    Two weeks ago, Dr. Rajter started adding Ivermectin to the cocktail of drugs currently used to treat COVID-19: hydroxychloraquine, azithromycin, and zinc sulfate. [–> shows where a lot of clinicians are]

    Since then he’s treated dozens of people with this combination, with results so encouraging, he calls them remarkable. Dr. Rajter is in the process of publishing a scientific paper, which could take weeks to publicize the findings.

    “But if I wait, every day that goes by is another day when lots and lots of people get very sick, go to ICU, many of them die and that could theoretically even be preventable and that’s why I thought it was so critically important to get this information out there,” Dr. Rajter said.

    He credits his wife, Dr. Juliana Cepelowicz-Rajter, with the idea of using Ivermectin for this purpose. She came across Australian research which showed Ivermectin destroys the virus in the lab, in vitro, but it has not been studied for this purpose in people. [–> sounds familiar regarding cumulative evidence? It should]

    “More studies need to be conducted,” Dr. Cepelowicz-Rajter said. “We haven’t had any ill effects from it and it’s readily available, we have some patients who are pretty advanced, not yet intubated, and even those, in 12 hours, they showed a significant improvement.”

    Notice, how he speaks:

    It is not a cure.

    That’s the first thing Dr. Jean-Jacques Rajter wants everyone to know about the treatment he’s using on his COVID-19 patients at Broward Health Medical Center.

    “Ideally, the sooner you get to them, the better off they are,” said Dr. Rajter, a pulmonologist.

    The key principle, clearly is, a stitch in time saves nine.>>

    Then comes my further note in 198:

    >>Notice, discussion in the context of a patient, a Mr Reed:

    Dr. Rajter said Reed fit the criteria he set for trying the new regimen. Reed was in bad shape, rapidly going downhill, but not yet ready to intubate. As Rajter explains it, once they’re intubated, the medication does not have as much impact.

    “I took those people who invariably were going to crash, meant they were going from room air to 50% oxygen in a matter of hours, I know where that’s headed,” Dr. Rajter said, pointing out that COVID-19 patients often deteriorate extremely fast.

    The FDA issued a warning today, saying while Ivermectin is approved for use in humans to fight parasites, more studies need to be done to prove its worth in fighting COVID19.

    Dr. Rajter agrees and so does Dr. Cepelowicz-Rajter, saying that’s exactly what they are doing. [–> through cases implicitly compared to business as usual]

    In fact, Dr. Rajter received approval late Monday afternoon from Broward Health to use his protocol in all of their hospitals. That means COVID-19 patients at Broward Health Medical Center, Broward Health North. Broward Health Imperial Point, and Broward Health Coral Springs might be receiving the Ivermectin cocktail, depending on their conditions.

    Notice, Ivermectin had in vitro effect and was tried using off label, emergency and compassionate principles. If this holds up, we may be seeing how further increments to the cocktail just may stretch the window of effectiveness.

    The pessimism on once one goes on tubes [or a ventilator] should also be noted.>>

    KF

  427. 427
    Mac McTavish says:

    “ In a dark season of pestilence, COVID has reduced to tatters the illusion of American exceptionalism. At the height of the crisis, with more than 2,000 dying each day, Americans found themselves members of a failed state, ruled by a dysfunctional and incompetent government largely responsible for death rates that added a tragic coda to America’s claim to supremacy in the world.”

    https://www.rollingstone.com/politics/political-commentary/covid-19-end-of-american-era-wade-davis-1038206/?fbclid=IwAR2QrkRZQyFY9Bl7jZ8dBJAGnL7TS9oZbT9GpIzGdwQo0S8U2Hac7thU0Cs

    Food for thought.

  428. 428
    Bob O'H says:

    Jerry @ 416 – here’s a test of your critical thinking. Give 3 reasons used by HCQ proponents to dismiss studies that apply to this study. Then explain why none of them are applicable.

  429. 429
    kairosfocus says:

    BO’H: Again, you fail the ethics-epistemology test. There is adequate cumulative evidence to see why HCQ based cocktails, applied to at risk sub populations at an early point on the U/L trajectory of CV19, will and do work quite well. Indeed, some results track consistently sharp reduction in virus load in 2 – 6 days, as was published months ago. Similarly, there is adequate cumulative evidence to show that there is a pattern of fallacious reasoning and investigations that tends to obscure that. The gold standard evidence fallacy fails ethical tests not to harm and not to deceive, also opening the door for selective hyperskepticism towards what is perceived as weak or dismissible evidence. when in fact, empirical cases are often cumulative, like a rope: short, relatively weak fibres are twisted to form a longer stronger strand. Such are counter twisted [or sometimes braided] to form a long strong rope. Linked, negative result tests strongly tend to be too late in the U/L trajectory, or isolate components of a synergistic system or target populations that are not at serious risk. In addition, lab evidence and linked plausible that HCQ cocktails will have antiviral effect are disregarded. To do so, it is often neglected that HCQ has a long track record as an orally administered drug and that key tests have used plausible concentrations. Similarly, that long track record shows manageable toxicity, which is a general problem for drugs. (Even water under certain circumstances becomes toxic.) KF

