Many Effects of Hydroxychloroquine against COVID-19

This is a scientific review, published to inform health care professionals and public officials, and for an open peer review. It is not medical advice.

Abstract

Hydroxycholoroquine (HCQ) is effective against COVID-19 in a variety of roles – the main two being antiviral and immunomodulator.  This “silver bullet” effect may have caused confusion between different effects. It is better to start HCQ-based treatment as early as possible.

Introduction

Hydroxycholoroquine (HCQ) has many mechanisms against COVID-19. This diversity of mechanisms may have created confusion, even among medical professionals. Most importantly, HCQ and its combinations are effective antivirals against SARS-CoV-2, the coronavirus causing COVID-19. As all antivirals, HCQ combinations should be taken early, before the virus overwhelms the body. Therefore, and because current COVID-19 tests have a large rate of false negatives, Dr. Zelenko recommends starting an HCQ-based treatment immediately upon suspicion of COVID-19 [1]: “Given the urgency of the situation, I recommend initiating treatment based on clinical suspicion as soon as possible, even without confirmatory testing.”

I can understand the theoretical basis for starting immediately. If common flu is treated with antivirals, the CDC recommends starting within 48 hours of symptoms onset [2]: “treatment is most effective when given as early as possible after symptoms develop, and its effectiveness diminishes markedly after 48 hours.” Those antivirals, like oseltamivir, begin acting immediately upon entering the bloodstream [3]. HCQ, however, is different. It needs to accumulate in the tissues, and that takes time. Thus, there seems to be no 48 hours window. HCQ’s anti-viral effect diminishes with every day that treatment is delayed.

HCQ as anti-viral

HCQ+AZ

The most tested HCQ-based treatment for COVID-19 is HCQ+AZ (Azithromycin). This drug combination treatment is associated with Didier Raoult, head of the Institut Hospitalo-Universitaire Méditerranée Infection (IHU) [4],  [5]. He and his colleagues cited earlier experience of doctors in China. 

The two drugs, HCQ+AZ, are considered synergetic in suppressing the SARS-CoV-2 spike — ACE2 interaction, which the coronavirus uses to enter the cell [5], [6]. These “spikes” make up the crown, or “corona”, which gives this type of virus its name. AZ is also an antibiotic, necessary to protect the body from any opportunistic bacterial infection during treatment.

To suppress the SARS-CoV-2 spike – ACE2 interaction, HCQ must accumulate in the lungs. This process begins when HCQ enters the bloodstream and proceeds slowly from there. This is explained in [7] (on chloroquine):

Drug disposition proceeds in three phases—distribution from blood to tissues, equilibration between blood and tissues, and release from tissues back into blood. These phases have half-lives of 3–8, 40–216 h, and 30–60 days, respectively

The times vary by tissue.

HCQ+Zn+antibiotic

Zinc (Zn) prevents viruses from multiplying within cells, however, little Zn is found within cells. Zn ions cannot cross cell membranes. HCQ is known as Zn ionophore – it crosses cell membranes and carries Zinc with it [8]. This antiviral mechanism is entirely distinct from HCQ+AZ ability to suppress the SARS-CoV-2 spike – ACE2 interaction.

Unfortunately, HCQ does not shuttle back and forth through cell membranes carrying Zn but tends to enter the cells and stay there. Some level of tissue saturation is needed for HCQ to be effective as an ionophore.

I am not aware of any reported results on HCQ + Zn + (non-AZ antibiotic) treatment for COVID-19. Dr. Vladimir Zelenko and Dr. Anthony Cardillo (Thousand Oaks, CA) give their patients HCQ + Zn + AZ, so it is hard to say whether HCQ + Zn works. Dr. Zelenko has just registered a clinical trial [9], in which he will compare HCQ + Zn + AZ vs. HCQ + Zn + Doxycycline. Doxycycline is a milder antibiotic with no known activity against the coronavirus.

HCQ

When used on its own, HCQ does exhibit antiviral effect against COVID-19, but not strong enough [10].

HCQ as an Immunosuppressant

HCQ is most known as an immunomodulator (mild immunosuppressant). Hence, its use against auto-immune diseases like lupus and rheumatoid arthritis. The main direct cause of death from COVID-19, like many other pulmonary diseases, is a cytokinetic storm and related acute respiratory distress syndrome (ADRS).  This is caused by excessive immune reaction to the infection, which leads to multiple organ failure and death. HCQ decreases this excessive reaction and can do so at any time in the development of COVID-19. Apparently, early attempts to use HCQ against COVID-19 were done in the late stages of the disease.

Remarks

HCQ combinations are being used for COVID-19 treatment all over the world, from India to Czechia, with excellent results. Random population sampling is needed to evaluate the spread of the coronavirus infection and immunity to it.

Chloroquine was noticed for its antiviral and immunomodulatory effects in context of SARS epidemic in 2003 [11]:

Chloroquine exerts direct antiviral effects, inhibiting pH-dependent steps of the replication of several viruses including members of the flaviviruses, retroviruses, and coronaviruses.

… chloroquine has immunomodulatory effects … which mediate the inflammatory complications of several viral diseases.

… the tolerability, low cost, and immunomodulatory properties of chloroquine/hydroxychloroquine are associated with biochemical effects that suggest a potential use in viral infections, some of whose symptoms may result from the inflammatory response.

As regards viral diseases, what is clear is that the drug has antiviral and immunomodulatory effects that warrant particular consideration.

References

[1]V. Zelenko, “To all medical professionals around the world,” 2020.
[2]Centers for Disease Control and Prevention (CDC), “What are Flu Antiviral Drugs,” 2019.
[3]B. Davies, “Article Navigation Pharmacokinetics of oseltamivir: an oral antiviral for the treatment and prophylaxis of influenza in diverse populations,” Journal of Antimicrobial Chemotherapy, 2010.
[4]P. Gautret and D. e. a. Raoult, “Clinical and microbiological effect of a combination of hydroxychloroquine and azithromycin in 80 COVID-19 patients with at least a six-day follow up: A pilot observational study,” Travel Medicine and Infectious Disease, 4 April 2020.
[5]G. Hache and D. e. a. Raoult, “Combination of hydroxychloroquine plus azithromycin as potential treatment for COVID 19 patients: pharmacology, safety profile, drug interactions and management of toxicity.,” Mediterranee Infection, 22 April 2020.
[6]G. Sakoulas, “ACE2 Is the SARS-CoV-2 Receptor Required for Cell Entry,” NEJM Journal Watch, 18 March 2020.
[7]D. J. Browning, “Pharmacology of Chloroquine and Hydroxychloroquine,” in Hydroxychloroquine and Chloroquine Retinopathy, Springer, 2014.
[8]J. e. a. Xue, “Chloroquine Is a Zinc Ionophore,” PLOS ONE, 2014.
[9]A. Thakore, “Hydroxychloroquine and Zinc With Either Azithromycin or Doxycycline for Treatment of COVID-19 in Outpatient Setting,” clinicaltrials.gov, 1 May 2020.
[10]C. e. a. A. Devaux, “New insights on the antiviral effects of chloroquine against coronavirus: what to expect for COVID-19?,” International Journal of Antimicrobial Agents, 12 March 2020.
[11]A. Savarino and et al., “Effects of chloroquine on viral infections: an old drug against today’s diseases,” The Lancet, November 2003.

259 thoughts on “Many Effects of Hydroxychloroquine against COVID-19

  1. The statement “created confusion, even among medical professionals” is a key concept. MD’s work off of protocols that may take decades of accumulated knowledge to develop. They are not really even allowed to practice outside the protocols unless they are in private practice or Medical Directors. This is why the MD’s are openly hostile to novel treatments and new interpretations of the causes of diseases. The medical profession has performed abysmally during the crisis.
    The good news is we might not make the same mistakes in the future.

    • Right, archie, but I wonder how many of the confused professionals have presented us with an investigatory opportunity? To wit, how many patients already under treatment with HCQ, for lupus and rheumatoid arthritis, developed Covid-19? Some medical group could find this out, and, since the HCQ was “administered early” we have the perfect test case. Not sur how to weigh Zn and add-on antibiotics though. Press on.

      • The HCQ cocktail has been proving effective as many doctors are saying. It has some very serious side effects if taken in large doses for an extended period of time, but as a virus treatment that is short term and should not harm anyone.

