Guest post by Alec Rawls
For weeks Dr. Anthony Fauci has dismissed all of the mounting evidence for the efficacy of Hydroxychloroquine treatments for Covid-19 as “anecdotal” and “the slightest hint of evidence” because it doesn’t come from clinically controlled trials. That is just wrong. Valid statistics do need a control group but the control does not have to be clinical.
New York alone has recently amassed many thousands of case histories of Corona patients who were given various HCQ treatments (HCQ plus zinc and/or Azithromycin in various dosages) as doctors swapped information about what seemed to be working. Despite the lack of a clinical control group (doctors are not withholding what they estimate to be the best medicine from half of their gravely ill patients), there still is a massive control group in place: the hundreds of thousands of case histories of Corona patients all around the world who never received any Hydroxy treatments.
The outcomes from large samples of both groups just need to be tallied and the statistical significance of the difference in mortality will far exceed what could ever be achieved through clinical trials (unless the CDC is planning on killing an awful lot of people by withholding already known to be life-saving medicine from them).
But Dr. Fauci has no plans to look at this huge body of field data. He plans to wait instead until clinically controlled trials are completed sometime this summer. From April 9th:
It’ll probably be months, sometime in the summer—we’ll start to see which are working, which are not and to focus on those that are we developing and will work.
Forget the fantastic progress that hundreds of doctors working feverishly on thousands of patients have already made in discovering “which [treatments] are working and which are not.” What’s the hurry? We’ll just re-invent the wheel.
Denigration of trials that use non-clinical controls is a 180° turn for Dr. Fauci
It turns out that Dr. Fauci knows as well as anybody that non-clinical control groups support perfectly valid statistical evidence because his own career-making medical research was entirely dependent on historic controls (comparing his treatment outcomes to historic mortality rates), with no clinical control groups ever involved.
This bit of Fauci history was mentioned by Dr. Stephen Smith in an interview with Laura Ingraham on April 6th. Ingraham asks what Dr. Smith thinks about Fauci’s skepticism and he responds:
What he’s saying Laura is that we don’t have randomized controls of the trials and that’s true but we have plenty of diseases including the disease that doctor Wolff and Dr. Fauci [unintelligible] got famous for: Wegner’s Granulomatosis. They developed a treatment for it in the 70s and 80s that saved lives. But if memory serves their article in Annals and their article in 1973, Annals [was] in 1983 I believe, they didn’t use, it was not randomized, it was not controlled. They didn’t even have contemporaneous controls, they used historical controls, and I’m not blaming them. I believe they did great work and that the treatment DID work.
But we use the data we have, and then we build up on experience. Now the experience that we have had treating patients with a combination of Hydroxychloroquine and Azithromycin is that the data accumulated, and if you get to it, the more you are on it, the lower your chances of being intubated or being on a ventilator are. Those are observational data but very very powerful data.
Dr. Smith is right, Fauci’s own medical research is rife with non-clinical controls
Here is a 1973 article that Dr. Fauci wrote on Wegman’s Granulomatosis with a Dr. Wolff (abstract, full text):
FAUCI AS, WOLFF SM. Wegener’s granulomatosis: studies in eighteen patients and a review of the literature. Medicine (Baltimore). 1973;52:535-61.
On p. 551 they use a pair of past studies to establish a baseline mortality for the disease they are trying to treat:
They found that the average time of survival of these patients was 12 ½ months as compared with the untreated patients in Walton’s review (106) where survival was 5 months.
106. Walton. E.W.: Giant-cell granuloma of the respiratory tract (Wegener’s granulomatosis). Brit. Med. J., 2: 265. 1958.
Ten years later in January of 1983 The Annals of Internal Medicine published another Fauci-Wolff study (abstract; full text):
Wegener’s Granulomatosis: Prospective Clinical and Therapeutic Experience With 85 Patients for 21 Years
ANTHONY S. FAUCI, M.D.; BARTON F. HAYNES, M.D.; PAUL KATZ, M.D.; SHELDON M. WOLFF, M.D.
For the mortality of an untreated control Fauci, Wolff et al. cite in this 1983 paper the same Walton review article they cited in their 1973 paper:
The mean survival of untreated Wegener’s granulomatosis was 5 months with 82% of patients dying within 1 year, and more than 90% of patients dying within 2 years (9).
9. WALTON EW. Giant-cell granuloma of the respiratory tract (Wegener’s granulomatosis). Br Med J. 1958;2:265-70.
Of course using a historical control is perfectly sound science. It is just 180 degrees opposite from what Fauci is for some reason insisting today, and the change is definitely recent.
Googling Fauci “historical control” also brings up from the New England Journal of Medicine a November 4th 2016 Fauci etal. abstract that concludes:
VRC01 slightly delayed plasma viral rebound in the trial participants, as compared with historical controls, but it did not maintain viral suppression by week 8.
So at least until November 2016 Fauci was fine with historical controls.
The CDC and Fauci’s NIAID are shirking their immediate responsibility to tally the massive existing field trial evidence
Dr. Fauci’s pretense that non-clinically controlled trials are unscientific keeps our public health bureaucracies from taking up their most immediate responsibility. Fauci is the head of the National Institute of Allergy and Infectious Diseases (NIAID). His group and the CDC are the ones who ought to sending a small part of their large federal workforces to New York and around the country to compile the massive number of existing case-histories into a data set that can be analyzed.
From the CDC’s mission statement page:
CDC in the 21st Century – confronting global disease threats through advanced computing and lab analysis of huge amounts of data to quickly find solutions.
Except they are not interested in collecting the already existing data that can quickly provide an accurate assessment of how much the HCQ treatments lower mortality for at-risk patients. Their official position under the guidance of Fauci et al. is that real-world data isn’t good enough to bother with. Instead they will wait until they can generate their own clinical data.
