Of Quinine And Chloroquine

Guest Post by Willis Eschenbach

After all the people saying we shouldn’t take chloroquine because of the side effects, let me take the opportunity to say some words about that curious drug.

I moved to the Solomon Islands, north of Australia near the Equator, in 1984. I ended up living and working there for nine years. The Solomons host all four kinds of malaria—Plasmodium falciparum, P. ovale, P. malariae, and P. vivax. Unlike most parts of the world, at the time the four kinds of malaria in the Solomons were not chloroquine-resistant.

malaria mosquito.png

So I took chloroquine prophylactically once a week to prevent the disease. 500 mg (300 mg base), one pill every seven days.

After I’d been there maybe three years, I thought “I don’t want to take this forever. If I get malaria, I’ll cure it, that’s what medicine is for”. So after having taken well over 100 doses of chloroquine, I gave it up.

Of course, after stopping chloroquine, I got malaria. It is a most curious and devious houseguest. Malaria has a bunch of forms, all with different shapes and different abilities, and it changes form like we change shirts. When it hits your bloodstream, it streaks for your liver as fast as it can. Along the way, it is shedding parts of its skin layer. These skin bits occupy and distract a large number of antibodies, which recognize enemies by their skin surfaces. This allows more of the malaria parasites to make it to the liver. When it gets to the liver, it changes form.

After living for a bit in the liver in that new form, it changes form again and goes back out into your bloodstream and gets inside the red blood cells. Where, of course, it changes into another form.

Unlike the other forms, this latest form can reproduce. It starts to produce thousands and thousands of descendants, which eventually rupture the red blood cells and re-emerge into your bloodstream.

Until that point, you don’t even know the tiny criminals have invaded your corporeal mansion. But when they rupture the red blood cells, your body gets the full-blown malarial crisis, shaking and sweating, chills and fever at once. I’d always thought stories about people’s teeth chattering in sickness from the chills were exaggerations.

I was very wrong.

Now, at the time we were living on a 280 acre (110 ha) coral atoll island called Liapari Island, way out in the outback. Here’s the island, on the right …

liapari island.png

The Solomon Islands are in the middle of nowhere, north of Australia below the equator. Western Province in the Solomon Islands, with the Western Province capital at Gizo Island, is even more nowhere. And Liapari Island, 17 miles (27 km) by water from Gizo, is the very heart of nowhere.

Fortunately, my gorgeous ex-fiancee is a family nurse practitioner. The doctors there advised quinine. So she took the company outboard skiff, drove it seventeen miles to Gizo, and brought back the quinine. I took the prescribed dose. Horribly bitter pills.

Well, I’m here to say that the damn quinine cure is far worse than the disease. It adds bad pain and weakness on top of chills and fever. I recall that at one point it took me about thirty seconds of hard work just to sit up in the bed. When I laid down, I thought “I can’t be that weak! I just can’t be! It can’t take that long just to sit up!”

So I tried it again.

45 seconds that second time. Crazy weakness and pain. I’d never felt anything like the combination of malaria and quinine, and I definitely don’t recommend it no matter how bored you are.

After that, I never took quinine again. I would take its chemical cousin, chloroquine, instead. But this time I was taking it curatively, not preventatively. It was not fun in the high doses, but it beat the malaria back, and it was much more tolerable than quinine.

Finally, after suffering a couple more bouts of malaria over the next couple years, my mad mate Mike told me that when you feel malaria coming on, and you can definitely can feel it coming on, to take three weekly doses at once (1500 mg, or 900 mg of base), then the same thing 24 hours later, then the same thing on the third day. He swore it fended off the malaria.

So I started using his plan, and I never got full-blown malaria again. Just take nine weeks worth of chloroquine in three days, it aborts the onset of the chills and fever, no problem.

In addition, at the time, I knew dozens and dozens of expatriates in the Solomons and maybe half or more of them used chloroquine for either prophylaxis or cure of malaria.

In summary: yes, as with any medicine, some people suffer side effects from chloroquine. But it is widely tolerated. In addition, it’s cheap because it’s been used since the 1930s, so it’s been off-patent for decades, and the side effects are well known

Do we know scientifically if it works for COVID-19? Nope. But I’ll guarantee you that if I get the ‘rona, I will take chloroquine and azithromycin and zinc. Nothing to lose, everything to gain, and Fauci is both mad and destructive to argue against it.

And to close out the story of the madcap transformations of the malaria parasite, we left it swimming in our bloodstream after rupturing the red blood cells. From there, a mosquito removes it from your body with its magic hypodermic needle, and it moves into the mosquito’s stomach where … yes, you guessed it, it transforms itself once again into a new kind of malarious being. And when the mosquito bites another person, it injects that form into your bloodstream, whereupon it starts racing for their liver to start the cycle again.

There is one final oddity of this most odd of life forms. Sometimes, P. falciparum vivax malaria can … yep, you got it … change into yet another form. It does this in the liver, and after changing forms it promptly falls asleep for maybe a year. Or two. Or more. This form goes by the absolutely wonderful name of a “hypnozoite”, after Hypnos, the Greek god of sleep. Hypnozoites are the source of the world-famous recurrence of malaria years, occasionally decades, after leaving the malarial zones.

When one of the hypnozoites wakes up after a two-year nap, I assume it stretches, yawns, looks at the other still-sleeping hypnozoites, and of course, it being malaria and all, just for fun it changes form. No longer a hypnozoite, it jumps into the bloodstream, reproduces inside the red blood cells until they burst … and that is how after I’d left the Solomons and had been living in Fiji for a couple of years, I suddenly felt that awful familiar feeling.

And being an honest man I must confess, at that moment I said very bad words. Not only that, but I engaged in needless and ultimately pointless vituperation, casting unpleasant but extremely satisfying aspersions as to the ancestry of the whole tribe of mosquitoes and malaria in all their evil blood-sucking cell-destroying forms.

I had been convinced at the time that I was done with malaria, but nooo … my main medical squeeze had to go hunt for chloroquine, there’s no malaria in Fiji. And once I got cured of the immediate malarial relapse, I took another drug that in theory kills the remaining hypnozoites, and me and malaria, we parted ways for good. At least I sure hope so.

And that’s my story of chloroquine and the reason why I say that anyone who gets the virus should at least try it. 

My best to all, stay well, wash hands, don’t invite any strange bats to dinner, don’t touch your face, or your bat’s face for that matter, wear a mask, avoid crowds, you know the plan …

w.

PS- Regarding schools as centers of infection, the Solomons uses the British system of boarding schools. Grade school kids go from their villages to the local boarding school, which is often on another island, where they spend the entire semester.

And we always had to gird our loins and break out the mosquito repellent when the kids all returned at semester break, because invariably they brought a surfeit of malaria back with them …

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468 thoughts on “Of Quinine And Chloroquine

  1. What is the evidence for hydroxychloroquine
    We know the first French study was fatally flawed, but I keep hearing that other studies show benefits. Is there decent evidence out there?

      • Latitude

        Did any of those who were administrated it have a ‘BCG’ when young? It was a vaccination administered as a matter of course to schoolchildren in the UK in the 70’s/80’s and beyond I belive, to combat TB.

        It’s also administered in much the same way in India.

        A recent study by an Indian doctor has found a 50% lower level of infection in those who have had the vaccine, and where it is still detectable, than with those who haven’t had the vaccination.

        My description is probably clumsy, but I hope the point is made.

        This whole thing is mega complicated.

        • Scot, I have no idea….I’m getting “Biden syndrome” and can’t remember where I saw that study either….
          ..did not know about BCG at all…I’ll try to look that up to

          in the mean time…

          ” Sixty-five percent of physicians across the United States said they would prescribe the anti-malaria drugs chloroquine or hydroxychloroquine to treat or prevent COVID- 19 in a family member, according to a new survey released today by Jackson & Coker, one of the country’s largest physician staffing firms.

          Only 11 percent said they would not use the drug at all.

          Meanwhile, 30 percent of the surveyed doctors said they would prescribe the medications to a family member prior to the onset of symptoms if they had been exposed to COVID-19, a highly contagious virus that causes a pneumonia-like infection of the lungs.

          “Working in healthcare, we’ve learned the best way to get a candid perspective on treatment options from a physician is to ask: ‘Would you give this to your family?’” said Tim Fischer, President of Jackson & Coker. “Families across the U.S. – and the world really – want to know what they can do to protect and save their loved ones.”

          Jackson & Coker conducted the survey of 1,271 physicians from 50 states from April 4 to April 7. It conducted the survey not to influence the debate in treating patients with anti-malarials but to make sure the voice of physicians is represented. It has a margin of error of +/- 3 percent with a 95 percent confidence level of the doctors surveyed.”

        • That’s very interesting. Being of that vintage I remember getting the TB shot when in school but that was 5+ decades ago. I don’t know what type it was or if it is still effective (I doubt it) but good to know.

          Something more to read up on. Thanks, you’ve filled a few hours of my day for me.

        • HotScot-

          You might be surprised to know that BCG is still being used – to treat bladder cancer. This from a quick google search:

          “Bacillus Calmette-Guerin or BCG is the most common intravesical immunotherapy for treating early-stage bladder cancer. It’s used to help keep the cancer from growing and to help keep it from coming back. … BCG is put right into the bladder through a catheter. It reaches the cancer cells and “turns on” the immune system.”

        • There is a totally kosher, n:1,000 clinical trial underway in the Netherlands (at Utrecht and Nijmegen academic hospitals) to get a proper understanding of what role the BCG vaccination might play in terms of anti coronavirus properties.

          If somehow effective, this would be great news as for instance in France, everyone got the BCG until 2007.

        • Aus is doing a 4k person trial in our med staff at the moment of the BCG
          it will be another option they slam as it too is old and off patent
          theory is it is an immune system booster( theyve also used it for Aid patientsI think I reaad somewhere)
          amazing that Aus (theortically) didnt have any chimps for lab use
          but theyve managed to magick some into being to test a new vax on
          I doubt I would be considering their new offerings until a hell of a lot of pepple have accepted and survived the vax let alone the bug
          The older known issues meds are far preferable

        • One of the great MedCram.com videos on the Wuhan Virus discusses BCG and how it seems to boost the immune system in general. The narrator concluded with a paragraph that landed somewhere between wondering out loud and recommending health professionals get the BCG vaccine as a way to help defend them from the pandemic.

      • There is a Dr Stephen Smith in East Orange, NJ that believes that HQ is pretty much the answer. I believe that his results are above 90%. Then there is a Dr Walsh in or near Los Angeles that has used HCQ for 42 years to treat Lupas. He has been treating coronavirus with HCQ also with very good results. The trick is to use HCQ before there is much lung damage. Many doctors in Europe are calling HCQ the weapon of choice at the moment. Dr Walsh says the chances of side effects are almost nil. Treatment with HCQ is only 4 or 5 days long. 600mg hydroxychloroquine and 250mg zinc per day. Zinc drives out copper so copper replacement after treatment may be a good idea. The media never mentioned HCQ until Trump brought it up. BTY.. hydroxychloroquine is more gentle on the body than chloroquine and is known for less possible side effects. Some people get a little rash. Those warning about side effects of HCQ don’t know much about it. I guess most people never listen to the possible side effects of drugs advertised on TV. I have an older friend that was taking Xarelto and he almost bought the farm from internal bleeding. In spite of the many law suits, it is still widely used.

        • “The media never mentioned HCQ until Trump brought it up.”

          Do you mean just the American media? I read about the use of hydroxychloroquine for COVID-19 long before I read about Trump mentioning it.

          • Must admit, the first mention of HCQ I heard was from Dr. Roy Spencer. Long before it became a household name, or before Trump mentioned it, Roy asked the question about it, if there was anyone with some information or experience of its merrits against CoVid 19. It was very slow to surface in discussions for a long time after that.
            Now, there has been a lot of talk about the BCG vaccine, here in Ireland, for the past couple of weeks. It seems to be gaining traction.

            Either way, stay safe folks and wash your hands.
            Eamon.

          • It was first recommended by chinese medical authorities. Then Trump picked it up whereupon it instantly became non-PC to use, and at least some hospitals in Sweden stopped using it.

      • But worldwide, 94% don’t die from it.
        In Australia, 98% don’t die from it.
        Regardless of treatment.
        That is from Johns Hopkins data website.

        • Would you spin a wheel with only a 2 percent chance of death if it lands wrong for fun? What would it take for you to spin it? Food for thought.

          • I’m 64 today, and yes I would spin that wheel if it meant not hobbling the economy my children and future generations have to try to live in. In a monstrously indebted world, this self inflicted wound could easily get out of control, and make 1929 look like a Weekend at Bernie’s.

      • Yes, the French one does not even count as a study. Open label. Low n value (few patients). Even less controls. Unblinded. Systematic and confirmation biases.

        Bad science.

        • Embrace: Better to be anecdotally alive than scientifically dead!
          -etcb

          Unless you just can’t stand the thought of your pearls getting soiled …

        • Observations are not bad science. What you mention is not bad science as long as all are known. It just should lead to more and better science.
          Leukemia drug tried in blind study, doctors went holy crap, and gave control group the drug immediately extending lifespan of fatal disease by five years. Became standard treatment. Was that bad science since it was nonblind?

        • Yes, the French one does not even count as a study.

          The paper was not a clinical trail. No one claimed it was. It was annectdotal evidence of a possible treatment for a pandemic already hitting 100s of 1000s of people.

          Those who are still parroting the 22 cases as a reason to dismiss the whole question are either totally brainwashed by MSMs campaign against hcq on a large part based on TDS.

          The medical profession is so dependent of the “generosity” of big Pharma they are basically pill pushers under their orders.

      • Petie_Barde
        The study was even more flawed than Andrew Wakefield’s MMR study

        Things like
        the leader promoting the effectiveness before the study started
        Not having a control group because it would be unfair on the people not on HCQ
        Removing people who died from the study and then claiming 100% success rate

      • Label warning: they are “extremely toxic in overdose.” Get a doctor’s prescription.

          • Add sugar and water to that list…
            Water is extremely and frequently fatally toxic in overdose.

          • Label warning: they are “extremely toxic in overdose.” Get a doctor’s prescription.

            — So is water

            Yes, in my younger long distance running days I literally ran into a couple of people who got themselves into medical distress by taking on way too much water before and during a run. It certainly can be fatal at the extremes.

    • What exactly were the “fatal flaws”? Seriously. I hear that but when I looked all I could find was “it wasn’t double blind” and “there was no control group”. The second study had 78/80 cured in days. Or is that study “fatally flawed” as well. Doctors on 3 continents (so far) have reported excellent results NOT when used alone but when used in the trifecta.

      • “What exactly were the “fatal flaws”? Seriously. I hear that but when I looked all I could find was “it wasn’t double blind” and “there was no control group”.” Well, those are pretty much fatal flaws in a medical study, particularly when most people eventually recover from covid, making it hard to know whether giving patients chloroquine helped anyone or not.

        • Yes, 90+% recover on their own. Since most have little symptoms, they recover at hone with reporting.

          Green Tea would probably “work” against COVID. Which is why every snake oil dude has a “treatment” now. We might as well repeal the Pure Food and Drug Act…

          Victims often die from untreated bacterial infections, often of undiscovered type. Sometimes the invader is normal bacterium present in most peoples’ gut. Once friendly (Clostridia, Klebsiella, etc.), they become unfriendly if they colonize the inflammation site in the lungs. Hence the azithromycin which should be used prophylactically or immediately if the cough is severe or fever spikes (sign of another infection). AZT is great for these bacterial pneumonias. I have no idea if the chloroquine work from the anecdotal studies.

        • Be very careful where you go with that reasoning.

          In 2014, Ioannides at Stanford published a seminal overview that shows that supposedly top drawer biomedical research published in top drawer journal is irreproducible in 8 out of 10 cases.

          I was in the audience at the conference where he presented the data – he was treated to boohs and hisses and has been treated as toxic in research circles ever since. His data however is rock solid.

        • It was a VERY “small study,” indeed.

          They had only eleven patients: “There were 7 men and 4 women with a mean age of 58.7 years (range: 20-77), 8 had significant comorbidities associated with poor outcomes (obesity: 2; solid cancer: 3; hematological cancer: 2; HIV-infection: 1)”

          There was no control group, no comparison with other treatment protocols, and (obviously) no blinding.

          By climate science standards, it was quite rigorous: they actually tried to measure something, rather than just write computer programs to make guesses for them. But by medical standards it was very, very weak.

          • re: “It was a VERY “small study,” indeed.”

            Notice the title:

            No Evidence of Rapid Antiviral Clearance or Clinical Benefit with the
            Combination of Hydroxychloroquine and Azithromycin in Patients with
            Severe COVID-19 Infection

            Note also, NO mention of … what?

            Zinc.

            Note: As we have found out in other journal write-ups, jumping-in to treat “Severe COVID-19 Infection” patients is not the way to go. TOO MUCH damage to the lungs/blood? has been done at that point (and ALSO damage to the lungs from the intubation/ventilators we are FINDING OUT NOW.)

        • “particularly when most people eventually recover from covid”

          OK then the observation above is “pretty much fatal flaw” for the justification of the lock-down.

      • It is generally unhelpful to speak in euphemisms when trying to make a point concisely.
        So if you want to know exactly what was problematic, drop the idea of ‘fatal flaws” and focus on particular details.
        At this stage, anyone unwilling to look up the criticisms of the work is probably not the type to pay close attention to details.
        How much do you want to get straight and unfiltered info?
        The place for that is the source.
        This is the internet

    • It is not an anti-viral drug.

      But it could reduce lung inflamation for patients in bad shape.

      Nations with high maleria rates have low covid19 rates.

      Perhaps from the warm weather, or perhaps from anti-malaria drugs.

      • If it’s not an antiviral drug and works by reducing lung inflammation…

        …how come it kills SARS in a test tube?

        Even if it doesn’t work in the human body, at worst it’s going to have no harmful effect on pretty much anyone who takes it. The only reason it’s opposed is because powerful people don’t want a cheap, simple cure for this disease when they can instead use it to push their political agenda.

      • Low incidence in the S. Hemisphere in places where there is no malaria. New Zealand, for example. It is summer there. In N. Hemisphere it was winter when it began. Coronaviruses are normal viruses for the “common cold”, these as respiratory ones. Rhinoviruses are head cold common cold viruses. Dozens of each of these. See CDC,gov for types of viruses and their seasonality.

      • “HC” appears to operate against COVID19 by moving zinc into the cells, where it disrupts the virus’s reproductive path. Thus the inclusion of zinc in the treatment.

      • Or perhaps a side effect from having a malarially-exposed population regardless of drug consumption? Host populations that are undesirable to virus spread. Perhaps Singapore would be successful regardless of their much touted mitigation regime.

      • A couple mechanisms…

        Quinine / chloroquine / hydroxychloroquine are the same drug in different forms. Chloroquine is a non-enzymatically metabolized form of quinine, whereas hydroxychloroquine is a prodrug (the body breaks it down to chloroquine, then breaks it down to quinine). The goal with hydroxychloroquine was to allow longer dosage schedules and reduce toxicity by making the molecule harder to break down. Straight quinine is rapidly absorbed in the body, can have side effects due to that rapid absorption, and only has a half-life in the body of ~18 hours.

        The problem with hydroxychloroquine is that it’s been found to be 1.6 to 8.8 times less active than quinine against Plasmodium Falciparum (1.6 for PF which isn’t resistant, 8.8 for PF which is). I don’t have the study available right now, but you can likely find it easily.

        Anyway, I use quinine… it interferes with sialic acid biosynthesis, which the ACE2 (angiotensin-converting enzyme 2) receptors release. In order for anything to attach to a cell, there must be a pH gradient, and the Covid19 virus uses that sialic acid to attach to the ACE2 receptors via sialic acid moieties.

        The ACE2 receptors also are responsible for increasing blood pressure, which is why some infected with Covid19 experience low blood pressure. If you have heart or circulatory system problems, consult your physician before using any of the above-mentioned medications.

        So the first mechanism is that it makes it more difficult for Covid19 to attach to cells. If it can’t attach as effectively, that gives the body a chance to clear the virus without having to deal with a rapidly-spreading infection at the same time.

        The second mechanism is that it prevents cytokine storms. Again, I don’t have the studies handy, I can post them when I get home, or you can search for my prior post in another thread, which has the references at the end.

        An interesting thing comes to light here… they say that those taking ACE2 inhibitors for high blood pressure are at higher risk of contracting Covid19 because…. {drumroll}… the drug paradoxically increases the amount of ACE2 the body produces when taken long-term… so these drugs likely don’t work the way they say they do. Oh, but don’t stop taking your ACE2 inhibitor for your high blood pressure, despite the fact that doctors just admitted that it does the opposite of what it’s supposed to do when taken long-term. LOL

        • I am interested in knowing more about Quinine in Covid. Does quinine itself help get Zn into the cell through ionophoric processes? That is what I understand is the mechanism for why hydroxychloroquine is effective. The Zn in the cell, where the virus uses the cell to replicate its RNA to make more virus, disrupts the RNA replication at the source.

          So the question is: Is quinine a Zn ionophore?

          Mario

    • Not so fast. Just because the original was open label and a small n: and the respected researcher who ran it happens to look like a Druid, doesn’t mean the outcomes weren’t indicative and worth pursuing.

    • Not fatally flawed but not statistically significant and scientifically correct. However, it was still valid as a pretrial.

      In these days of suffering they were looking for a quick fix. They think they found it. More trials and tests are proceeding.

    • What is the evidence for lockdowns and completely dismantling the economy? I haven’t seem any papers where they did double blind studies.

    • How many clinical trials, over how many years, were done before penicillin was released for general use?

    • Dr. Vladimir Zelenko’s clinic in NYC has seen over 1,000 COVID patients. As of the last report, they’ve treated 383 of the high risk ones with HCQ, zinc, and azithromycin, and had only 3 put on ventilators, and 2 deaths. It’s on YouTube. There is also a video of Dr. Cardillo of LA who uses the same drug cocktail, and says patients usually are free of symptoms in less than a day.

    • Thats bullshit Andy. There ought not have been any studies. We knew enough to be treating Sars-2 right away since we had treated the Sars-1 with it. The studies were all stalling tactics. Its just the deep state sending everything down the memory hole. 70 years experience with the drug and no-one has found evidence that its NOT zinc enabler.

  2. Fauci actually did not argue against it, at least not for long – he said he would take it if he had the virus. Fauci did argue that the nornal tests should be made, and they are, along with the use of hydroxychlorine as an off label treatment. One doctor who treats Lupus patients said he has prescribed hydroxychloine for 42 years without seeing any side effects other than skin rashes.

    • I thought Fauci and Trump said pretty much the same thing, just one with a glass half empty attitude and the other trying to pep up the country.

      • That was it exactly.
        Fauci had his lab-researcher hat still on, not recognizing that people would die.
        He did piddle on Trumps parade when Trump tried to hold out some good news of a medication that could possibly treat this virus. One that has had know side-effects for about 90 years.

        Instead of trying to offer calm and hope to a society that was panicking, which the media was there to foment, he snatched away the only positive thing that the president was holding out.

        • Disagree.
          Fauci is only an expert in HIV a couple of extremely rare immune diseases in the same box as HIV/AIDS. His position, at best, has been admin at NIAID. NIAID has a charter that includes infectious diseases but Fauci has never, ever, in his career had anything other that titular head of any respiratory disease.

          He’s a great example of government failure at it’s best. How someone that has spent 30+ years in the politically correct HIV/AID’s focus while simply ignoring detection, treatment and control over respiratory viruses which literally kills tens of thousands each and every year. In the US, in 2017, about 16,000 people died having a diagnoses of HIV as CDC reports “These deaths may be due to any cause.”

          Since the mid-1990’s US deaths from respiratory viruses range from 32,000 to over 60,000 per year. Meaning they were the leading death in the US for NIAID’s charter. Yet Fauci did absolutely nothing (maybe sign the budget request).

          Fauci is, simply, not any kind of infectious respiratory virus expert. Dr. Birx worked in Fauci’s lab and led HIV vaccine work. Neither is a respiratory infectious pathogen expert.

          What we have are two highly skilled HIV experts running a response as if it were an HIV transmitted disease. Everything they have proposed is rooted in HJIV transmission “mitigation” from social distancing to self-isolation with mostly ineffective (from published meta studies of clinical trials at PubMed) items of hand washing, masking tacked on. Even Fauci’s latest brainstorm of having Certified ID Cards issued to those testing positive for the antibodies screams of methods to contain HIV. They are the so called Deep State at their worst and are, frankly, highly destructive and even more contagious for the population.

          Total and complete incompetence. In the words of the Left, we must Move On from these faux respiratory pathogen “experts” and go to people that are experts in these viruses. After all, I’d bet anyone that Fauci learned of the new strain from news reports, just like his BFF Hillary and Obama learned things.

          Later, the Facui and Brix should be relegated to a special cure HIV task force (as a reward) and, if we keep CDC, appoint people that actually care about the biggest killers of US citizens. Including how to detect new strains, etc.

          • The CDC inoculates us against the brain disease we might otherwise get from you, NG.
            However, like any other authority, blind trust in them has been shown to be ill advised.
            The world is not black and white.
            People who are completely wrong about one thing may be and often are exactly correct and insightful regarding something else.
            The people to be wary of are those who represent their ideas as factual, and the latest video they have watched as a “finding”, and some half baked idea they like as a what “is known”.

          • “Fauci had his lab-researcher hat still on…”

            [snip] Same hat he had on when he killed all those people with AZT. They are asking us to forget everything we know about this drug.

  3. “So I started using his plan, and I never got full-blown malaria again. Just take nine weeks worth of chloroquine in three days, it aborts the onset of the chills and fever, no problem.”

    Just what we did after taking weekly quinine for the first 3 years in India, except it was a combination of chloroquine and something called Daraprim. I must confess to some scepticism about chloroquine for the most recent lurgy.

    Our son just got out of quarantine after coming back from a working holiday in Oz at a highly inflated airfare. He is here for the duration with girlfriend because no work in either hospitality or management consulting. He will be able to get the odd few days casual construction work here. Basically the lockdown puts them back to square one in terms of employment.

      • Your clarification of the dormant form of malaria is very interesting – since I grew up in Kalimantan, I had malaria enough times that it is part of me. I have just recovered from a severe (and nearly fatal) ecoli blood infection that brought on a malaria attack just to keep things interesting. You have not exaggerated the experience in the slightest.