        • I’ve seen very few of the serious side effects reported and only anecdotally. I believe they are being intentionally exaggerated.

          • The best way to determine the extent of the side effects is to just follow the mainstream news. By doing so, you can easily conclude that they haven’t been occurring. Why is that? It’s easy. If the mainstream news could find just one case of a serious side effect caused by the short term use of HCQ, they would spread the word across the world in less than 24 hours. That’s all we would be hearing for two to three days following the discovery.

            And if there were dozens or hundreds, well, the doctors that did the prescribing would already be in the social media equivalent of the medieval stocks.

            Instead we get…crickets. There are no cases of the side effects the media keeps warning us of. Period. That doesn’t mean they aren’t a risk, but the risk is obviously very small under present circumstances. Yes, I overstate the point, but only by a tiny bit. Somewhere there is doubtless a poor soul experiencing one of the more serious side effects; the media just can’t find him.

          • Rod: “That’s all we would be hearing for two to three days following the discovery.”

            That, and the word Trump.

          • guys….Hydroxycholoroquine is sold over the counter…doesn’t even involve a Dr
            …millions of people take it and they are not dropping off like flies

            If it was killing people….like the LSM talks it up….it wouldn’t even be used for things like arthritis or lupus….the risk would be greater than the benefits

            …if Obama or some other idiot democrat had suggested it…the LSM would be singing the praises

          • From reading up on it pre COVID19 uses for lupus, some people had retina damage after 5 years of heavy use.

          • Plaquenil has been freely available in France like forever, and just in January, it’s declared toxic and you need a prescription, which you can’t use to buy it either, because you can’t use it against Kung Flu, and the prescription doesn’t say why you have one, so…

        • To suppress the SARS-CoV-2 spike – ACE2 interaction, HCQ must accumulate in the lungs.

          One wonders whether an HCQ inhaler would help with its rapid delivery into the lungs.

          • Now that’ you’ve said that, some idiot snowflake will attempt to inhale the inhaler, instead of its contents, and Trump will be to blame.

        • None of the side effects (see the Mayo Clinic site for details of each of the components) seem to be life threatening and not detectable by a treating MD. Others have posted here they’ve taken HCQ for weeks as a prophylactic against malaria (Escheback?).

          Someone might comment regarding whether a population taking the HCQ combo for three weeks could resolve the current pandemic? It’s lots cheaper than all those ventilators, makeshift hospitals, stimulus checks, and related trillions.

          • Add 50 micrograms vitamin D3 per day into the mix and if everyone did that I think lockdown would soon be over. Someone needs to check this out. Just think of the money this would save on a world-wide basis. Why isn’t it already being done! They need to go into an area with a high level of infection and pay people to participate. Tweek it, get it to work and then roll it out. The people in the medical business wouldn’t last in the car repair business. We need an engineer’s approach to this problem.

          • I took chloroquine every Friday for over 20 years as protection against malaria in Rhodesia. No side effects at all.

            Why Friday? I hear you ask. That was the military pay-day and we were obliged to swallow the pill before they would hand over our cash. If you caught malaria you were charged with damaging government property, I never did.

            Good times.

          • Actually, there is a a drug disease interaction that has killed quite a few people. COVID19 in advanced stages causes arrhythmia, atrial fibrillation. HCQ is known to possibly cause a prolongation of the QTC interval, which is not a good thing in atrial fib.

            Thus …. this is a case where the side effect profile for malaria or lupus is not relevant, as the disease itself causes a condition that can be a conflict with HCQ treatment.

      • “how many patients already under treatment with HCQ, for lupus and rheumatoid arthritis, developed Covid-19?”

        Not many. Dr. Oz is looking into this and came up with one result where he queried something like 10,000 of these patients records and only got a few dozen that had contracted the Wuhan virus. I think the federal government is currently doing a big research study of this issue.

        It sounds to me like everyone should be taking a dose of hydroxychloroquine similar to a lupus or RA patient’s dose as a preventative until a vaccine comes along. The older, vulnerable population should defintely get it, imo, and we should not rule out giving it to everyone including children because the Wuhan virus is causing some strange, unknown problems even in asymptomatic people and in young people. The best bet might be to try to keep the Wuhan virus out of the body as much as possible from the very beginning and not waiting for symptoms to develop.

        I’ve got a doctor’s appointment today at the VA, the new way: over the telephone. I may ask him if he will prescibe me some hydroxychloroquine. I have a little touch of arthiritis. Yeah, that’s the ticket. 🙂

        • Here’s Dr. Marik’s protocol for Covid prophylaxis (suppressing infection):

          Prophylaxis

          While there is very limited data (and none specific for COVID-19), the following “cocktail” may have a role in the prevention/mitigation of COVID-19 disease. While there is no high level evidence that this cocktail is effective; it is cheap, safe and widely available.

          ■ Vitamin C 500 mg BID and Quercetin 250-500 mg BID (BID = twice a day)

          ■ Zinc 75-100 mg/day (acetate, gluconate or picolinate). Zinc lozenges are preferred. After 1-2 months, reduce the dose to 30-50 mg/day.

          ■ Melatonin (slow release): Begin with 0.3mg and increase as tolerated to 1-2 mg at night

          ■ Vitamin D3 1000-4000 u/day (optimal dose unknown).

          Relevant paper by Marik, et al: (2020) Does vitamin D status impact mortality from SARS-CoV-2 infection? Medicine in Drug Discovery, 100041 http://www.sciencedirect.com/science/article/pii/S2590098620300282.

        • Well, my Doc told me there “wasn’t a chance in hell” of him writing me a perscription for hydroxychloroquine. He said it nicely, though. 🙂

          • Hydroxychloroquine is a prodrug form of chloroquine.
            Chloroquine is a non-enzymatically bioactivated form of quinine.

            The end product that has effects in the body is quinine. CQ and HCQ just take longer for the body to break down into Q, and thus reduce side effects of rapid absorption of large doses. The slow breakdown, however, paradoxically necessitates larger doses of CQ or HCQ (as compared to Q), since some of it is hepatically metabolized and flushed from the body before it is broken down into Q, which reduces its activity. For instance, HCQ is from 1.6 (as prophylaxis) to 8.8 (for those infected) times less active against malaria than Q (for malaria which isn’t resistant to Q).

            You can get quinine in your supermarket… Indian tonic water (look in the alcohol section… it’s used in gin and tonic). In the US, tonic water is limited to 83 mg / L, but doctors are reporting good results treating people infected with Covid19 with as little as 30 mg / dose of CQ (remember, the more complicated molecules take longer for the body to break down, but reduce the activity as compared to Q), with additional zinc supplementation.

            Half-life of Q in the body is ~18 hours (it is rapidly absorbed, but equally rapidly excreted), so drinking 500 mL tonic water every 12 hours would smooth out the dosage.

            It’ll take ~5 days to reach equilibrium levels in your body, where the Q enters the cells of the organs (importantly, the lungs). Once you stop drinking the tonic water, it takes ~5 days to hepatically flush it from your system sufficiently that it won’t show up on drug tests (they test for Q when testing for cocaine use, since cocaine is frequently cut with Q-containing material), but it takes as long as 30 days for the Q to move out of the cells and be completely flushed, so you’ve got about a month of (decreasing) prophylaxis after pre-dosing.

            So Q (Indian tonic water), with vitamin C, vitamin D and zinc supplementation. Cheap, readily available, effective.

          • Thanks for the advice, LOL@Klimate Katastrophe Kooks. I’m off to the liquor section!

        • It is currently not recommended to take HCQ for prevention of COVID-19. When HCQ is taken for prevention of malaria, it is taken at much lower dosage than for treatment.

          • Proflaxis Using Hydroxychloroquine Plus Vitamins-Zinc During COVID-19 Pandemia
            Healthcare professionals mainly doctors, nurses and their first degree relatives (spouse, father, mother, sister, brother, child) who have been started hydroxychloroquine(plaquenil) 200mg single dose repeated every three weeks plus vitaminC including zinc once a day were included in the study. Study has conducted on 20th of march. Main purpose of the study was to cover participants those who are facing or treating COVID19 infected patients.PArticipants, age, sex, BMI, smoking history, comorbid disease were also registered.
            Study Type : Observational
            Estimated Enrollment : 80 participants
            Observational Model: Case-Control
            Time Perspective: Prospective
            Official Title: Proflaxis for Healthcare Professionals Using Hydroxychloroquine Plus Vitamin Combining Vitamins C, D and Zinc During COVID-19 Pandemia: An Observational Study
            Actual Study Start Date : March 20, 2020
            Estimated Primary Completion Date : July 1, 2020
            Estimated Study Completion Date : September 1, 2020

            https://clinicaltrials.gov/ct2/show/NCT04326725

          • “Stitch in time saves nine.”