Listen to CDC chief Dr. Robert Redfield dismiss evidence from field trials about the effectiveness of HCQ treatments (at 1:10 here):
Yeah, I’m not going to recommend it and I’m not going to not recommend it. I think that you and I are very similar. We’re probably similar to my friend, Dr. Fauci. We-we-we we’re very comfortable to responding when we have data.
He is following Fauci, refusing to regard field trials as having statistical significance. Because field controls are not clinical they supposedly produce no “data.” These are the heads of the two bureaucracies that need to be out processing this data and they both at least claim to believe that real-world data isn’t actually data.
We might have a substitute for social distancing in eight days
In his initial interview Dr. Smith spoke to this perverse phenomenon of health bureaucrats badmouthing the attempts of doctors in the trenches to tell each other and the world what is working for them. Instead these agencies ought to be coming in to collect and process the field data for themselves.
Here is what Smith said about Fauci denigrating the early French study as “anecdote”:
The French had the virologic study first. I think that was March 17 maybe? They showed that if you used these two drugs together [HCQ + Azithromycin] the patients stopped shedding virus, or cleared virus, by day six. American researchers — I’m a private practicing I.D. Doc [Infectious Disease] — If American researchers were worried about that [about the validity of the French findings] they could come up here to New Jersey and have that study done in eight days. I don’t understand the hand ringing. I don’t understand the hesitation. If you’re worried about getting studies done, do them.
Yes, and if steep drops in the level and duration of viral load is borne out it means we have a way to dramatically lower Corona transmission rates independent of social distancing and economic shut-down. Just ask everyone who gets flu-like symptoms to drive through for a Corona test and if they come up positive give them 5 days of Hydroxy and zinc, then we can all get back to our normal lives tomorrow.
But getting this crucial information in eight days doesn’t interest the CDC and NIAID. They only consider clinically controlled trials to be meaningful (at least since November 2016), so they aren’t going out and running virology tests on patients in the field. Neither are they collecting the existing patient data from Dr. Smith’s practice and a hundred other New York area practices and a thousand other practices around the country. What actually happens in the world is not evidence as far as they are concerned.
Doctors in the trenches are doing what bits they can of the data analysis that our AWOL CDC and NIAID should be doing
With Fauci and Redfield refusing to let NIAID and CDC do their jobs it gets left to the overworked doctors in the trenches to tally the small chunks of data from their own practices, yet even those small chunks of data show great therapeutic efficacy of strong statistical significance.
Smith says that his treatment results can be analyzed as an inter-cohort control. Out of 72 very sick patients the 20 who he had to put on ventilators had all been on Hydroxy treatments for two days or less. None of the patients who had done a full five day treatment went on a ventilator. His amateur statistician sons tell him the probability of that result being chance instead of a product of the treatment is “point zero, zero, zero, something.”
Assuming the CDC would want a more professional estimate Dr. Smith invites the CDC to come do its job and analyze his data for themselves.
“Point zero, zero, zero something” is pretty good but the CDC could really drive the uncertainty down by pulling together the case histories from hundreds of such practices.
Dr. Zelenko, an hour to the north of Dr. Smith, is up to 911 patients. As part of his ongoing effort to get the word out about the success he is having with his HCQ + Azithromycin + zinc Coronavirus treatments he tallied his own numbers in this April 4th YouTube video:
Zelenko (at 12:20): Now let’s do some statistics. Depending on which country you look at the mortality rate in the high risk patients is between five and ten percent. We’re an advanced country so let’s take the lower number of 5%. Out of those 350 patients [the number of Zelenko’s patients who he categorized as high risk] we statistically should have seen 17 dead people and a multiple of that on respirators. What did I see? Zero dead people and only three people on the respirator.
Set aside the exact statistical significance of that finding. If a full tally of all the case histories in all the practices in the New York area show similar reductions in mortality and morbidity the statistical significance/certainty of that finding will be extreme. Get it done. In the meantime Zelenko’s quick and dirty estimate is telling in itself.
Is a well controlled 1061 patient sample still “anecdote”?
Doctor Didier Raoult, the French doctor who Fauci originally discounted for running a small non-clinically controlled trial, just released a larger non-clinically controlled trial. For his control group Raoult used “patients treated with other regimens both at IHU and in all Marseille public hospitals,” which is a lot closer to Raoult’s treated-patient population than the control that Fauci used for his own research.
Raoult’s new trial involved 1061 patients and examined the effects of early intervention. His conclusion:
The HCQ-AZ combination, when started immediately after diagnosis, is a safe and efficient treatment for COVID-19, with a mortality rate of 0.5%, in elderly patients. It avoids worsening and clears virus persistence and contagiosity in most cases.
That’s the Case Fatality Rate, not the Infection Fatality rate, which is probably an order of magnitude lower. IFR for a normal flu is about .1% so the IFR of Corona when Raoult’s treatment is used should be about half that, and that is in elderly patients who have the highest Corona fatality rates.
Clinical trials don’t even know what to look at without field experience on what works
Some doctors, like Dr. Cardillo in Los Angeles, are finding that HCQ treatments are more effective with the zinc. Is the CDC planning to drag out its clinical trials by running separate trials for all the different drug combinations and dosages being tested now by doctors in the field?
They should do that, just don’t make us wait for it. Tally the field data now. It already exists and is perfectly adequately controlled and it has the numbers to yield a high level of statistical certainty.
The CDC and NIAID need to do their jobs and get on this. It is dereliction of duty that data compilation and analysis is being left for doctors in the trenches to pick up piecemeal.