        Since the Wuflu arrived here in BC, I have been dosing myself (and advising others to) with Schweppes Tonic Water, for the quinine in there. So far so good, and no side effects.

        • Yes, I had wondered about that, since I’m fond of the taste.
          I drank it lots more when younger, straight, not mixed with gin or anything.
          But at my current age, I really wish there was a version of the old Schweppes without so much sugar. Having a look, I see that there are several.

      • Willis

        Great post on Malaria and Hydroxychloroquine/chloroquine! I, too, would try One of them along with azithromycin and maybe zinc (zinc, esp if I had GI issues, which some have with Covid-19—-diarrhea can deplete zinc stores from the body.)

        Minor correction: P. Falciparum malaria causes most of the severe life-threatening cases in the world, but does not cause relapse from hypnozoites. Hypnozoites are seen in P. Ovale and P Vivax, and require treatment with a drug like primaquine, in addition to the usual anti-malarials.

        You certainly in the Solomons may have been infected by multiple different malaria species.

        Regards
        Keith Winterkorn, MD

      • . . . but eeryone’s different …

        Emphasis added.

        Brilliant. Truly brilliant. I hope you meant to do that!

      • I remember taking Chloroquine in the 1990s when I worked for some months in India. It made me nauseous for the day and I recall it gave me a dose as well. Unfortunately near the end of my time there I realized it was supposed to be taken on a full and not empty stomach – apparently it made all the difference!

    • Salute!

      No schitz, Henry.

      From my personal experience and the hundreds of fellow warriors I knew and flew with and supported in that sorry war, upset stomach was largest complaint. Never saw or heard of a rash or cramp or anything, and we were getting aviation physicals on a frequent basis.

      My not so humble opinion is the medical folks are in the CYA mode to avoid lawsuits when some stoopid dweeb takes a bottle of pills or aquarium treatment. The FDA has come clean and said, “take the stuff” , with the note that it has not been proven an effective treatment for the corona critter. It took years and years for folks to get stevia sweetner on the grocery store shelf next to “splenda” and “sweet and low” and other sweetners that had clear labels of potential problems. They finally got it for sale as an herbal supplement or whatever. And how ’bout CBD?

      Oh well, hope the Easter Bunny is nice for your kids and grand kids.

      Gums sends…

  4. Ah Willis is a great story teller. Very entertaining and informative anecdote.

    The red blood-cell thing is apparently the link to COVID which seems to breaking the iron ion off the haemaglobin. Recent reports of hypoxia being the real disorder which needs treating rather than lung dysfunction and the for forced ventilation could be critical and reports of severe lung damage killing many patients may explain the horrible odds of coming out of the other end of being put on a ventilator.

    Hypoxia also fits with accounts of the heavy male/female death toll reported in China where most of the older generation males are heavy smokers. They are thus already in a state where upto 60% of their haemoglobin it locked up with a CO molecule and permanently out of action. They have an oxygen transport problem without COVID.

    Progress on this issue would be a game changer. If you have not understood the pathology , you are poorly equipt to cure it.

    • I’m wondering if sickle cell disease has anything to do with the Black Community being more impacted with the Wuhan virus?

      • I suspect the cause of that is being majoritarily poor and fat ( without trying to dress it up in medical terms for PC correctness. ). Poor diet, lack of vitamins, BMI all seem to be factors. Though a genetic factor like sickle cell is worth considering.

        • Plus Black Americans have much higher rates of hypertension and vitamin D deficiency. Vitamin D deficiency has a critical role in regulation of the renin-angiotensin system so the two are not unrelated.
          And sickle cell is protective for malaria.

    • Throw in a steadily growing body of evidence that in what appears to be a substantial number of cases the actual cause of death is a cytokine storm, and we have yet another manifestation of the bug.

  5. An RTO in our platoon didn’t take his pill and ended balled up wrapped in his poncho liner shaking uncontrollably. That guy was scary sick.
    At the time we were taking a combo pill – Chloroquin and Primaquin.

    • LOL! Reminds me of the time the doctor was in our bedroom tending to my brother while I was curled up on my bed, wrapped in blankets doing the shaking. We both survived, but I couldn’t donate blood for decades afterwards. Sneaky little hypnozoites!

  6. Ah Willis is a great story teller. Very entertaining and informative anecdote.

    The red blood-cell thing is apparently the link to COVID which seems to breaking the iron ion off the haemaglobin. Recent reports of hypoxia being the real disorder which needs treating rather than lung dysfunction and the for forced ventilation could be critical and reports of severe lung damage k-i-lling many patients may explain the horrible odds of coming out of the other end of being put on a ventilator.

    Hypoxia also fits with accounts of the heavy male/female death toll reported in China where most of the older generation males are heavy smokers. They are thus already in a state where upto 60% of their haemoglobin it locked up with a CO molecule and permanently out of action. They have an oxygen transport problem without COVID.

    Progress on this issue would be a game changer. If you have not understood the pathology , you are poorly equipt to cure it.

  7. “I will take chloroquine and azithromycin and zinc. Nothing to lose, everything to gain, and Fauci is both mad and destructive to argue against it.”

    I think Fauci didn’t want chloroquine to become toilet paper.
    He probably knew doctors take chloroquine because it lower chance of getting the Chinese virus. And with 300 million Americans start taking it, not to mention hoarding it, there would be chloroquine for medical workers.
    And once a supply stock was secure for Medical workers, he was saying follow medical advise from your doctor.
    Though it’s possible Fauci thought there was side effects, and if 320 million Americans take it, it could cause more problem than the Chinese Virus.
    But apparently if take it in proper doses, there is very minor side effects which are rare.

    • Good Lord, are we so incompetent that we can’t ensure an adequate supply of chloroquine? Probably the answer is yes, because we’re in lockdown, the economy is going to hell, people are scared shitless, people are dying, but we can’t seem to get off our butts and get enough test kits out.

      Fauci’s role: fear-monger-in-chief. That’s job #1.

      • “Good Lord, are we so incompetent that we can’t ensure an adequate supply of chloroquine? ”

        Here’s a hint: the US government has allowed pharmaceutical manufacture to decay to the point where 97% of US antibiotics come from China.

        • Well, to listen to the ‘press’ in 2017 we lost drug manufacturing facilities in Puerto Rico during hurricane Maria. But, then there is this:

          Title: Puerto Rico Pharma: Battered but Unbroken
          One year after Hurricane Maria, Puerto Rico’s pharma industry is standing its ground.

          https://www.pharmamanufacturing.com/articles/2018/puerto-rico-pharma-battered-but-unbroken/

          Excerpt from within: PHARMA’S TROPICAL HUB
          Puerto Rico may often be thought of as a picturesque getaway, but in the pharma world, it’s one of the globe’s most vibrant hubs of manufacturing.

          The island became a leading destination for pharmaceutical companies after 1976, when Congress passed a tax code to make it more attractive for businesses. Called Section 936, the law exempted companies from paying corporate taxes on profits made in Puerto Rico, and was enacted to help bolster the island’s sputtering economy. It paid off. Soon, companies flocked to Puerto Rico to set up shop, including most of the biggest players in pharma: Pfizer, Bristol-Myers Squibb, Merck, Mylan, Eli Lilly and Company, and many others.

          Amgen built its flagship site in Puerto Rico, which is also the biggest pharma facility on the island. About 90 percent of the company’s products now pass through the sprawling complex with 1.7 million square feet of manufacturing space and about 2,000 employees.

          In particular, Puerto Rico became the place to make high-profit blockbuster drugs. Today, 11 of the world’s top 20 drugs are manufactured in Puerto Rico, including Humira, Enbrel and Lyrica.

          • re: “The problem with hydrocholoquine is that it is not a high-profit blockbuster.”

            Understandable. That was then. Now is now. Do we all know what the term “retooling” means? I’m assuming the production facilities in PR are still operable; time to produce HCQ for awhile … order those raw, precursor chems now …

  8. There is a vigorous campaign in Canada to deny the use of the chloroquine and azithromycin and zinc cocktail. Our public broadcaster has daily articles about the total lack of any evidence for its use and the horrific and often deadly side effects and conversely stories about Canadians with diseases like Lupus helped by chloroquine who will be left to suffer horribly when the supply runs because of stupid people demanding in unproven cure all. Not only has the public been subjected to this but medical practitioners have been warned in writing that any use of chloroquine and azithromycin and zinc for treating COVID19 is off label and could result in license discipline. I have no idea how many Canadians doctors are refusing to use this drug in an off label fashion due to the threats. As to why there is such a campaign, I am stymied unless our government wants us to be as sick as possible and have as many die as possible.

    • I’m in Canada also. I brought up hydroxochloroquine with my GP because I’d read about its use in a completely different condition which I have. He flipped out. Started lecturing me about all the awful side effects, how dangerous it was, could cause blindness and liver failure…and the capper…Trump is promoting it because he has a financial stake in its production. The medical community here has lost its mind over this.

      • Get a new doctor. I’m also Canadian and it seems like 90% of the canadian population suffers from TDS. While at the same time we have a foppish Mr Selfie fltting around the globe giving billions of taxpayer money away to get his name in the papers. Why can’t we get a PM that puts Canada first.

        • “Why can’t we get a PM that puts Canada first.”

          Because there is no Canada. It’s a myth.

          Not in the sense that there’s no place marked as ‘Canada’ on the map, but it’s not a nation, it’s a collection of many competing nations shoved together in the same country by the declining British Empire. One of the largest of which is a suburb of China.

          You can put your nation first. You can’t put a multicultural mess of competing nations first.

          Much the same, of course, applies to the US and UK. Or anywhere there’s been mass immigration. Diversity is our destruction.

      • …it’s so dangerous it’s sold over the counter like aspirin
        …no doctors, no prescriptions….just a little piece of paper with instructions

        …in about eight different languages

        You can buy it in Tijuana

        • Latitude-

          You can buy any legal drug in Tijuana without a prescription. Prescriptions are not required in Mexico.

      • “The medical community here has lost its mind over this.”

        No actually it had no mind for some time, but YOU never bothered to check if it still had one.

    • There are probably ten drugs that are an effective treatment of lupus. One or another can substitute for chloroquine over the period it’s needed for the covid-19 outbreak.

      I don’t doubt that a government guaranteed purchase program would stimulate a rapid ramp-up production of chloroquine and hydroxychloroquine.

      My suspicion about why chloroquine is talked down, is that grievance culture has so permeated the culture that anything that impacts some small group is seen as oppression by the privileged majority. That corrosive attitude seems almost reflexive in the press.

    • If by public broadcaster you mean the CBC, I think we all know the reason — the “Virus in Chief” currently occupying the White House.

    • “As to why there is such a campaign, I am stymied unless our government wants us to be as sick as possible and have as many die as possible.”

      How many people take too many vitamins? Generally, taking vitamins does not have much in terms of serious side effects. And of course being deficient in vitamins, as the name “vitamins” suggest they are vital, can cause serious health problems. But with vitamin D added to milk [or milk substitutes} , iodine {a mineral] added salt, common deficiency is “roughly” solved.
      I sometimes take way too much vitamin C- but not vast amounts which could a be problem- I believe there is not particular problem taking a lot of C. And I am almost routinely and daily taking about 5 mg of Zinc, as Zinc is needed immune system and I don’t want to be deficient in Zinc while being in a global pandemic, the max recommended for male is 11 mg of Zinc on a daily basis- so 5 mg in a pill should be enough, maybe I will take 2 a day if I am particularly worried about getting the Chinese virus. But more than 40 mg is not recommended, though if I took 100 mg of zinc once it probably would not have any bad effects, and probably not even a 1000 mg over time period of few days. But probably many people have and may regularly taking more this and they imagine it’s good for them- and might be doing them harm in some way. But imagine evidence of any harm is anecdotal, rather than double blind and large and varied group study done for years.
      Or generally it’s unlikely larger doses of zinc has a “public health benefit” and could have harm. But everyone seems to agree it’s needed for the human immune system.
      But it seems if promoted the use of supplemental zinc as something the public needs to take {or they will DIE from Chinese flu] I would expect there would a shortage of Zinc supplements- even though many people are crazy about taking vitamins {and mineral Zinc} and there is vast supply of it.
      You will have hoarding and some even people taking dangerous levels of Zinc.
      As far as Pandemic and most humans are somewhere near the peak of it,
      it seems the chance catching SARS-CoV-2 virus is high and chance of dying from it is low, and it’s even lower because you could already have it, and not know you have it- or had it and not know you had it {that might give you immunity from it].
      It seems SARS-CoV-2 spreads very fast, and one reasons it appears to spread fast, is takes days to get symptoms, and some percent of people don’t develop any symptoms {and the degree that they could spread it is not known}.
      But at near it’s peak, Europe has hundred of deaths per million. US is 62 per million at moment, and Canada is at 17 per million.
      But hundreds per million is a low risk, but in a classification of groups, I would be in a higher risk group, or much high chance of dying from the Chinese Flu and even higher chance of at least getting seriously ill.
      But I would say that we are still flying blind with this Chinese Flu and it seems we will be still partial blind, and trying to move towards getting out of having the economy shut down.

    • I think it’s the same as the masks, they said they don’t work so don’t bother at the same time all the front line medical staff are freaking out that they don’t have masks.
      I think it all come down to our socialized system, there are only so many dollars to spread around so they don’t want us plebes using up the limited supply.

      • Every 65 year old who dies from CoVID saves the Canadian Treasury several million dollars. The average person uses 85% + of their lifetime Health Care costs in the last three years of life. They also save a bundle on unused Long Term Elder Care. The Canada Pension Plan pays only a one time $1500 Death Benefit for funeral expenses. The Treasury absorbs the entire balance of the lifetime contributions of the deceased, plus all the interest earned on them. When this disease hits the elderly so hard, one would be foolish to believe that the Government can be an honest arbiter of treatment options with such a massive conflict of interest.

    • Don’t believe everything you read or see on MSM. There are a large number of doctors in Canada that were educated in India or Pakistan. They are quite familiar with hydroxychloroquine and are prescribing it to patients.

    • Justin.
      Do some online research about food supplement ionophores and then go to your local health food shop.

    • It’s interesting that *chloroquine is both an abominable toxic and a nice drug for regular or permanent use by some subgroups of the population.

  9. On PBS this morning, a doctor (didn’t catch his name) said he got the corona virus, tried chloroquine and azithromycin (sp?). They did not help, and later he read up on their effect on cardiovascular disease and rued taking them.

    • If hydroxychloroquine works because it is a zinc ionophore, then taking it without supplemental zinc may not work at all.

    • The doctor is still alive so how does he know it didn’t work?

      The networks interview 100 doctors. 99 say it works. 1 says it doesn’t. That 1 is put on the air, the other 99 are never mentioned. This goes on day after day to the point where absolutely no one can trust the news anymore.

    • if thats what he took 1) he’s no doctor 2) thats not the complete cocktail …*(thus the #1)

  10. Orange man bad.
    Orange man like chloroquine.
    Ergo, chloroquine bad, Q.E.D.

    Sic transit ratio.

  11. Interstng story willis

    Did the natives have a natural immunity to Malaria or did they also have to take various malaria drugs?

    Tonyb

    • I’ve read that people with Sickle Cell Anemia have some resistance to malaria, and that the genetic change which causes it has survived in Africa because of that property. I’ve never heard of it occurring outside Africa.

        • No, that is not what happened. If that were true then that defective gene would be found in most peoples of the tropics, and it isn’t. And, it would manifest as the Sickle Cell Disease in people of other tropical descents who emigrated outside the tropics. In North America the only people to my knowledge who carry the gene, fall ill with, or die from Sickle Cell Disease is black people of African descent.

          • Actually, sickle cell anemias *are* found throughout *all* malaria endemic areas, which prior to the last half of the 20th century, was much of the whole world. There are *more* forms of sickle cell hemoglobins than just hemoglobin S. I want to say for SW Asia, the predominant form is C. For SE Asia, the predominant form is E. NB that persistent hemoglobin F (the fetal form) is somewhat protective, as well. For the Americas, it is S due to importing sub-Saharan Africans.

        • Sickle cell anemia does occur in other malarial areas.

          Since it kills homozygotic carriers the frequency is a balance between mutation rate, malarial deaths and anemia deaths.

      • Sickle cell anaemia is an advantage for those with 1 copy of the gene if they live in a malaria region. If 2 people, both heterozygous for SCA have children, on average, 1/4 will lack the gene, 2/4 will be heterozygous like the parents, and the 4th will be homozygous for SCA with very little chance of survival without modern medicine – even then considerable disability. What this says is that malaria resistance is so much of an advantage that you get ahead even if you lose 1/4 of your children just from this. Check out WIKI on recessive genes.

        There are a number of other anaemias that confer malaria resistance around the Mediteranian region. Again they are a dissadvantage for homozygotes. These traits also show how bad malaria is for everyone, and those who have either treatment or prophyaxis have a big advantage over the rest.

    • I spend 1,5 years living in Gabon and i took my malaria pills religiously with no side effects.

      Once I asked the lady that cleaned my room if she had any children?
      Yes she said proudly, 5!
      2 living and 3 dead from malaria when they were infants.

      That was a real ‘welcome to the real world’ moment for me (i was fresh out of university at the time).
      Most people from the ‘western’ world have no concept of the suffering the people in the developing world go through on a daily basis.
      The damage done by western do-gooders by banning/restricting insecticides, fertilizers, fossil fuels and other amenities which could help untold numbers of ordinary people overcoming poverty and disease is the greatest injustice of the modern age. At least in my opinion.

      So to answer tonyb’s question, no the native people don’t take various malaria drugs, they get sick and many die.

      Hopefully some good will come out of this corona crisis and the healthcare systems will get some much needed (global) attention and governments stop wasting money on non-existant problems.

      All the best stay safe and happy in these troubeling times,
      Willem

  12. Not sure we will ever hear of the results of chloroquine for a defense for “rona”. Does not seem that it should be so political. Great story as always.

  13. Willis, is there any evidence that quinine and its cousins work differently in different people?

    I have an amazing treatment/cure for my chronic condition (I won’t go into the details because it would immediately identify me). It doesn’t seem to work for everybody though. The Chinese members of the family tell me it’s because I have a cool body type and the ones it doesn’t work for have a hot body type.

    The reason for my question to you is just part of building up something like a knowledge base so I can make up my mind on the body type ‘thing’.

  14. Can I add, that I think this comment from “LOL@Klimate Katastrophe Kooks ” a few days ago belongs in this thread? (I cannot vouch for its accuracy, but I offer it as further ‘food for thought’.)

    ———————
    https://wattsupwiththat.com/2020/04/08/coronavirus-wuhan-coronavirus-guest-post-four/#comment-2959870

    LOL@Klimate Katastrophe Kooks April 8, 2020 at 11:36 pm
    Quinine has a half-life in the body of ~18 hours, so after 5 or so days, it’s below testable levels. It only imparts a prophylactic effect when present in sufficient levels in the body.

    I started by pre-dosing with 83 mg / day of quinine, then increased that to 110 mg / day. I’ve been exposed by a guy at work coughing all day as I worked with him (he thought it was just a cold… I want to catch the colds, so I can get over them quickly, so I didn’t mind the coughing). We now have three people at work out with Covid. I’ve been trying to catch Covid, so I could get it done and over with and gain immunity, but the worst symptoms I had was a slight tickle in my throat and a feeling of general tiredness for a day, then it was gone.

    I’m no young buck, I rarely get enough sleep, I slug down 1 L per day of Mountain Dew, I’ve chewed tobacco since 4th grade (I’m a farm boy)… about the only things I do which are good for my health is eat healthy food, take a daily multivitamin, and work a physically demanding job. I’m not obese (190 pounds, 6’1″), my job keeps me pretty muscular. I obviously don’t have diabetes nor any other health maladies (except for nerve damage in my feet from walking too much in steel-toed boots while carrying heavy equipment in a multi-million square foot building, so the soles of my feet always tingle… but that’s another (long) story about a shite-head boss who increased our work load (with make-work) for no good reason and with no net effect, all to ‘get back at’ a supervisor he didn’t like… that boss is now gone… I swear, I had nothing to do with his being fired). 😉

    Anyway, here’s my research…
    Quinine was used in India in the form of a drink known as Indian tonic water to treat / prevent malaria. The British, colonizing India at the time, added gin, giving us gin and tonic.

    Chloroquine is an amine acidotropic form of quinine that was synthesized in Germany by Bayer in 1934 and emerged approximately 70 years ago as an effective substitute for natural quinine [4]. Natural quinine was so cheap that mass production wasn’t sufficiently profitable until after 1941.

    By the 1930s Dutch plantations in Java were producing 22 million pounds of cinchona bark, or 97% of the world’s quinine production. When Japan invaded Java in 1941, natural quinine supplies dried up, necessitating mass production of synthetic derivatives. [8]

    Chloroquine *is* quinine produced synthetically and altered slightly to produce a new molecule for patenting purposes. The end product in the body is still quinine. Newer molecules (such as hydroxychloroquine) decrease toxicity due to rapid absorption by making the molecule harder for the body to break down, allowing longer dosage schedules.

    Quinine is eliminated mainly by hepatic metabolism [1]. Seven metabolites have been identified with 3-hydroxyquinine being the major metabolite [1]. Other majority metabolites are (10R)-10,11-dihydroxyquinine and (10S)-10,11-dihydroxyquinine [2].

    Quinine acts against malaria by targeting its purine nucleoside phosphorylase enzyme (PfPNP) [3], but it has other effects in the body which act against coronavirus.

    Namely, it targets angiotensin-converting enzyme 2 (ACE2) [4], interfering with sialic acid biosynthesis [4]. SARS, MERS and Covid-19 use sialic acid moieties as receptors, so quinine (and its synthetic counterparts) prevent viral attachment to cell receptors.

    Hydroxychloroquine / Chloroquine / quinine can also act on the immune system through cell signalling and regulation of pro-inflammatory cytokines. [4]

    It also acts to increase zinc uptake, which has anti-viral effects. Quinine used to be sold, prior to the FDA banning it for this use, as a treatment for leg cramps. The mechanism of action is increased uptake of zinc, calcium and magnesium by reducing hepatic metabolism [10]. Now it is recommended to directly ingest zinc, calcium and magnesium for leg cramps rather than taking quinine. [9]

    This may be why people infected with Covid-19 experience a loss of the sense of taste (and smell, since the two senses are intricately connected) [11][12]. They become zinc deficient.

    It generally takes 4 to 5 days to completely flush quinine from the body [5]. The consumption of 10 oz. of tonic water can result in a quinine positive urine sample for a period of up to 96 hours (4 days) after intake. [5] Approximately 20% of quinine is excreted unmetabolized [6]. It has a half-life of approximately 18 hours [6].

    Quinine in tonic water in the US is limited to 83 mg / liter [7].

    Thus, we can make a simple linear extrapolation, assuming a half-life of 18 hours and ingestion of 83 mg / day. This means that after 24 hours, approximately 27.67% of the amount from the prior day remains in the system. Thus it accumulates until the body is excreting as much as is ingested. That occurs after approximately 5 days, when the dosage varies between 124.5 mg immediately after ingestion to 41.5 mg immediately prior to the next ingestion.

    https://i.imgur.com/zYZFjYL.png

    Is that enough to have a prophylactic effect?

    Well, the National Institutes of Health state that chloroquine is “a potent inhibitor of SARS coronavirus infection” [13] and since SARS binds to the same cellular receptors as Covid-19, and since chloroquine is a synthetic version of quinine, it would appear that it should work.

    Pretreatment with 0.1, 1, and 10 μM chloroquine reduced infectivity by 28%, 53%, and 100%, respectively. [13]

    The EC90 value of chloroquine against the 2019-nCoV in Vero E6 cells was 6.90 μM, which can be clinically achievable as demonstrated in the plasma of rheumatoid arthritis patients who received 500 mg administration. [14]

    Interpolating the dosage of 500 mg to 6.9 μM concentration, for a dosage of 124.5 mg daily (83 mg from tonic water, the remainder being that remaining in the body from prior dosages), that should give a concentration of ~1.71 μM, reducing infectivity by ~60% immediately after ingestion of 1 L of Indian tonic water, decreasing over the next 24 hours to ~.47 μM, with a reduced infectivity of ~40%, per [13].

    That would be more effective at ‘flattening the curve’ than any measures taken thus far. Covid19 has a R0 of ~2.2… so we could conceivably reduce that (assuming an average reduced infectivity of 50%) to ~1.1, effectively completely ‘flattening the curve’.

    Given that no doctor is going to give you chloroquine or hydroxychloroquine as a prophylactic measure, using Indian tonic water containing quinine to reduce infectivity would seem to be a prudent preventative measure.

    The wrap-up: It would appear that quinine interferes with sialic acid biosynthesis, which the Covid19 virus takes advantage of to attach to cell receptors. If the virus has a more difficult time attaching to cells, that allows the body to clear the virus without having to simultaneously deal with a rapidly-spreading infection.

    [1] https://www.drugs.com/npp/quinine.html

    [2] https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2710.2007.00788.x

    [3] https://blogs.sciencemag.org/pipeline/archives/2019/01/22/quinines-target

    [4] https://www.sciencedirect.com/science/article/pii/S0924857920300881

    [5] https://friendslab.com/quinine-use-and-detection/

    [6] https://www.drugbank.ca/drugs/DB00468

    [7] https://en.wikipedia.org/wiki/Tonic_water

    [8] https://en.wikipedia.org/wiki/Quinine

    [9] https://healthfully.com/287838-leg-cramps-magnesium-calcium.html

    [10] https://www.webmd.com/drugs/2/drug-19765/cal-mag-zinc-ii-oral/details/list-interaction-details/dmid-455/dmtitle-aluminum-and-magnesium-antacids-quinidine-quinine/intrtype-drug

    [11] https://academic.oup.com/jn/article/131/2/305/4687001

    [12] https://www.businessinsider.com/coronavirus-symptoms-loss-of-smell-taste-covid-19-anosmia-hyposmia-2020-3?op=1

    [13] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1232869/

    [14] https://www.nature.com/articles/s41422-020-0282-0

    My not-so-patented technique for getting over pretty much any cold or flu quickly:

    1) Antihistamine if your nose is running… it works just as well for colds and flu as it does for allergies. For mild colds, it removes nearly all of the symptoms for me. You’ll have to experiment to see which antihistamine works best for you… Loratadine 10mg / day works wonders for me.