            “An once of prevention is worth a pound of cure.”

            Cliches, sure, but grounded in sound scientific observation & measurement.

          • Not so fast.

            A very interesting analysis at Roy Spencer’s website showed that nations with the highest malaria rates, implying high usage of HQL by the population, had extremely low COVID19 rates.

            I assume small doses of HQL taken regularly was most common but the analysis did not cover the dose

          • It is not currently recommended because Fauchi is dirty… check out how financially-entangled he is with Remdesivir, and ponder why he’d be pushing that while denigrating any competing treatments:
            https://podcasts.captivate.fm/media/6711ee06-2997-48a9-8c33-7042d2fd1fec/podcast-18-3-audac.mp3

            Why push quinine / chloroquine / hydroxychloroquine which costs less than a dollar per dose, when he can make billions of dollars pushing Remdesivir, which would cost ~ $900 – $1000 / week (a week being one dose schedule)?

            Stop listening to so-called ‘experts’ who have an agenda, without first checking out their financial ties… after all the times the so-called ‘experts’ have led the public astray to enrich themselves, you’d think people would learn this simple lesson… be skeptical of anyone pushing an agenda.

            The quinine you get from Indian tonic water (limited in the US to 83 mg/L) is pretty close to the exact amount you need to decrease infectivity of coronavirus by ~50%. That makes it more difficult for the virus to attach to cells in the body, which allows the body to clear the virus without also having to deal with a rapidly-spreading infection. Don’t forget the zinc, vitamin C and vitamin D supplements, as well.

        • Tom
          You said, “… one result where he queried something like 10,000 of these patients records and only got a few dozen that had contracted the Wuhan virus.”

          A “few dozen” is ambiguous. I’ll assume that it is somewhere between 3×12 (36) and 6×12 (72), or about 50. That is equivalent to about 50/10,000, or 5,000 cases per 1,000,000 population. There have been about 1.24 million cases of COVID-19 in the US, as of today, out of about 331 million population, (0.37%) or 3,700 cases per 1,000,000 population.

          5,000 per million is larger than 3,700 per million. Based on that, one is more likely to get COVID-19 if taking HCQ. You have not presented a very convincing argument. Check my calculations. Maybe I made a mistake.

          • The most recent random sample done in New York showed that 21% of the population showed SARS CoV 2 antigens in their bloodstream, indicating a current or prior infection. Since that equates to over 1.6 million individuals just in the New York City Metro area, it would seem that your claim of 1.24M in the U.S. is wildly undercounted. This is because you are looking only at the “confirmed” numbers, meaning individuals who were tested and received a positive reading.

            Given that the latest numbers are showing that as many as 80% of cases are asymptomatic, we have to assume the positive tested patients are merely the tip of the iceberg.

            If, in fact, we simply multiply the rate of known positives by a factor of 5, for those who are asymptomatic, the infection rate jumps to 18,500 cases per million and 1.85%. But, if we use the results of the random sampling, then we have to assume that 21% of the population have been infected, meaning an infection rate of 210,000 per 1,000,000 population, which would then put the HCQ population into an extremely low infection rate category.

            In any case, trying to extrapolate statistically meaningful numbers from these numbers that suffer from selection bias, over and under counting, and lack of testing, or even intentional falsification, is nearly impossible under the current circumstances. One of the most frustrating things about this whole situation is the complete lack of any meaningful statistical data coming out of any group, without massive political or ideological bias attached to it.

            To quote Mark Twain, “There are lies, damned lies, and statistics.”

          • Jeffrey
            I used the same source of information routinely used by Willis Eschenbach and Christopher Monckton: https://www.worldometers.info/coronavirus/#countries

            Since I wrote the comment, the estimate has increased to 1.26 million. It almost certainly is inaccurate. However, it is probably a better estimate than yours, because your calculations are based on other estimates of unverifiable accuracy, and New York does not seem to be representative of the country as a whole.

            However, I would say that the least reliable numbers are those attributed to Dr. Oz. My point was that the ‘evidence’ for the efficacy of HCQ was not convincing. I think that conclusion still stands.

        • I have been having tonic water which contains quinine with added lemon juice and occasionally with alcohol. It seems not to have been rushed off the shelves. I also have a couple of dozen anti-malarial pills from a working trip to the bush in Minas Gerais, Brazil a couple of years ago which I keep for emergency.

          I’ve taken anti-malarials intermittently since the 1960s and (with family with me) have never had adverse side effects nor have I known of serious side effects among countless colleagues and their families.

          There has been a lot of lefty hype on dangerous side effects. One person I know had some moderate intermittent dizziness, spells of lost sleep and some nightmares, but the alternative certainty of getting malaria is much worse. These symptoms were significantly mitigated by taking the drug only with meals. Warnings on all drugs look pretty scary but I’m sure the incidence of problems are few and far between for a family of drugs that have been used since Victorian times by Europeans and by native people for hundreds of years.

          • Gary

            You are making the same logical fallacy as others here. You are basically saying that because you are an honest man, and you don’t know any criminals, it must be concluded that criminals don’t exist!

            Are you suggesting that there is no evidence for serious side-effects (despite testimonials here) and that the pharmacies are inventing things to provide with the prescriptions?

            I have generally found you to be a reasonable and rational person. But, when it comes to this topic, you are not being consistent and are not demanding the same level of evidence that you have for ‘climastrology.’

          • RE:

            You are making the same logical fallacy as others here. You are basically saying that because you are an honest man, and you don’t know any criminals, it must be concluded that criminals don’t exist!

            Are you suggesting that there is no evidence for serious side-effects (despite testimonials here) and that the pharmacies are inventing things to provide with the prescriptions?

            One of the most prominent advocates of the drug’s off-label use on WUWT described his early experiments at non-recommended doses. Several years ago he also shared with readers his unfortunate heart health history. People here have short memories. So, apparently, does he.

            Not to say I wouldn’t use it if I needed it. Question is whether HCQ builds up to the necessary concentration in your blood before the virus does a number on your lungs. If used according to recommended doses, it might not accumulate fast enough.

            But maybe it’s more to the point to keep the focus on how serious this disease is. Only a few people have written about it here, but it would certainly be interesting to hear more personal accounts. If anyone has had antibody testing and can attest to the disease’s effects and symptoms, it would be great to know about them. The following hospitalization rates help put its seriousness in perspective:

            Laboratory-Confirmed COVID-19-Associated Hospitalizations (Rate per 100,000 population): 40.4
            https://gis.cdc.gov/grasp/covidnet/COVID19_3.html

            Laboratory-Confirmed Flu Hospitalization (Rate per 100,000, for Nov-May 2019-20 Flu season): 69
            https://gis.cdc.gov/GRASP/Fluview/FluHospRates.html

            The increase in Covid cases is slowing in U.S. and likely will level by summer.
            https://www.visualcapitalist.com/infection-trajectory-flattening-the-covid19-curve/

            Further, we vaccinate millions of people for flu. Without this campaign the number of flu deaths would rival those of Covid-19.

            We keep hearing “This isn’t the flu. Coronavirus is NOT THE FLU.” I’m beginning to believe they were right. It is MUCH, MUCH less serious.

          • @Clyde Spencer
            It’s always the question of the probability of whatever side-effect. Not everybody suffers from side-effects, in general, side-effects are in general rare, but m a y occur. In so far, it is right and necessary to name them. Also may it it possible, that under certain conditions, a new side-effect m a y occur. But seen the milions of doses taken since the first use of HCQ, it seems, these side-effects are very seldom.
            And of course, contra-indications have to be considered.