For whatever reason Fauci and Redfield don’t want to analyze real world data. They need to be fired (if not court-martialed, to employ President Trump’s war metaphor) and replaced by people who will get the job done instead of blocking the job from getting done.
Only a very dishonest person can pretend that statistics are not valid unless they are based on clinical controls, which makes it not so surprising that the leading proponent of this claim is someone who professed the exact opposite until November 2016.
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As a retired MD researcher I couldn’t agree more. Though RCTs are the gold standard, often drugs are approved using alternative study designs, particularly for life threatening conditions. Real world data on thousands of treated and untreated patients having the same clinical severity ratings are readily available today, and the question could be answered in 1 week, with very high confidence. Fauci doesn’t want that for whatever reason, he should be sacked yesterday.
https://wattsupwiththat.com/daily-coronavirus-covid-19-data-graph-page/ and no mention of Sweden metrics exactly the same as countries with extreme lockdowns
In the news this am the US emergency management agency says they have 20 million doses of HCQ available. Also this am the US avation authority FAA have ruled that pilots are prohibited from flying for 48 hours after taking HCQ. Seems inconsistent yet both agencies report to Pres. Trump. Odd that a drug on the market for 60 or so years should just now fall under the eagle eyes of the same agency that blessed the Boeing MAX.
Presumably the previously wasn’t much chance of pilots flying after taking HCQ (how many pilots suffering from Malaria are there each year? not many I suspect), so not much need for the ruling before.
Also remember, the FAA, like most government agencies, are run by deep state bureaucrats. They don’t always agree with Trump nor rule I ways Trump would agree with (ever notice how many tweets Trump has made railing against deep state bureaucrats at agencies within the Executive branch). Trump maybe in charge of the executive branch, but he’s had to battle the deep state bureaucrats at the various agencies within the executive branch every step of the way. It’s not called the deep state for nothing.
From what I have read, HCQ is no longer much use for Malaria but still taken for Lupus and RA. Odds are there are pilots flying with a touch of RA. Wikipedia says “This (having RA) is between 0.5 and 1% of adults in the developed world..” The lady at the FAA who issued this rule got the job in 2012.
This whole thing smells of the “deep state” and political bias issues that you mention. To me it also illustrates the opportunistic even cancerous overlapping growth of bureaucracy equipped with excessive funding. I don’t know if the FAA has a SWAT team, or a division of them, but I’m willing to bet they do. In this case the FAA are making rulings outside their lane. They should look after Avation (doing a crappy job recently) the center letter in their name. The FDA should be issuing Drug rules; Drugs are the center letter in their name.
Pilots with RA already have other hoops to jump through to get permission to fly.
Wes
Well, one difference is that HCQ has much more public visibility than at any time in its history. Inasmuch as the typical malarial treatment is one pill a week, it shouldn’t be much of an inconvenience to wait 48 hours to see if the known issues of mood changes or suicidal thoughts manifest in the pilots before allowing them to fly. The FAA may just be 60 years late in taking prudent measures. What do you expect from a federal bureaucracy?
The report actually says that the FAA has long had a ban on flying within 48 hours after taking either of the malaria drugs.
I wonder if Fauci is deliberately misleading us.
At the beginning of the epidemic, faced with a looming face mask shortage, the authorities lied and told us that face masks weren’t necessary. link
Is Fauci trying to prevent a run on quinine?
Very interesting commieBob.
I always thought it was strange the medical personnel were wearing them but they were of no use to us plebes.
Possibly so. I suspect many hospital staff are taking it as a prophylactic.
icisil
On what do you base your suspicion? Speculation is not the same as evidence. That’s like saying global warming could, may, might, or possibly have catastrophic effects.
I don’t know what my suspicion is based on. Just a suspicion. Maybe it’s because I have a good idea how people think and the way the world works.
The bioavailability of zinc is best when delivered as a chelate, e.g. ZMA zinc aspartate. It also contains magnesium aspartate.
William
Why are the cold lozenges made of zinc gluconate?
The best is zinc acetate. Minimum 75 mg per day (for only a few days). Other zinc forms and lesser doses weren’t as effective. There’s a scientific study that determined all that. You could probably easily find it based on the words I provided. Good luck finding zinc acetate now, though. Every place I’ve found is sold out.
Doing double-blind control drug tests for life-threatening diseases is immoral because it forces doctors to play god by arbitrarily deciding who may live or who may die…
If researchers wish to double-blind test new hair-growth medication, fine… the control group just loses some hair, not their lives…
There is plenty of historic data to compare a new drug’s efficacy by comparing it other therapies that didn’t include the new drug, with very high statistical relevance..
Ending double-blind testing for life-saving drugs is now being debated by the FDA, as it should be.
A statement, Dr. Raoult made in his first study too, no control group without treatment, when live is in question.
Don’t understand someone may have the idea of doubble-blind studies in cases like this.
“Ending double-blind testing for life-saving drugs is now being debated by the FDA, as it should be.”
Fake news, thank God.
re: “Fake news, thank God.”
Thank you, Loydo, I mean Nicholas McGinley. That forced me to do a little searching, in which I found the following article:
“FDA SUGGESTS AVOIDING DOUBLE BLIND, RANDOMIZED CLINICAL TRIALS USING A PLACEBO FOR CERTAIN TYPES OF DEVELOPMENT PROGRAMS”
https://www.wepclinical.com/fda-suggests-avoiding-double-blind-randomized-clinical-trials-using-a-placebo-for-certain-types-of-development-programs/
The FDA doc the article links to:
“Placebos and Blinding in Randomized Controlled Cancer Clinical Trials for Drug and Biological Products Guidance for Industry”
AUGUST 2019
https://www.fda.gov/regulatory-information/search-fda-guidance-documents/placebos-and-blinding-randomized-controlled-cancer-clinical-trials-drug-and-biological-products
Thank you again, Loy -er- Nicholas McGinley for the inspiration to pursue this.