    2) Hot showers… and I mean hot… if you can stand under the water without dodging around to prevent the water stinging you, it’s not hot enough. Breathe deeply, that water vapor loosens any mucus in your lungs, allowing you to cough it out more easily.

    3) 4 thick blankets… this takes a bit of experience to get right. The first few times, you can easily overheat yourself. When going to sleep, lift your feet to tuck the blankets under them, then roll left and right to tuck the blankets under your left and right sides, then cover your head and sleep in your little cocoon. Regulate your temperature (and allow enough oxygen in to breathe) by peeling back the top 3 blankets to about chest level, adjust their height if you get too hot or cold, or if you need more oxygen. Try to maintain ~104 F body temperature. Once you’ve done it a few times, you’ll know where to position the blankets. The first few times, though, use an oral thermometer and monitor your temperature. You’re going to sweat a lot… a plastic liner on your mattress is recommended.

    4) This is a new addition for coronavirus infections… quinine in the form of tonic water. 2 L per day for the first 4 days (loading stage), then 1 L per day after that (maintenance stage). Right now I’m doing 1 L per day, along with a 12 ounce can (because my wife found some Trader Joe’s lime-flavored tonic water in 12 oz. cans and bought it to try, and no one else wants to drink it… I hate lime, it tastes vile to me, but I slug it down in a couple drinks to avoid the bad taste) as a prophylactic measure against WuFlu.

    5) Zinc and vitamin C supplementation. Don’t take more than the RDA for zinc. If you start getting diarrhea, you’re taking too much vitamin C… that starts happening for me at around 10 grams (10,000 mg) per day, so I generally take 4,000 mg / day when a cold or flu is in the incipient stage. Costco has a really tasty chewable vitamin C tablet (Kirkland Signature Chewable Vitamin C, 500 mg).

    6) If you start getting lung congestion, sleep with your head lower than your feet, to allow gravity to assist in moving the mucus out of your lungs. An inversion table works wonders set at 45 degrees or steeper, but you have to get used to the blood rushing to your head. Even just putting 4×4 wood blocks under the foot-end of your bed will help a bit. If your nose is running, this’ll make it run even more, so the antihistamine is a necessity.

    Most colds I’m over and done with in less than 3 days… the last flu I caught was brutal, I had lung congestion so bad that I was short of breath, but I got over it in 3 days. It hit me like a load of bricks… one minute I felt fine, a half hour later I felt terrible, with alternating hot and cold flashes. I finished the work day, went home, dosed up on vitamins and water (this was before I started using tonic water), and went to sleep for two days. Woke up with lung congestion, took a hot shower, coughed out huge amounts of phlegm, ate some food, dosed up on vitamins and water again, went back to sleep, and was back to work the next day feeling fine.

    • I would add a note that because they regulate how much quinine is in the tonic water, I have a sodastream and use their tonic syrup and just mix it strong then drink with orange juice
      Added bonus as my girls hate carbonated beverages I just mix theirs with tap water
      Lots of quinine for all and my canadian health care system can go pound sand

      • Shhh Pat !

        Don’t say it too loud. Justin Trudeau might hear you.
        He won’t understand … but he might hear.

      • The Zinc supplements makes sense. as it the Zinc that stops the covid virus from connecting to the molecule in our cells to replicate.

        Zinc in our cells stops covid from reproducing.

        The Chloroquine is only required to get the Zinc into the cell.

        Another option is just take more Zinc supplement.

        Question: Maybe we are all Zinc deficient?

        Chloroquine is a Zinc Ionosphere that allows a small amount of the positive zinc ion (Z+2) into our cells which are negative polarity. The positive Zinc ion stops the covid virus from replicating.

        It has been proven in vitro that the Zinc when it enters the cell (all of cells require Zinc and we are Zinc deficient) it make the ACU-2 molecule which the covid must connect to positive.

        That stops the covid virus from replicating.

        So that is the mechanism. We only need Chloroquine to get zinc into the cells….

        A small amount of Chloroquine gets the required amount of Zinc into our cells is…

        Chloroquine —–30 mg/day
        Zinc—————30 mg/day

        … that has been shown to stop the covid virus from replicating,

        If low dosage Chloroquine is tolerable for say a year this would provide protection for until there is vaccine other solution.

        High dosages of Chloroquine are dangerous and purposeless.

        https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4182877/pdf/pone.0109180.pdf

        This is more on the Chloroquine and Zinc question.

        https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4182877/pdf/pone.0109180.pdf

        • One of the now recognised symptoms of COVID-19 infection is a loss of sense of taste and smell.
          This is curious because from the online website What is Zinc? We find that :

          Zinc is also needed for your senses of taste and smell. Because one of the enzymes crucial for proper taste and smell is dependent on this nutrient, a zinc deficiency can reduce your ability to taste or smell

          It may be that the symptom of loss of smell and taste with COVID -19 infection arises because all of the Zinc inside the infected cells in the nostrils and taste buds has been used up by these cells in fighting the viral infection.

    • Great stuff Jim. I suggest one addition. Anecdotally, North Atlantic fisherman (rough waters) tend to not get colds or the flu and their landlubber families do. This gave rise to a saltwater nasal spray, first out of Sweden, if I recall, however I use a more drastic cheaper method. As soon as I feel a tickle in my throat and other subtle beginnings, I make a cup of warm water with ~1/3 a tsp of salt – should not “burn” the nostrils. I snuff this sharply up my nose from a puddle in the palm of my hand and repeat until the cup is empty.

      Most of the water comes out your mouth but a small bit goes down your throat. You blow your nose several times when you are finished. Your sinuses all get partially flooded too and sometimes an hour or two afterwards, you feel a warm trick into your nose as the sinuses decide to drain. You even feel a saltiness in the eyes, probably from the back up of the “tear drain”.

      This you do a couple of times the first day day and once the following morning. Continue longer if you wish. On some occasions I get up in the night for a repeat. Since these bugs get started in your mucous membranes this first aid may kill them right off, or at least let your natural defences get a head start. The Mountain Dew may have a synergistic effect, too!

      I have been drinking tonic for a couple of weeks and I drink a bottle of “Ensure^TM, the regular. It carries 40% of daily disage of zinc and all the vitamins and minerals.

      Cheers all and good health, Gary

      • re: “This gave rise to a saltwater nasal spray”

        My sister uses a Nettie pot; I have not tried that and am hesitant to do so (Ima pain-fearing chicken).

        I did get her to start using Cayenne Pepper, which for me, in part, has helped ward off debilitating sore throats for ~25 years now.

        • Jim, my daughter introduced me to the big slug of tabasco and a deep, hot as you can bear, bath immediately and the sweat you get probably tops up the tubwater a few mm. This recipe she got from a Chinese foreign student 30yrs ago.

          My mother used to slap a mustard plaster on our chests and that put out sweat and snot I’ll tell you. There were no antibiotics when I was a young schoolboy and l had friends quarantined for 40 days (from the French for 40 – quarante) with their families. Neighbors dropped off boxes of groceries on the front step for them.

          This quarantining self could have been better worked out once they had stats that the elderly and people with other health issues could have been quarantined and the rest allowed to work. Add the HCQ and most of the problems probably would have evaporated. Oh well 20-20 hindsight and all that.

          Once this is all over, I’m going to put together a little health kit. Another thing that should be done is for governments to get China to regulate their ‘wet’ food markets and stop small producers from raising the menagerie of creatures they do inside their own small homes. Most of the major cross-over viruses seem to come from China.

          • “If low dosage Chloroquine is tolerable for say a year this would provide protection for until there is vaccine other solution.”

            There is never going to be a vaccine. Thats a fantasy and like vaccinating against the common cold.

    • The British gin is a bastardised copy of the old Flemish genever – which is still much nicer.
      Never really liked gin – it tastes like an industrial solvent.

      • Phil,
        There are now many dozens [possibly a couple of hundred?!] different artisan gins being made in the UK. All differ a bit in their herbs, I gather.
        But gin is now fashionable – until we were held hostage by the Wu Flu from China.

        Auto – note, I don’t blame Poisoner Putin for this one.

    • Chloroquinine has a half-life of 22 days, considerably longer than quinine’s half-life of 14 hours.

  15. I bought a half dozen 12 packs of cans of Tonic Water over the last two weeks. Each can contains 20 mg. of quinine hydrochloride. I read somewhere that’s only about a third to half the level it used to have in the old days. What I don’t know is … and likely know one knows yet, …
    A) is it of any benefit against CoVID ?
    B) if it is does it need to be mixed with gin to work ?

    • I would just run with option B), but in the same dosage as Willis took his curative potion, that is – 90 says worth of g+t in 3 days.
      Then you just won’t care if it cures the Wuflu or not.
      Cheers!

    • It contains a ton more sugar. If you try dosing yourself with that I suspect that you won’t die of covid-19, but of diabetes.

      When I first heard about this, I orders a three month supply of chloroquinine from my usual source in India ($9 worth!!). But I was too late. Planes stopped flying and India banned its export, so eventually they gave up and refunded my money.

      BTW, surprise, surprise, it seems that the companies that assemble the raw ingredients into pills in the US have now suddenly bumped up the price by several hundred percent.

      That should be a hanging offence.

    • The gin is to make the medicine go down pleasantly and was a British colonial concoction that became a nice summer drink around the world.

    • To get an effective dose of quinine you’d need to drink about 56 gallons of tonic water per day

      That’s also going to be a lot of gin

      • Quite wrong, that’s all that used to be available and Eurpean coloniaists actually learned about in Africa or India, I’ve forgotten which. It works for malaria, that is certain (modern meds are more effective and easier to stomach, but based on the same chemistry).

    • Would have been a lot less harrowing if the part that went, “After I’d been there maybe three years, I thought ‘I don’t want to take this forever. If I get malaria, I’ll cure it, that’s what medicine is for’. So after having taken well over 100 doses of chloroquine, I gave it up,” hadn’t happened.

      • Perhaps, James, and perhaps not. I had several considerations.

        First, I don’t like taking any such very strong drug long-term.

        Second, in addition to prophylaxis, chloroquine was used there for treatment. I figured if I got malaria while taking chloroquine, and some folks did, if I were taking chloroquine to prevent the disease, whatever strain I’d get wouldn’t be cured by chloroquine.

        Third, I started reading that long-term use (years to decades) could damage your eyes.

        Overall, I figured that occasional chills and fever, with drugs to cure them, was the better path.

        w.

    • Because we can.

      We are humans and can live anywhere, provided of course the global temperature doesn’t change by more than 0.1 degrees because that would kill us all stone dead.

    • Why on earth do people live in areas with malaria?
      ≠========
      Until we put in place public health and sprayed with DDT, malaria used to be in almost every country.

      • If I remember correctly, one of Mussolini’s much-touted success stories was ending malaria in Rome by draining the swamps outside the city.

        I’m surprised the left haven’t vilified him post-mortem for destroying natural wetlands.

        Save the malarial mosquito!

      • Used to be common in the UK – centuries ago and went by the name of the Ague. Seems that the Little Ice Age brought an end to it in the UK as it killed off most / all of the mosquitoes that carried it.

        • Oliver Cromwell suffered from malaria and he lived well inside the Little Ice Age. Besides one of the worst places for mosquito infestations is the Arctic tundra during the summer. If mosquitoes can survive the Arctic winters they wouldn’t have been worried by the LIA.

          The way I heard it was that the species of mosquito that carried malaria in the UK prefers cattle blood to human, so that when cattle raising became more common the transmission cycle got broken. Add to this that the marshes got drained to make farmland reduced breeding grounds for mosquitoes. Think I read about in Lamb’s book on climate history.

    • Until DDT huge tracts of the USA and the Mediterranean were infested by Malaria.
      DDT knocked out the populations in Europe and the Americas before it was banned, leaving pools in Asia and Africa.

      Louisiana was, I believe, pretty bad…

    • “Why on earth do people live in areas with malaria?”

      Up to about 1850 that was “almost eveywhere except the Arctic”. The largest malarial epidemic ever was in the 1920’s in Siberia.

  16. Nothing to lose, everything to gain, and Fauci is both mad and destructive to argue against it.

    Didn’t Trump make the phrase “You’re fired” sort of a personal tag line?

    • Keep your friends close and your enemies closer…until you give him enough rope to hang himself.

  17. Here in the US there is a concerted effort by the Deep State and main stream media to delay as log as possible the use of Hydroxychloroquine! Universally they respond that the drug is not tested yet. No one reporter asked if there is any evidence that it worked or asked, since the side effects are mostly mild, why it is not being tried more often. By the time the proper trials are over the virus will have run its course.

    Now a cynical person like myself would think that the US left WANTS to see as many deaths as possible. I.e. never let a good crisis go to waste.

    • Cynical? Is it not the U.S. Left’s ideology that results in fewer potential human lives from even existing?

  18. People are being entirely too forgiving of Fauci. The data in favor of HQ is too detailed now to avoid the obvious reality that this treatment is successful for the Wuhan.

  19. You were probably not infected with P. falciparum as this is frequently fatal due to cerebral occlusions. From what I have heard, the other three only make you wish you were dead, and your description of your illness fits that!

    I had the good fortune of working with William Trager when he developed the technique of cultivating blood stages of P. falciparum in vivo. That has certainly helped in the study of drugs against this disease.

    Hopefully what we are seeing with chloroquine and hydroxy chloroquine may lead to better treatment of these viral infections as well.

    • Actually, I did have falciparum, twice. Once was the relapse. P. falciparum is the recurring one.

      w.

  20. Willis,
    you always bring back memories for me, we spent four years in the Zambian copperbelt, Malaria, Yellow fever and Sleeping sickness to name just a few, fortunately either my immune system, which was only just over 25 years old did a good job or I was never bitten by an infected mosquito, then there was the putzi fly, Ughh, revolting insect, we always made sure any clothes dried outside, which they always were, had been ironed well to kill off any eggs laid in the seams.

    I did come down with some form of severe hepatic infection that laid me low for three months, jaundiced with yellow eyeballs, just the thought of eating anything greasy or drinking alcohol would make me nauseous, the cause was never ever diagnosed, even with significant testing over the years since, however no apparent long lasting health effects as so far I’ve made my three score and ten plus some. I’ve learned to listen to my body ever since that episode.

  21. Willis: Great article and story. Well worth the read… a full course in a short story!
    I have been telling people that quinine does not work like hydroxychloroquine because quinine is not an ionophore. Am I wrong about that? Also, that drinking tonic water has a very low amount of quinine and would not be enough to even help malaria… as well that malaria today is resistant to quinine anyway.

    • If you did not need extra zinc at the cellular level , then it would not matter if it were not a zinc ionophore. Any other therapeutic effect would still be present.
      Glutathione level is very important. That’s why zinc is critical.

      • Yes farmerbraun: Glutathione is important, which requires glutamine, an amino acid I supplement when under stress. But my question was whether or not quinine is an ionophore and would act like hydroxychloroquine. I asked because people are suggesting tonic water with quinine will do what hydroxychloriquine does. I think they are not similar in that respect.

  22. I really hate it when “Scientists” use the statement that there are no accepted studies that … , as a way of claiming that the opposite is true, when in fact there have been no studies at all.
    That’s the case with hydroxychloroquine, no properly conducted studies have been completed, hence they don’t know either way, yet many are using this to claim it doesn’t work.

    However a statistical analysis of co-morbidities of serious covid patients should quickly and authoritatively provide strong evidence that some medications for chronic diseases that are seriously underrepresented in serious Covid-19 patients seem to stave off the worst effects of the virus. There is a claim that lupus is underrepresented which would point to hydroxychloroquine being effective, but I haven’t seen the evidence of this underrepresentation.

    That’s all we need, an effective treatment against the worst effects, we don’t need a vaccine.

  23. Willis: Great article and story. Well worth the read… a full course in a short story!
    I have been telling people that quinine does not work like hydroxychloroquine because quinine is not an ionophore. Am I wrong about that? Also, that drinking tonic water has a very low amount of quinine and would not be enough to even help malaria… as well that malaria today is resistant to quinine anyway. Posted again because error message.

    • So, I’m guessing no one with diabetes ever went to Africa or took malaria drugs as prophylaxis? Perhaps they did, but no one ever looked into the death rate of diabetics falling ill prior to their trips to malaria prone hotspots.

  24. I took chloroquine every week for 3 years in the early 60s in Penang. As did my whole family. None of us ever suffered side effects.

  25. “What are the dangers associated with chloroquine?
    Doyon: Chloroquine has been used for the management of malaria for decades. Both chloroquine and hydroxychloroquine have some usefulness in the management of certain inflammatory diseases such as rheumatoid arthritis and lupus. It must be emphasized that chloroquine is a very toxic medication, and when you ingest too much of it you will develop symptoms including loss of hearing, loss of vision, and potentially cardiac arrhythmias. Chloroquine is a prescription product and should always be taken under medical supervision.

    Zhong: A previous study has shown chloroquine can exacerbate acetaminophen-induced liver injury in mice due to its ability to inhibit autophagy and mitochondria function. Whether hydroxylchloroquine can make liver damage worse in combinational use with acetaminophen is unknown. What are the up-limited doses of acetaminophen and hydroxylchloroquine for COVID-19 patients? Unknown. The knowledge is so urgently important for tens thousands of people who are suffering COVID-19 in the US and needs to be addressed quickly.”
    https://today.uconn.edu/2020/03/qa-ibuprofen-chloroquine-covid-19/#

    • For those not convinced that HCQ is benign, with not significant side-effects, as attested by laymen, I suggest reading the following:
      https://www.drugs.com/mmx/hydroxychloroquine-sulfate.html

      Note especially, “Doses of chloroquine phosphate as small as 0.75 to 1 gram in children, and 2.25 to 3 grams in adults, may be fatal. It is assumed that hydroxychloroquine is equally toxic.” And, “Since there is no specific antidote, treatment of hydroxychloroquine overdose should be symptomatic and supportive …”

      • re: “Doses of chloroquine phosphate as small as 0.75 to 1 gram in children, and 2.25 to 3 grams in adults, may be fatal.”

        Strawman; I have not seen recommended dosage levels that extreme by anyone.

      • Who was ever talking doses measured in GRAMS ?

        The highest I saw here was I think 800 mg … milligrams.

        My twofer cans of Tonic Water daily is 40 mg … milligrams.

        • Jim & sendergreen

          “…, my mad mate Mike told me that when you feel malaria coming on, and you can definitely can feel it coming on, to take three weekly doses at once (1500 mg, or 900 mg of base), [1.5 grams!] then the same thing 24 hours later, then the same thing on the third day.”
          — Eschenbach

          1.5 grams is dangerously close to the toxicity threshold, which almost certainly varies with individual sensitivities, and does vary with the weight of the person taking it. LD50, which is the level at which 50% of test subjects die, is given as milligrams toxin/kilogram of body-weight. That is, what a 100 kg man may survive will probably kill a 50 kg woman or child. How many laymen realize that? Would they be tempted to give their sick child the same dose recommended for an adult if they had a bottle of HCQ?

          “The highest I saw here was I think 800 mg.” = 0.80 grams > 0.75 grams
          Unfortunately, in our culture, there is an attitude that if a little bit is good, a lot is better.

          I have not seen anything in the news about how much the two people took of the aquarium cleaner (chloroquine phosphate), but the death of the husband and severe illness of the wife suggests in the “grams” range.

          People in India have been drinking cow urine, many people have died in the Middle-east from drinking methanol, and two are known to have died from chloroquine in the US. This all strikes me as being only slightly removed from believing that a rabbit’s-foot charm will bring good luck, despite it obviously having brought the rabbit bad luck. There is a reason that civilized people quit using witch doctors and demanded that physicians use medications that have been shown, by controlled experiment, to actually work. The natural recovery rate for COVID-19 is so high, and often so rapid, that the ‘lives saved’ by HCQ can be explained easily by the assumption that the people would have recovered without the HCQ. The fact that HCQ apparently doesn’t work on those severely ill can be explained by the fact that these are people who didn’t recover naturally; hence, giving them an ineffective treatment will not work.

          • Clyde copies :
            “my mad mate Mike told me that when you feel malaria coming on, and you can definitely can feel it coming on, to take three weekly doses at once (1500 mg, or 900 mg of base), [1.5 grams!] then the same thing 24 hours later, then the same thing on the third day.”

            So not a clinical or prescribed dose but one from … Dr. Mad Mike ?

            A graduate of the Philosophy Department of the University of Woolamaloo. We’ll just call him “Bruce”

          • Clyde, here is the story of the second US doctor to become infected.
            45 years old, “In 21 years on the job, almost all at EvergreenHealth, he said he had taken only five sick days.”

            “His colleagues at the hospital put him on the anti-malarial drug hydroxychloroquine, whose effectiveness for the coronavirus is still unknown, but Dr. Padgett’s condition continued to worsen.

            By March 16, his heart was struggling, his kidneys were failing and his lungs were not providing enough oxygen to his body. The levels became so dire that he was on the verge of injuring his brain through oxygen starvation.

            Dr. Padgett’s team at EvergreenHealth decided to transfer him to cardiac specialists at Swedish Health Services in Seattle. Dr. Matt Hartman, a cardiologist there, said it was clear that Dr. Padgett’s condition was rapidly worsening and that if they did not do something, he would not survive.

            “We didn’t know if this was someone who was just going to die no matter what we do,” he said. “We think with his age, and the fact that there’s no other major comorbidity or problem, that we should at least give it a try.”

            The team decided to hook Dr. Padgett up to a machine known as an ECMO that could essentially serve as both an artificial heart and lung, taking his blood out of his body, oxygenating it and returning it to him. While such procedures are most often done in the surgery suites, in this case it was all done in the intensive care unit, to prevent the spread of the coronavirus elsewhere in the hospital.

            “We brought the operating room to him,” said Dr. Samuel Youssef, a cardiac surgeon at Swedish.

            The team also began consulting with oncologists. Indicators of inflammation in Dr. Padgett’s body were “astonishingly high,” suggesting that he was potentially dealing with a “cytokine storm,” a dangerous phenomenon in which the immune systems of otherwise healthy people overreact in fighting the coronavirus.

            News to stay informed. Advice to stay safe.
            Click here for complete coronavirus coverage from Microsoft News
            The doctors administered the drug tocilizumab, often used for cancer patients who can have similar immune system reactions. They added high-dose vitamin C after seeing reports that it might be beneficial. These experimental treatments had also been tried on another patient, a 33-year-old woman, with some success.

            Over that week in mid-March, there were signs of improvement. As his inflammation numbers came down and his lungs started to provide more oxygen, the team began scaling back the ECMO machine, until they finally removed it on March 23.”

            It is harrowing, and an important read.

            ““It goes from kind of initially feeling like this was a flulike illness where the vulnerable are the ones that are going to get sick, and now understanding that the vulnerable are getting sick and there’s going to be some young, healthy people that get cut down with this,” he said. “That’s the scary part. I think of my colleagues still on the front lines. That’s what I fear for them.”

            Dr. Padgett said he was still working to recover physically and mentally. He worried now about whether he would regain full cognitive function, noting moments of memory and attention problems””
            https://www.msn.com/en-us/news/us/he-was-a-doctor-who-never-got-sick-then-the-coronavirus-nearly-killed-him/ar-BB12zNAs?ocid=msedgntp

      • “Doses of chloroquine phosphate as small as 0.75 to 1 gram in children, and 2.25 to 3 grams in adults, may be fatal. It is assumed that hydroxychloroquine is equally toxic.”

        Bad assumption. Different drugs. Different chemistry. Chloroquine phosphate is used as a fishtank cleaner. Hydrosychloroquine is an over-the-counter drug in most places.

        • Pauligon
          You are claiming to be more of an authority than those who run the drugs.com website? They certainly provide more detailed information than you do, and also provide citations, which you don’t.

          While chloroquine phosphate is used as an aquarium cleaner, that is not its only use. Your claim is like saying that because antibiotics are given to hogs, antibiotics should not be used by humans.

        • Iamknot Amedic — That is obvious!
          The article you linked to is basically about dietary phosphate intake, and does not speak to the the toxicity of of chloroquine phosphate. Indeed, the summary says, “Of relevance, phosphate toxicity induced by excessive exogenous phosphate administration can be fatal …. Although the lethal dose of phosphate in humans is unknown, …” He is talking about calcium phosphate, the mineral apatite, principally. Although, sodium phosphate enemas are referred to. The closest that the phosphate ion comes to being independent is in phosphoric acid, used in flavored drinks. The other forms of phosphate, bound to a metallic cation, are less soluble and vary in their individual toxicities.

  26. In a Frank and Ernest cartoon one asks the other, “If we are at the top of the food chain, how do you explain mosquitos?”

      • I’m getting daily low doses with Tonic Water. It’s sugar-ed like a coke so lowering blood sugar levels isn’t a concern.

        Heart Arrhythmia? Again low dose, and the key … I have four daughters and haven’t slept since 1987. : )
        Not scared yet.

      • I believe it’s the azithromycin which has potential coronary side-effects. But other similar drugs have been used to replace it in this combination and seem to work as well.

        The media nonsense is all just Project Fear.

  27. “I am a medicinal chemist who specializes in discovery and development of antiviral drugs, and I have been actively working on coronaviruses for seven years.

    However, because I am a scientist and I deal in facts and evidence-based medicine, I am concerned about the sweeping statements the president has been making regarding the use of chloroquine or the closely related hydroxychloroquine, both antimalarial drugs, as cures for COVID-19. So let’s examine the facts.”
    https://www.minnpost.com/other-nonprofit-media/2020/03/could-chloroquine-treat-coronavirus-five-questions-answered-about-a-promising-problematic-and-unproven-use-for-an-antimalarial-drug/

    • But, he’s not a clinician.

      cli·ni·cian /kləˈniSHən/
      noun
      a doctor having direct contact with and responsibility for patients, rather than one involved with theoretical or laboratory studies.

      • And neither am I.
        Thank you for pointing that out.
        No one should ever make any medical decision based on anything I have opined on…ever.
        That is for sure.
        Evidently there are people here who are far smarter with a far more keenly honed intuition that I could ever want to assert, as well as having, based on their willingness to offer medical advice, actual bona fides to do so.
        Keep up the good work, and all the best to you.