  430. 430
    kairosfocus says:

    MMT,

    inadvertently revealing propagandistic, utterly fallacious nonsense tracing to undue ideological polarisation tied to culture form marxist domination of progressivist political thought; a thinly disguised version of the long since discredited crisis of capitalism. Stalin hoped that the 1930’s were the crisis, his genius economist Kondratiev showed this was a long wave phenomenon; Stalin had him shot, but 90 years of onward history and scholarship shows him right.

    First, the US is not now nor has it ever been a failed state, something comparable to Somalia, Venezuela or the like. Where. stirred up street theatre agit prop and riots duly media amplified and twisted through journalistic malpractice do not portray a responsible first, rough draft of history.

    Second, the American experiment created the breakthrough to the modern, constitutional, rights guarding democratic state, an achievement that said marxists are ever so eager to bury through tendentious misreadings of history such as the silly contrast 1619 vs 1776; proponents of such are now forced to admit critical historical flaws in that new narrative.

    Third, coverage of the pandemic is too often a case of demanding impossible perfection and drawing dubious comparisons that do not properly reckon with the key differences between societies and economies. Where, any flu like epidemic that breaks out will naturally infect millions to dozens of millions and will have a fairly high death toll especially among the elderly. At this point we do not credibly know infection rates and infection fatality rates, though indicators are, it is comparable to a bad flu season, down in the per thousands.

    Yes, a novel experiment in lockdown was tried and predictably induced recession [no work, no wealth creation, consumption falls, debts and other financial pressures mount etc], already limited reopening has led to a bounce back, reflected in employment numbers.

    I suspect, there will be a lot more skepticism about such lockdowns in future.

    KF

  431. 431
    jerry says:

    Give 3 reasons used by HCQ proponents to dismiss studies that apply to this study. Then explain why none of them are applicable.

    All the studies that are use to dismiss HCQ are done either at the wrong time of the virus progression or on the wrong target patient population. A third is they are done using the wrong criteria for evaluation.

    The appropriate time is early in the progress of the virus with high risk patients. The objective is preventing hospitalization and thus mortality. All three must be present for any study to be valid. Not just one or two. So any study in hospitals is out for disproving HCQ. Any studies on low risk patients is out for disproving HCQ. Any studies not using hospitalization or mortality is out for dis proving HCQ.

  432. 432
    jerry says:

    By the way Fauci was lying in front of the US Congress. Why?

    He knows the three criteria ar essential. Especially when there is no competitive effective treatment.

    A lot of promising alternatives are out there. Remdesivir is not one of them.

  433. 433
    ET says:

    The only thing US governments did wrong was forcing sick elderly people to go back to their respective nursing homes. Everything else that went wrong is on we, the people. But people, especially alleged journalists, cannot handle being responsible so they try to blame others.

  434. 434
  435. 435
    jerry says:

    From the hottest of the hot spots in US. New Jersey. Just spent two weeks there on vacation.

    June/July deaths in NJ 2018: 11,986
    June/July deaths in NJ 2019: 11,734
    June/July deaths in NJ 2020: 11,881

    I assume numbers are right. Posted on Twitter. Of course northern NJ and south Jersey are very different worlds. We were in south Jersey.

  436. 436
    Bob O'H says:

    Jerry @ 428 –

    The appropriate time is early in the progress of the virus with high risk patients. The objective is preventing hospitalization and thus mortality. All three must be present for any study to be valid. Not just one or two. So any study in hospitals is out for disproving HCQ. Any studies on low risk patients is out for disproving HCQ. Any studies not using hospitalization or mortality is out for dis proving HCQ.

    Thank you. Now read the study.

    The appropriate time is early in the progress of the virus

    The subjects were enrolled at a hospital. From the paper:

    We enrolled 99 patients confirmed with SARS-CoV-2 infection at Yeungnam University Medical Center in Daegu, Korea.

    and lest there be doubt (because that is not clear), in the net paragraph they write

    Patients were enrolled if they met one of the following criteria: (1) cured and discharged within 30 days without viral shedding; (2) remained in the hospital without viral shedding; (3) viral shedding at 30 days.