.
Jim,
The man with the reading comprehension of an exceptionally stupid turnip, thinks these two sentences are equivalent:
“Now” and “September 8th, 2018”
“Ending double-blind testing for life-saving drugs is now being debated by the FDA”
…and…
“Placebos, defined as inert substances with no pharmacologic activity, are commonly used in
double-blind, randomized controlled clinical trials. Blinding investigators and patients in these trials to the treatment patients are receiving decreases the likelihood of biased observations of the effectiveness outcomes, may decrease differential patient drop out, and allows for unbiased observation of outcome measures, which are particularly important when the assessment includes subjective endpoints. For example, a placebo-controlled study design may be useful or preferred in maintenance therapy, in add-on trial designs, in trials of adjuvant therapies (for which standard of care is surveillance), and for indications where no treatment is available (best supportive care can be added to both arms to ensure all available care is provided to patients).”
Did you even read what you posted, Jimbo?
I sincerely doubt it, since it is clear the statement by Whiten was wrong, as stated.
They never debated anything of the sort.
The question was regarding a specific circumstance where it is already considered unethical to use placebos (a deadly disease for which treatments exist), and during which it will be very obvious to everyone who gets a placebo…namely in trials for treatments for “certain malignant hematologic and oncologic diseases.”
Got that?
In trials for new drugs for treating cancers, everyone will know who gets the placebo because they are the ones not throwing up and do not have their hair falling out.
The second document (thanks for that) is the final guidelines. There is no debate. The questions are settled, and guidance issued.
It is more of a clarification than anything else.
It is already unethical to use placebos for “hematologic malignancy and oncologic disease” for which treatments are available.
And everyone knows who gets a chemo drug and who gets saline, because chemo patients typically start throwing up immediately and stuff like that, so blinding makes no sense anyway.
There was never any question about ending all such studies for any life saving drugs…only when there are already treatments available, and particularly when the condition is a cancer or leukemia. IOW, the people are gonna die soon.
They are clarifying when placebos are unethical.
There are other such situations, such as with vaccines. But it was particularly addressing new cancer drugs in cases where their are existing treatments.
In which case you compare the study drug to the existing treatment.
But you have to read the documents to understand any of this.
No one is debating ending double blind placebo controlled clinical trials for any drugs that might be “life saving”.
As usual you have no idea what on Earth you are talking about.
Maybe if you learn to read one of these days you will stop embarrassing yourself.
Better yet, stop talking about subjects of which you know less than nothing.
Of course, I cannot call you by your full name, because no one has any idea who you are, being that you cravenly hide your identity.
But you go ahead and keep mentioning my name.
I am gonna be right here and everyone knows who I am.
I will be demanding a full apology quite soon, and an admission from you that you were completely wrong and said things that may well have gotten Lord only knows how many people k!lled in this pandemic.
If, that is, anyone was stupid enough to pay one single bit of attention to medical advice from someone named “-Jim”, who knows less about health matters than my least intelligent cat.
That’s exact the question we are talking about, not more, not less.
What ever your name is, I hope nobody takes your statements for in any way serious.
I am not the one cowering like a frightened kitten behind a pseudonym, Krishna.
Krishna,
I was actually reading his posts until he tried to make a point by saying zinc is the most abundant metal …
Then said opps … meant it in this manner …
which more supported an argument agin his point.
Most abundant trace metal Don.
Sorry I left a word out of one post, but in many others I did not omit the word.
I am heartbroken you have deserted me.
You see Don, I am not presenting a point of view by excluding contrary information.
Soon enough, we will have results from many trials and huge numbers of people at all stages of illness.
I am very confident I will be holding my head high no matter what the results show, and I am also sure many here will not be able to run from the fact they made many many false assurances that were so proven to be ill advised and poorly informed.
I will challenge you to go back and find any statements I have made that were poorly supported or declared I knew anything which was not supportable any evidence.
If you want to point to one post out of hundreds and hundreds of lost posts in which I omitted a word, I can show you others before and since that one, made right here, in which I did not omit that one word.
So here you are, criticizing me for one sentence, and supporting people who have made long lists of factually incorrect assertions over and over again.
Good judgement, bud.
For most drugs, the efficacy is rather low. It doesn’t matter much which group you’re in. Where there are early signs of high efficacy, the trial will be terminated and both groups will be treated.
Samurai
You raise an interesting point. But, what would you recommend as an alternative to prove that the trial drug actually works, rather than it being coincidence or the well-known placebo effect? What if efficacy is assumed when unwarranted, and people die with treatment from something that is ineffective? What if something is found through double-blind testing that is far better than the assumed effective treatment, and over the long run more lives are saved with the new treatment? Isn’t it immoral to allow people to die because unwarranted assumptions are made from a poor study-protocol?
You said, “There is plenty of historic data to compare a new drug’s efficacy by comparing it other therapies that didn’t include the new drug, with very high statistical relevance.” Isn’t that functionally equivalent to having a control group that is not taking the new drug of unknown efficacy? That is, if there is an existing treatment that has some success, but those given the proposed new drug are denied the old treatment, isn’t that “playing God?” How do you propose finding the most effective treatment out of the 60 some being tried without withholding the ultimate winner from those taking the other 59 treatments?
Even with clinical trial results, once a drug is approved, the actual use in practice will trump (pun) their clinical trials. Scan the list of withdrawn drugs and note those that were withdrawn because of serious outcomes that were not “flushed out” during the clinical trials.
https://en.wikipedia.org/wiki/List_of_withdrawn_drugs
The short version of why they were approved and later failed during use stems from not having sufficient number of patients in the trials to uncover the “other effects” of a drug. It’s like testing a teenager at home then releasing them out, unsupervised, on the world (just kidding) but only through clinical treatments can the other effects, if any, be discovered.