  28. “With years of experience researching Malaria, Professor G Padmanaban is the right man to clarify why the anti-malarial Hydroxychloroquine is being pushed to the frontlines against COVID-19.”
    ” In the case of COVID-19, the side effects of HCQ treatment are not fully known. Since, some countries have adopted the same and doing trials, adequate data on efficacy and safety would soon be available. The public needs to be aware that it is a prescription drug and clinicians should decide when to use it. Self-medication needs to be strictly avoided.”
    https://www.thebetterindia.com/223475/coronavirus-covid19-hydroxychloroquine-malaria-trump-modi-india-iisc-expert-nor41/

    • re: “Self-medication needs to be strictly avoided.”

      HOW do you get a prescription drug dispensed from a pharmacy w/o a doctors’s prescription?

      Uhh … just asking …

      • Jim-

        Easy. You have a friend or relative with rheumatoid arthritis or lupus. Plaquenil (hydroxychloroquine sulfate) is routinely prescribed for both. Most people get a prescription for three months supply. So you just ask them for a few days worth when you feel like you have the virus. And remember to take a zinc supplement with it.

        Taking it long term as a preventative is a different story.

        • re: “You have a friend or relative with rheumatoid arthritis or lupus.”

          (Criminally) Involve another in a ruse? We’re talking conspiracy now … and this assumes the other party will participate.

          • Jim
            You said, “…this assumes the other party will participate.” Which they often do! After all, if everyone is hearing that the only reason HCQ isn’t being used is because of some kind of conspiracy by Big Pharma, or oppression by those with TDS, it is easy to rationalize saving a friend or family member’s life, even if it means committing a misdemeanor.

          • re: “because of some kind of conspiracy by Big Pharma”

            Persons of that sort of persuasion are not entirely rational IMO; Recall the adage: Conspiracy theories are the favored tools of the weak-minded.(Attributable to one Vic LaRoca, now SK)

    • “In the case of COVID-19, the side effects of HCQ treatment are not fully known…..”

      [snip] He’s been brainwashed by the deep state zeitgeist. They are pretending to forget everything they knew of three generations of medicine just in the last three months. As we have seen , the writer behind this thread took 3 weeks supply in 3 days. And he didn’t even have a heart attack or anything.

  29. Hi Sendergreen..
    No one else seems to have responded so here goes..

    A) Do not know for certain whether I have had Covid, cos here in the UK we cannot get tested until very ill. (too late for a lot of people).

    B) I came into contact with a guy from Madrid 30 days ago. After passing some papers to me he stated that he had not quarantined and had got back from Madrid 2 days previously. I was very annoyed by him, as I am 76 years old.

    I was concerned and 3 days later my temperature went above 37.8C up to 38.6C.

    Decided I probably had been affected.
    Went into isolation.

    Had always drunk Whisky and Dry. Never G &T’s.
    Decided I had nothing to lose as knew that Tonic Water contained quinine and I was aware that China and other countries were buying up supplies.
    Added ginger (drove off all the horrible CO2) and a little lemon juice to supply a better taste.
    4 hrs later my temperature had dropped to 38.1C. Another drink….
    Net morning I was back to my normal 36.6C. This was at day 4.

    I have continued with a tipple each day and have had no real problems although I did start a bit of a cough at day 12.

    My wife who has the immune system of an Ox has had no symptoms but also started a slight cough (unknown for her) after day 13. (ie 1 day behind me). I found even walking to be a tough exercise until a few days ago.

    I do not know yet whether I did contract it.

    My recovery from whatever I had has been fantastic.

    My advice – take it – it can do no harm and will at least speed up your recovery.

    • Thanks much Dave. I’m already 64 in the U.K, won’t be 64 here in Ontario Canada for another 3 and 1/2 hours.

      I’m having 1-2 cans (355ml) of Tonic Water a day. All I had so far was one early morning scare. I woke up with the back of my neck feeling hot, and some slight pain. Thought oh-oh. I passed one of my daughters holding my breath on the stairs. She said “Dad you got one ripping sunburn on the back of your neck”. Forgot that I’d been out on the first sunny day in weeks here. It was only 40°F (4°C ?) outside so I didn’t notice I was UV’ing in the grocery line-ups (queue). I’ve never been relieved to have a sunburn before.

  30. Zinc supplements have been touted as a treatment or prevention of coronaviral disease.
    This comment is not about subjects that have a zinc deficiency that actually need supplementation.
    In mammals the immune response to infectious, mainly bacterial disease, is to increase temperature, so run a fever,shut down, so curl up and sleep and strip zinc from the circulation. Zinc is used as a substrate by bacteria so they can grow fast.
    With coronavirus, in the mouse, so not man, a zinc metallo enzyme aids the entry of coronavirus into the cell being infected.
    https://www.ncbi.nlm.nih.gov/pubmed/28148786
    So for the normal mouse, it would not be a good idea to supplement with zinc.
    Perhaps ‘of mice and of men?’

  31. Thank you, Willis
    Amazing post
    Very informative and also entertaining
    I grew up with malaria but not as bad as your experiences but I can’t really remember the details as well as you do.

  32. Failed to say that I have added a Zinc supplement from day 5.

    Interesting to see whether

    1) I have had it?
    2) Have I developed Antibodies?

    Has my ‘medication’ worked or was I lucky and had a mild version of the Virus?

  33. Anecdotal evidence, but it is creating some deliciously funny political angst! Democrat Michigan State Representative Karen Whitsett contracted the Chinese virus and became very ill. After hearing President Trump speak favorably about hydroxychloroquine, she convinced a MI doctor to prescribe it for her, even though the democrat governor of MI had ‘banned’ its use because ‘orange man bad’. Rep. Whitsett made a rapid recovery and has publicly credited President Trump for advocating for the drug and ‘saving her life’. As Ms. Whitsett is a ethnic democrat female, her testimony has left the TDS afflicted rock throwers in a bottled up foment of impotent frustration. The links below provide an interview story in the Detroit Free Press and a video interview with Laura Ingram.
    https://www.freep.com/story/news/local/michigan/detroit/2020/04/06/democrat-karen-whitsett-coronavirus-hydroxychloroquine-trump/2955430001/
    https://youtu.be/Ql3LJP7OP_s

  34. We have some information of whether hydro-chloroquine works for covid19. How useful this information is or how reliable this information is we don’t really know. But it is information non the less. Some doctors will prescribe it based on this imperfect information and some won’t. It is a matter of a doctor’s individual judgement.

    If I get covid, I will find a doctor to prescribe it. That doesn’t mean it works, but based on my assessment of the risk reward trade off I’ll take it.

    When the explorer Jacques Cartier was exploring Canada in 1535 and his crew began to suffer from scurvy with 25 dying from it and the rest weak with their teeth following out, he was told by the Indians to boil pine needles and drink the soup. Well it worked. I doubt the Indians had done any double blind studies. They knew it worked from experience and generations had passed down the cure. Only much later did we find out pine needles are rich in vitamin C.

    • SteveK
      You said, “Some doctors will prescribe it based on this imperfect information and some won’t.” Yes, the last news item I read on this indicated that about 30% of physicians are using HCQ in their treatment protocol. That is not exactly a resounding endorsement of the efficacy as assessed by clinicians.

      • In my jurisdiction the Government has laid out the threat to go after the medical licence of docs who prescribe it. Part media hype, part control issues. Like the bylaw officer here who wrote up an $880 ticket for a guy walking his dog in an empty park.

        • Why would this guy let the bylaw cop get closer than 6 feet and take a ticket covered in the Chi Com V?

          • RusselDyer replied:

            ” Why would this guy let the bylaw cop get closer than 6 feet and take a ticket covered in the Chi Com V? ”

            My guess is that the guy only had some lapdog the size of a nerf football, with a vestigial jaw. : )

  35. If you want to know more about COVID-19 and Hydroxychloroquine check out the youtube sites of “MedCram” (Dr. Seheult), “Weightless4life” (Dr. Bon Truang), “Dr. Eric Berg DC” and look up Dr. Zelenko from a community in New York State.

    Dr. Seheult has many short but informative videos on many aspects of COVID-19. He is an ER doctor that deals with COVID-19 patients regularly and uses hydroxychloroquine with Zinc and Z-Pack with his patients.

    Dr. Bon Truang is a medical doctor that uses hydroxychloroquine with Zinc and Z-Pack with his patients. He has many videos about COVID-19 and its effects and treatments. He also has a video dealing with how to treat diabetics on certain drugs. He has videos covering a few patients and their individual cases.

    Dr. Eric Berg DC has many videos that discuss COVID-19.

    Dr. Vladimir Zelenko has treated over 600 people in his community for COVID-19 using hydroxychloroquine with Zinc and Z-Pack. Some of his patients that were young and healthy were not treated with hydroxychloroquine because they could recover on their own. They were monitored by phone daily to be sure that they didn’t get worse. He believes in keeping people out of the hospital by treating early. Anybody that had any of the risky health conditions were automatically put on hydroxychloroquine with Zinc and Z-Pack and monitored.

    All of them have found that early treatment is important for survival.

  36. In Vietnam, they gave us chloroquine as big orange horse pills. Wife got the same years later on a deployment to Honduras. Only side effect that I felt, and others experienced it too was it disrupted your GI tract. However, knew guys in our unit who didn’t take them and they ended up with malaria, which is not pleasant at all. Years after that, took a 3 week dive trip to the Solomons and I was also given chloroquine to take as a prophylaxis, only this time the pills were much smaller and white. Didn’t experience the same side effects from those.

    • “In Vietnam, they gave us chloroquine as big orange horse pills. Wife got the same years later on a deployment to Honduras. Only side effect that I felt, and others experienced it too was it disrupted your GI tract. However, knew guys in our unit who didn’t take them and they ended up with malaria, which is not pleasant at all.”

      I got real sick in Vietnam and I’m not sure if I had the Hong Kong flu or if I had malaria.

      I took the malaria pills for a while, but they tasted very bad, and I eventually quit taking them.

      I don’t recall how my not taking the malaria drug correlates with the illness. I can’t say if it was before or after.

      My symptoms were a *very* high fever and I shivered and shook and sweated for close to three days. I didn’t go see a doctor although I was thinking about it on the third day but the fever finally broke and I recovered pretty fast after that.

      The illness lasted just a few days and within a week or ten days I was back to normal. I didn’t take any kind of medication while I was sick.

      I wouldn’t want to do that again.

  37. A first person experience is very compelling. Thanks Willis.

    Perhaps a compromise of sorts can help get things moving.
    Only lockdown or ‘herd’ immunity (by surviving covid-19 or vaccination) will work. Apply lockdown to those with fragile health and develop herd immunity in the rest with preventative practices & early aggressive treatment (best bet is hydroxychloroquine) of those testing positive.

    I am with you. Get the country back to work!

    • No. How about treating those who are ‘fragile’ with HCQ and the Z pac as soon as they are diagnosed. If they want to self-quarantine in stead they can.

      • I am OK with that (I’m in the ‘fragile’ group) but IMO what I recommended should reduce the peak number of hospitalizations and might be acceptable to more politicians. The Z-pak is in case of secondary bacterial infection but might be worth it. As far as I know, it wouldn’t hurt but attending doctor should decide.

  38. Ivermectin is said to effectively and quickly destroy corona-chan in vitro, supposedly by enhancing ATP responses at P2X4 receptors. Ginsenoside in Panax ginseng does the same thing.

    We investigated the selectivity of protopanaxadiol ginsenosides from Panax ginseng acting as positive allosteric modulators on P2X receptors. … Ginsenosides CK and Rd were demonstrated to enhance ATP responses at P2X4 by ∼twofold, similar to potentiation by the known positive modulator ivermectin.

    Ginsenosides Act As Positive Modulators of P2X4 Receptors
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6334005/

    • P2X4 receptors are only expressed on certain cell types. Are they expressed at all on the cell types targeted by SARS-CoV-2?

      • They are definitely expressed in the lungs, but I think the anti-viral action happens extracellularly. Apparently, Ivermectin and ginsenosides potentiate release of ATP from cells.

  39. https://www.americanthinker.com/blog/2020/04/chloroquine_may_never_get_the_perfect_study_proving_its_good_use_it_anyway.html
    “The reason for the FDA foot-dragging” — he lists three reasons and their counters.
    Then, possible reason number four…

    By raise of hand, who among you who are in the high-risk population group wants to contract COVID-19, agree to participate in a study, then volunteer to take your 50/50 chance of being assigned to the control group? Anyone?

    There are many in the TDS group who would insist on being in the control group. 🙂

  40. According to Chandler, Introduction to Parasitology, 1930, my edition 1949, a countess returning to Europe from Peru brought with her in 1640 some bark from a cinchona tree, an infusion which had been used by the native Indians to cure an attack of malaria from which she suffered. Its life cycle is a biological wonder, once read a book about how difficult it is to handle. Last I read they are still looking. My son once got a relatively mild case from not taking his medicine, when he got back doctor had a diagnosis problem. Made his own blood slide, sent me a picture, looked just like the book

  41. 3 million members of the US military took chloroquine weekly while serving in Vietnam. Lets hope nobody dies of corona virus because they were afraid to take chloroquine because of the lies told about its safety by the Trump hating lefties.

    • Can you provide me with a citation as to the effects those 3 million test subjects experienced?

      • Salute!

        Ball is in your court, Clyde.

        Up to you to show the enormous numbers of terrible, debilitating effects that we Vietnam vets and others in the south Pacific endured.

        We who have taken chloroquine or its cousin have testified here that it was no big deal. That’s our story, and we’re sticking to it. If zillions of us had problems, a few would be here with us with their anti-total war stories. ‘course, if they died of the chemical they wouldn’t be here to yell the sky was falling.

        Gums sends…

        • Gums
          Logically, it is up to the one who made the claim that 3 million users suffered no serious side-effects to provide proof of the claim. That is all I asked for.

          I think that the fact that there is a long list of well-known, serious side-effects, including ‘mild’ death, proves that the side-effects occur. In the case of vision problems, I have seen an estimate of about 25% with long-term use. I personally can attest to undesirable short-term side-effects including elevated systolic BP, and weakness in leg muscles, which is one of the known common problems.

          Can we be certain that the claims about Agent Orange were the result of the herbicide when everyone exposed was also taking chloroquine? Could they possible interact? Can we rule out PTSD and elevated suicide rates of veterans, after the widespread use in malarial countries, being caused by HCQ when the label on my VA prescription bottle warns to watch for mood changes and thoughts of suicide?

          • Salute!

            Sorry, Clyde if you suffered a few side effects ( if I read your post correctly).

            However, I still want to see more evidence of widespread, serious side effects. The VA might have some stats, but seems to me that the alarmists must produce the stats.

            Labels on just about every drug advertised on TV today have more warnings about more serious side effects than I have seen for the malaria chemicals.

            PTSD for the vets is kinda stretching it, huh? OTOH, there might be an effect if the weedkiller, aka Agent Orange, and malaria chemicals interacted, but haven’t heard of one. They can look at me as patient zero! Not only did I take the pill for a year on first tour, but I flew thru the mist when escorting the Ranch Hands while they sprayed. Lived a few hootches over from them.

            Willis and I and EW and others are not claiming that zero of the 2.7 million vets that served in-country had serious side effects. We are claiming that no study has shown a huge number of folks – like even 10 or 15 or 20 percent of us. We are the ideal study group.

            Gums sends…

          • Gums

            You said, “We are claiming that no study has shown a huge number of folks…” In other words, it is alright to resort to widespread use of a drug of unproven efficacy because at best it will only kill or injure a small percentage.

            If you or other vets who have shown a tolerance to HCQ (when you were young and healthy) want to volunteer, I don’t see a problem. But, someone cannot truly give informed consent to an experimental drug unless they are informed about the possible consequences, and there are many on this blog who claim that there are no serous side-effects. That claim is patently false. The most serious risk from short-term use is elevated BP and arrhythmia. Beyond that, we know little about how HCQ might interact with other drugs given concurrently.

  42. For cripes sake, hydroxychlorquine, azithromycin, and zinc sulfate have been used by Dr. Zelenko in NY state with good results. https://docs.google.com/document/d/1SesxgaPnpT6OfCYuaFSwXzDK4cDKMbivoALprcVFj48/preview

    Henry Ford Hospital is using it. https://www.michiganradio.org/post/henry-ford-uses-hydroxychloroquine-treat-covid-19-symptoms-says-benefits-outweigh-risks

    The CDC recommends it as a treatment option. https://www.cdc.gov/coronavirus/2019-ncov/hcp/therapeutic-options.html

    Eastern Virginia Medical School is using it. https://www.evms.edu/media/evms_public/departments/marketing__communications/EVMS_Critical_Care_COVID_19_Protocol__4_2_2020-revised.pdf

    How hard would it be to take 300 people who had symptoms of COVID and put them on the Zelenko protocol, early, and see what happens? We don’t have time to wait for the results of the ongoing double-blind placebo controlled trials.

    Early treatment is key, way before mechanical ventilation might be needed. What we really have is a pandemic of utter stupidity, so profound and unbelievable and apparently inept that one would think that the real intent is to panic people so that they beg to have their rights of peaceful assembly taken away.

    Thank you, Willis.

  43. Doctors are not comparing HCQ to treatment X. They are comparing HCQ to “do nothing”. So in effect people are saying “don’t use HCQ because it is dangerous”. Well, COVID-19 is dangerous. Are you suddenly removing the danger of C-19 by not taking HCQ.

    The press is arguing a false equivalence. And ignoring that HCQ is safer than CQ.

  44. While in the British Army, Royal Signals , in Burma, 1946 to 48 we took a anti Malian drug. Much later while in Papua, New Guinea Police 1956 to 73, again we, wife and children, we were all on a anti malarian drugs s and never sick. No side effects.

    I suspect that there are two reasons why we are not told to use it, its way out of patient so the big Pharmercial Companies are not interested, and second the Doctors have this obsession to not harm the patient, even when they are dying,, wanting years of testing.

    VK5ELL MJE

  45. So I take plaquinel for arthritis… because it is effective against some forms of arthritis… I’ve been taking 400mg of this stuff every day for close on 15 years…

    Anyone have any thoughts or ideas on the efficacy of chloroquine vs Covid-19 when the person already takes the drug for other medical reasons??

  46. We spent so much time focusing on air thinking COVID-19 is a SARS virus.
    From what I have read we seriously goofed. It seems to attack blood cells and the resulting low oxygen state in the body is what is causing the lung damage. Which ventilators only make worse.

    Can’t help but think of this quote from the movie Andromeda Strain.

    Dr. Hall: “Air doesn’t matter! Blood does. That’s the answer.”

    • That’s what I have been reading too, and those who are O+ seem to be less affected by it.

      • “Air doesn’t matter! Blood does. That’s the answer.”

        If so… then how to oxygenate the blood fast enough to mediate lung damage? Get blood O2 back up above at least 93+%? If not some expensive transfusion or adding O2 to one’s own blood by machine infusion?

        • Hyperbaric Oxygen Chamber ?
          Just a shot in the dark.
          The Mayo Clinic has a Department devoted to it’s use.

  47. “Horribly bitter pills.” Understatement. I took a weekly dose of chloroquine as an AFS student to Mombasa, Kenya in 1983. My pills were accompanied by a piece of bread with about half a jar of strawberry jam on it, washed down by copious amounts of very sweet Swahili tea. And then I would roll around and gasp at the bitterness of those pills. On a scale of 1-10 of bitterness, chloroquine is probably about 170.

    • That shows it works. It has been scientifically proven that the nastier the medicine, the more effective it is.

    • Why did you let them touch your mouth? We would throw them down our throat after a cup of cream, never tasted anything. 1972 Vietnam

  48. Thank you for your always educational and entertaining posts. I am truly blown away by the many bristlingly smart, knowledgeable, generous-minded people who post on this amazing blog.

    I have a bottle of anti-malarials that were prescribed for some work I did in Minas Gerais, Brazil in 2017. They are a combo of Atovaquone 250mg and Proguanil HCl 100mg, the latter is the old Paludrin my family and I took in Nigeria in the 1960s. The molecular diagram looks like the Quinine/chloroqine one including a couple of hydoxide ions. I’m not sure they work but by golly I’m prepared to take them if I get symptoms.

    The ‘woke folk’ are going to kill us with their anti-chlorquine fake news because of anti-Trump. In Canada, doctors have been warned not to prescribe this stuff for Covid. Canadians should tell their doctors they are going on a jungle trip an get the stuff. Maybe the Yellow Fever shot you are obliged to get has a synergistic effect, too!

  49. Willis

    A nice and entertaining story about malaria. I appreciate most of the sleeping parasite story, that it seems to linger, quiescent until some time in the future, and, at times, inopportune times, for a recrudescence. Popping up as fever and shaking chills while in Northern Minnesota and health care practitioners not sure what is going on until an imported pathologist, from a land so far away, does a thick smear of blood and lo and behold, malaria. Then, the ensuing morning, on morning rounds for the medical practitioners: “have you ever traveled outside of the United States? if so, where?

  50. Great post. I first took chloroquine when traveling in Africa in the 80’s. Hated it. Made me anxious and seemed to interfere with a good nights sleep. Stopped taking it when we were in the Saharan desert, but always when in jungle areas.

    Fast forward a couple of decades. Took a trip to Indonesia and was prescribed Mefloquine (Lariam) as an anti-malarial by Kaiser doctor. This drug was developed during the Vietnam era as a “better”prophylactic than chloroquine and widely given to those serving in that arena. What a nightmare. Literally. Complete loss of short term memory and crazy night sweats and nightmares. I’m not prone to psychosis, but was on the verge pretty quickly. Like Willis, chose to risk Malaria rather than losing my mind.

    Wonder if it works on Covid 19. Still would never take it again.

  51. Thanks, Willis, for that fascinating account of the parasite’s life cycle. In the 70s, I spent a couple of months in Papua New Guinea. I took chloroquine weekly, as advised, but nevertheless experienced a few bouts of malaria upon my return to a temperate climate. It happened on and off for a few years. The symptoms were always the same. At about 5pm (it was probably triggered by the lower temperature at that time) I would start to shake violently (yes, your teeth do chatter and your skin does turn yellow) and sweat profusely. This would go on for about an hour and then you would throw up and be left with a raging headache. This would happen daily for four or five days at a time. I eventually found a doctor who knew tropical medicine and he prescribed Camoquine, which instantly put a stop to the daily bouts. Every time I had a recurrence the Camoquine would knock it over quickly and without and complications or side-effects. After about five years I ceased having the episodes. It’s been decades now and I have never had a recurrence, although I have heard of people who have had it for life.

  52. Not to go to far off topic, but relating to your previous post, have you seen the materials released by Minnesota in conjunction with its model. They are found here, https://mn.gov/covid19/data/modeling.jsp. Not bad in some ways, but most interesting and to your point, note that there is almost no difference in deaths across mitigation strategy scenarios. Also note that in the briefing they acknowledged doing no studies or analysis of the economic and non-economic harms of the shutdown order. Be very interested in your review of the materials.

  53. Jeez, after reading this story I want to start taking Hydroxychloroquine just to be able to sleep at night – hiding in my blankets, listening for the dang mosquito in the room!

    There has to be data by now that supports (or disproves) the effects of hydroxychloroquine. If it were highly effective then it should be easily evident. I am losing hope that it will prove to be effective. Guess we all just wait on the vaccination in a year – bleh.

    • Oodles of data point to no benefit, just not for this exact virus, which is the only reason the people that know about such things have not spoken up forcefully.
      Because they were being scientific.
      Because they will wait for scientific evidence for this particular disease and this virus.

      If there is literally nothing else to try and nothing to lose, it does not matter.
      But neither of those things are really true here.
      We have right to try laws, which will give a lot of people hope at times, while it is killing them.
      No one really knows, because this is a new virus, and this could be the one virus on God’s green Earth that these drugs will kill.
      Maybe.
      (Just like maybe the WAIS is about the slide into the ocean tomorrow.)

      They have value as anti-inflammatories and immunomodulators.
      They are inactive in vivo re viral replication.
      I have posted evidence day after day and week after week.
      I even spoon fed it to the people that kept insulting me for knowing what I am talking about and keeping an open mind.

      • “Oodles of data point to no benefit,…”
        What data are you looking at, Nicholas? All of the in vivo trials carried out point to viral load reduction at least.

        I have seen only one flawed, small sample, Chinese study which suggested little efficacy, and one anecdote about a doctor somewhere who decided to stop using the treatment after some unspecified adverse reactions from an unspecified number of patients with no metadata given. What else do you have?

        Against that, there was a randomised clinical trial in China (https://www.medrxiv.org/content/10.1101/2020.03.22.20040758v3), and clinical evidence from France, Spain, Italy, Bahrein, S Korea,Malaysia, Brasil and the USA.
        In Italy, the national health authority authorised treatment with HCQ/Zinc/Azithromycin on the 29th March. On 4th April, they reported that they had spare ICU beds available for the first time. The number of patients in ICU has continued to decline dramatically.

        In Brasil, Dr Paolo Zanato from Prevent Senior, in an interview with Portal Brasil Without Fear said;
        “In São Paulo, the Prevent network had 96 deaths from coronavirus until March 22, almost half of all deaths reported by the government of São Paulo. Today they have only one person in the ICU. Since Prevent adopted this protocol, it has not registered any more deaths from coronavirus. And the people who had a problem are those who entered this protocol late, already with advanced disease.

        “Two important points in this protocol. The use of tomography to know when to apply the medication and the use of Hydroxychloroquine associated with Azithromycin and Zinc.

        Hydroxychloroquine should be administered at the very beginning of the disease, from the 2nd to the 4th day of the appearance of the first symptoms, such as fever, cough, runny nose and breathing more than 22 times per minute. People who manifest this condition should receive the medication at home. The drug is inexpensive and has few side effects.”

        None of this anecdotal data is a substitute for a large scale, randomised, double-blind clinical trial, certainly. However, it is unlikely that such trials will yield useful data for several months, and, in the case of the European trials, it seems like HCQ is deliberately being set up to fail. The protocols call for its application only when patients are at death’s door.

        In the meantime, most doctors are voting with their prescription pads. As one European pharmacist commented wryly : “It’s amazing the number of people who have suddenly developed rheumatoid arthritis.”

        • kribaez
          You recommended, “Hydroxychloroquine should be administered at the very beginning of the disease, from the 2nd to the 4th day of the appearance of the first symptoms, …” After a long life of observations, it has been my experience that when I have had upper-respiratory viral infections, I typically get better on my own within 3 to 5 days!