          • Krishna
            It isn’t JUST the probability of a serious side-effects. One can’t turn to a grieving family and console them with, “We’re sorry, but your husband/father was one of only 1% that reacts poorly to the medication.” Physicians swear an oath to “First, do no harm.” They have to have a reasonable expectation that there will be no fatal or permanently debilitating side-effects. Unfortunately, because HCQ has a half-life of nearly two months, once the level builds high enough in the blood stream to cause life-threatening reactions, it isn’t sufficient to simply stop the dosage, and there are few ways to clear the system as is done with chelating agents to treat heavy-metal poisoning. It seems to me that those who are strong advocates of HCQ therapy have not given much thought to the ethical and moral ramifications of treating large numbers of people with a drug that is not proven conclusively to work, and have unpredictable and potentially fatal side-effects. What’s worse, the recommendations are to only use the drug at an early stage when the people might get well on their own. So, the use puts people at an unknowable risk at a time when they may not need it.

            The small but potentially fatal risk of using the drug, is best dealt with by the patient, or their family, giving informed consent to the trial. It isn’t “informed” when commenters here deny that there any risks whatsoever, or say that the only side-effects are always mild. The potential user will have been misled. It is irresponsible to downplay the risks, especially when they are well-documented.

        • Tom Abbot, not sure why some comments can be replied to and not others
          But regarding quinine
          I have a sodastream, the tonic syrup has quinine and you can make it stronger if you wish

          • Is there and real documentation that quinine is a zinc ionopre as is hydrocloroqine

      • This has been looked at, not in great detail, but there is some info in this YT series by a US pathologist, info from Italy at about 10min (the rest is worth a watch, as are his other YTs on cv.

    • Puting this out again. Treating covid is more than the antiviral part. I could clip parts and drop them in, but read them from links. A lot of people have died needlessly. Still not a word about this here

      Here is a recent description, sorry for the political bent..

      https://spectator.org/a-report-from-the-front/

      For the protocol it self, make sure to read pages 9 and 10
      Evms.edu/covidcare

      One of these day this site might even do at top level article on this.

      • A comment from a medical friend:
        “I was never one for protocols as they end up tablets of stone,*

    • Archie,

      The Medical ‘Profession’ is all about the money. That explains why the Medical Profession has made ‘bad’ decisions and the fact that there are two ‘miracle’ simple cures for Covid that an idiot could find.

      The tests of hydroxychloroquine must include Zinc supplements. Tests have shown only 30 mg/day of Hydroxychloroquine and 30 mg/day of Zinc stops the virus from replicating.

      Hydroxychloroquine or Chloroquine can stop the virus from replicating if those drugs are given within zinc supplements BEFORE the patient is exposed to the virus.

      In vitro tests have shown that Zinc stops from the covid virus from replicating, however, the zinc positive zinc ion +2, needs an ionophore to get into our cells

      The drugs Hydroxychloroquine and Chloroquine are Zinc ionophores.

      Hydroxychloroquine and Chloroquine help the positive Z+2 ion get into our negative cell. The Z+2 ion and then makes the recepitor ACE-2 slightly positive which stops the virus from replicating.

      It appears, that Chloroquine and hydroxychloroquine the malaria fighting chemicals, are most useful only useful in fighting the virus, when they are used with Zinc supplements!

      https://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1001176

      Zn 2+ Inhibits Coronavirus and Arterivirus RNA Polymerase Activity In Vitro and Zinc Ionophores Block the Replication of These Viruses in Cell Culture

      Trump got the idea from Rudy Giuliano who interviewed this doctor.

      https://www.ibtimes.sg/us-doctor-claims-have-cured-nearly-500-coronavirus-patients-using-hydroxychloroquine-video-42075

      “I blended the two treatments from South Korea and France and made a three drug regimen which are hydroxychloroquine, which is the common denominator by both treatments, then I used zinc, and azithromycin. The virus gets inside the cell and begins to hijack the cell industrial machinery. It is well known that zinc interrupts that. So, the concept is that it interferes in the replication of the virus,” said Dr Zelenko while revealing about his course of treatment.

      “But the problem with zinc is that it does not get inside the cell very easily, only very small percent gets in. What is interesting is that hydroxychloroquine is a ionic core; so it is the key that opens the canal and facilitates the work of the zinc. When you have a severe viral infection, it is well known that you can get a secondary infection, so I believe the zithromax is there as a precaution and if there begins a bacteria process, it kills it before it causes a bigger problem,” he went on to add.

      This is the Jewish physician that treated 700 sick covid patients with higher dosage Chloroquine and Zinc supplements with close to 100% success rate.

      https://techstartups.com/2020/04/03/updates-from-dr-vladimir-zelenko-now-treated-700-coronavirus-patients-with-99-9-success-rate-using-hydroxychloroquine-zinc-sulfate-and-z-pak-1-outpatient-died-after-not-following-protocol-exclusi/

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

      • I posted this link before, but it bears repeating. From St. Luke’s Clinic —
        https://swietylukasz.pl/en/2020/03/20/zinc-and-covid-19-infection/
        HCQ is apparently not the only zinc ionophore. Two others are:
        quercitin (plant flavonoid, found in many fruits and vegetables) – supports the immune system and increases the effectiveness of treatment of viral infections,
        AND
        phosphatidylcholine (a phospholipid that builds cell membranes, contained in lecithin) – necessary for the proper work of the nervous system, mitochondria, immune system and also helps to detoxify the body.
        Both of these are common OTC supplements with a long history of zero side effects. Worth noting that excessive Zn can also be a bad thing, just like excessive vitamin D3 (or excessive almost anything) but intelligent supplementation with Zn, D3 and one of these ionophores during this crises would be a good bet for most people, especially those of us in the high latitudes with minimum sunlight exposure.

    • Dr. Raoult released the results of treating 1,061 patients:

      ” 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.”

      https://www.paulcraigroberts.org/2020/04/11/professor-didier-raoult-releases-the-results-of-a-new-hydroxychloroquine-treatment-study-on-1061-patients/

      • Some “science” people say: Raoult treatment is useless and possibly harmful, even causing death.

        IOW, some people think: COVID assassinates less than 0.5%, you only have to not follow Raoult.

        Except, they don’t SAY that. They either don’t dare, or these science/academia people don’t know what they mean.

    • “The medical profession has performed abysmally during the crisis”

      I’d say they perform abysmally almost all the time. It’s just more obvious and more dramatic.

    • I agree with you that the “House of Medicine” is a very conservative, malpractice-shy place. Often it is those, such as medical directors and those in private practice, who will take risks in order to push the envelope for novel or less-than-traditional treatments. While I am a believer in EBM ( evidence based medicine) Science is not a monolith. EBM depends on who is presenting the “evidence”, how strong is it, has it been reproduced, as well as financial and political considerations. I have been promoting an osteopathic protocol for viral infections for a decade, based on osteopathic treatment since the 1918 influenza pandemic and used , in modified form, for the last 100 years, often quite effectively. You can see it at : http://www.nysoms.org, for “Covid-19- A Missing Link to Treatment?”

  2. An interesting resume. Filled in some gaps in my knowledge. Brief and to the point. Many thanks.

  3. What is aggravating about the HCQ debate is that there is nearly nothing to lose by trying it. Short term side effects are nearly nil and the profiles of those few at risk are well known. Its like being told lottery tickets are free, but you aren’t allowed to buy one because you might get a paper cut that gets infected and kills you. Thanks, but I’d like to take my chances.

    • …your chances of winning the lottery, and getting a paper cut that kills you, are about the same…..

    • Excuse me, there is a lot to lose. If this treatment is widely known and promoted, it will make Donald J Trump look good. Most of the media would rather cut off both their thumbs than to say something good about him. Seriously.

      Human lives mean little to these people. Consider the leftists love of so-called renewable energy that harms the poor the most. Since they are rich enough that it will not harm them, they don’t care. Consider the emotional harm the media has inflected on people by making low-risk people think that just walking outside your apartment for a second will mean instant death.[i] An economy that is ruined means nothing to these leftists, because they will still be rich. Are others out of job and poor? They don’t care, as long as Donald Trump loses the election. Those people are beneath them anyway. For some of these leftists, hundreds of thousand dead is a small price to pay if it means Donald Trump would lose the next election.

      [i] http://www.alexberenson.com/the-mental-toll-of-coronavirus-lockdowns-on-families-and-children/

  4. According to the UK NHS, none of this is important, and we can’t use this medicine until clinical trials are complete in a few years time…..