The point is a clinical trial of, say, 4,000 patients, sliced and diced, only point to the safety of the group selected whereas clinical treatments of 10,000+ patients and their outcomes is the final arbiter.
Hydroxychroloquine has passed the treatment trials – the amount of this drug taken worldwide since it’s approval is measured literally in tons.
Plus, it’s used not only for malaria treatment but for prevention and even off label in oncology. Millions of clinical treatment doses. Any critical thinker should conclude that Dr. Fauci has an agenda. A very dangerous agenda during a crisis and should be removed. Even if he has no agenda (ignoring his I love you Hillary emails, etc.) he should be considered a befuddled thinker and not a treatment doctor.
“Global Health Leaders Launch Decade of Vaccines Collaboration | Bill & Melinda Gates Foundation”
https://www.gatesfoundation.org/Media-Center/Press-Releases/2010/12/Global-Health-Leaders-Launch-Decade-of-Vaccines-Collaboration
Conflict of interests…?
For weeks Dr. Anthony Fauci has dismissed all of the mounting evidence for the efficacy of Hydroxychloroquine treatments for Covid-19 as “anecdotal” and “the slightest hint of evidence” because it doesn’t come from clinically controlled trials.
——————————-
The criminal intent of the Faucis of this world, the incompetent gutless moronic minority dictating the medical health care response globally, by utilizing and abhorring the same logic-rationale towards
antibody test, by causing unnecessary delay, which actually leads to increased aggressivity response of all other programs.
There is no excuse or justification for unfounded delays in consideration of the antibody tests.
It is already too far delayed;
already a lot of unfounded and unbearable damages from such very highly aggressive response to COVID-19… due to such delays.
The antibody test should have being there since the first moment and already applied hand to hand with the other tests and by now should have overtaken the other tests and other monitoring programs.
Further delay simply will support further harsher aggressive responses,
where the claim that delaying because it will help with herd mentality and keep the trust of the herd with the “authority” in this case, will simply be counterproductive and at some point backfiring badly.
Silly nit-picking towards the antibody test, like in the case of Hydroxychloroquine, has only one objective;
delaying it as much as possible.
In life is the efficiency of antibody response to a disease that keeps immune system from going full tilt aggressive and killing you, or causing too much harm… where timing is of paramount importance.
Same parallel here in consideration of antibody test versus the response programs contemplated and applied… time is of paramount importance, where time lost may not ever be recovered.
In concept and principle, antibody test is easier and simpler than other tests…but still not properly applied yet… where in the case of high and deep responses, like for COVID-19,
is very very much needed… with it’s own fully functional and well established platform…
As else the response will be blindfolded and in full “darkness”, where many programs will end up to be too aggressive and resembling a “whack a mole” game… and very dangerous.
cheers
Trump has the necessary information to send everybody back to work tomorrow. He can easily have his people devise a treatment strategy for workers who get sick and for a prophylactic strategy for their co-workers. Some localities may have to be temporarily exempted and certain governors will have to be dealt with. The under 65 workforce may experience some sickness but few or no deaths. The MSM will howl loudly, but so what?
I don’t think you can say no deaths. Just for a point of reference, of the 45 or so cases in my county all but 4 where in the 60+ age range (so close to 10%). only one was below the age of 50 (she was in her 30s according to the country reports).
In other words 10% of the current death rate for the under 60 crowd of 2% for the under 50 crowd. That’s still means a good sized number of deaths when you are talking a work force measured in the millions.
So a “few”, but by no means no, deaths would certainly be expected (at a minimum) assuming a work force of only the under 60 crowd, even fewer for an under 50 workforce The workforce however, does not only consist of those under 50 or 60. There are many 65+ workers still in the workforce. And the younger members of the workforce are not immune from getting the worst of it, particularly for those with underlying conditions (which people can have at any age), not to mention the possibility for the younger workers to bring the virus back home to their older relatives.
So yes, the workforce could be sent back to work tomorrow, the only question is how much death that would bring with it (and it’s not as simple an answer as you seem to think, nor as small a number as you seem to think it certainly wouldn’t be the “no deaths” you posit as a possibility).
It seems reasonable to expect that Fauci, along with the media’s support, was responsible for X number of deaths.
E.Martin
April 15, 2020 at 6:22 am
Not necessary in consideration of COVID-19 disease itself,
and that is and happens to the most ugly thing there…
the unnecessary Xtra harm and pain… inflicted due to this crazy pressure from all sides lead and achieved by people like Fauci, organizations like W.H.O and UN, and further supported by certain political and industrial affiliations.
cheers
Are French national health officials now recommending the CHQ-AZ treatment? If not, why not?
They did.
In addition to the ever growing list of countries that are warning of fatalities from the malaria drugs and Zpak, and new clinical trial of 150 patients shows no signal of efficacy and a large number of adverse events.
Ample warnings are emerging, and yet people who are not paying any attention to the growing chorus of warnings continue to hype a dangerous experimental treatment.
“When testing new treatments, we are looking for signals that show that they might be effective before proceeding to larger studies,” said Allen Cheng, an infectious diseases physician and a professor of epidemiology at Melbourne’s Monash University. “This study doesn’t show any signal, so it is probably unlikely that it will be of clinical benefit.”
https://www.medrxiv.org/content/10.1101/2020.04.10.20060558v1
Because it is showing to be dangerous and increasingly clear to have little if any benefit.
https://www.msn.com/en-us/health/other/hyped-malaria-pill-doesn-t-help-clear-coronavirus-in-study/ar-BB12EEbv?ocid=msedgntp
And a large number of harms are occurring, including many de@ths.