          The critical thing is that many on this blog are downplaying the potential side-effects of a drug that may not work, but is being touted because it appears to miraculously ‘cure’ COVID-19 within the period of time that most people with strong immune systems will commonly overcome similar viral infections. If it were as simple as holding one’s breath and drinking a glass of water to cure hiccups, I’d say “Go for it!” However, most are in denial about the potential that they might be one of the small percentage that are particularly sensitive to this drug. What is worse, those who are not physicians are trying to persuade others that there is no risk based on either personal experience or pure ignorance. It is irresponsible.

          • Also, Clyde, this is not about ” it has been my experience that when I have had upper-respiratory viral infections, I typically get better on my own within 3 to 5 days”

            It is about preventing a LOWER respiratory viral infection… leading to pneumonia and potential death.

          • Jim
            No, I’m not a physician, and I’m pretty sure that you are not either. If Raoult posts here, I will respect his opinion, but reserve the right to question him if he were to say something illogical. An important point is that I’m not advocating a treatment, but instead, I’m following the ‘Prime Directive’ of physicians: “Do no harm.” That is, I’m suggesting caution in the light of known potential problems with chloroquine and HCQ for a minority of users. I’m concerned that many of the posters here are advocating treatments they have read about, are dismissive of known problems, and are willing to accept claims of efficacy without question, that, if they were about climate, they would be complaining against quite loudly. I’m suggesting intellectual consistency and restraint in advocating things that are beyond your expertise.

          • re: “I’m concerned that many of the posters here are advocating treatments they have read about, are dismissive of known problems, and are willing to accept claims of efficacy without question”

            My God man, you’re nearly as stupid and dense as ng. MOST of the ppl commenting have READ the reports, many reports, UNDERSTAND the science and are COMMENTING from an informed opinion. They don’t need a NANNY like you “urging caution”. We’re adults here, and a LOT of us have held significant technical positions in our lifetimes, meaning, we understand detail and complexity. I don’t think you should be commenting here (my opinion), maybe a Yahoo board or back to some obscure subReddit would be a better ‘match’, and THEY could probably use your nanny-ing to boot.

          • UV Meter
            You said, “It is about preventing a LOWER respiratory viral infection…” I know that very well, because I’ve often developed a secondary bacterial infection, lower down, that required antibiotics. The point is, for those who have a strong immune system, if they can defeat any upper respiratory viral infection in a few days, then there is probably little risk of a lower respiratory viral infection. Those who need intervention are those who could not shake it off on their own. The point that I’m trying to make is that those who get well very quickly with HCQ may well have gotten well anyway. We will never know when we administer drugs that have not been rigorously proven to kill the virus. It is whistling in the dark!

          • Clyde,
            You wrote:- “You recommended…”
            Please read my post again with some care. I am not recommending anything. I am merely pointing to data sources. The recommendation does not come from me. It comes from the leading physician of the main clinic in Sao Paolo where they have been using this treatment for several weeks now. The question I am posing to Nicholas is a genuine one. Where is he finding negative data against HCQ?

          • kribaez
            My mistake. I missed the quotes and thought that you were making the recommendation.

          • Jim
            You insulted me with, “My God man, you’re nearly as stupid and dense as ng.” Now that you have provided an excuse to fire me from my command, perhaps you should resign. 🙂

            Stupid I’m not, and I’ve never been accused of being dense — except by people who resort to ad hominens when they don’t have an adequate argument. You have already had a couple of comments deleted. Are you trying for a third?

          • Jim sez:

            “MOST of the ppl commenting have READ the reports, many reports, UNDERSTAND the science …”

            And he wonders how anyone could disagree with his knowledge of “the science”?
            Wow.
            Just wow.
            But this is the guy who gets vitriolic at anyone who doubts his belief in hydrino energy.

        • kribaez,
          If you want to take a small part of one sentence, and then create a straw man by ignoring what I said in the rest of the sentence, I have nothing to say to you, except, please do not misquote me.
          If you just got here and have not seen the last two months of this conversation, then I am not surprised you are lost.
          Go back and catch up.
          I am not going to correct your straw man argument, or repost information that has been posted over and over again.
          Grow up.
          BTW…you made several false assertions in the rest of your disjointed and incoherent post.
          Try to speak accurately and truthfully.
          I do.

    • What kind of data could show that corona vaccination is a sound idea?

      Or even suggest that?

      Why don’t you request randomized trials showing the real benefits of vaccines?

      • niceguy
        Why would that be necessary when polio has been eliminated in first-world countries and smallpox has been eliminated in the world?

  54. Enlightening post and I rather like the way this gorgeous ex fiancee crosses the story every so often.

    This discussion about the use of potentially helpful alternative treatments is a battle that Pres Trump started when he was candidate Trump.

    RIGHT TO TRY: Congress passed the Right to Try Act of 2017, sending a priority bill to President Donald J. Trump for his signature.

    The “Trickett Wendler, Frank Mongiello, Jordan McLinn, and Matthew Belllina Right to Try Act of 2017” passed Congress on May 22, 2018.
    The bill amends Federal law to allow certain unapproved, experimental drugs to be administered to terminally ill patients who have exhausted all approved treatment options and are unable to participate in clinical drug trials.
    Eligible drugs must have undergone the Food and Drug Administration’s (FDA) Phase I (safety) testing.
    The bill requires any manufacturer or sponsor of an eligible investigational drug to report to the FDA on any use of the drug on a “Right to Try” basis.
    The FDA will post an annual summary report of “Right to Try” use on its website.
    The bill limits the liability of drug sponsors, manufacturers, prescribers, or dispensers that provide or decline to provide an eligible investigational drug to an eligible patient.
    A RIGHT TO LIFE: Right to try legislation returns treatment decisions back to patients, giving them the right to make healthcare choices that could save their lives.

    “Right to Try” gives the over 1 million Americans who die from a terminal illness every year a new tool to fight and make potentially lifesaving decisions about their treatment.

    I lose no love on the FDA so rather than say more I will simply get my hat.

    • The FDA simply makes sure that pharmaceutical companies don’t make $1B/year by advertising and selling a drug that haven’t been proven to be safe and efficacious in placebo-controlled or comparator-controlled double-blinded clinical trials. They do the same thing that Steve McIntyre did to those using tree-rings to prove that a Medieval Warm Period didn’t exist. He saw that the tree-ring sites chosen were cherry-picked after the fact, not selected for study by some unbiased method.

      There is nothing wrong with terminally ill patients who have no other options being given a right-to-try an unproven treatment. It would be unethical for a drug company to advertise such drugs or for politicians who have no medical expertise to do the advertising for them. However, entering a hospital with COVID-19 is not a death sentence. Boris is recovering, Tom Hanks survived. However, the prognosis could turn grim in a few days. With too little oxygen reaching your brain, does it make sense for you to decide whether to take an unproven drug being touted in internet chat rooms or tweeted by a president seeking to re-assure voters? Should a frantically worried family member make that decision? This law permits this – but don’t expect a lot of rational decisions to be made. Just like the decisions made at the infamous wild animal “wet” food market in Wuhan that may have started this epidemic, where affluent Chinese citizens sought increased virility or better health.

      Every year the WSJ has an editorial about how the big, bad FDA is bankrupting an small pharmaceutical company by not approving a drug that failed to show efficacy using the pre-determined standards in the pre-determined patient population. Someone on the board of the company (who has been given shares in the company) is probably friends with one of the WSJ editors. The sponsors have cherry-picked a subset of patients or selected new endpoints that show efficacy, but there are thousands of possible ways to perform such cherry-picking and one of those ways is likely to show efficacy at the 95% confidence interval simply by chance. The FDA – correctly – want a new clinical trial using only the patients and endpoints the company believes will show efficacy and the company doesn’t have the money. Is this a tragedy for both patients and shareholders? No. If the sponsors re-analysis of the clinical trial data is really promising, the drug will be acquired by one of dozens of highly competitive pharmaceutical companies and get a second chance. Take Erbitux for example, the drug that failed its first large-scale clinical trial – and infamously sent the CEO of Imclone and Martha Stewart to jail for selling their stock based on insider knowledge of that failure – was developed by other companies and is now a highly successful drug with sales of $2B/yr. The drug was eventually approved on the basis of this modest efficacy:

      “a trial involving 329 patients, of which 10.8% responded when Erbitux was used by itself, delaying tumor growth by 1.5 months. When used in conjunction with a standard chemotherapy treatment, irinotecan, 22.9% of patients responded and tumor growth was delayed by approximately 4.1 months.”

      Patients had to wait to buy this drug for the three additional years it took to identify a patient population and dosing regime that would produce even this minimal level of benefit. Compassionate use programs were possible then – if the sponsoring company wanted to participate.

  55. Thousands of physicians worldwide have successfully treated Covid-19 with HCQ. If it did not work, we would know by now. Everyone in the media is trying to undermine this administration. If they found one doctor claiming HCQ does not work, it would be the top story for days.

    None of this is scientific, but it’s still true.

    • Jeffery P: Thousand of physicians bled sick patients for centuries without realizing it was hurting them. Doctors treating desperately ill patients want to believe they are doing everything humanly possible to save the lives of those patients – a perfect scenario for confirmation bias – remembering data suggesting that HCQ helped some patients and failing to assimilate other data suggesting failure. This is an extremely common human weakness. In medicine, we have learned that the only way to establish the truth about efficacy is through placebo-controlled double-blind clinical trials.

      Americans who believe their country is on the wrong track find it easy to ignore fact Bernie’s socialism has been rejected in much of the EU and that wealth taxes have been tried and repealed there. Other Americans find it impossible assimilate the numerous weaknesses of Trump into their consciousness, and do stupid things like attributing justifiable skepticism about HCQ to an anti-Trump bias.

      When/If the US per capital death toll from COVID-19 exceeds that of China when the 2016 election rolls around, I predict that many will blame the skeptical news stories about HCQ spread by the liberal MSM that caused underutilization of HCQ in America compared with China. They will ignore the fact that US doctors working in hospitals don’t make decisions about what drugs to prescribe based on what they hear in the media. They review the scientific evidence available and their local experience as a team with a leader who has read everything about HCQ. Trump’s opponents will blame his delay in calling non-essential workers to remain at home or work from home, but they will forget that Democratic governors and other foreign leaders were slow in making the same decision – because of the huge economic cost. With the number of cases doubling every few days, the cost of delay has been enormous. A more cerebral leader who listens to and places more value in government experts would have had a better chance of acting earlier, but decisions that need to be made over the next four years might be better made by someone who is more skeptical of experts and listens to his gut. I suggest we judge on the basis what happens next, by how soon and SAFELY we can get our economy re-started. This is a problem that every leader has known would be coming for more than a month.

  56. I am shocked.
    Does no one here know what happened?
    Just gonna leave this here.

    “Compassionate Use of Remdesivir for Patients with Severe Covid-19”
    https://www.nejm.org/doi/full/10.1056/NEJMoa2007016

    Well, I have waited over 24 hours, and exactly no one has said anything about Remdesivir except exactly one lukewarm reply to my post last night. (Maybe Greg is not a complete numbskull after all, just way too hardheaded and rude)
    This changes everything.
    The worst off patients now have a small chance of dying. 18% If confirmed. High confidence.

    (Correction…a reread shows 13% of severely ill patients died. These were people on life support…the ones dying at rates of up to 78%)
    The pretty badly off patients have about a 4-5% chance of dying. If confirmed. High confidence.
    Patients not on oxygen or mechanical ventilation will likely have zero chance of dying. If confirmed. High confidence.
    This is the game changer.
    There is zero evidence chloroquine or HCQ has allowed anyone on life support to be extubated and go home.
    Now those people have about an 18% chance, if confirmed.
    It does need confirmation, but this was a careful and detailed look at the first people who took it when there was nothing else…perhaps the sickest of the sick at that time.
    I do not want to be disparaging, but it is obvious almost no one, possibly no one, commenting here has any idea how to read the results of a drug trial.
    No adverse events that were attributable to the drug.
    The 8 people lost to follow up may have simply recovered and felt no need to go back to the hospital that treated them.
    If confirmed, and there is everything to be hopeful for here…even if the results are only half as good…the odds of dying with this disease just went down by about an order of magnitude at least.
    And that is average of all stages.
    If and when approved, I do not see any reason why anyone would need to be let get to an end stage where the odds are only 18% and they are on a life support machine. If supplies can be stretched. The trial looking at 5 days vs 10 days is going to be a huge one…twice as many courses of treatment worth. Maybe 300,000 people, with another one to two million people’s worth by year end.
    But I expect it will be a lot more than that…everyone will start making it under license that has the facilities.
    Raw materials may be a bottleneck.

    Also…every hospital in the world should have ECMO.
    At present, US has a lot of them over 264 hospitals and adding more fast, some in B.C. Canada, a very few in England and Wales, zero in Ireland or Scotland, 40 hospitals in Germany, Poland has 47 machines, Sweden has 7 or more, Russia has a few hundred, Japan has over 1400, and China has at least 400.
    No one else seems to have a single one.

    You heard it from me first…this is huge, and only the supply will keep almost everyone newly infected from being cured quickly…although it is like there will be some non-responders, as there almost always is.
    Even if only half as good as these initial results a game changer.
    Il-6 drugs will save still more.
    No one wants to pour too much cold water on malaria drugs, because anything is possible.
    But if these drugs kill this virus, it is literally the only virus ever tested on, that it does that for.
    It treats some symptoms, but adverse events may outweigh any benefit.
    It is always good to be optimistic, but you have to have a real hard head to ignore all the hard scientific evidence that exists for this drug on other viruses, as well as 70 years of zero epidemiological data despite millions taking it.
    And many deaths in places using it, and rising sharply.
    And no trials halted by a DSMB for success.

    And recall the place that had the first trial that started this?
    Here is one of the doctors from there:
    “Chinese Doctors at Coronavirus Hub Say Evidence on Chloroquine Is Inconclusive”
    https://www.wsj.com/articles/chinese-doctors-at-coronavirus-hub-cast-doubt-on-chloroquine-as-cure-11586448660

    • What have we got to lose?
      Only your life, if you did not take something that worked instead.
      I wonder how many have and will still die and did not need to, by this inane focus on HCQ and frickin zinc!?
      I expect few will even change their minds.
      People decide what they believe and then lock their minds up tight.
      Where do we know that sad story from?

      • re: “Remdesivir … I expect few will even change their minds. People decide what they believe and then lock their minds up tight. Where do we know that sad story from?”

        Can you ‘lay out your case” as cleanly as MedCram does for Zn and hcq? Showing the method by which Remdesivir works at the cellular level? If you can, you will entertain an audience first and adherents second:

        • It is not my job to be a huckster.
          Go watch Dr Oz and “Doctor” Rigano if that is what you value.
          Do you think I am an advocate?
          That is the mistake you are making, not me.
          Interesting that appeals to authority are what sways you, and a convincing case for a “mechanism”.
          You will find you and a lot of other people here have destroyed your credibility when it comes to demanding scientific rigor from warmistas.
          Again, not my concern…but I find it terribly regretful.

    • Don’t worry Nicholas your shares in Gilead will do just fine.
      That class of antivirals that mess with nucleotides need to be carefully kept away from (potential) expectant mothers due to the potential risks of birth defects.
      Thalidomide is also a very potent drug for a number of indications – but that’s not what it is remembered for.

      • Phil
        Apparently you did not read the link I provided above. HCQ is not recommended for expectant mothers either!

      • For the record, I do not own shares or options in Gilead or any other stock right now.
        I do not think they will make any money on this in any case.
        I would think it unfortunate though, if anyone used anything but objective criteria in deciding what course of treatment to seek should they need a treatment, for COVID or for anything.
        I would not use cost, who made something, or any other such trivial details.
        What works and for what does some hard evidence exist for.
        The question is hardly settled, but my ability to parse the difference between evidence and hopes and possibilities leads me have more hope than I have had, that good news will be forthcoming shortly.
        Until that day comes, my personal plan is to avoid the virus like the plague until something has been proven to show efficacy and safety, and is available, in case I should have an unlucky spin of the roulette wheel if and when (I expect when, not if) I finally do wind up getting my turn to spin it.
        It will be a while yet.
        I am curious though…have you decided you would reject something based on what you have already decided, or your seeming dislike for some particular corporate entity, even if one you have decided you do not like is the one which proves best?
        I will take what has been shown to work best if and when I need it, using all data and with particular attention to anything of a more scientifically gathered chain of such evidence.
        I learned long ago that trying to guess about new drugs is a fool’s errand.
        But clues are emerging.
        I want more than clues, but that will not stop me from using inferential data…ALL of it, if need be.

        • Having said all of that and the below, I believe that the data released from Gilead in The New England Journal of Medicine on April 10th, along with the open letter from O’Day on that same date, is indeed far better than I had concluded would be forthcoming since no trials had been halted by the DSMB.
          Time will tell.
          There are a huge number of people in a large number of trials for all of the drugs discussed here and more.
          We will be able to go back and compare results with who said what over the past few months.
          This is way different than global warming.
          We will soon know who knew what the %#&* they were talking about… and who did not.

    • Nicholas,
      I am very surprised by your last post. You have generally argued that there was insufficient evidence to support the use of HCQ+ because the in vivo data came from clinical studies which did not meet the gold standard of being fully randomised, double-blind clinical trials.
      Yet here you present the result of a study of remdesevir based on a small-sample opportunistic cohort with no control group – a study which was moreover funded by the manufacturer of remdesevir – and declare the result to be a game-changer. What happened to your argument about the need for carefully controlled trials? Your arguments then shift to advocacy divorced from cool scientific evaluation.

      It was applied to the “sickest of the sick”. No, I think those guys are definitely dead.
      No adverse events that were attributable to the drug. There are a total of 32 adverse events recorded, and 2 patients had the drug discontinued because of elevated hepatic enzymes. You should explain how you conclude that none of these were attributable to the drug.
      The 8 people lost to follow up may have simply recovered and felt no need to go back to the hospital that treated them. Or they could all have quietly died.
      There is zero evidence chloroquine or HCQ has allowed anyone on life support to be extubated and go home. I agree with you, but the claim is that early treatment reduces the probability of ending up on life support.

      To be clear, I do believe that this might be good news. However, I am struck by the change in tone of your argument as you go from attacking the evidence for HCQ (we need gold standard to recommend a new treatment) to supporting what must still be considered “anecdotal” evidence for remdesevir. You are moving the goalposts.

      • I have never attacked the evidence of HCQ, I have pointed out the problems with the quality of recent studies of it in COVID patients, the safety issues, and the previous trials of the drugs with other viruses, including with SARS in mice, which were uniformly disappointing.
        I was also one of the first, I think THE first, to point out that in the US, no approval from any authority is required to seek HCQ, because it is an approved drug and any doctor in the US can prescribe it if they see fit to. So all anyone who wants it needs to do is find a doctor who will.
        But in this last post I am stating quite frankly that while hopeful, I am quite skeptical and not seeing any reason to be champing at the bit to be getting me some chloroquine.
        If new data warrants, I will respond accordingly.
        Too many people are unable to parse caution from scorn.
        But if we are to go on the totality of evidence, the odds, in my estimation, are against HCQ and Chloroquine having direct antiviral activity, but it is known to be useful as an immunomodulator and anti-inflammatory.
        I have posted over and over many types of evidence pro and con and how I size them up and why.
        Remdesivir works in mice and other animals including primates with viral infections. It has extraordinary antiviral activity in vitro, against a wide range of virus types.
        And now we have evidence that it has allowed many patients who were on life support to walk out of the hospital in proportion far greater than the stats posted by Monckton for people on mechanical ventilation from UK and from Texas.
        Many reports have informed us that the odds of survival once on a ventilator are quite low, and that for all patients who are hospitalized, the overall fatality rate is far higher than was seen with these small number of patients getting remdesivir on a compassionate use basis.
        I also am aware of the criteria for those getting approval for compassionate use.

        They are:
        Your disease is serious or immediately life-threatening.
        No treatment is available or you haven’t been helped by approved treatments for your disease.
        You aren’t eligible for clinical trials of the experimental drug.
        Your doctor agrees that you have no other options and the experimental treatment may help you.
        Your doctor feels the benefit justifies the potential risks of the treatment.
        The company that makes the drug agrees to provide it to you.

        More recently, the drug has been opened up for less strict usage called “expanded access”.
        But this paper detailed just some of the first patients, who were given the drug in the period before expanded access. They were not eligible for any then existing clinical trials, or it was prior to any trial being offered in their locations. Specifically:
        “This cohort evaluated data from 53 patients in the United States, Europe, Canada and Japan who received at least one dose of remdesivir on or before March 7, 2020, through Gilead’s compassionate use program. All patients were hospitalized with severe acute respiratory coronavirus 2 (SARS-CoV-2) infection and either an oxygen saturation of 94 percent or less, or a need for oxygen. The median duration of symptoms before initiation of remdesivir was 12 days. The majority of patients (75 percent) were men over the age of 60 years with comorbid conditions, including hypertension, diabetes, hyperlipidemia and asthma. Combined, all three of these factors have been associated with adverse outcomes of COVID-19”

        These were mostly people with poor prognosis. They had been having symptoms for an extended period, an AVERAGE of almost two weeks, with the range from 9 to 15 days.
        The average age of the group on ventilation was stated…it was 67 years old.

        I could go throught the whole thing line by line to help you understand what I was able to glean after a VERY close look at all that was recorded and described.
        These were ALL people with severe disease.
        Some had been on mechanical ventilation for 8 days.
        Many were elderly, many had numerous comorbidities.
        I know how to interpret a hazard ratio.
        I have a very good idea that this group was older, sicker, and had more comorbidities than the set of all patients in other settings that were hospitalized.
        This report contains no blandishments…you need to be able to parse it carefully to understand what is implied by these results.
        It is far more positive than it may appear.
        Another key finding:
        “Sex, region of enrollment, coexisting conditions, and duration of symptoms before remdesivir treatment was initiated were not significantly associated with clinical improvement.”

        Think about that. We know that long duration of symptoms is bad in people receiving SoC.
        We know that male sex is associated with worse outcomes.
        We KNOW that coexisting condition is highly correlated with a bad outcome.
        But not here…with remdesivir, those did not matter in people with severe disease and who were hospitalized for many days on average.
        Age was by far the highest hazard ratio.

        As for my assertion that none of the adverse events could be directly attributed to the drug, was the statement that “Mild to moderate liver enzyme (ALT and/or AST) elevations (23 percent, n=12/53) were observed in this cohort. No new safety signals were detected during short-term remdesivir therapy.”

        Six of 34 patients on mechanical ventilation died. One of the one not on mechanical ventilation died.
        Overall, 13% died.
        Of those intubated on a ventilator, 18% died.

        Now, what percentage have been shown to survive at this stage and with these particulars in any other circumstance?
        I am not going to answer that…you need to look for yourself and arrive at a number you think.

        I will quote one passage from the NEJM study regarding comparison cohorts in other studies:
        “In a recent randomized, controlled trial of lopinavir–ritonavir in patients hospitalized for Covid-19, the 28-day mortality was 22%.10 It is important to note that only 1 of 199 patients in that trial were receiving invasive ventilation at baseline. In case series and cohort studies, largely from China, mortality rates of 17 to 78% have been reported in severe cases, defined by the need for admission to an intensive care unit, invasive ventilation, or both.23-28 For example, among 201 patients hospitalized in Wuhan, China, mortality was 22% overall and 66% (44 of 67) among patients receiving invasive mechanical ventilation”

        Go that?
        Overall mortality when 1 out 199 patients were on ventilation in one study was 22%.
        The people in this study were far sicker.
        Look at the data Christopher Monckton has reported.
        Numerous info on mortality of people on ventilation is available from around the world.
        Nothing approaches this at a similar stage of illness.
        The ones who dies were old and sicker to begin with.
        I am making inferences based on everything I have ever learned.
        Confirmation is required.
        If further data is on line with this, how does it sound to you?

        These were all, according to compassionate use guidelines, people who were expected to die.
        Lets discuss it again when we see clinical trial data.
        If I am wrong, I will apologize for being a fool.
        Until then, I will respond to any more questions you might have re my rationale and willingness to speculate favorably.

        I do not want to be pessimistic about any other treatments, but if one single person who reads what I wrote makes a decision which helps the or someone they known survive, it is well worth it to me to stick my neck out and to be quite frank.
        I am reassessing based on new info, and on what I see as a sense of unbridled and unjustified faith in malaria drugs.
        My only goal post is life for as many as possible.
        I am not telling anyone what they oughta do…that is a decision for a patients and their health care professional team.
        I am only providing my OPINION of what the best of my knowledge is SEEMING to indicate.
        Take it or leave it.

        All the best to you and yours.

      • Kibeaz,
        A few other things I did not mention.
        Consider this all started with a small study out of China.
        Now consider China has long since halted all use of the malaria drugs, according to doctors in Wuhan.
        Pay attention to what they say and do not say.
        Pay attention to the lack of good faith and personal promotion of such people as a certain French doctor, who just happened to leave out of his study results the person who died and the three who went to the ICU after getting his treatment, and the failure to disclose the disparity in the treated and untreated cohorts. Little details like that.

        Also, I happen to know what a publicly traded company is and is not allowed to say before study results are published for all to see at the same time.
        I also have a good idea of how expensive it is to run clinical trials.
        I have no good way to give a dollar figure for what Gilead is spending on giving away all their supply, the manufacturing ramp up, and all the incredible number of studies they have initiated, but I will bet it is an eye-popping amount of billions of dollars.

        Read the NEJM report, every word of it, two or three times, including all of the supplemental materials and the pres releases from Gilead and what doctors involved in the trials are saying.
        Low key, just a hint, which by itself is very unusual.
        Usually they say nothing and let the data do the talking.

        • re: “Pay attention to the lack of good faith and personal promotion of such people as a certain French doctor, who just happened to leave out of his study results the person who died and the three who went to the ICU after getting his treatment, and the failure to disclose the disparity in the treated and untreated cohorts. Little details like that.

          Do you have MORE information on top of this (since this paper was released) research paper:
          https://www.mediterranee-infection.com/wp-content/uploads/2020/03/COVID-IHU-2-1.pdf

          Because, if it is taken as _true_ in that paper what you wrote is NOT TRUE.