    It’s impossible to be discharged from a hospital without being in it.

    OK, now point 2:

    with high risk patients.

    From the paper:

    Forty-three patients were determined as men (43.4%) and the median age was 59 years (interquartile range [IQR], 45 – 68 years).

    So over 3 quarters were below 70 years old, and most were below 50 years old. So most weren’t in the high risk categories.

    The objective is preventing hospitalization and thus mortality.

    Well, all were hospitalised. What about mortality? This is what they say about it:

    Nine patients who died less than 30 days after the diagnosis with viral shedding were excluded.

    IOW they ignore it.

    So, you’re 3/3: by your standards the study should be ignored.

    FWIW, I was expecting you to say that it’s not just HCQ, it should be an HCQ+AZ treatment (possibly even HCQ+AZ+Zn) that needs to be considered. Of course, the paper only mentions HCQ.

  437. 437
    RHolt says:

    Bob O’H @ 433 those were the criticisms I was going to make of the posted study. It, im my opinion, is the poster child for why retrospective studies are considered as a very weak form of analysis. Discarding problematic patients introduces fatal biases into the research. The only way to tease out cause, effect, and efficacy is via randomized controlled trials, with or without placebo, where all patients in the study are included under the intent to treat category.

  438. 438
    ET says:

    Proper OTC supplementation would have prevented over half of the covid-19 fatalities. The media should be hyping that medically recommended prophylaxis.

  439. 439
    jerry says:

    Now read the study.

    What study? I found the one referenced in Korea and don’t know what relevance it has. It’s a small study of the characteristics of hospitalized C19 patients back in March.

    It has no relevance in disputing HCQ.

  440. 440
    rhampton7 says:

    For those individuals who do contract the virus and are hospitalized, treatment options continue to be available for those patients, including remdesivir and dexamethasone. Michael Lamanteer, the chief medical officer for the BSA Health Care System said BSA has treated more than 40 patients with remdesivir and around 200 patients with dexamethasone.

    Brian Weis, the chief medical officer at Northwest Texas Health Care System, said 16 patients are currently being treated with remdesivir at Northwest, out of the 74 patients overall that have been treated with the medication.

    But one treatment both hospitals were offering, tocilizumab, has been proven to not have a benefit against the COVID-19 virus, Weis said.

    “They showed no benefit, in terms of these patients clinically, from this drug,” he said. “That now takes out hydroxychloroquine and tocilizumab as two drugs that we thought might be promising, but now the data is telling us that they are not beneficial in patients hospitalized with COVID-19.”

    https://www.amarillo.com/news/20200808/medical-professionals-speak-on-covid-19-treatment-potential-of-vaccine?template=ampart

  441. 441
    rhampton7 says:

    Patients treating lupus and other autoimmune diseases are having a difficult time filling their routine hydroxychloroquine prescriptions, as the product has not only become very scarce but very expensive when it is available.

    Experts have also warned that patients with Lupus, which has no cure, will be facing tougher times in the weeks and months to come if the scarcity of hydroxychloroquine continues because the drug is crucial for its management.

    The experts say when lupus or rheumatoid arthritis patients stop taking their medication regularly, they can become more ill or their symptoms may aggravate.

    The scarcity and high cost of hydroxychloroquine, according to findings of PUNCH HealthWise is as a result of its increased demand due to reports it can be used to treat COVID-19 – even though there is no scientific evidence of its efficacy against the viral infection.

    https://punchng.com/experts-warn-of-tougher-times-for-lupus-patients-as-hydroxychloroquine-price-soars/?amp=1

  442. 442
    rhampton7 says:

    Israeli health officials reported on Sunday morning that another 16 coronavirus patients have died from various complication in the past 24 hours.

    The Health Ministry said since midnight Sunday alone, five people have succumbed to the disease, bringing the national death toll to 597.
    There are 394 patients in a serious condition, of which 118 are ventilated – the highest tally since the peak of the first wave in mid-April. The number of ventilated patients has seen a spike of 25% in the past nine days.

    Hadassah Ein Kerem Hospital, Shaare Zedek Medical Center, Ichilov Medical Center and Sheba Medical Center all reported their coronavirus wards have reached full capacity, even though they continue to accept more patients.

    https://www.ynetnews.com/article/SypohXpWv

  443. 443
    Bob O'H says:

    Jerry @ 435 – you highlighted it with the title Hope. Are you now saying that hope is irrelevant?

  444. 444
    rhampton7 says:

    In May, Brazil recommended the chloroquine and hydroxychloroquine for even mild Covid-19 cases. Hhealth minister Nelson Teich, an oncologist, resigned a month later after refusing to back Bolsonaro’s insistence on the treatment.