      • Medicinal Marijuana sailed through approvals in numerous states based solely on anecdotal stories.

        Apparently anecdotes are okay for some health policies but not for others.

        What’s even more galling is that Trump was and is still being crucified over not flooding the country with unvalidated COVID tests from the WHO and elsewhere in the first few weeks after the impeachment circus wrapped up.

        They insist on anecdotally sound tests before hard scientific evidence was available, but demand the exact opposite with HCQ. The only consistent point is Trump bad.

        • In the UK the BBC and others seem to jump on every perceived failure by President Trump over this on a daily basis, claiming that he was completely wrong, HCQ doesn’t work ‘as we now know’, (it isn’t clear who ‘we’ is and why it doesn’t work, but that is completely irrelevant when Trump is the focus), whilst completely ignoring the disgusting behaviour of China, or the utter failure of the EU to do ANYTHING. This is why I don’t bother with news- it makes absolutely no difference to my life other than to possibly bring on a stroke. I’m 58 and can honestly say I’ve never known the media to be so obsessed over a US president.

          • That “as we know” was the Left’s conclusion from a non-clinical study at the VA where the patients had progressed to the point they were intubated and zinc was omitted from the protocol!

            The Left is so devious they probably caused the deaths of a number of veterans just to get the results that fit their political agenda! It seems to be a valid case of malpractice but broken eggs are cheap!

          • I dunno, Andy.

            I’m 57 and I seem to remember the meeja studies typists were worshipping (for want of a cruder term) Obama as if he were Blair or JFK or something. But that’s the opposite face of the coin.

            DJT does leave himself rather open to saying stuff which, video-clipped out of context, can be made to look pretty dumb. Though that may of course, be a BoJo-style double-bluff some of the time.

            Funny how these supra-national disorganisations like EU and The Who? have been utterly useless in co-ordinating any of the data/protocols on this. Anyone might think they were superfluous.

          • RockyRoad
            You opined, “The Left is so devious they probably caused the deaths of a number of veterans just to get the results that fit their political agenda!” If you will pardon the pun, that is way out in left field.

            I don’t think that you are actually familiar with the study. You might want to read this:
            https://apnews.com/a5077c7227b8eb8b0dc23423c0bbe2b2

          • Clyde thank you for providing the link. Here’s my take on it.

            “The drug has long been known to have potentially serious side effects, including altering the heartbeat in a way that could lead to sudden death.”
            So, should people in malaria infested areas stop taking hydroxychloroquine prophylactically even though it has been used in this fashion and considered safe for many years?

            “Earlier this month, scientists in Brazil stopped part of a study testing chloroquine, an older drug similar to hydroxychloroquine, after heart rhythm problems developed … “
            It was because of these side effects that chloroquine was phased out in favour of hydroxychloroquine. Incidentally, chloroquine is still being used in areas where mosquitoes have developed immunity to hydroxychloroquine. Presumably, the side effects were considered less of a problem than dying of malaria.

            As a matter of interest how old were the people in this group and how advanced were their symptoms before hydroxychloroquine treatment was administered? It is important to start treatment as soon as the patient is diagnosed, ideally before blood clotting in the lungs begins. Finally, were ventilators used. People die from the CHINESE COMMUNIST PARTY Virus because their lungs stop oxygenating their blood. (Stop working.) Putting them into a ventilator is like trying to push-start a car that has run out of petrol. Is death by ventilator less painful that death from the disease?

          • Michael
            I think that a couple of points need to be made. Most commonly, those using antimalarial drugs in First World countries are of military age, of working age and traveling on business, or young and off to see the world. Co-morbidities that usually accompany age, are going to be less frequent in the above groups. Additionally, the malarial prophylactic dosage is smaller than for other uses, and it is recommended that one start use before leaving the country. If a bad reaction occurs before leaving, one should cancel their trip. For people who live in countries where malaria is endemic, they have a choice of dying from malaria, or dying from hypersensitivity to HCQ. They may also try other drugs.

            One of the issues about the concern that the claims of HCQ efficacy are anecdotal, is that there is a high rate of mild symptoms; a very small percentage die. Not everyone who uses HCQ would have needed it to recover. So, if large numbers of people were to be treated routinely, one could expect to see a higher rate of HCQ side-effects, where the cure became worse than the disease.

          • I agree with your assessment. This is “groundhog day”. Until November 3rd, election day 2020, every day , every media report and political statement of legislative pronouncement with be about the election and the Democrats using all their energy and clout to bring down Donald Trump…. regardless of the costs, except to their rich supporters and followers, and their “sheep”. Until election day, every day is November 3rd.

        • “Apparently anecdotes are okay for some health policies but not for others….”

          #Believeallwomen is also ok for some accusations and not others….

          • Some were sacrificed. Democratic leadership at NBC is out. BTW, the disgraced democrat Harvey Weinstein is free of coronavirus.

      • Nothing anecdotal about basic science.
        Safety profile of HCQ is well known based on the millions of doses already taken in other other conditions. This is not a gummy-bear and therefore therapy needs to be monitored. This is not a shot in the dark.

        BTW – that paper below is well known to Fauci as it’s from his NIH
        I don’t want to be a tin-hat wearing guy but one needs to follow the money. When officials pronounce that remdesivir DOA (ie the drug did not show benefit vs placebo) but then a couple days later change the goal posts and say it does work well but ‘lessening the duration of illness by a couple of days’ – that’s anecdotal, not scientific

        Things that make you go hmmm?
        HCQ $20/dose
        antiviral remdesivir $1200/dose

        ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
        Chloroquine is a potent inhibitor of SARS coronavirus infection and spread

        Martin J Vincent, Eric Bergeron, Suzanne Benjannet, Bobbie R Erickson, Pierre E Rollin, Thomas G Ksiazek, Nabil G Seidah & Stuart T Nichol
        Virology Journal volume 2, Article number: 69 (2005) Cite this article
        216k Accesses 112 Citations 17599 Altmetric Metrics

        Conclusion
        Chloroquine is effective in preventing the spread of SARS CoV in cell culture. Favorable inhibition of virus spread was observed when the cells were either treated with chloroquine prior to or after SARS CoV infection. In addition, the indirect immunofluorescence assay described herein represents a simple and rapid method for screening SARS-CoV antiviral compounds.

        • Because HCQS (S for sodium) is a generic substance, a 200-gram pill typically can be purchased for 63 cents each in bulk!

          Companies can’t make money that way and the patent has long expired! Too bad everybody is in the habit of buying based on price yet the healuth-care industry has largely been successful in convincing rubes like us to avoid that approach when it comes to our health.

          • RockyRoad
            The “S” is actually for sulfate. It concerns me that people who obviously don’t know what they are talking about are promoting self medications. Half the comments here are little better than Rain Dance ‘Science.’

        • rickk

          You posted, “antiviral remdesivir $1200/dose.” Do you expect that to be your insurance co-payment, or what your insurance will pay? There is a good reason that most people who can afford insurance buy it!

          If the insurance companies felt that HCQ was as good as remdesivir, I’m sure that they would be lobbying in favor of HCQ. For those of you prone to conspiracy theories, I suggest that you investigate the role that medical insurers play in the prescription of drugs.

          • No one is really paying attention to you ‘Lying’ Clyde, except maybe the man or woman paying you by-the-word to post here …

            You are looking at this point as “paid opposition”.

          • _ Jim
            I don’t take kindly to being called a liar. However, it has happened all too frequently on Yahoo comments when people don’t have a factual, logical rebuttal to facts that I present, usually with links.

            I get paid as much for trying to introduce sanity into the discussion about COVID-19, as I get from Big Oil for the 10 WUWT guest articles and thousands of words I have contributed to comments here.

            You may be right about no one paying attention. After all, you can drag an ass to water, but you can’t make him think — especially if he has already made up his mind.

    • +10,000 Dodgy. The vacillation is staggering given the bleedin’ obvious point that people are dying in numbers. If you have a person contract the virus (assuming they are ever tested) and who has any of the potential survival risk factors (eg age over 50, excess weight etc), wouldn’t he/she and his/her family not want you to go for the potential cure right away? You do wonder just how many of those who have died would have survived. As with masks, vitamin supplements and various other aspects of this story with limited downside you really do wonder about the strength of leadership in the UK’s (very highly paid) senior management with the NHS and Public Death England.