          NOTE also the deaths recorded by Raoult’s organization here as a result of their work with hcq et al:

          https://www.mediterranee-infection.com/covid-19/

          The figure is up to 10 as of my writing this. Raoult (“the French doctor”) seems rather open with his papers, his studies and stats where as Nicholas McGinley provides no cites or supporting documentation whatsoever.

          • “no cites or supporting documentation whatsoever.”

            Are you serious?
            What exactly is it you think I made up?

          • So that Yahoo story discusses people with “severe disease” and that was used to suggest something negative about hydroxychloroquine, and shows what we already know. You should think about how it works and why and when it has been shown to be effective.

            We know how it works, as a significant ionophore for Zn, and why it is effective in the right cases when used early enough. We also already know why it would not be effective when administered too late, since it works by disrupting the RNA replication of viruses with Zn within the cell.

            If the body is already overwhelmed by the free rein of virus and its complications, the treatment will not address the virus’ already replicated. This study confirms all that we already know. It does not show that it is dangerous when used properly.

          • Clyde says: “You want supporting documentation?”

            news.yahoo.com is documentation now ?

          • We do not know that Mario.
            That is at best a fringe idea as to the mechanism for any benefit as an treatment for a viral illness.
            Here is what doctors and medical researchers believe to be the case:
            “Chloroquine:Mechanism
            of action

            Fusion and
            un-coating
            blockade, by
            lysosomal
            alkalization
            [9,10];
            Interaction
            with the
            ACE2
            receptor [9];
            “immunomodulation”?

            Hydroxychloroquine: Mechanism
            of action

            Not fully
            elucidated
            but assumed
            to be similar
            to that of
            chloroquine.”

            ***You are perhaps paying attention to people here and elsewhere in media and the internet who are by no means medical professionals, experts in physiology, microbiology, virology, immunology, or any relevant discipline.
            The finding by some researchers that these drugs are zinc ionophores has never been demonstrated scientifically to be in any way related to their possible usefulness in treating viral illness.
            In fact the whole question of them being antivirals at all is still, at best, weakly supported.
            Extending this thought to what I am currently worried about, is that there are an awful lot of people who are not waiting for any evidence from any clinical trials for a scientifically derived base of evidence regarding these drugs and what they can or cannot do, and that besides for the public health implications of people waking unwarranted assumptions and becoming advocates for what may turn out to be a very harmful distraction, is the political implications: We are in a situation now, where it may well be that the Trump Presidency and who wins control of the US House and Senate may hang on the question of the efficacy and safety of these drugs for treating COVID -19.
            I cannot personaly imagine anything more insane than what may possibly result from this unwarranted obsession based on extremely flimsy evidence.
            That people here, who have spent many years talking about issues of scientific rigor, have so totally abandoned any effort or willingness to reserve judgement on an open question of medical science, is IMO jaw dropping, galling, and very worrisome.***

            Beyond that, we now have a large number of people here and elsewhere who have abandoned all thoughts of civility or willingness to engage in reasoned discussion with anyone who does not believe as they do on any one of a number of topics related to this virus and this disease and certain medical intervention.

            We have Trump supporters infected with a awful case of anti-TDS
            We have skeptics of CAGW adopting the very worst parts of the warmista playbook and making it their own.
            Right down to lumping anyone who differs in any way from some aspect of this new COVID meme as outside of their new cult.

          • Sendergreen sez,
            “Clyde says: “You want supporting documentation?”

            news.yahoo.com is documentation now ?”

            According to Jim, you tube videos are now “the science” re medicine, medical science, virology, pharmacology, virology, epidemiology…and anything else which supports what he wants to believe.
            Contrary information is ignored and given zero attention or reply.
            He has learned his warmista playbook and repurposed it well.

          • Nicholas: You said no to this statement I made:
            “We know how it works, as a significant ionophore for Zn, and why it is effective in the right cases when used early enough. We also already know why it would not be effective when administered too late, since it works by disrupting the RNA replication of viruses with Zn within the cell.”
            ____________
            You did not show me that my statement was wrong, other than saying “we do not know that”. The appealing to authority statement that one must be a medical professional distracts from the conversation, especially since there are medical professionals on literally both sides of this argument. So that fluff does not fly in a logical discussion.

            As well, I am a process control engineer… every process is bound by things that can be understood by physics and chemistry and other sciences…

            Zinc ionophores either exist or they don’t. I believe they exist. So let’s not argue that.

            You believe there is no proof that hydroxychloroquine is a Zn ionophore? If we can get past that part, then the second part is:

            Does Zn interfere with RNA replication or does an alkaline environment interfere with RNA production.

            Since Zn++ in being carried by ionophore through the cell membranes, it turns an otherwise acidic cell more alkaline, then the alkaline theory of interfering with RNA replication or the Zn interference with RNA replication is what we’re arguing about.

            I certainly believe that you do not know since you told me that. But your statement of “we” is incorrect.

          • No, you misunderstand Mario.
            I did not say or mean to imply that these drugs are not zinc ionophores.
            I am saying that being zinc ionophores is not known to be the mechanism by which these drugs have therapeutic value for treating people with viral infections.
            Some effect being asserted or hypothesized is not knowledge.
            Being an engineer, which is in itself a non sequitur, you ought to be aware of the distinction between something which is thought by some to be true, and knowledge.
            I made no appeal to authority, I demonstrated that it is not generally taken to be true that the mechanism you assert is factual…hence it is not knowledge.
            You rightly point out that appeals to authority are logically fallacious as evidence, but then you assert your personal credentials as being evidence of something.
            An analogy would be someone saying “we know CO2 is a radiative gas, and that it traps heat which is warming the globe”.
            Then saying they are a climate scientist so let’s not argue about it being a radiative gas, when what was being argued was not the radiative properties, but that heat trapping by CO2 being the cause of global warming counts as knowledge.
            You will not find any place in any comment I have ever made that asserts or implied I doubt that these molecules are zinc ionophores.

            If I said that these people who are medical professionals having a different view, means that they are correct because they are doctors, that would be an appeal to authority.
            What I did was show that others do not share this view you have adopted as known.
            Which demonstrates it is a belief that is not universally held, hence not knowledge. More like an unsupported hypothesis of a mechanism for antiviral activity.
            To look at it another way…how many ways do these malaria drugs act as antivirals.
            As many ways as can be asserted?

      • Ok, just one more…I think:
        “This preliminary report describes the clinical outcomes in a small cohort of patients who were severely ill with Covid-19 and were treated with remdesivir. Although data from several ongoing randomized, controlled trials will soon provide more informative evidence regarding the safety and efficacy of remdesivir for Covid-19, the outcomes observed in this compassionate-use program are the best currently available data. Specifically, improvement in oxygen-support status was observed in 68% of patients, and overall mortality was 13% over a median follow-up of 18 days. In a recent randomized, controlled trial of lopinavir–ritonavir in patients hospitalized for Covid-19, the 28-day mortality was 22%.10 It is important to note that only 1 of 199 patients in that trial were receiving invasive ventilation at baseline. In case series and cohort studies, largely from China, mortality rates of 17 to 78% have been reported in severe cases, defined by the need for admission to an intensive care unit, invasive ventilation, or both.23-28 For example, among 201 patients hospitalized in Wuhan, China, mortality was 22% overall and 66% (44 of 67) among patients receiving invasive mechanical ventilation.7 By way of comparison, the 13% mortality observed in this remdesivir compassionate-use cohort is noteworthy, considering the severity of disease in this patient population; however, the patients enrolled in this compassionate-treatment program are not directly comparable to those studied in these other reports. For example, 64% of remdesivir-treated patients were receiving invasive ventilation at baseline, including 8% who were receiving ECMO, and mortality in this subgroup was 18% (as compared with 5.3% in patients receiving noninvasive oxygen support), and the majority (75%) of patients were male, were over 60 years of age, and had coexisting conditions.

        Unfortunately, our compassionate-use program did not collect viral load data to confirm the antiviral effects of remdesivir or any association between baseline viral load and viral suppression, if any, and clinical response. Moreover, the duration of remdesivir therapy was not entirely uniform in our study, largely because clinical improvement enabled discharge from the hospital. The effectiveness of a shorter duration of therapy (e.g., 5 days, as compared with 10 days), which would allow the treatment of more patients during the pandemic, is being assessed in ongoing randomized trials of this therapy.

        No new safety signals were detected during short-term remdesivir therapy in this compassionate-use cohort. Nonclinical toxicology studies have shown renal abnormalities, but no clear evidence of nephrotoxicity due to remdesivir therapy was observed. As reported in studies in healthy volunteers and patients infected with Ebola virus, mild-to-moderate elevations in ALT, AST, or both were observed in this cohort of patients with severe Covid-19.18,19 However, considering the frequency of liver dysfunction in patients with Covid-19, attribution of hepatotoxicity to either remdesivir or the underlying disease is challenging.29 Nevertheless, the safety and side-effect profile of remdesivir in patients with Covid-19 require proper assessment in placebo-controlled trials.

        Interpretation of the results of this study is limited by the small size of the cohort, the relatively short duration of follow-up, potential missing data owing to the nature of the program, the lack of information on 8 of the patients initially treated, and the lack of a randomized control group. Although the latter precludes definitive conclusions, comparisons with contemporaneous cohorts from the literature, in whom general care is expected to be consistent with that of our cohort, suggest that remdesivir may have clinical benefit in patients with severe Covid-19. Nevertheless, other factors may have contributed to differences in outcomes, including the type of supportive care (e.g., concomitant medications or variations in ventilatory practices) and differences in institutional treatment protocols and thresholds for hospitalization. Moreover, the use of invasive ventilation as a proxy for disease severity may be influenced by the availability of ventilators in a given location. The findings from these uncontrolled data will be informed by the ongoing randomized, placebo-controlled trials of remdesivir therapy for Covid-19.”

        Now, I know how they usually word these discussion, so here are things where I believe they are using careful language to telegraph what they cannot say out loud:

        “…the clinical outcomes in a small cohort of patients who were severely ill…”
        “controlled trials will soon provide more informative evidence regarding the safety and efficacy of remdesivir for Covid-19, the outcomes observed in this compassionate-use program are the best currently available data.”

        “improvement in oxygen-support status was observed in 68% of patients, and overall mortality was 13% over a median follow-up of 18 days. In a recent randomized, controlled trial of lopinavir–ritonavir in patients hospitalized for Covid-19, the 28-day mortality was 22%. It is important to note that only 1 of 199 patients in that trial were receiving invasive ventilation at baseline.”

        “…the 13% mortality observed in this remdesivir compassionate-use cohort is noteworthy, considering the severity of disease in this patient population…”

        “… 64% of remdesivir-treated patients were receiving invasive ventilation at baseline, including 8% who were receiving ECMO, and mortality in this subgroup was 18% (as compared with 5.3% in patients receiving noninvasive oxygen support), and the majority (75%) of patients were male, were over 60 years of age, and had coexisting conditions.”

        “…Moreover, the duration of remdesivir therapy was not entirely uniform in our study, *largely because clinical improvement enabled discharge from the hospital*.”

        *patients who were severely ill*
        *patients who were severely ill*
        *patients who were severely ill*

        *noteworthy, considering the severity of disease*
        *noteworthy, considering the severity of disease*
        *noteworthy, considering the severity of disease*

        *largely because clinical improvement enabled discharge from the hospital*
        *largely because clinical improvement enabled discharge from the hospital*
        *largely because clinical improvement enabled discharge from the hospital*

        Emphasis mine.

        “contemporaneous cohorts from the literature, in whom general care is expected to be consistent with that of our cohort”

        “Moreover, the use of invasive ventilation as a proxy for disease severity may be influenced by the availability of ventilators in a given location.”

        So, what are they saying here, without saying it because they cannot?
        Some of these people were not on ventilators because none were available?

        Page 11 of the supplemental material.
        Of the initial cohort of 61, one had some problem related to what sounds like a mistake by someone in the hospital.
        7 of severely ill patients had no post 1st day data.
        Why?
        They said as much…they were improved and sent home.
        If they died or got worse they would have been obligated to say so.
        IMO.
        13 stopped before getting all ten days worth, and why?
        From above emphasis mine comments:
        “*largely because clinical improvement enabled discharge from the hospital*”

        Then is a description of each fatality, in detail, starting on page 14, narratives of death.
        This describes people who were very sick with severe preexisting illnesses.
        Some are very likely deaths due to cytokine storm, IMO.
        Hence my opinion that IL-6 blockers may have save some more.
        I could be wrong:
        79 year old, kidney failure.
        68 year old with diabetes, anemia, bipolar disorder,
        hypothyroidism, hyperlipidemia, and allergic rhinitis. Morbidly obese with anemia and diabetes. Multiple organ failure. Cytokine release syndrome, IMO.
        75 year old, myasthenia gravis and prostatic hyperplasia. Italy. Apparently they had no ventilator for him. He died without adverse events of respiratory failure. Just could not hang on.
        72 year old, gastrointestinal cancer and diabetes. Multiple organ failure. No additional adverse events.
        78 year old, no medical history could be obtained. Italy. Worsening condition after admittance to hospital. Multiple organ failure.
        72 year old, no history reported. Worsening condition and invasive ventilation prior to treatment, hung on for 17 more days after beginning treatment, respiratory failure, acute respiratory distress syndrome.
        77 year old, w/ medical history, including asthma. ARDS and multiorgan failure.

        The rest survived.
        Now, those sound like some very sick people to me. But it also sounds like several held on for quite a while after they were about to die before getting treated.
        A larger number of “severely ill” patients walked out of the hospital within one to ten days.
        Maybe as much as 250% more?

        So…that is why I am hopeful.
        How many of us are that badly off to begin with?
        How would these 7 who died have fared with more timely treatment?
        My guess is “better”.
        Just a guess.

    • “Also…every hospital in the world should have ECMO.
      At present, US has a lot of them over 264 hospitals and adding more fast, some in B.C. Canada, a very few in England and Wales, zero in Ireland or Scotland, 40 hospitals in Germany, Poland has 47 machines, Sweden has 7 or more, Russia has a few hundred, Japan has over 1400, and China has at least 400.
      No one else seems to have a single one.”

      That will result in a high death toll. A significant number of cases need ECMO. Especially cases of younger patients that get into a severe condition without any obvious reason. Those patients have very good survival rate with ECMO but die without it.

  57. President Trump has been criticized for “promoting” the Raoult protocol, but I don’t think he was for promoting the US cancer industry and the low rate of deadly cancers in the US. There is no randomized trial showing the US cancer industry is doing a better job by “lowering” the rare of deadly cancers, and a lot of evidence showing that it wrecks the live of many people by doing as much “prevention” as possible.

  58. Willis, you wrote “Unlike most parts of the world, at the time the four kinds of malaria in the Solomons were not chloroquine-resistant.” Is that still true today or has something changed? Is there another drug used to prevent it in places where malaria has become chloroquine-resistant?

    Very interesting read and very informative. I had no idea about the life cycle of malaria or that there are actual 4 different types. Fascinating.

    It sure seems that the left doesn’t want Trump to be proven right about this.

    • Trump is no scientist, and it seems people on his own team are leading him off the cliff.
      At least he has mostly qualified his advocacy.
      Just think carefully about this sentence, and evidence, and what it means to “know” something”
      “It sure seems that the left doesn’t want Trump to be proven right about this.”

      My best interpretation is that the events and the TDS of the left has given some on Trump’s side a case of reverse TDS that may be almost as severe.
      They so much want him to be wrong, so of course people on the other side just have to insist and hope like hell he is right.
      Oh, not hope.
      You know it, now you just have to prove it!
      Anybody here read Brad Keyes’ essay?

      “The stars of stage and screen recite the lines someone else gave them. So if their bespectacled, pocket-protected character says something straight out of a Wachowski Brother, like…

      1. “The results are clear: Efexovir has no effect on the virus. The experiment failed.”

      2. “Studies show Decretussin reduces coughing, though not significantly.”

      3. “Bigpharmox is what’s making these cattle obese, I know it; now I just have to prove it!”

      …they can always blame bad writing. And by bad, I mean “good, unless the viewer happens to understand what the writer doesn’t.” To wit,

      1. the entire point of an experiment in science.

      2. the significance of ‘significance’ in science.

      3. the absolute precedence of evidence over knowledge in science.”

      • Nicholas,

        You are out of luck. I believe the President has mentioned “Remdesivir” in a positive light several times. Therefore I predict that Remdesivir will receive the “HCQ” treatment by the US / Canadian media in any case.

    • “Is there another drug used to prevent it in places where malaria has become chloroquine-resistant?”

      There are, usually lariam (mefloquine) or malarone (atovakvon/proguanine). Both have considerably worse side effects than chloroquine, especially mefloquine. Still, it’s better than malaria.

  59. Willis,

    Since your Coronavirus tab doesn’t allow comments, I’ll add a brief Sweden comment here. An indicator of things to come w/ Sweden is the ratio of the Serious, Critical cases compared with the number of deaths. For Sweden, that ratio is approaching 1 (not good). For the US, Spain, Italy, France, and the UK, the ratio is about .5 or less (not as bad). In my opinion, Sweden is not out of the woods yet.

    • It’s clear. The temperature in Sweden is not as high as in southern Europe. It is far from full spring.

      • Next-door neighbor Norway has better numbers than Sweden and the weather should be similar. Finland – not so much – but Finland like Sweden is an EU member.

    • Farmer,

      Playing the Devil’s Advocate, perhaps Sweden intends to deal with its Muslim issues with the Wuhan Flu. I admit that I have no data on the demographics of the Swedish outbreak.

  60. Covid-19 is very insidious. During the first five asymptomatic days, you can infect your interlocutors without your knowledge.
    Therefore, medical personnel should receive plasma with antibodies prophylactically. Especially the personle after the age of 50.
    Chloroquine should be administered no later than 6 days after the first symptoms. Once the lungs are already occupied, it may be ineffective.
    It seems that chloroquine cannot be taken prophylactically.

  61. Deadly coronavirus comes in three variants, researchers find
    Types A, B and C are all derived from the pathogen first found in bats but have evolved in different ways, according to a report by British and German geneticists.
    Findings show the virus has become well adapted to human transmission and mutates as it spreads, Chinese epidemiologist says.
    https://www.scmp.com/news/china/science/article/3079491/deadly-coronavirus-comes-three-variants-researchers-find

    • From 0 to 24:00 on April 11, 31 provinces (autonomous regions and municipalities directly under the Central Government) and the Xinjiang Production and Construction Corps reported 99 newly diagnosed cases, of which 97 were imported cases and 2 were local cases (2 cases in Heilongjiang); none New death cases; 49 new suspected cases, all imported cases (43 cases in Shanghai, 3 cases in Heilongjiang, 2 cases in Inner Mongolia, and 1 case in Jilin).

      • And, you would expect anyone believe this report … why ?

        Chinese doctors, and others who reported on the Covid early in the pandemic have been “disappeared” in a manner reminiscent of the Geheime Staats Polizei’s marking of N.N on a prisoners secret internal file … “N.N.” It meant ” Nacht und Nebel” The Night and Fog. The prisoner had disappeared into the Night and Fog. A condition everyone inside knew was incompatable with life. The manner of disappearance was deliberately contrived to terrorize the thus far unarrested populace.

  62. To the surprise of the scientists, the T cell became a prey to the coronavirus in their experiment. They found a unique structure in the virus’s spike protein that appeared to have triggered the fusion of a viral envelope and cell membrane when they came into contact.
    The virus’s genes then entered the T cell and took it hostage, disabling its function of protecting humans.
    https://www.scmp.com/news/china/society/article/3079443/coronavirus-could-target-immune-system-targeting-protective

  63. A combination of Hydroxychloroquine, Azithromycin and zinc supplements has been shown anecdotally to be the most effective cure and prophylactic against COVID19.

    Hydroxychloroquine is one of only a few ionophores which can pass through cellular membranes and deliver zinc inside a cell. Zinc has been proven to stop COVID19 RNA from replicating, which is why it’s 70~90% effective. The key is to take these drugs before too much lung damage occurs.

    Doctors who have prescribed Hydroxychloroquine from many decades for lupus and rheumatoid arthritis attest that it is very safe and only if 400mg/day is taken for over 5 years, are a few side Long-term effects like ventricular arrhythmia (1 in 1,000) and retinal damage (1%) observed. The chances of any of these side effects occurring over just 2 months of taking Hydroxychloroquine for COVID19 is nil…

    Occasionally, patients have mild allergic reactions but it’s very rare and only suffer mild rashes and/or some vomiting/diarrhea.

    The main reason Leftist media, political and bureaucrat hacks are so rabidly anti-Hydroxychloroquine is that Trump is for it; it’s just a glaring example of Trump Derangement Syndrome…

    • “Hydroxychloroquine is one of only a few ionophores which can pass through cellular membranes and deliver zinc inside a cell.”

      Quercetin and EGCG are two others. No prescription needed.

      Zinc ionophore activity of quercetin and epigallocatechin-gallate: from Hepa 1-6 cells to a liposome model
      https://www.ncbi.nlm.nih.gov/pubmed/25050823

      • Icicles-san:

        Hydroxychloroquine has been an extremely effective drug used around the world for 65 years for the treatment of malaria, lupus, rheumatoid arthritis and now the Wuhan flu.

        I suppose some drug company could spend $2 billion to get FDA approval for Quercetin and EGCG if they like…..

        • No approval necessary. They are simply extracts from food sources. Widely available as dietary supplements.

        • Samurai
          I’m curious about something. If the drug companies make so little money on HCQ, wouldn’t they have an incentive to make something that was more expensive, but worked better, for malaria, Lupus, and RA? What is holding them back?

          • I am counting a very short list of people here who have retained their rationality, and I am glad your are on it, Clyde.
            You have always been one of the most lucid and well informed denizens of WUWT.

            I think we are in more trouble than a virus and a disease, or an economic freeze.

          • Nicholas,
            Thank you! I was beginning to feel that my comments were falling on deaf ears, or perhaps more appropriately, blind eyes.

            I have long felt that most (if not all) humans are fundamentally irrational. They are only capable of rational behavior for short periods of time, in order to achieve their irrational goals. Most of the commenters here have reinforced that belief. There is a difference between being smart and being wise. While it is obvious that most commenters are smart and well-educated, I’m disappointed in the lack of wisdom demonstrated. However, that is why wisdom has been revered through the ages — it is so rare!

        • Samurai: Even if quercetin had the potential to be effective drug – which is unlikely because it is quickly metabolized and all blood from intestines passes through the liver (the main site of metabolism) before traveling to the rest of the body – it isn’t a novel molecule that can be patented. Without the legal right to exclusive sale of a drug for 20 years that comes with a patent, no company is likely to spend the hundreds of millions it takes to prove a new medicine is safe and effective. Occasionally companies will isolate a natural product from plants and get a less-valuable patent on the use of that molecule for treating a particular disease, for example artemisin for malaria or for a process of obtaining the drug. Any company can manufacture and sell a drug once the patent expires, so a competitive marketplace often offers that drug for sale at a price that includes the cost of manufacture, distribution, sale and a competitive profit margin. While the sponsoring company holds a patent on the exclusive right to sell a drug (for whatever is left of its 20-patent life after 5-10+ years of development and clinical trials), the only competition comes from other drugs with the same mechanism of action. It is during this period that pharmaceutical companies recoup the cost of developing the drug and the cost of all of the drugs that failed to reach market and the 20% profit margin investors seem to demand for investing in such risky businesses. (30% for biotechnology drugs.) When the desired profit margin isn’t being obtained, you often see to companies merge, cut back on R&D and use the combined sale of existing drugs to restore their profit margin.

          It is worth distinguishing between a medicine – which has been proven to be safe and effective (probability of null hypothesis of no effect less than 5%) usually in two large clinical trials – and medicinal use of non-drugs – which haven’t been proven safe or effective, and often contain an unknown amount of active ingredient(s) and/or toxins. Smoking tobacco is a dangerous way to treat yourself with nicotine, but highly rewarding since the drug reaches nicotine receptors your brain in seconds. Vaping was safer until they started adding a lot of flavors which decompose upon heating. Nicotine patches aren’t as rewarding since they deliver drug slowly through the skin. Oral bioavailability of nicotine is low, which is why some users chew tobacco for a long time and absorbed it in their mouth rather than swallow.

  64. There may be a one-off price to pay for not being instantly ready to respond to a pandemic – but that would dwarf into insignificance compared to the total price of living our lives and running our society and economy in a way that meant we were immediately ready for a pandemic/meteorite impact/any other conceivable major disaster.

    In practice, given what was known at each stage, I do not think that we have put up a poor show. Deaths are not high. The people who have shown themselves to be the worst responders were unquestionably the journalists – which is a lot better for our society than if it had been, for instance, hospital administrators.

    We now have to consider how to get out of lockdown. Just releasing people would run the risk of a second flare-up, so we need to have established some counter to this before ending it. Luckily, there are some helpful indications of advances which may help.

    The delivery of a vaccine, which would enable lockdown release, is a year or so away. Even if accelerated testing is uniformly successful, the administrative process for getting most people in the country vaccinated would take many months on its own.

    So I think that the most likely approach is a graduated release, maintaining the vulnerable in lockdown until a vaccine is developed while releasing the working people which the economy needs. This could be justified if Covid treatments were improved sufficiently to make the disease better able to be cured, and there are indicators of that on the horizon, viz:

    1 – clinical trials of many drugs are now beginning, and several of these look promising.
    2 – understanding of the mechanism of the virus attack is developing. In particular, hypotheses about its impact on blood cells seem to me to be well founded. If understanding is achieved here, better directed ICU treatment can immediately be implemented.

    The timescale for the above advances could be measured in weeks. I anticipate that the lockdown could be lightened in a month or less if we get the developments in these fields that I am anticipating….

    • Yep, there it is. Severe immune system overeaction due to ACE/ACE2 imbalance that causes ALI and pulmonary microvascular thrombosis.

      ACE and ACE2 act in a counter-regulatory manner: ACE promotes inflammatory response, ACE2 promotes counter-inflammatory response.

      ACE inhibitor (ACEi) and ARB meds inhibit ACE expression, but not ACE2 expression. Thus inflammatory response is lowered in people on these meds.

      ACE2 expression decreases when cells with ACE2 expression are infected with Corona-chan. Counter-inflammatory response is lowered.