Wake up.
Before we hand November to the socialists.
McGinley – a new name for “short-circuited Brain syndrome”?
I think you are safely settling into the background noise, Nicholas, like a milder case of Loydo.
“Despite a lack of evidence on efficacy, HCQ and HCQ+AZM have become the most popular treatment/s
for COVID-19. This is the largest ever analysis of the safety of such treatments worldwide, examining over
900,000 HCQ and more than 300,000 HCQ+AZM users respectively.
The results on the risk of SAEs associated with short-term (1 month) HCQ treatment as proposed for
COVID-19 therapy are reassuring, with no excess risk of any of the considered safety outcomes compared
to an equivalent therapy (SSZ). However, long-term treatment with HCQ as used for RA is associated with
a 65% increase in cardiovascular mortality.”
https://www.medrxiv.org/content/10.1101/2020.04.08.20054551v1.full.pdf
From the study:
Where is your problem ?
It’s written in the study that the treatments went over two weeks, short enough ?
HCQ as treament
Jim
Are you capable of engaging in adult-like dialog without insulting those you disagree with? You are settling into my “background noise” precisely because you have demonstrated more talent for juvenile insults than objective discourse on what are obviously contentious subjects. Ad hominem attacks add nothing to the dialog.
What I read was a newspaper pamphlet bcause of Trump, nothing about more letal victims, some little harmless side effects. Do you have a lecture problem ? Btw, the article refers to the study you linked before.
The protocoll of Raouls treatment wasn’t followed.
Because he is a quack and that combination is very dangerous.
re: “Because he is a quack and that combination is very dangerous.”
Yes, a quack. And also a French physician and microbiologist holding M.D. and Ph.D. degrees and specializing in infectious diseases. In 1984, Raoult created the Rickettsia Unit at Aix-Marseille University (AMU). He teaches infectious diseases in the Faculty of Medicine of Aix-Marseille University and since 1982 has supervised many M.D. and Ph.D. degrees.
Since 2008, Dr. Raoult has been the director of the Research Unit in Infectious and Tropical Emergent Diseases), collaborating with CNRS (National Center for the Scientific Research), IRD (Research for the Development Institute), INSERM (National Institute of Health and Medical Research) and the Aix Marseille University, in Marseille. His laboratory employs more than 200 people, including 86 researchers who publish between 250 and 350 papers per year and have produced more than 50 patents. Raoult has also been involved in the creation of eight startups.
I think that about does it for Nicholas McGinley’s credibility, perhaps even less than duck soup now?
.
Aaand another one:
“Michigan Medicine just changed its guidelines on prescribing these drugs. There’s a lot of excitement about whether these already existing options for malaria could be useful in COVID-19, but so far that excitement hasn’t materialized in patient care data.
“Our infectious disease division and our antimicrobial pharmacists have reviewed all the available data and we found no convincing evidence that these drugs were effective in treating people with COVID-19,” Kaul says.
That’s consistent with what’s been observed firsthand in Michigan Medicine’s hospitals.
“We haven’t seen any clear evidence of benefit so we aren’t going to use hydroxychloroquine routinely anymore,” Chopra says. “We were initially recommending it to both inpatients and outpatients, but we’re no longer doing that routinely. That’s based upon the fact that we’ve been prescribing hydroxychloroquine for a few weeks, did not see therapeutic benefit, but did see adverse effects.””
https://labblog.uofmhealth.org/rounds/chloroquine-ibuprofen-and-beyond-doctors-discuss-latest-treatments-and-treatment-rumors-for
Oh, BTW…have you begun drafting your apology?
I think I am really gonna have to insist on some groveling.
Out of the _Jim link:
😀 😀
Now I found, why he isn’t liked from certain media 😀 😀
You read about the mentioned contra-indications in Raoults paper ?
What you linked wasn’t a study.
Jim you wrote, “I think that about does it for Nicholas McGinley’s credibility, perhaps even less than duck soup now?”
“I think that about does it for Nicholas McGinley’s credibility, perhaps even less than bat soup now?”
There, fixed!
He is a quack ? 😀 😀 😀
And you, what are you ?
I’ll better be silent about 😀
I am not a doctor, offer no medical advice, and do not claim to have “the cure” with very weak evidence to back it up, while refusing to follow standards of medical reportage, like he does.
A quack is a doctor like Raoul.
If someone who is not a doctor can be a quack, try looking in a mirror.
You rewrite the textbook on viral pharmacology on a daily basis.
““Worryingly, significant risks are identified for combination users of HCQ+AZM even in the short-term as proposed for COVID19 management, with a 15-20 percent increased risk of angina/chest pain and heart failure, and a two-fold risk of cardiovascular mortality in the first month of treatment,” said the report, according to Science Translational Medicine.
In France, where the initial buzz started about treating COVID-19 with a combination of antimalarial drugs and azithromycin, data released by the country’s drug safety agency showed 43 cases of heart incidents linked to hydroxychloroquine, highlighting the risk of providing unproven treatments to COVID-19 patients, as The Hill reported.”
https://www.nationofchange.org/2020/04/15/drugs-touted-by-trump-for-covid-19-increase-heart-risks-studies-find/
You caan’t read ??
Out of your pamphlet linked:
They talk about chloroquine, something completely different.
Krishna
How do you define “completely different?” They are both synthetic drugs based on quinine, developed to prevent malaria. The general assumptions are that they have similar toxicities in animal studies.
If I follow the thread here I see, these are completely different drugs, with different side effects, with different doses, HCQ was developed for better tolerance than CQ. That both are based quinine says nothing. Take Chinosol or Neo-Chinoseol, both are only for external use, but in case of N-CL for gargling, nothing happens if you swallow it.