      • you really do wonder about the strength of leadership in the UK’s (very highly paid) senior management with the NHS and Public Death England.

        Sadly, I do not. This pandemic has proved that governments, politicians, bureaucrats, etc. of all types are completely and utterly useless when it come to actually doing anything effective. They can witter and waffle, tell us what we can and can’t do, pass laws, but can’t actually take action themselves. Why anyone thinks that the public sector is superior to the private is totally beyond comprehension.

        • In the U.S., the left is trying to shift the blame of higher incidence of cases and deaths among blacks onto a lack of “social justice.” It is, as you say, just another failing of the establishment and big government.

      • Not a ‘senior management’. In the Soviet Union they went by the name of ‘nomenklatura’…

  5. “as early as possible”

    And, quite possibly, earlier than possible…?

    It should be available in all the stores and should be listed at the top of every masthead in the news paper business.

    And, it is… as tonic water… and you can buy zinc tablets at the store, too.

    But not in the news paper business… oh, no, can’t do that:

    Gotta leave us all… “like sitting ducks.”.

    The public health crimes that have been committed in this panic: BY OMISSION.

    Basic “take your vitamins & minerals” omitted from the dais of the so-called “experts.”

    While hydroxycholoroquine isn’t “vitamins & minerals”, what we know: Trump was right to announce it to the American public… and push it… the way Trump does.

    But the MSM media scoffed and people died.

    Disgusting.

    • In the morning newspaper, today (a large, absentee owned paper):

      “scant evidence” hydroxycholoroquine works.

      That’s false.

      Doctors around the world report beneficial results.

      But the newspaper is satisfied to mislead its readers.

      • James

        I will agree that most newspapers are liberal and routinely print misleading and non-factual articles. However, your claim that “scant evidence” is false, is not provided with anymore supporting evidence than the typical newspaper! You are only stating your personal belief, which is no better than the liberal editors.

        • Right, because no one should be able to refer to simple, established facts as, you know, simple, established facts. Everything must be proven over and over again. And documented! Don’t forget the documentation. Because life is really just one long geometry proof.
          Remember, people, take Clyde’s point to heart – no one here is to simply stipulate anything! You want to say the sun rises in the east? PROVE IT.

          • Matthew
            As far as I’m concerned you can believe that the sun rises in the east, instead of the Earth rotating in a manner that makes it appear so. You can self-medicate based on any level of evidence, or lack thereof. However, it should be self-evident that if in any medical trial there is poor control, confounding factors such as different ages, unknown pre-existing medical conditions, and a cocktail of different components is used so that it can’t be determined clearly which ones were most effective or if the dosages were optimal, then you aren’t doing science. And, should you follow your own advice, you deserve whatever should happen to you. But, it is unethical to encourage others to follow you over the cliff.

        • Clyde Spencer –

          PAID OPPOSITION. “Resistant to fact, immune to logic; paid to think in a particular vein.”

          Change my mind …

          • _ Jim
            I’m afraid to change your mind I would have to teach you about the Scientific Method, controlled experiments, and logic. From what I have seen, that might take more time than I have left.

            I do hope you have more to contribute to this forum than insults and unsupported accusations.

    • James
      You said, “It should be available in all the stores and should be listed at the top of every masthead in the news paper business.” If it were, you would see people taking it inappropriately and have widespread side-effects, including ‘mild death.’ It might well end up with the ‘cure’ being worse than the disease.

  6. Fully agreed on all the above points! There is almost no downside to using this drug combination. The drugs all have Very acceptable therapeutic indices (the ratio of Toxic dose vs effective Dose) so there is very little risk of toxic side effects.

    Furthermore, there is a logical, putative (but as yet unproven) pharmacological basis for the combination to offer some help in countering the infection progression and the immune response to that.

    We need to consider this as “battlefield medicine” for now since we have no vaccine in sight for a while and these drugs are cheap, safe & widely available. Even if the dugs only provide a placebo effect, that would probably save some lives.

    It is absolutely disgusting – no other word for it – to consider the part the media & vested interests in the medical/Pharma community have trashed the potential of this nostrum. They are potentially culpable for many tens of thousands of lives if this combination proves worthy on post-pandemic analysis……and we should NOT let them forget this fact….ever!

    • I agree with your assessment. This is “groundhog day”. Until November 3rd, election day 2020, every day , every media report and political statement of legislative pronouncement with be about the election and the Democrats using all their energy and clout to bring down Donald Trump…. regardless of the costs, except to their rich supporters and followers, and their “sheep”. Until election day, every day is November 3rd.

  7. No mention of side-effects? See, among others, http://www.healthline.com/health/hydroxychloroquine-oral-tablet.

    “HCQ combinations are being used for COVID-19 treatment all over the world, from India to Czechia, with excellent results.” Evidence? References? In fact, most people who get COVID-19 recover anyway. Death rates at 6 May 2020 are: Australia 1/71, India 1/29, Czechia 1/30, USA 1/17, UK , France 1/6. I don’t think anyone in Australia has being treated with HCQ. On the other hand Australia’s numbers of confirmed cases are probably much more accurate than say, India’s or Czechia’s, because it has one of the most extensive testing programs. If India’s official confirmed case number is lower than it really is, then the death rate would be higher.

    Still, in the face of serious life-threatening situations, it is easy to understand why humans want to believe that someone has the solution, http://anash.org/dr-zelenko-encourages-letters-in-miracle-sefer-torah/

    • “I don’t think anyone in Australia has being treated with HCQ.”

      Maybe HQC is reserved for movie stars ?

      Tom Hanks and his wife Rita Wilson were tested positive and treated at Queesland Hospital :
      https://abcnews.go.com/Entertainment/wireStory/tom-hanks-rita-wilson-australian-hospital-virus-69551695

      Rita Wilson has been treated with HQC (see link below) but at the time (in March) she was fine with no reported side effect at all.

      But some times after (about a month later), Rita Wilson suddenly warned about “extreme HQC side effects” :
      https://www.web24.news/u/2020/04/for-his-wife-rita-wilson-chloroquine-caused-extreme-side-effects.html

      Firstly, this confirms that she has actually been treated with HQC (this was known since March) in Australia, secondly, the fact that no whatsoever side effect was reported before by Rita Wilson and/or relatives tends to show that all this “extreme side effect” meme which very oddly and suddenly appeared mid April is a complete bullshit.

      • The ‘extreme side effects’ she referred were fatigue, nausea, dizziness, muscle weakness! Extreme or not, they are all typical symptoms of virus infection and its aftermath. Why she wanted to blame HCQ is unclear. She seems ill-acquainted with such discomforts. Given that, can we rely on her statement that she was treated with HCQ at all? Clarification needed.

      • Petit-Barde: I stand corrected. There are trials going on in Australia. Also our very own eccentric billionaire politician, Clive Palmer, has been taking out multipage newspaper ads touting HCQ, and has allegedly bought up 33 million doses. Australia’s population is 24 million, and less than 7000 people have tested positive to COVID19, so maybe some of these may be available to others?

        Of course, he’s also been building a full-sized replica of the Titanic, named Titanic II, since about 2010. According to the last press release, dated 2018, the ship is to be launched in 2022 for a reenactment of the original voyage across the North Atlantic (leaving from Dubai) for those still brave enough to go on an ocean cruise (no doubt there’ll be plenty of HCQ on board).

        Truth IS stranger than fiction.

    • All pharmaceuticals have possible side-effects. Read the fine print of any common over-the-counter medication.

      Are you implying that a strong devotion to religion somehow delegitamizes the work of Dr. Zelenko and others?

      Given the statements of the naysayers, no currently recommended, officially or otherwise, treatment can ever be satisfactorily proven to be more effective than a placebo.

      • AC Parker: No I wasn’t implying that devotion to religion delegitimises Dr Zelenko’s work. Just that in crises people want to believe there is a solution, whether religious or medical, or as in this case, apparently a combination of both.

        I do think HCQ is worth testing but I am cautious of optimistic claims based on one doctor’s say so, when that doctor has limited experience in virus epidemiology research.

        • There are papers going back to at least 2004 discussing the effectiveness of chloroquine against corona viruses.