      ACE expression increases in hospital patients on ACEi/ARB meds because those treatments are stopped upon hospital admittance. Inflammatory response is elevated.

      Also, ACEi decrease PAI-1 production. PAI-1 inhibits tPA, which breaks down blood clots, preventing thrombosis. So stopping ACEi treatment in hospital patients increases risk of thrombosis.

      And that’s what k!lls most patients on day 10-14: pulmonary microvascular thrombosis.

      Two obvious, possible treatments: don’t stop ACEi/ARB meds in infected patients, and take an anti-coagulant.

      ACEi/ARB treatments aren’t the only thing that elevate ACE2 expression. Basically any insult/injury to the lungs does so, like heavy chronic air pollution and smoking,

  65. Willis!
    Nice story but: Plasmodium falciparum does not have hypnozoites. You have mixed up with P. vivax. P. ovale are now been divided into two species. Your picture is not an Anopheles mosquito (the genus that can transmit malaria). An anopheline has long palps.

    • Lena, thanks much. One of the joys of writing for the web is that my mistakes don’t last long … and having suffered through three of the big four (now big five as you say) malarial species, I get confused.

      Also, I made no attempt to find an anopheles skeeter, I just wanted a photo of skeeter X in full drilling mode, and that one popped up.

      Your correction is appreciated, stay well,

      w.

  66. Numerous cases of acute and chronic pulmonary conditions are accompanied by extravasation of erythrocytes to the lower respiratory tract (lung hemorrhage). These pathological events are frequently associated with marked leukocyte influx and an increase in inflammatory markers [1–7]. In cases of moderate to intense hemolysis that succeed hemorrhagic events, the scavenging of free heme by blood-derived hemopexin or albumin collapses, leading to the accumulation of free heme in the extracellular milieu [3]. It has been previously reported that high expression of haptoglobin, the major protein responsible for the removal of free hemoglobin, reduces tissue injury associated to blood exposure [1]. Accordingly, the induction of heme oxygenase-1 (HO-1) can promote cytoprotective responses in some models of lung injury [8–10]. This stress-inducible enzyme controls the deleterious effect of large amounts of free heme, catabolizing this porfirin in biliverdin, carbon monoxide, and free iron, which are addressed, both directly and indirectly, as cytoprotective agents [10]. These observations support the hypothesis that free heme may be involved in the onset and/or amplification of pulmonary inflammatory responses.
    https://www.hindawi.com/journals/mi/2013/946878/

    • Under oxidative stress however, some hemoproteins, e.g. hemoglobin, can release their heme prosthetic groups.[34][35] The non-protein-bound (free) heme produced in this manner becomes highly cytotoxic, most probably due to the iron atom contained within its protoporphyrin IX ring, which can act as a Fenton’s reagent to catalyze in an unfettered manner the production of free radicals.[36] It catalyzes the oxidation and aggregation of protein, the formation of cytotoxic lipid peroxide via lipid peroxidation and damages DNA through oxidative stress. Due to its lipophilic properties, it impairs lipid bilayers in organelles such as mitochondria and nuclei.[37] These properties of free heme can sensitize a variety of cell types to undergo programmed cell death in response to pro-inflammatory agonists, a deleterious effect that plays an important role in the pathogenesis of certain inflammatory diseases such as malaria[38] and sepsis.
      https://en.wikipedia.org/wiki/Heme

  67. It’s too early for the tornado season, but the furious unseasonal winds sweeping the USA arise from a different source – the unprecedented flurry of cash filled brown envelopes from US pharmaceutical giants like Gilead (balm – shmarm! there’s cash in Gilead!!) violently opposing the use of off-patent drugs like hydroxycloroquine against cv19, and furiously lobbying for adoption of their own top dollar wanna-be blockbusters.

    Fauci, Trump, everyone in any position of influence needs to get to their storm shelter quick or be swept off their feet by that storm of cash filled envelopes like a mail-owl message from Hogwarts in a Harry Potter movie.

    This is how America works. No crisis can be missed as an opportunity to create a fortune-making monopoly. Gilead and their rival-comrades will sweep into their Swiss bank accounts the lion’s share of the multi-trillion stimulus package due to the simple rule of medicine in the land of the phree – the more expensive the better! And blasphemously off-patent generics will receive their public stoning to death as written in the unwritten law.

    • re: “This is how America works.”

      A bit jaded, in fact, quite jaded and an over-simp (simplification). You overlook the age we live in, the internet-of-things age (which adds onto the internet and information ages?). We have the best informed public in the world today, just don’t pay any attention to the ‘majors’ (the MSM), who have lost notable market share the last couple decades. For instance, I mark this as my 23rd year on FreeRepublic.com, for instance, a site that predates most ALL so-called ‘social media’ …

    • Jim
      Yes perhaps an exaggeration for rhetoric effect.
      It’s true the US public are better informed about medicines, you don’t get advertisements for serious drugs directly at the public in Europe the same way you do in the US. In Europe doctors alone decide on drugs so the pharma sales people swarm around them like flies but leave the public alone. Neither BTW do we get the ambulance-chasing adverts every 90 seconds, do you have mesothelioma? etc. (amazing that they’re still milking that one).

  68. Willis:

    There’s a data set that you might be interested in for further analysis at healthweather.us. It’s provided by Kinsa, a company that makes “smart” thermometers that combines people’s temperatures with their locations via their smart phones, virtually real time. It can estimate what percentage of people showing temperatures above normal and this can be compared with empirically derived trends of flu-like infections as a function of time in the flu season. One cannot specifically see covid-19, but you can see when and where fever-inducing disease occurs.

    The amazing thing is that you can see how social distancing has dramatically killed the flu season. The US may be in its healthiest state ever with respect to fever-inducing infections. Remarkable.

  69. Willis,
    Thank you for sharing.
    It seems strange to take medicines when you are not ill, but it clearly works. Then we have the problem of the view: “But this is a virus and so why use a drug that targets against an organism?” As you so vividly explain the Plasmodium Sp. parasites are the beasts from hell. How do we really know what part of its life cycle the hydrochloroquinine impacts? As was so clearly stated by a medic on the front line describing his patient’s presentation “You don’t have to follow the protocol – you have to follow the physiology.”

  70. While I can’t vouch for the effect of chloroquine on CoVID-19, I can back Willis on its lack of side effects. My sejours in malarial areas have been shorter than his, but I’ve used chloroquine several times for periods of months at a time without any noticeable side effects. And so have many million others. There can be very few drugs that have been used so long, by so many, with so few problems.

    Unfortunately the falciparum variety of malaria has become chloroquine resistant in many areas, necessitating a shift to other antimalarials like proguanil (paludrine) and mefloquine (lariam) which have considerably worse side effects. I personally have not suffered anything worse than an upset stomach, but I know people that have had serious neurological problems from mefloquine.

  71. By the way Willis, your Fiji relapse was probably due to Plasmodium vivax which is the species normally associated with chronic/relapsing malaria.

    Plasmodium vivax was quite common in most of Europe and North America until the late nineteenth century when better housing and living conditions in rural areas gradually eliminated it. Or at least that is what the textbooks mostly say. However DNA studies of old tissue samples now indicate that falciparum also occurred in Europe. So it isn’t really a tropical disease at all.

  72. There are some interactions regarding Zinc, according to the Mayo Clinic and other good sources.

    Interactions

    Possible interactions include:

    Antibiotics. Using oral zinc while you’re taking quinolone or tetracycline antibiotics can interfere with their ability to fight bacteria. Taking the antibiotic two hours before or four to six hours after taking zinc can minimize this effect.
    Penicillamine. Using oral zinc with the rheumatoid arthritis drug penicillamine (Cuprimine, Depen) can reduce the drug’s ability to ease arthritis symptoms. Taking zinc at least two hours before or after taking the drug might minimize this effect.
    Thiazide diuretics. These blood pressure drugs increase the amount of zinc lost in urine.

  73. Willis’s story of quinine and chloroquine is very interesting. In addition to being an antimalarial, the Merck index (or mine does at least) lists it as an antipyretic (at least for veterinary use) and one would think it would relieve chills and fever, but with Willis it did not — people have varying success with medications. Now chloroquine is not listed as an antipyretic, nor is hydroxychloroqine nor any other salt. However, it is in use to treat symptoms of Lupus; and there is at least one reference in the Journ. of the AMA (McCarty, Carrera, jama, 248, 1718, 1982.) of it being used in conjunction with other medicines to treat rheumatoid arthritis. Thus, it appears to have some use to treat immune system dysfunction. Perhaps this has something to do with whatever success it has with COVID-19, but I am a bit disappointed by the results being reported so far.

    As Commiebob puts it, it is megacomplicated.

    • Lupus and RA are autoimmune diseases
      They are a result of a hyperactive immune system attacking cells, goodies and organs of the patients own body.
      Lupus is very rare.
      RA is far more common.
      Many RD and lupus patients have used the chloroquine for many years, but it is only one of many treatments and it is not the case that all people with these diseases usevthem.
      What the drugs do is reduce symptoms related to inflammation, which is a process that occurs when the immune system is activated.
      They also modulate the immune system directly, dialing down the immune response, the immune response that harms these patients by being directed at their own tissues.

      Phrasing this by day they treat immune dysfunction without specifying how, might give some the impression the drugs strengthen immune response. They do the opposite.
      Patients with severe lupus and RA take much stronger drugs like prednisone or biologics. Biologics are monoclonal antibodies that, in this case, then of specific parts of the immune system by blocking specific cytokines.
      Powerful steroids like prednisone and biologics like Remicade or Humira are dangerous because they act to turn of the immune system. Steroids in a general way, biologics in focused and specific ways.

    • I am reposting to correct a bunch of autocorrect my tablet made.
      Lupus and RA are autoimmune diseases
      They are a result of a hyperactive immune system attacking cells, tissues, and organs of the patients own body.
      Lupus is very rare.
      RA is far more common.
      Many RA and lupus patients have used the hydroxychloroquine drugs for many years, but it is only one of many treatments they may use, and it is not the case that all people with these diseases use them.
      What the drugs do is reduce symptoms related to inflammation, which is a process that occurs when the immune system is activated.
      They also modulate the immune system directly, dialing down the immune response, the immune response that harms these patients by being directed at their own tissues.

      Phrasing this by saying they treat immune dysfunction, without specifying how, might give some the impression the drugs strengthen immune response. They do the opposite.
      Patients with the most severe cases of lupus and RA, take much stronger drugs like prednisone or biologics.
      Biologics are monoclonal antibodies that, in this case, turn off specific parts of the immune system by blocking specific cytokines.
      Powerful steroids like prednisone and biologics like Remicade or Humira are dangerous because they act to turn of the immune system. Steroids in a general way, biologics in focused and specific ways.
      People with autoimmune diseases have an overactive immune system.
      They are known to be less likely to get infections, especially if they do not treat or use milder treatments, because they have a strong and activated immune system.

  74. Willis,
    The dosages you mention for preventative malaria use (300mg/week = 2-200 mg hydroxychloroquine pill) are far lower than what Raoult and others are using in their studies. They’re talking about 600 mg/day or even 800 mg/day – specifically: targeting a blood concentration of over 1 mg/L when 2 mg/L may be toxic: https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa394/5816960.
    The larger doses – basically one time shots to get HCH levels in the blood to some target level – are different than taking 800mg/day for a week or more.

    • c1ue, I was taking three weekly doses per day for three days for driving away malaria once I got started, and much less than that for prevention. Back then a dose was 500 mg of the phosphate, which equates to 300 mg of the base. Not sure which one you’re referring to, base weight or total weight.

      w.

      • Thanks for the info.
        According to this web site: http://www.rheumaknowledgy.com/hydroxychloroquine-and-chloroquine-phosphate/
        1-250 chloroquine phosphate tablet is 150 mg of active ingredient vs. 1-200 mg hydroxchloroquine tablet containing 155 mg of same.
        So you were taking basically 3+ tablets for 3 days to stop a new malaria attack.
        The same web site notes safe use at different levels: 2 hydroxychloroquine tablets to start then less (5 mg/kg) vs. just 1 chloroquine phosphate tablet (2-3 mg/kg).
        It is because of this site, and the previous note, why I wonder what the safe dosage (vs. effective vs. nCOV dosage) for hydroxychloroquine and/or chloroquine phosphate is.

  75. Willis: There is no doubt that chloroquine has activity against coronavirus in cell culture, but this activity is at least an order of magnitude weaker (IC50 1-2 uM) than typically for useful anti-virals. (For example, the median cell culture IC50 for Tamiflu is 0.004 and 0.06 uM for Influenza A and B.) In addition to treating malaria, chloroquine is also used to treat rheumatoid arthritis and lupus. That means it has immuno-suppressive activity – which may not be the greatest thing for patients trying to fight off a life-threatening viral infection. I’ve heard that COVID-19 patients who have taken ibuprofen for fever before going to the hospital have a poorer prognosis than those who haven’t. On the other hand, if a “cytokine storm” is drowning a patient’s lungs with fluid, immuno-suppressive activity combined with even modest antiviral activity may be an ideal therapy. During the SARS epidemic, steroidal anti-inflammatory drugs were used to suppress this cytokine storm. When an acquaintance of mine needed an increasing amount of oxygen due to chronic lung inflammation, a steroidal anti-inflammatory drug completely eliminated an need for oxygen within 24 hours(!) and allowed a life-threatening bacterial infection to developed in 48 hours. Azithromycin has no activity against coronaviruses, but can help with bacterial pneumonia. Finally, a very small percentage of people have something called qT prolongation, which puts them at risk for sudden cardiac arrest. A surprising number of older drugs make qT prolongation worse, but this problem wasn’t identified until recently. In a modern hospital, a patient is likely to be given an EKG to detect qT prolongation before chloroquine is administered. If everyone on the planet were given chloroquine to prevent COVID-19, more people might die from sudden cardiac arrest, than might escape death from the virus. We face exactly the same problem if we are rushed into administering a vaccine before its safety has been fully established.

    In other words, the decision as to whether chloroquine is likely to help a particular patient is a very complicated one that probably has little to do with its anti-viral activity in cell culture. Doctors working on the front lines with desperately ill patients with a novel disease want to believe that their treatment is keeping their patients alive. When they are free to select patients and endpoints that demonstrate some measure of limited efficacy without a control group, you have a classic recipe for confirmation bias, especially when a combination of two or three drugs with multiple possible mechanisms of action are being used. We will have some reliable information after placebo-controlled double-blind clinical trials with pre-determined endpoints begin to report. Based on its high IC50 in cell culture, I’d be surprised if chloroquine causes a significant drop in viral load in the first few days of therapy and it might even cause an increase due to immunosuppression.

    • Frank says …

      ” I’d be surprised if chloroquine causes a significant drop in viral load in the first few days of therapy and it might even cause an increase due to immunosuppression.”

      Some 68 year old guy living in a mid sized city in Spain where the Government has mandated zero treatment to the aged with severe Covid … what else have they got ? They don’t have six months to two years for trials.

      Don’t blame me for on the ground reality. Blame the Chines Communist Government that promised a year or two ago to close down the “wet markets” where this pathogen came from … and didn’t.

      • “…what else have they got ?”

        Two trials for remdesivir expanded access in Spain:
        https://clinicaltrials.gov/ct2/results/map?term=remdesivir&cntry=ES&map=

        1.5 million doses, the entire existing inventory on the shelf and in production, to be given away from free:
        https://www.gilead.com/stories/articles/an-update-on-covid-19-from-our-chairman-and-ceo

        Update letter from O’Day, April 10th:
        “Two Phase 3 studies are being run by Gilead in areas with a high prevalence of COVID-19 in the United States, Asia and Europe. One of these is for patients with severe disease and the other studies remdesivir in patients with more moderate symptoms. One of the many questions that these studies aim to answer is whether treatment duration can be shortened from 10 days to 5 days. The severe arm fully enrolled the number of patients it was originally designed for and we have now expanded the study so that thousands more patients can participate, including those on mechanical ventilation.”

        https://www.gilead.com/stories/articles/an-open-letter-from-our-chairman-and-ceo-april-10

        Many other trials for many other treatments can be found at clinicaltrials.gov.
        Here are 16 that come up in search for Spain and Covid:
        https://clinicaltrials.gov/ct2/results?cond=COVID&term=&cntry=ES&state=&city=&dist=

        Many others can be found with more general search, including one’s for numerous IL-6 blockers and all sorts of other stuff. Here are 440 studies for COVID-19:
        https://clinicaltrials.gov/ct2/results?cond=COVID-19

        • Remdesivir was originally developed for treating Ebola. It works in a monkey model for Ebola, but a patient population, treatment regime and endpoints where efficacy weren’t identified during the 2014-6 Ebola epidemic. Therefore the drug has never been approved for sale, which is probably why Gilead is giving it away for free. The safe shelf life is likely only a few years. Nevertheless, certain doses of the drug were proven to be safe.

          Chloroquine and remdesivir are the only known drugs with antiviral activity in cell culture at non-toxic concentrations. Most of the other drugs being tested are intended to deal with the dangerous inflammation or “cytokine storm” that develops in many patients who are hospitalized. The same problem plagued patients with SARS-CoV-1. Some of them were treated with steroidal anti-inflammatory drugs.

          • One data point regarding the Ebola trials which has been widely overlooked is the disparity between Ebola patients treated with remdesivir (and indeed with any of the four drugs tested) when the treatment was given shortly after exposure to the virus, vs those that were only treated after their condition was greatly deteriorated.
            The difference was very large, for all of the drugs, even the MAB’s that were deemed to have “passed” the clinical trial and judged to be effective.
            In fact for the most effective drug, the range between the survival rate for those treated early was even wider than for remdesivir and for ZMAPP.
            Although it is also true that in all classifications of disease progression, the Regeneron monoclonal antibody was much more effective than either of remdesivir or ZMAPP.

          • “You have no idea what you are talking about Frank.”
            This is pertaining to your assertion that, “but a patient population, treatment regime and endpoints where efficacy weren’t identified during the 2014-6 Ebola epidemic.”

            There is excellent data from the clinical trials for Remdesivir.
            Whatever else can be said about Gilead, the trials they have been involved with are very well designed and run, and data sets are impressive.
            If you have never seen the data, that is not the same as it not existing.
            I have reviewed much of it here and posted links to much more of it, including the trial protocols used in that Ebola epidemic.

          • And I am sorry I said that to you Frank.
            Some of the conversation here has made me more than a little impatient with comments I assess as not completely accurate, but that is no excuse.
            I do apoogize.
            I am trying not to be antagonistic to anyone, but it seems easier said than done right now.

          • Nick: For what it is worth, I worked in drug discovery for more than a decade for an organization where drugs to treat HIV were the largest effort. It is unlikely that we would have taken into the clinic a drug candidate with an IC50 above 1 uM against viral replication in cell culture (and toxicity at 10 uM). Remdesivir, however, has already been shown to be safe for humans at certain dose and can easily to tried in humans. You can see the antiviral activity in cell culture for GS-5734/remdesivir in Table 1 in this article. Notice that it has an IC50 between 0.003 and 0.066 uM against four strains of Ebola and less than 0.1 uM against several other viruses.

            https://www.nature.com/articles/srep43395

            This potent in vitro activity is what prompted Gilead to take this drug through preclinical studies, Phase I (safety) and Phase II (small efficacy studies) and beginning Phase III studies for Ebola. The only efficacy data in humans I have seen comes from an uncontrolled study where 50% of infected patients survived and it was claimed that the expected mortality rate was 75%. Of course, with more experience, doctors have gotten better at helping Ebola patients survive, patients have been getting professional help earlier, and with time the less lethal viral strains tend to spread the fastest, so Gilead still needs a proper placebo-controlled (or comparator-controlled) clinical trial to prove that the drug is efficacious to gain marketing approval.

            Cell culture activity against coronaviruses before the discovery of SARS-CoV-2 can be found in this article:

            https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5567817/

            Again, there activity at less than 0.1 uM and below and some of this activity is reported in units I am more used to seeing IC90 or IC95 or logs of viral reduction. However the IC50 I have seen for one strain of SARS-CoV-2 is modestly above 1 uM. The other data in this paper illustrate some of the other challenges faced by remdesivir. It is a pro-drug that must survive in the blood long enough to get into the cells susceptible to viral entry, it needs to be converted inside the cell into the free nucleoside monophosphate and converted to the triphosphate, which is the actual species that inhibits the viral RNA polymerase.

            There certainly may be other data currently unknown to me that might make me more optimistic. If so, please provide me a link.

      • Sendergreen wrote: “Some 68 year old guy living in a mid sized city in Spain where the Government has mandated zero treatment to the aged with severe Covid … what else have they got ?”

        That 68-year old guy has a 68-old-year old immune system which will eventually get around to clearing a viral inflection if the doctor and hospital can keep him alive long enough – and if his immune system isn’t suppressed by chloroquine. The first rule of medicine is “do no harm”. We may break that rule for terminally ill patients, but entering the hospital at 68 with COVID-19 isn’t a death sentence.

        Before we had double-bind placebo controlled clinical trials, that 68-year-old man would have been bled – as George Washington was before he died at 67 with a cold. (5 pints of blood if Wikipedia can be believed). Of course, not all medicines and procedures used before modern clinical trials were performed have been proven to be worthless or dangerous, but many have been.

        My aging immune system struggled with influenza last winter until I paid a visit to the emergency room. One hit from an inhaler used for asthma made it easier to breath and cleared my head. An antibacterial may have helped me deal with and defeat a touch of pneumonia. These things can be done to your 68-year-old patient. And they had Tamiflu, which is one to two orders of magnitude more potent against viral replication in cell culture than chloroquine is against SARS-CoV, and proven to be safe and effective as shortening the course of flu in a doubled-blind placebo-controlled clinical trial – though such efficacy was only observed when taken within 48 hours of symptoms. (I’d been sick for a week.)

        The wet market in Wuhan should have been shut down long ago. Americans and Chinese would be healthier if Prohibition was still in effect, too. The published evidence shows the first patient with Covid-19 was likely a 89-year old man to frail to leave home, who was hospitalized two weeks before anyone from the market. The patients whose viral RNA was sequenced several weeks later were associated with the market. In the case of HIV, the person originally identified as Patient Zero was not. HIV had been in the US for more than a decade before “Patient Zero” and had jumped to humans in Africa a half-century earlier. If the Chinese government allows a full investigation, we may find out more later, including the intermediate host between bats and humans, if there was one. Maybe we will learn that the rumors on social media are correct, and Patient Zero was actual a researcher at the Institute of Virology in Wuhan, but so much fake information is deliberately spread by social media these days that such rumors are meaningless. The bats that harbor many strains of coronavirus are a much bigger problem in Southern China (than in Wuhan) where SARS jumped from bats to civets (and several other species) before reaching humans. Someday we may find that SARS-CoV-2 actually got its start at a wet market in Southern China.

        • Frank :

          You even copied it TWICE but somehow missed the phrase ” … in Spain where the Government has mandated zero treatment to the aged with severe Covid … ”

          Then go on to explain how they can survive with a myriad of treatments. None of this has surprised those of us who have watched the “Death Culture” grow over the past fifty years from both ends of the trail of human life.

          • sendergreen: My comments were intended to be about whether a 68-year-old man should be treated with chloroquine simply because there is no other medication known to be efficacious. I deeply respect your concern that older patients might not be given the appropriate care (like I received for influenza) and did not intend to criticize that. IMO, we are paying a huge economic price by shutting down much of our economy so that our hospitals have the beds and ICU beds to properly treat every patient who needs help. Some cities are looking for new spaces to treat sick patients, but they may not have the trained medical staff needed to handle them as well as respirators and other equipment. They could even be running out of the drugs that were used to treat me for influenza. It is such a breakdown in civilization that all political leaders fear. I presume, but don’t know, that the Spanish measures you are complaining about are due to their inability to properly treat every patient who needs treatment.

    • “Azithromycin has no activity against coronaviruses”

      And you know that, because…?

      “We face exactly the same problem if we are rushed into administering a vaccine before its safety has been fully established.”

      Yes, and many (most?) real vaccine skeptics are skeptical of both Raoult protocol and of the moral authenticity of the noisy anti Raoult crowd.

      • Niceguy: We have assays for anti-viral activity that are run in cell culture (in a petri dish). In the case of SARS-CoV-2, you add the virus to a human derived cell line (such as Vero cells) that express the ACE2 receptor used by the virus to enter the cell and let those cells grow in the presence of various amounts of potential antiviral drug. Then you use PCR to quantify the amount of viral RNA in the culture, and calculate the drug concentration (IC50) needed to reduce viral RNA by 50% compared with a control with no drug. Then you check to see if the drug candidate interfered with the growth of Vero cells. Reducing viral growth by killing the cells they replicate in isn’t a useful mechanism of action. In the case of chloroquine, the IC50 from reducing the growth of Vero Cells is about 10-fold higher than the IC50 for reducing viral RNA.

        Azithromycin has no activity against viral replication in such cell culture assays, chloroquine and remdesivir have IC50’s a little above 1 uM. A potent antiviral like Tamiflu and the drugs used to treat HIV have IC50 in cell culture below 0.1 uM.

        Azithromycin is active against the bacteria that cause pneumonia. Patients with COVID-19 often develop pneumonia and may benefit from treatment with azithromycin for this reason. Or it may be appropriate to use azithromycin to ensure that a COVID-19 patient who doesn’t yet have detectable pneumonia never adds bacterial pneumonia to his problems.

        For what it is worth, I am not a skeptic about vaccines, because they have been proven to be save and effective. However, if you want to give everyone in the country a vaccine against SAR-CoV-2, you can’t test it on only 1,000 volunteers. If one dies, and the same fraction of the population dies from vaccination, you will have killed 330,000 Americans. If none of the 1,000 dies, you might have been lucky and 1 in 1,000 will die in the long run. So cautious doctors will insist that we test the vaccine on 10,000 or 30,000 volunteers before beginning a nationwide vaccination campaign. An impatient administration isn’t going to want to wait this long.