    The health ministry said it has distributed 4.4 million chloroquine pills, millions of which were produced by the army.

    Julio Croda, a professor of medicine who until March ran Brazilian Health Ministry’s Transmissible Diseases and Immunization Department said, “ They are focused on treatment with no scientific proof. The Ministry is doing nothing from the technical point of view.”

    Brazil’s Covid-19 statistics have also come under scrutiny because of widespread underreporting. Brazil has performed 2.1 million antibody tests — 945,000 of them in private laboratories — the health ministry said, and 2.6 million less accurate “fast” tests. In June, Brazil’s health ministry even stopped publishing total numbers of deaths and cases, until a Supreme Court judge intervened and ordered the reporting to resume.

    Jesem Orellana, an epidemiologist with Fiocruz, said he believes Brazil’s total deaths could already be as high as 90,000 to 100,000, because many victims are buried without tests or even reaching a hospital. He and four other researchers calculated 22,000 excess deaths in just four cities — Rio de Janeiro, São Paulo, Manaus, and Fortaleza — from February 23 to June 13, compared to the averages from 2015 to 2019 for the same periods.

    https://theintercept.com/2020/07/21/coronavirus-brazil-interior-bolsonaro/

  445. 445
    rhampton7 says:

    I give you below the comment I made on this news from Agence France-Presse published by Médiapart:

    >> “Brazil deplores 478 deaths per million inhabitants, a figure equivalent to that of the United States (487), but lower than that of Spain (609) or Italy (583).”

    >> In France, we deplore to date (8/9/20) 30,324 deaths for 66,524,000 inhabitants, or 456 deaths per million inhabitants.

    >> So about as much as in Brazil and the USA but with one small difference, it is that in Brazil and the USA, things are still blazing while it is calming down in France despite the alarmist remarks made “ad nauseam” in all JT.

    >> Something bothers me all the same in terms of experience:

    >> tell me, it’s not in Brazil that Professor Raoult’s treatment is prescribed in the event of infection with COVID19? ”

    I have no doubt for a single second that the valiant defenders of Professor Raoult’s treatment will be able to give me all the useful explanations on this astonishing similarity between these figures of COVID19 mortality per million inhabitant between an enlightened country like Brazil and an obscurantist country. like France, which we can read on a number of comment threads that it is supposed to have had the worst results in the world in terms of COVID19 mortality and that, of course, because Professor Raoult’s treatment did not had not been administered.

    Astonishing, isn’t it?

    These figures once again confirm what I have already written on April 10, 2020 as well as on April 22, 2020 , and repeated quite a few times on a lot of comments thread devoted to COVID19, namely that, according to the figures (even those given by the IHU Marseille-Méditerannée), the effectiveness of the HCQ-Azithro treatment by Pr Raoult is far from being demonstrated.

    https://blogs.mediapart.fr/le-concombre-masque/blog/090820/hcq-azithro-traitement-miracle

  446. 446
    rhampton7 says:

    Steve Kirsch, founder of San Francisco-based COVID-19 Early Treatment Fund and entrepreneur and philanthropist, is hoping to help researchers identify early treatments for people with COVID-19 by establishing CETF in April. It is focused on funding outpatient trials of repurposed drugs where participants do not have to stay overnight at the hospital.

    One trial at the University of California, Los Angeles, approved by CETF will test the effectiveness of the oral drug Favipiravir, an anti-influenza medication. And researchers at Stanford University are conducting the first outpatient clinical trial of Favipiravir in the United States, which does not involve CETF, to assess whether the oral drug can reduce the severity of people’s symptoms and lower transmission rates.

    Another repurposed drug in CETF’s clinical trial pipeline is Interferon Lambda. It has been tested on people with either Hepatitis B or Hepatitis C virus, according to CETF. And the trials of the drug for people with COVID-19 are conducted by a team at Stanford University and researchers at other institutions.

    Even though some of the CETF-approved trials are now underway, others such as the UCLA trial of Favipiravir are still pending for funding from CETF.

    “We are strapped for cash. We’ve raised only three million. We need 20 million,” Kirsch said. “For $20 million, we will find something that is effective against this virus that is costing us trillions of dollars.”

    https://www.sfexaminer.com/news/san-francisco-based-fund-supporting-covid-19-treatment-trials/

  447. 447
    rhampton7 says:

    Earlier, experts believed that the incubation period of this virus s 4 to 5 days. But now Chinese scientists have come up with a new estimate for the median incubation period of COVID -19, w