          For example, Keyaerts, et al., In vitro inhibition of severe acute respiratory syndrome coronavirus by chloroquine BBRC 323, 264–268

          The evidence is not just anecdotal. The success of HQC against covid occurred within the context of very strong inferential evidence of its likely effectiveness.

        • Like any good doctor, Dr. Zelenko researched the literature, written by virologists and epidemiologists specifically experienced in SARS research, and determined a treatment for his many at-risk patients.

          No treatment will be truly verifiable until years after this crisis has passed. Anecdotal is about as good as we are going to get. Action must be taken now to save lives now.

          HCQ is a demonstrably safe medication that can be taken as a prophylactic. It showed promise against SARS in laboratory testing, that is why it is used to treat Xi virus patients worldwide. That is why it was given to Rita Wilson and also to my congressman (though, as a Democrat, he is loath to mention it), both of whom have recovered from the virus.

          Your statements exhibit much more than mere caution.

          • ACP
            You provided the medical advice, “HCQ is a demonstrably safe medication that can be taken as a prophylactic.” What is the correct dosage, the malarial prophylactic dose, or the larger RA daily dose? On what do you base your recommendation?

          • Krishna
            From what I have read, Dr. Raoult was treating patients showing symptoms. Are you claiming that he was instead providing prophylaxis?

        • Raoult used hydroxychloroquine, (HQC) Ron, not chloroquine.

          His average serum HCQ level was 0.46 μg/mL = 1.06 μM.

          According to his initial publication, “The proportion of patients that had negative PCR results in nasopharyngeal samples significantly differed between treated patients and controls at days 3-4-5 and 6 post-inclusion (Table 2). At day6 post-inclusion, 70% of hydroxychloroquine-treated patients were virologicaly cured comparing with 12.5% in the control group (p= 0.001).

          At day6 post-inclusion, 100% of patients treated with hydroxychloroquine and azithromycin combination were virologicaly cured comparing with 57.1% in patients treated with hydroxychloroquine only, and 12.5% in the control group (p<0.001)

          Seems pretty promising to me.

    • “…No mention of side-effects? See, among others, http://www.healthline.com/health/hydroxychloroquine-oral-tablet.
      ……………. In fact, most people who get COVID-19 recover anyway. .”

      Er.. the side effects , contra-indications and the correct dose levels have been known for over 50 years. This is a safe and VERY well tested medicine.

      Actually, most people who get Covid-19 don’t even know that they have it. This medicine would be prescribed for:

      1 – people in the early stages of a severe Covid illness.
      2 – people working with Covid patients – typically nurses and care assistants. To stop them getting it and spreading it.

      I sometimes wonder about the mentality of people who would prefer to sacrifice the lives of useful members of society rather than agree that a politician whom they oppose was correct. I think they call it ‘identity Politics’….

    • All drugs have side-effects. And not all drugs work on every person. We shouldn’t restrict the use of a drug just because 10% or 20% of the people do not respond to it. And, which is worse: a temporary side-effect or death?

  8. Hydroxycholoroquine sucks.
    It has no effect on covid19 whatsoever, but causes a lot of negative side effects.

      • You are right John. If it is so dangerous why didn’t we see all these warnings decades ago? Why now, exactly after Trump touted it? Hmm.

        • Vincent and John
          Your remark is a non sequitur. You may not have seen the warnings because you had no interest. I received my HCQ from the VA a year before the COVID-19 and the warnings were both on the prescription bottle and with the paperwork that came with the prescription. In my case, I immediately manifested HBP, which wasn’t on the list. If an elderly person already has HBP, taking something that exacerbates it is NOT desirable!

          It is no more rational to deny the existence of common side-effects than it is to resist HCQ use because of who recommended it. It becomes one “dumbas” arguing against another “dumbas.”

          • The warnings they wrote about is the massive negation of use HCQ because side-effects, as you f. e. demonstrate. They wrote not about warnings in instruction leaflets. Or will you say, that in the last about sixty years there was a comparable campaign because of side effects in HCQ despite of the fact certainly millions of doseshas been consumed ?

          • Krishna
            Malaria is a horrible disease. Those who found it necessary to work in countries where it was endemic generally made the choice to put up with any mild side-effects. But, if the side-effects were bad, a prudent person would voluntarily leave the country they were traveling in, and not use the drug.

            If someone knows that they tolerate HCQ well, there seems to be a small downside to volunteer to be a guinea pig. Although, those who tolerated it in their youth, may find that as they have aged, they no longer tolerate it as well. And, the other side of that coin is that COVID-19 seems to have a host of unusual symptoms, some of which may be exacerbated by common side-effects of HCQ.

            To summarize, my objections and complaints have been towards those who deny that there even are any HCQ side-effects, and are offering medical advice based on their personal experience or general lack of knowledge, without acknowledging that there can be serious side-effects for a small percentage of the population. The problem is, when you are dealing with a very large number of people, even a small percentage translates into a large absolute number. There is a significant number of commenters here who are giving potentially risky medical advice, because they want to believe there is a simple cure.

      • sorry but as someone whos takenit there ARE side effects and some are unpleasant
        it took just 44 pils ie 22days for me to have oedema of the face/head and be unable to see well with haze n bluetinges when I looked at anythingbright.
        and I was in immense pain from RA and was praying to a drug that worked
        it didnt work for the ra either for me.
        I also wonderif the annoying tinnitus i have had for over a decade also stemmed from that drug,
        the eyes gradually recovered but maybe not s good as before either

        would I risk a short course for covid?
        dunno Id wanna be in hospital for immediate care if it caused a second wore event
        and Im glad theyre trialling it with Doxycycline
        both HQ and Zpak have known heart effects
        why double up the risk?

    • Oh, ye of little faith.
      With that attitude, no wonder it does not work for you.
      You gotta BELIEVE!

    • Alex, the claimed side effects of hydroxychloroquine are all the effects of the corona virus infection that many of the medical community seem to be completely ignorant of. They think that COVID-19 is a ‘simple respiratory disease’ but it is actually a disease of the endothelium. This leads to the diarrhea, conjunctivitis, blood clots, heart attacks, kidney damage, strokes in young people as well as the lung damage and viral pneumonia.

      https://www.webmd.com/lung/news/20200424/blood-clots-are-another-dangerous-covid-19-mystery

      It would really serve medicine well if all the symptoms of COVID-19 were listed, it would stop the less well read doctors making fools of themselves and perhaps harming their patients. It does seem that while we are repeatedly told that anecdotal evidence is insufficient for efficacy of HCQ; anecdotal rumours generated by doctors who do not understand the disease they are treating are easily sufficient to shut down treatments.

      • The side-effects of HCQ were known and experienced long before COVID-19 infected humans. So if the side-effects of HCQ are the same as the effects of COVID-19, then maybe it’s not a good idea to double-up the impact on people who come down with the virus? Hopefully the trials will look at age differences in patients – to see if HCQ is effective for older people with a higher risk of dying, or only for young people who have higher survival rate anyway.

        Many years ago I took anti-malarial tablets for about 18 months. I can’t remember now whether it was chloroquine or hydroxychloroquin, but I have had bad tinnitus since around that time, with no medical explanation. I had no idea that this was a common side effect of HCQ until this recent publicity. I note that no doctor has ever asked me if I had ever taken HCQ.

        • These effects Covid-19 may cause are not the result of HCQ, but in many cases, treating early enough,with HCQ will decrease the risk to get these effects.
          It’s not the question of doubbling these effects.

      • Ian
        You are reading selectively. Ozspeaksup just gave a testimonial of her(?) experience, which clearly are side-effects. Yet, you still de-Nye that they exist. What does that say about your objectivity when someone tells you something and you say it isn’t true?

    • Your powerful argument convinced me. Despite evidence to the contrary.

      https://www.fox7austin.com/news/fox-26-gets-unprecedented-access-to-texas-1st-nursing-home-to-treat-covid-19-with-hydroxychloroquine

      South Dakota, heavy treatment of hydroxychloroquine, 0.88% death rate. Michigan which all but banned hydroxychloroquine, 9.41% death rate. But your argument convinced me! (May 6 – South Dakota, 24 deaths out of 2721 cases. 24/2721 = 0.88% ** Michigan 4179 dead out of 44397. 4179/44397 = 9.41%)
      https://www.worldometers.info/coronavirus/country/us/

      • And then there’s Bahrain. First case in late Feb. Adopted HCQ as a protocol a few days later. Despite testing at four times the U.S. rate (implying relatively few cases have gone undetected) the number of deaths in the entire country is eight, working out to five per million people (vs. the U.S. 200+ per million and climbing).