        I researched the vaccine for Yellow Fever for a friend who was traveling to the waterfalls on the border of Argentina and Brazil, where Yellow Fever is endemic in monkeys and transferred to humans by mosquitos. The well-charcterized serious side-effect rate for the Yellow Fever vaccine (a weakened strain of Yellow Fever virus) is 2 per 100,000, but rises to 5 per 100,000 for those over 60. What are the chances of getting Yellow Fever if you visit this area for a day or two? The people who live there normally have about a 5 in 100,000 chance of contracting yellow fever during the several month long yellow fever season, but this number is very poorly known. Perhaps it could be as high as 5 in 10,000. The coastal cities of Brazil began getting an epidemic of Yellow Fever when mosquitos were transmitting the disease from one human to another without the involvement of monkeys. They had to vaccinate everyone in their southern coastal cities. Getting yellow fever isn’t a death sentence, but some people do die. My friend was over 60. Should I have recommended the vaccine or not?

        I told my paranoid friend that the odds were excellent no matter what choice was made, but I personally wouldn’t get the vaccine (which isn’t normally recommended for those over 60). I said my friend was running far more serious risks than the risk of getting yellow fever or having a reaction to the vaccine. Worry about something more important. Prescient, as it turns out, since the trip also involved a cruise from Argentina to Chile in February of this year.

        • “…you add the virus to a human derived cell line (such as Vero cells)…”
          Vero cells are not human derived cells.
          They are cells derived from the Kidney of a green monkey.
          Many other cells lines used in research are derived from human cells, but they are extraordinary (even for cancer) cancer cell lines like HeLa.
          There do seem to be a limited number of cells suitable for cell culture studies that are not of dubious utility as a model for a human being, but Vero and HeLa are not among them.
          Just sayin.

        • BTW, your explanation of the need to parse data regarding clinical trials and vaccines and disease rates and the dangers of those disease, are well made.
          It is clear to me that there are a lot of people here and around the country who simply have no experience in knowing how to interpret problematic data of drugs and disease, what good data from a clinical trial looks like vs what we have seen for some of the early chloroquine patient sets.
          When one goes to a repository of information such as clinicaltrials.gov and examines some studies and the way protocols are written, how and how much data is collected and collated, and how results are presented, then it is very obvious how trivial, lacking in rigor, and unfit for any purpose of comparison or scientific appraisal of safety and efficacy they are.
          The simple act of taking several thousand patients and selecting out some smaller set of them to report on, means that for something like this disease, it is absolutely impossible to infer anything regarding the drugs…except that they are not killing some large percentage of people most of the time.
          But they did in Brazil.
          Giving the malaria drug to some subset of asymptotic patients suspected of COVID infection, without including detailed descriptions of inclusion and exclusion criteria, all by itself makes the data unscientific and impossible to compare to any other set of patients.
          But any method of selecting patients that does not then include a randomized selection of control groups and treatment arms from the same poll means that the data is similarly worthless, not matter how well described or followed the inclusion and exclusion criteria are.
          When only 1 to 2% of all infected patients are dying, and the possibility exists that the true number is lower due to not knowing the denominator, it is meaningless to draw a conclusion about the results for some triaged set of patients given a treatment.
          Even not having the randomization double blinded has been amply demonstrated to invalidate results. Bias creeps in when caregivers know who is getting what treatment.
          Many of the patients who wind up with a bad outcome get very sick almost immediately upon becoming symptomatic.
          If these people go to a hospital and are admitted, and the ones who get symptoms that are mild go to a doctor who treats them with a treatment, the ones who see the doctor in a regular office setting have already had the worst off set of patients subtracted, which may in fact contain most of the people who will at some point have a bad outcome.
          One can glean this sort of thing when looking at the language employed by the authors of the NEJM article regarding remdesivir compassionate use.
          Those people are not directly comparable to any other cohort of patients, strictly speaking from a scientific point of view.
          But that does not preclude making some observations and some tentative speculations regarding what that data is telling us. It does for them, but not for us.
          Compared to the results published by Raoult, the NEJM data from Gilead is the difference between a clay figurine made by a child and a sculpture from a master artist.
          The difference in detail is gigantic.
          For actual clinical trial data when we see it, it will be steps above the NEJM data.
          It is not just the control groups that make it different, it is the amount, consistency, and quality of all of the data that sets it apart as well.

          • “When one goes to a repository of information such as clinicaltrials.gov and examines some studies and the way protocols are written, how and how much data is collected and collated, and how results are presented, then it is very obvious how trivial, lacking in rigor, and unfit for any purpose of comparison or scientific appraisal of safety and efficacy they are.”

            Clarification…how unfit for such the chloroquine data from people like Zelenko and Raoult are.

  76. Willis: I just ran into some useful information about your thermostat hypothesis. Figure 3 in the paper below shows the diurnal variation in tropical precipitation over land and water. In accord with your hypothesis and personal experience, the least precipitation falls over land at 9:00 am and the greatest between 3:00 pm and 6:00 pm. The difference is huge, about 0.17 mm/h (4 mm/day 1.5 m/y). Over water, however, exactly the opposite pattern is observed with the greatest precipitation at 6:00 am and the least from 6:00-9:00 pm. This difference is smaller, but not trivial, about 0.08 mm/h. This makes perfect since the mixing and larger heat capacity of the ocean prevents it from warming more than 1 degC, while the surface of land can rise more than 10 degC. Interestingly, the paper shows that normal climate models completely fail to reproduce the observed diurnal cycle of precipitation in the tropics. Best wishes.
    https://journals.ametsoc.org/doi/pdf/10.1175/BAMS-D-18-0210.1

    • In accord with your hypothesis and personal experience, the least precipitation falls over land at 9:00 am and the greatest between 3:00 pm and 6:00 pm.

      It was exactly so when we lived in Kuantan, Malaysia. Every afternoon for days on end the rain came at almost the same time, we heard it advancing through the jungle toward us giving us a minute or two warning. It was the same water falling every late afternoon, having transpired-evaporated during the day.

  77. “Fauci is both mad and destructive to argue against it.” Please provide a quote.

    Did he argue against it, or say it hasn’t been studied adequately?

    • There are many people who have no willingness or ability to discern a difference.
      They seem to only understand head nodding.
      Any response besides for that is taken to be rabid opposition.
      Very surprising for people who spot the illogic of such mentality when talking about proponents of CAGW.
      They are utterly blind to it when they do the exact same thing, regarding something they have long ago made up their minds about.

  78. Willis-

    I realize this post is “getting long in the tooth” as they say, but Latitude’s comment April 11,2020 at 5:51pm about Plaquenil being available in Tijuana without a prescription, got me to thinking: could availability of Plaquenil without a prescription have some effect on the case and death rates in various countries? If people can decide on their own whether to take a med, without having to get a doctor’s okay, maybe people would self-medicate with Plaquenil.

    I found a website that shows the countries by whether or not a prescription is required:

    http://www.motherjones.com/kevin-drum/2012/03/lots-countries-dont-require-prescriptions-oral-contraceptives/

    A large number of countries don’t require prescriptions, including South Korea! I also looked at Greece which doesn’t require prescriptions. Since it was right across the Adriatic from Italy, one might expect it to have the same case and death rates as Italy (which does require prescriptions). But that’s not so:

    Italy 2586 cases/million pop. 329 deaths/million pop.
    Greece: 203 cases/million pop. 9 deaths/ million pop.

    Of course there could be all kinds of reasons, but I just found this curious.

  79. old engineer
    The article that you link is about oral contraceptives, not HCQ. While HCQ has reportedly been used for abortions in Africa, (as well as suicides), that is not a routine use in first-world countries.

    • Because Di-antalvic was often used for suicide in ONE country in Europe, in was banned all over the EU.

      (Also, because it wasn’t patented, I believe.)

    • Clyde-

      Yeah. Noticed that it was for oral contraceptives after my comment. My mistake. Too much in hurry to find the data I wanted. I still wonder about self-medicating though. I haven’t been able to find a site that shows countries that require prescriptions for most drugs, as in the U.S. Mexico is the only country I know of that doesn’t require prescriptions for most (maybe any) drugs.

      • ” I still wonder about self-medicating though. I haven’t been able to find… ”

        Try the following: Any nutrition store will have quercetin supplements. Quercent is a known Zn ionophore. It will drive Zn into cells and has other beneficial effects. Also bump up your D3 and or get some sun if you can. And of course, vitamin C. This is the best we can do, with 100% safety and no need for prescriptions. As well, green tea (I take the extract). I don’t charge for this information, but if you want to start a go-fund-mario page, I will happily accept.

        Now If I can get a call back from Red Cross so I can donate my antibodies through plasma…

      • o e
        I’m not going to take the time to try to run down the citations at the moment because this thread is so old that you may not even read it. However, from my reading, it appears that many drugs are available on the Black Market in Africa. The downside is that many are thought to be counterfeit drugs with no efficacy. It also becomes a situation, not unlike the US, where many illicit drugs are not as represented and often are dangerous.

  80. Just looked up BCG vaccination and found it was for TB. Got me wondering whether TB exposed persons (i.e with strong antibodies for TB and Positive Mantoux Test but without development of TB) are likely to succumb to Covid-19. I am curious because as a child in the 1950s I had a next door neighbour who had TB of the hip that I used to play with. I tested positive very strongly to the Mantoux test when I was 21 but x-rays showed no lung infection or any indication of such. If there are any studies showing this someone like me could still have antibodies that could be of use for vaccine development. Of course this may not be necessary if the BCG vaccine is also effective.

  81. Dr Didier Raoult who became noted during this crisis by publishing the results of his first small test where he combined hydroxychloroquine with azithromycin as a new Covid-19 treatment has just released the results of his latest test where he has 1061 patients. The most basic result is he saw 5 deaths.
    Perhaps we should do some simple math since the “so called experts in the medical profession” still seem to me mathematically challenged.
    5 deaths out of 1061 patients is 0.47%
    As of today France has recorded 129,654 confirmed cases and 13,832 deaths.
    This is a death rate of 10.67% per confirmed case.
    Currently the same random population in France shows a death rate that is 22 times as large in the population who was not treated compared to the 1061 in this test that were treated. This incredible result is the definition of statistically significant.
    For those asking for a “control group” as some magical requirement for statistical significance in their rigid illogical and unthinking brain, I recommend they use 1061 of the 129,654 confirmed cases which has resulted in the 13,832 dead French who are available in the morgues of France. They represent a truly random group and the only significant difference in their outcome compared to this treated group is they were blocked from a treatment the Chinese and Koreans have been dispensing FOR MONTHS and have published generally positive if not “PERFECT” results.
    I personally could not care less if Dr Raoult is arrogant, or labeled a quack by other self important quacks during any previous studies. I only care about results of any useful treatment to reduce the suffering from this deadly virus. This treatment has never been called a cure for this disease, it is a treatment when used early can limit the number of people who eventually DIE. This is not a study on the latest treatment for hair loss, or skin dryness, this is an attempt to have less DEATH. Any fear mongering about a drug which has been safely prescribed for 70 years is the mindless blathering of a fool. I don’t see any indication this drug came close to KILLING 10.67% of the 1061 patients who took if for the short term of this test. We would expect 10.67% of these patients would be DEAD using the average death rate from the rest of France. What is so difficult to understand between 0.47% and 10.67% DEAD.
    At this point anyone who is blocking this treatment should be removed due to there being only 2 possible reasons for their obstruction. Either they are grossly incompetent, or they are criminally blocking a viable safe treatment for financial or professional benefit.

    • It would be nice if you could provide a clue where to find this report of which you speak.

        • IOW you have no idea where to find a new report showing results of over 1000 patients from Raoult?
          Or you refuse to say?

          • NM, it’s in one of my previous posts to; maybe it hasn’t/didn’t or won’t make it through (moderation?) to posting.

            It’s BEEN posted before, in this thread even, here: https://wattsupwiththat.com/2020/04/11/of-quinine-and-chloroquine/#comment-2963751

            BTW, one can find ALL these reports/dispatchs here: “COVID-19 Therapeutic and Prevention” by Didier Raoult and Dr. Po-Ren Hsueh here:

            https://www.sciencedirect.com/journal/international-journal-of-antimicrobial-agents/special-issue/10V3JMBH9GZ

            JUST to be complete HERE is a link to the dispatch regarding the 1,061 patients treated by Dr. Raoult and associates:

            https://www.mediterranee-infection.com/wp-content/uploads/2020/04/Abstract_Raoult_EarlyTrtCovid19_09042020_vD1v.pdf

            Excerpt: Methods
            The study was performed at IHU Méditerranée Infection, Marseille, France.

            A cohort [test population] of 1061 COVID-19 patients, treated for at least 3 days with the HCQ-AZ combination and a follow-up of at least 9 days was investigated. Endpoints were death, worsening and viral shedding persistence.

            For “Findings” read the dispatch.
            .

          • This is in the findings:
            “A good clinical outcome and virological cure was obtained in 973 patients within 10 days (91.7%). Prolonged viral carriage at completion of treatment was observed in 47 patients (4.4%) and was associated to a higher viral load at diagnosis (p < 10-2) but viral culture was negative at day 10 and all but one were PCR-cleared at day 15. A poor outcome was observed for 46 patients (4.3%); 10 were transferred to intensive care units, 5 patients died (0.47%) (74-95 years old) and 31 required 10 days of hospitalization or more. Among this group, 25 patients are now cured and 16 are still hospitalized (98% of patients cured so far).”

            In other words, it works remarkably well.
            The use of the term ‘endpoints’ is quite misleading to us ordinary folks.

          • I was wondering what dosage was used but haven’t found it. I read some place that too much HCQ (600mg/day for 10 days) causes heart arrhythmias so how little has high probability of working? In the news stuff they show pictures of 200 mg pills. Willis says he took 500 mg once per week to prevent malaria.

            It appears that the Trump-haters are OK with thousands of people dying as long as they can spin it to make Trump look bad.

          • “If no hydroxychloroquine
            available, consider chloroquine
            base 600 mg (10mg/kg) at
            diagnosis and 300mg (5
            mg/kg) 12 h later, followed by
            300 mg (5 mg/kg) BID up to
            Day 5 or chloroquine
            phosphate 1000mg at
            diagnosis and 500mg 12h
            later, followed by 300mg BID
            up to day 5.”

          • Not a word about how they selected or excluded patients.
            These where not people that presented at hospitals.
            If you consider this scientific, I suppose that is why so many are having problems communicating.
            In fact this is a typed sheet of paper.
            Anyone could have written that.
            No wonder it shows up on zero searches, and appears no where in discussion anyplace except social media.
            Show we one place where this appears on something that does not look like a ten year old could have typed it up.
            On that there are people that claim they have a cure.
            I cannot wait for the day.

          • re: “Not a word about how they selected or excluded patients.”

            People (walk-ins) presenting known symptoms, subsequently testing positive as well. Ppl who KNOW something is off, that something has ‘taken ahold’ of them, and have seen no improvement in several days. Ppl who want to return to a state of wellness again. With no “brain” in gear on your end, NM, this gets tedious quite quickly. Do you know what the full set of symptoms are? Raoult and associates operate an infectious-disease medical research and treatment facility in southern France. This is the research institute’s website here: https://www.mediterranee-infection.com/ Mission and objective statement: https://www.mediterranee-infection.com/linstitut/missions-et-objectifs/

            Two more questions, have you been through the virology course here yet (it is up to date and mentions the latest corona virus):

            Virology Lectures 2020 #1: What is a Virus?
            Vincent Racaniello
            https://www.youtube.com/watch?v=lj3NhPgOoX4
            (A number of videos follow in succession this video.)

            and have you read ANY of the papers cataloged, linked here (the page appears to be updated every week or so):

            http://clarivate.com.cn/coronavirus-resources/research04.htm\
            (Language is Chinese; FlashPeak Slimjet or Chrome browsers will translate.)

            Also regarding the following (swerving ever-closer into idiot classification): “Show we one place where this appears on something that does not look like a ten year old could have typed it up.” have you seen the followup table (WHICH) I posted previously in your direction? It lists known pre-existing conditions of patients ion this 1061 patient ‘study’:

            Table 1. Baseline characteristics according to clinical and virological outcome of 1061 patients
            treated with HCQ + AZ ≥ 3 days at IHU Méditerranée infection Marseille, France with Day 0 between
            March 3 and March 31, 2020.
            https://www.mediterranee-infection.com/wp-content/uploads/2020/04/Table_final_website_IHU_09_04_2020.pdf

            Pls, read more, and retain more. This gets tedious, for all of us, NM.

          • You are off the deep end pal.
            You have no idea what anyone who disagrees with you is talking about.
            You have abandoned science and are now a rabid take no prisoners advocate for some inane political point of view or illogical obsession with an open question which has been settled beyond all doubt…but only in your mind, not in any way settled in reality.
            I do not hope to reason with you or explain anything I think you will comprehend.
            I am merely saying so for the record, and in case you have a moment of clarity, in your fevered imagination.
            Do not bother including me in your ranting, or answer questions I ask someone else please.

    • Ken: I applaud your post. And would add, if Zn and Hydroxychloroquine were given earlier rather than later, I suspect the results would be even more amazingly positive.

    • Ken
      You derisively commented, “For those asking for a “control group” as some magical requirement for statistical significance in their rigid illogical and unthinking brain, …”

      So, if I take most of the watermelon-flavored jelly beans out of a box, before pouring them into a jar for subsequent sampling, by your reasoning, it shouldn’t effect the outcome of trying to determine the proportions of the different flavors. Now, do you care to comment more on just how you define “unthinking?”

  82. “The Brazilian study included 81 hospitalized patients, with about half being given a dose of 50 milligrams of chloroquine twice daily for five days. The other participants were prescribed a dose of 600 milligrams for 10 days.

    Patients taking higher doses experienced heart arrhythmias, or improper beating of the heart, within three days, according to the study. Eleven patients died by the sixth day of treatment and caused the research on high-dosages to end”
    https://thehill.com/policy/international/492460-small-chloroquine-study-stopped-after-irregular-heart-beats-detected-in

    • What a nice study! Give half the patients a sixtuple dose, call it a research, and be surprised!

      • What are you talking about?
        The dosage was 600 mg.
        Are you asserting that some protocols for COVID -19 are based on a dose of only 100mg a day?
        In fact, 600 mg is the recommended dosage.

        This is the third country, after China and then Sweden, to halt usage of Chloroquine due to toxicity and side effects issues.
        Why don’t you get your facts straight?
        Obviously you never bothered to look at what dosage is being used anyplace else, or you would never have said anything so dumb.

    • Nicholas: There is a typo in the article in The Hill. Follow the link in the article to the paper itself.

      “Eligible participants were allocated to receive orally or via nasogastric tube high dose CQ (600mg CQ twice daily for 10 days or total dose 12g); or low dose CQ (450mg for 5 days, twice daily only on the first day, or total dose 2.7g). In addition, all patients received ceftriaxone and azithromycin.”

      “Eligible participants were allocated to receive orally or via nasogastric tube high dose CQ (600mg CQ twice daily for 10 days or total dose 12g); or low dose CQ (450mg for 5 days, twice daily only on the first day, or total dose 2.7g). In addition, all patients received ceftriaxone and azithromycin.

      “Regarding cardiotoxicity and QTc over time, the variation in the QTc as compared to the baseline ECG increased more on days 2 and 3 in the high-dose CQ arm, with both arms showing more similar QTc variations in the last three days of follow up. Two patients in the high dose CQ arm evolved with ventricular tachycardia before death. This severe type of arrythmia is usually facilitated when QTc is prolonged.”

      The high dose arm of the study was discontinued, but the low dose arm is ongoing.

      “The fact that in many countries the ‘compassionate use” of CQ or HCQ has already been formally indicated for severe patients , made it UNETHICAL TEO TEST PROPER EFFICACY DUE TO LACK OF A PLACEBO ARM AS A COMPARATOR. Our study aimed to comprehensively evaluate primarily the safety, and secondarily the efficacy of CQ in two different dosages.”

      So all of the publicity about the alleged efficacy of CQ from non-placebo controlled double-blind trials has made it impossible the proper clinical trials.

      “In a unique pandemic situation, health care PROFESSIONALS have to choose between offering medical assistance and generating a reporting reliable data, a dichotomy that compromises the generation of good quality evidence for clinical management. Global recommendations for COVID-19 are being made BASED ON UNPOWERED STUDIES, however and due to the chaotic urgency, such drugs are being prescribed in a compassionate manner given the severity of the disease. However, CQ, despite being a safe drug used for more than 70 years for malaria, MIGHT BE TOXIC IN THE DOSAGES RECOMMENDED BY CHINESE AUTHORITIES (high dose 10 g for 10 days). Our study raises enough red flags to stop the use of 12 g of CQ … in total in order to avoid more unnecessary deaths.”

      “Placebo-controlled studies could still be performed in countries no routinely using the drug. Several ongoing trials have been addressing the early use of CQ, IN WHICH THE ANTI-INFLAMMATORY PROPERTIES COULD BE USEFUL. That information is urgently needed.”

      In an earlier comment, I half-jokingly compared treatments whose efficacy and safety hadn’t been established in double-blind, placebo-controlled clinical trial to the old practice of bleeding patients. However, automatic use of CQ with patients with QTc prolongation or other serious heart conditions may be as bad as bleeding. The problem is that doctors treating a patient may not be sure if the heart problems he sees were previously mild, but are being made worse by viral attack on heart tissue (for which there is some evidence), or whether CQ is too risky to use on this patient.

      • Ah, I see, it was not 50 mg, it was 450 mg in the low dosage arm.
        That makes more sense.
        I was wondering about that dosage.
        Honestly I am sifting through so much material to read I am not taking the time to follow up on every detail of such stories.
        What I found noteworthy was the discontinuation, the third I have found in the past day (China, Sweden, and now Brazil. The China doctors in Wuhan seemed to be pouring cold water on the entire idea of these drugs having efficacy, without coming right out and saying so. This is because it is not scientific to do so until there is at least some proof, from a double blind placebo controlled trial, that it is so, no matter how low confidence may be).

        I have come across assessments of the size of the set of all people for whom the malaria drugs are not safe. In these assessments, the drugs can only be assumed to be relatively safe in about 90% of the population, given all of the known drug interactions and the number of people who take one of those, the contraindications regarding various medical conditions, and so forth.
        So there drugs are unsafe in something like 10% of people in the US, and possibly anywhere.
        It is entirely possible that even if they have some therapeutic value, it could well be outweighed by possible harms, and almost certainly will be without careful screening.
        Many drugs that are general safe for healthy people, are decidedly unsafe for sick people…and that goes for any sort of drug.
        It is just not the same to assume something has the same safety profile in people who are critically ill that it does in healthy people. But even healthy people need to be screened when considering using one of these drugs.

        As to the point about not knowing why patients died, who may have done so due to the drugs used for treatment, which were then not recognized as such because it was assumed they were from the disease, I totally agree with your point and that made by several authors.
        The danger of not having good data from large and properly designed trials is immense.
        And this is one reason why trials typically stretch over a period of many years, and involved several stages of testing and long periods of monitoring.
        Many harms do not become apparent for long periods of time. A few months or even a year will not catch many of the well known and recent cases of harms caused by medications.
        The gold standard of safety is all cause mortality after some period of time, and the longer the period and the larger the set of patients studied, the better.
        One problem, of course, is that “safety” has a different meaning when used in the context of a treatment or cure for a deadly condition or disease. This adds urgency. As does the sheer number of people at risk. But that very urgency and number at risk might cause a discarding of standards that ends up being extremely deleterious to public health in the long run, and may do so even in the short term if standards are simply abandoned.

        As an aside, this same concept of long term all cause mortality brings up another shortcoming of simply looking at disease mortality stats in the short term, the binary lived/died question so many are focused intently on.
        If there are five to ten cases of viral pneumonia for every death, with most of them walking out of the hospital eventually, this may well not be revealing the true mortality rate, if many of those pneumonia patients have suffered harm which has drastically shortened their life…which I believe will turn out to be the case for people who have viral pneumonia for an extended period but eventually recover enough to be released from the hospital, and declared cured or resolved. Many of these people may be dead within a year or two, or whatever time period one may consider.
        Some diseases damage a person permanently in a life shortening way, although they will likely die from something else down the road and not pneumonia or a lung ailment.

        • Nick: Glad to hear someone here is interested in wanting to know what drugs work – rather than believing they work or don’t work because of what the President or liberal media say. Try reading original sources whenever possible which can often be found by searching google scholar even when published in journals with a paywall. And have some faith in the experts who are advising or making decisions. It a crisis like this one, they may not make all of the correct decisions, but they do have informed reasons for choosing one course over another. You can’t say that for the president or his critics.

          The article from the Brazilian doctors was extremely informative. Normally a new drug is shown to have efficacy (and safety in some animal model before it is tried on humans). However any doctor can prescribe an approved drug (ie one believed to be safe enough to use for some condition) for any condition he sees fit (but drug companies are not allowed to encourage the doctor to do so for a new condition by advertising). Normally a drug is tested in a double-blind clinical trial against a placebo – something the French and Chinese doctors didn’t do before publicizing the use of chloroquinine. However, once there is a drug assumed to be useful for treating a disease, it is unethical to conduct a clinical trial and give half of the patients a placebo. The Brazilian doctors cleverly avoided this problem by doing a trial with the same dose of chloroquine as used by others, but for a slightly longer period, and added a comparator arm with a lower dose. This allowed them to unambiguously demonstrate that the high dose of chloroquine had safety issues.

          Those seeking to develop a new antibiotic must run double blind clinical trial using an existing antibiotic (not a placebo) as a control, because it would be unethical to withhold a useful treatment from any patient. A new antibiotic can be approved by being as good as an existing antibiotic because resistance is making many antibiotics less effective. Unfortunately, a new (expensive) antibiotic has trouble competing against a cheap older treatment unless no older drugs work for a patient and it takes a few days for lab work to demonstrate efficacy against an infecting antibiotic.

          In the case of COVID-19, if chloroquine is assumed to be useful, a clinical trial that tested remdesivir against placebo would be unethical, because that would be withholding useful treatment from a patient. So by prematurely and widely publicizing (and now politicizing) the use of chloroquine, every new clinical trial might need to use chloroquine instead of placebo as the control. This is complicating the scientific challenge of learning what treatments are effective.

  83. Per the epidemio pdf, the interim clinical guidance for adult dose for confirmed mild to severe covid-19 is hydroxychloroquine 400 mg at diagnosis, 400 mg 12 h later and 200 mg BID [means twice a day] on days 2-5. Because of the long elimination half-life of the drug (32–50 days), the duration of treatment should not exceed 5 days.

    Critical cases (on ventilator) use Remdesivir instead.

    Chloroquine is different stuff with worse side effects and different dosage.

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