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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.

Comments
From the BBC: where are the COVID-19 hotspots and which countries are experiencing second waves? https://www.bbc.co.uk/news/world-51235105JVL
July 29, 2020
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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?JVL
July 29, 2020
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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?Bob O'H
July 29, 2020
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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.ET
July 28, 2020
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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-632704rhampton7
July 28, 2020
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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.rhampton7
July 28, 2020
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"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/rhampton7
July 28, 2020
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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-19/33449623rhampton7
July 28, 2020
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https://twitter.com/drericding/status/1283465624203788290?s=21Mac McTavish
July 28, 2020
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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. KFkairosfocus
July 28, 2020
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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. KFkairosfocus
July 28, 2020
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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?rhampton7
July 28, 2020
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The “censored” doctor Stella Immanuel: https://heavy.com/news/2020/07/dr-stella-immanuel/rhampton7
July 28, 2020
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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?rhampton7
July 28, 2020
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The censored doctors https://www.americanthinker.com/blog/2020/07/hcq_censorship_cubed_social_media_giants_shut_down_doctors_testifying_from_experience_that_hydroxychloroquine_works.htmlkairosfocus
July 28, 2020
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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?rhampton7
July 28, 2020
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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.jerry
July 28, 2020
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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.rhampton7
July 28, 2020
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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.jerry
July 28, 2020
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There is no cure Jerry. You think the Israeli are dumb?rhampton7
July 28, 2020
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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.jerry
July 28, 2020
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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.rhampton7
July 28, 2020
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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/rhampton7
July 28, 2020
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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-1520878rhampton7
July 28, 2020
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“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-covidrhampton7
July 28, 2020
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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-hydroxychloroquinerhampton7
July 28, 2020
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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-spermrhampton7
July 28, 2020
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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. KFkairosfocus
July 28, 2020
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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.rhampton7
July 28, 2020
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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.jerry
July 28, 2020
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