Krishna Gans April 15, 2020 at 10:01 am
You caan’t read ??
Out of your pamphlet linked:
Yes he can, the French study he referred to in that article was about Hydroxychloroquine, it also referred to the Brazilian study of Chloroquine but Nicholas didn’t mention it.
There seems to be something to it. Whether and how it should be used are key questions. Form your link, “The drug did help alleviate some clinical symptoms of Covid-19, however, and the patients who took it showed a greater drop in C-reactive protein, a measure of inflammation.”
There are far safer drugs that reduce inflammation and provide immunomodulation.
No one hinders you to use vitamine C as much as you want, start with 3 g daily 😀
Add curcumin together with black pepper, don’t forget ginger and argil.
No, I don’t tease you, seriously !
Wait until the longer post that is in moderation is posted.
Countries now warning about adverse events, deaths, halted trials, cessation of usage due to dangerous side effects, ect, is longer and growing dailt.
China, Brazil, Sweden, Germany, France, Denmark.
Agencies in the US warning not to use:
FAA has warned pilots are not allowed to fly within 48 hours of taking either drug.
CIA has advised against using it to all of it’s people.
I have a question: What number of deaths due to following your advice are you willing to accept before you admit you were wrong?
“ect”
You should see a doctor about that.
I have top men working on it.
“Really,” Jeff?
Why is the man supposed to “see” a doctor about a medical procedure that’s “only” done when you “see” a doctor?!?
What are you saying, Jeff, and “why” are you saying it?!?
https://www.psychiatry.org/patients-families/ect
SYH
How many deaths will you accept not giving HCQ+AZ+ZN ?
Btw, what is your proposal ???
You forget these patients using it over month and years against malaria without suffering any side effect.
What’s about them ????
What I see is a campaign against Trump, the other what I see is the problem, no patent on HCQ and no money in sight.
Speak for yourself.
I have no problems with my memory.
What patients used it over month and years with zero side effects?
Oh, here is another new study.
We should be getting a lot of these now:
https://www.medrxiv.org/content/10.1101/2020.04.10.20060699v1.full.pdf
Requiring O2 – to late, the earlier the better, as symptoms start.
Nicholas McGinley
April 15, 2020 at 12:43 pm
There is nothing “with zero side effects”.
For some, the peanut butter side effect is lethal.
For some a normal antibiotic dose could be lethal.
For some sugar could be lethal.
And so on and so forth.
Everything that has an effect has a side effect, for all.
The point is the pro and cons in consideration of the side effect V the effect.
Well known overall low-small side effects can not and should not block a medical promising treatment even in the case of an expected but not yet validated positive effect… especially in the case of a medical emergency… when all is expected to be managed and handled by the professional medical structure.
cheers
Krishna
You said, “You forget these patients using it over month and years against malaria without suffering any side effect.” The implication of your statement is that it is safe for everyone. It is not! Some people cannot take it.
Lets assume that it is around 1%. That is the same order of magnitude of the elderly who are dying from COVID-19. You don’t want the cure to be as bad as the disease!
Yes, and that why it has to be prescribed, there are known contra indications, and should be used under medical control in case of Corona, including ECG – follow the Raoult protocol.
I only wish I could buy stock in malpractice attorneys at this point.
We are watching the disintegration of judgement and credibility on a scale I have never seen in my life.
If you will lose your money, start buying 😀 😀
I’ll just say it. Fauci knows better. His agenda is more death and economic destruction. His motives are anybody’s guess.
HID
This sort of speculation on a person’s motives, which you have no way of knowing, does not reflect well on you or this blog. If you have evidence to support your claim, present it. Otherwise, I can get all of this kind of unsupported speculation I want from climate alarmists.
Clyde,
Some of us are going to have what we have said vindicated by the results of the many trials now underway, and many will be utterly refuted.
I think we both know who is who.
At some point in the near future, everyone will know who is who.
Dr Fauci and Dr Redfield won’t accept real world data as actual data, then what is real world data and where does it come from.
I think I may have a headache but won’t know until clinically tested under controlled conditions. This may take a year. Or so.
These two should go.
Real world data from France.
New study, just released a few hours ago:
“Abstract
Background
Treatments are urgently needed to prevent respiratory failure and deaths from coronavirus
disease 2019 (COVID-19). Hydroxychloroquine (HCQ) has received worldwide attention
because of positive results from small studies.
Methods
We used data collected from routine care of all adults in 4 French hospitals with documented
SARS-CoV-2 pneumonia and requiring oxygen ≥ 2 L/min to emulate a target trial aimed at
assessing the effectiveness of HCQ at 600 mg/day. The composite primary endpoint was
transfer to intensive care unit (ICU) within 7 days from inclusion and/or death from any
cause. Analyses were adjusted for confounding factors by inverse probability of treatment
weighting.
Results
This study included 181 patients with SARS-CoV-2 pneumonia; 84 received HCQ within
48 hours of admission (HCQ group) and 97 did not (no-HCQ group). Initial severity was well
balanced between the groups. In the weighted analysis, 20.2% patients in the HCQ group
were transferred to the ICU or died within 7 days vs 22.1% in the no-HCQ group (16 vs 21
events, relative risk [RR] 0.91, 95% CI 0.47–1.80). In the HCQ group, 2.8% of the patients
died within 7 days vs 4.6% in the no-HCQ group (3 vs 4 events, RR 0.61, 95% CI 0.13–2.89),
and 27.4% and 24.1%, respectively, developed acute respiratory distress syndrome within 7
days (24 vs 23 events, RR 1.14, 95% CI 0.65–2.00). Eight patients receiving HCQ (9.5%)
experienced electrocardiogram modifications requiring HCQ discontinuation.
Interpretation
These results do not support the use of HCQ in patients hospitalised for documented SARSCoV-2-positive hypoxic pneumonia”
https://www.medrxiv.org/content/10.1101/2020.04.10.20060699v1.full.pdf
To late if the need O2. The earlier the better.
So we should ignore people who say they were about to die but were saved by these drugs?
??
I thought you will us make belive it doesn’t help, so what ??
I never stated “it doesn’t help”.
That is what you hallucinated I said when your brain did not want to accept what I have actually said.
Just like when warmistas hear anyone who is not a rabid warmista, all their brain hears is “denier”.
The fact is you are just making it up as you go at this point.
This assertion from you contradicts nearly everything else that other proponents are saying about the malaria drugs.
But according to you, they should not be given to anyone with serious illness because it is too late?
But the vast majority of people with no serious symptoms will be fine with no treatment.
So what percentage of people are you saying can be helped with this pronouncement?
Only those with no O2 (how you know this is a complete mystery) need bother?
And of those with no serious illness, how many are going to die?
Everyone thinks this number is very low.
At this point, HCQ and zinc proponents are making warmistas look like the most educated people on the planet.
You are using all the same logic and argumentative reasoning.
Fauci also has financial interests in things going one way …
https://jvi.asm.org/content/78/20/11334
I found the last paragraph enlightening.
You mean the Acknowledgements?
Sorry. The information regarding Quercetin in the document.
Here’s more on zinc.
https://res.mdpi.com/d_attachment/nutrients/nutrients-11-02273/article_deploy/nutrients-11-02273.pdf
In Coupeville, WA, there is a small rural hospital (the only non-Naval hospital on Whidbey Island). Over the past month or so they have had ~9 COVID-19 patients, all of them from the local skilled nursing facility – meaning all very elderly.
All but two have recovered enough to be sent back to the SNF. I don’t know what methods they used to treat them, but none have died.
I’m taking 500mg Quercetin, 50mg zinc as a precautionary measure due to age and arthritis issues. The Quercetin and zinc have dramatically helped my arthritis out and have a good supply of Amoxicillin just in case.
Located just south of Boston and do residential/ commercial electrical work.
We are essential and also do work in nursing homes. Not taking chances and let you all know if I contract virus. I’m surprised I haven’t so fat.
john
So far…
What form of zinc supplement are you using? oxide, sulfate, gluconate, etc?
Gluconate
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 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.
7 deaths out of 1061 patients is 0.66%
As of today France has recorded 143,303 confirmed cases and 15,729 deaths.
This is a death rate of 10.98% per confirmed case.
Currently the same random population in France shows a death rate that is 17 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 143,303 confirmed cases which has resulted in the 15,729 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 10.98% of the 1061 patients who took if for the short term of this test. We would expect 10.98% of these patients would be DEAD using the average death rate from the rest of France. What is so difficult to understand between 0.66% and 10.98% 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.
+1000
Fauci:
Moving the goalpost is okay when I do it.
Doctors treating patients and getting good results: Fauci says merely “anecdotal”… (foot-dragging from Fauci)
What we’ve seen from Fauci: inconsistent statements, foot dragging, wildly off projections (models) justifying lock-downs.
Oh, boy, he’s the leader we need… not!
James
I believe that Fauci, as well are many US leaders, is using the model from the University of Washington, considered by most to be the premiere epidemiological modelers in the world.
Epidemiologists are idiots. They never get it right because they’re working from a false paradigm.
Does anyone dare ask what exactly you are claiming is a false paradigm?
The entire field is a fools errand, is that what you are saying?
I believe that we are starting to see the beginning of mass protests against Lockdownds re Michigan This is just the beginning this will become a worldwide movement very soon my 2 cents worth Governments everywhere beware except Sweden!
And Belarus
Is it true we shutdown the country based on Professor Neil Ferguson’s faulty model? Is it true Fauci, et all, based their recommendations based on that model?
Where are the medical ethics in randomized controlled trials, where the outcome of withholding treatment is death? How many other deadly diseases were subject to randomly controlled testing? Did Jenner inoculate half his patients, then not inoculate the other half, to discover a treatment for smallpox?
Sure, if you are looking for a small difference between two modes of treatment, and you have not tie constraints, the controlled trial makes sense because you can ensure that every patient receives nearly identical care. However, even in an environment that is not controlled, if your sample size is large enough, the variance shrinks due to the Law of Large Numbers.
for example: If you have the results of treatments by 2 doctors, they could be widely different. But if you have the results from 2000 doctors, the results will be roughly the same. This effect allows you to construct a controlled trial without actually needing the controls. Let the data size be your control.
The medical profession needs to move away from its fascination with randomized controlled trials when dealing with epidemics. There is simply not enough time available for controlled trials.
What the medical professions should recognize that what we have in epidemics is patients, lots of patients. And it is this volume of patients that can be analysed using “large data” methods to determine the efficacy of treatment alternatives, long before clinical trials can be completed.
Bioethics is at the core of all research into new medications.
Is this really a carefully considered point?
Just look it up.
We hope Willis does an update on the coronavirus data becuause as far as I can see all countries and USA states with or without lockdown are following the same trend. The people of Michigan are starting the first worlwide protests against these stupid lockdowns. Watch them increase exponentially tommorow USA first then worldwide.
Eliza
Actually, there were protests in Columbus (OH) last Thursday that could be heard over the governors press briefing. There were more protests this week. Those people who are losing their incomes, jobs, and businesses are losing patience with the lockdowns. The press hasn’t been saying much about the protests.
The Michigan governor overstepped her bounds with the restrictions she imposed. That’s the reason for the protests.
Seventy-five percent of Americans polled support the social distancing policy.