        And it’s not because they don’t have confirmed cases. They have about 60% of the level in the U.S. (on a per million basis). That somewhat lower rate just might be because with their effective treatment regimen they haven’t allowed Covid to run wild in their nursing homes as has happened in several U.S. states.

        And, while I’m a bit skeptical of this number, Worldometer indicates that they have just four present cases listed as serious/critical. Four. And that’s not per million either. Compare to 50+ per million in the U.S.

        But maybe their vitamin D3 levels are sky high in Bahrain, always a possibility.

      • Wade
        It is obvious that you don’t understand the basis and need for controlled experiments. One has to be careful that the cohorts in the study are similar in age, general health, and other confounding factors are controlled for. It is currently well known that the death rate for Blacks is about twice the rate for Whites; Michigan has a lot more Blacks in their population.

        It is starting to look like there are at least two major strains of COVID-19, which have different behaviors. Without testing to determine whether those in South Dakota are experiencing the same strain as Michigan, you might as well be comparing rabies with tularemia.

        The difference between anecdotal claims, and scientific evidence, is that one can’t be sure in the first case that one isn’t dealing with a spurious correlation. In a well-designed medical trial, great pains are exercised to avoid that.

        • Your ‘cover’ is blown, Clyde; why do you persist?

          Does the payment-per-word agreement with your pharmaceutical ‘contact’ (handler) still apply?

          • Why do I persist? Because I object to people stating falsehoods and I’m concerned that if someone doesn’t call them on it, some lives might be lost unnecessarily.

            Your intended insults are without any evidence. I’m still waiting for something of substance from you. That tells me a lot about you.

    • Your political bias is showing. Maybe you should pull up your britches. My wife has been on it for ten years and zero problem.

      • Taz
        Are you addressing your remark to me? By “political bias,” do you mean that you can tell that I vote a straight Republican ticket? Surely you aren’t suggesting that because you know one person who tolerates HCQ well that your observation can be extended to every human on Earth! Maybe it is YOUR political bias that is showing.

  9. Trouble is, will they (medics) read it?
    I’ll forward this to my GP. I already told him that based on my 3 years of taking chloroquine I think this might be the answer, but it has to be prescribed as a preventitive or at very early onset.

  10. The greatest test of HCQ is currently still ongoing in Turkey. They are giving HCQ to everyone who tests positive, or have enough symptoms to suspect covid. Their numbers of recovered patients is incredible in comparison to all other nations with large numbers of infected. Current numbers are 74+K recovered, and 52+ active cases. No other nation reached such a ratio until they reached the far end of their plateau. Turkey has accomplished this prior to reaching the middle of their outbreak. Their very low 42 deaths per million proves how effective HCQ is when used early on.

  11. Thank you for posting this summary. It doesn’t contain anything really new that Rud Istvan and several others haven’t posted before. It mostly references Zelenko and Raoult, which goes back quite a long time now in this fast-moving matter.

    This is surprising as there has been plenty of time for new information to appear. It might well be that HCQ turns out not to be beneficial at all (wouldn’t be the first time a a high profile drug has crashed and burned) but my opinion is that the downsides of taking it as a prophylactic, or imediately upon the first sign of symptoms, are so limited as to be worthy of ignoring. So I’d take it – if I could get it. But of course I can’t. What I need is more news on it, updated news. At least in USA you have been talking about it.

    In UK there has been a near-complete news blackout on HCQ. We can’t get it and clinicians are advised not to use it except as a trial. We don’t know whether any units in the UK are using it, let alone what their results are. One of the downsides of a monolithic National Health Service is that different units are mostly doing the same thing. We don’t get comparatives, we don’t get second opinions, we don’t learn as quickly as we might. Yes, we do have a Nanny State. We get the official line, put out by the media, and that’s it. We don’t even know which clinicians in which countries have used / are using HCQ, and in view of the very different results countries appear to be getting (okay, that appearance may be misleading, I agree) this may be worth exploration. This information must be out there. But we are not getting it. We are not even getting anecdotal stuff about HCQ. Our media is usually so transfixed on ‘human interest’ stories, usually inconsequential ‘fluff’- and is so short of other news with which to fill its time slots (BBC, note that please!) that one would have thought this anecdotal, but in depth stuff, would be a major part of their programming. But no, nothing. Zero. More information, please.

    • We took a dose of straight chloroquine (on the advice of British High Commission) once a week for 8 years while working in Africa, this as an anti-malarial prophylactic. You certainly needed to take it a good week before entering a malarial area. Side effects – probably the tinnitus I’ve had ever since. I’ve read that Hydroxychloroquine seems to be less harsh in its side effects. With malaria choloroquine’s main action is to stop the parasites replicating through the cells. That’s presumably why its use with Covid 19 would need to be started asap. It needs to be in the system, but once there appears to act on the virus in the same way as it does on malaria parasites, i.e. stopping its replication from cell to cell. Additional antiviral and zinc are also advised by some practitioners. As for the BBC, as an organ of public info, it is shameful. No independent journalistic enquiry on any topic allowed. A good blog for UK medical info and debate is ‘Dr Malcolm Kendrick’ here on WordPress.

      • Tish, yes, Dr Kendrick helped me understand the true reason behind coronary artery heart disease – that would be blood clotting abnormalities to keep the explanation short. For that reason I turned down a cholesterol PCSK9 inhibiting drug that was ‘more effective’, but cost £1000/shot once every two weeks. Sounds like the remdesivir business model perhaps?

        The malarial areas of the world are still lagging well behind the temperate regions for covid infections. Coincidence, I think maybe not.

    • When Willis did his first analysis on the Diamond Princess passengers my first thought was like his, why so few deaths given they were heavily biased toward the at-risk age group? It remains the most solid evidence for what happens in a closed community.

      There was the talk early on of Chloroquine and hydroxychloroquine. After a tiny bit of research on their connection to quinine, joining the dots I reasoned that G&T might be a popular drink on a cruise ship and they were probably free for anyone who wanted one. From that moment on I’ve been on a morning/evening 125ml glass of tonic water as a prophytactic. I’m an engineer, my medical chums in their slightly patronising way assured me the quinine dose was too low to have any effect, but I carried on anyway.

      After a month or so I noticed my blood pressure, which I take regularly because of past heart problems was unusually low, about 6% on average, that’s unheard of for me, and now after 3 months my resting heart rate has dropped by about 10%. Exercise and fitness pretty much the same throughout. These readings are all taken at the same time just after getting up in the morning. Curious I went to look for the side effects of quinine and lo and behold it’s a vasodilator and it can increase the Q-T interval, which would lead to lower blood pressure and pulse rate.

      I’ve had symptoms since the outbreak that could have been Coviv-19, but never bad enough top stop me doing what I wanted, so a test was never worth doing, better to save those for medics treating serious patients.

      So don’t necessarily believe the part time experts, this is new stuff. It’s also a huge reason why everybody should know what ‘normal’ blood pressure/pulse is for them, because a spot reading taken by your doctor will be all over the place and meaningless.

      BTW I don’t take any zinc supplements, just looked up foods that contain zinc and made sure I ate some regularly.

      • Richard
        Thanks. Good stuff. Where are you located? Here in the US, the FDA limits the quinine to 83 mg/liter.

  12. I don’t know how effective HCQ is. Most “studies” haven’t used Zn. Most are not studies in the sense of clinical trials, but the result of researchers going over patient notes to see what treatments given. Most HCQ treatments have been given late in the disease progression, and then reported as being not efficacious, which is not surprising.
    However, I am pretty sure that these “dangerous side effects” is the result of a media campaign to discredit it, probably because a) it is out of patent and b) Trump. When going over old – ie pre covid-19 instructions – nowhere are these dangers mentioned. People were prescribed this in the millions as a precaution when visiting certain countries. Yet now, suddenly, “serious side effects”. I say, follow the money. Or follow the politics. Probably both.

      • Yes I’ve seen that. But they don’t give any indication of probabilities. When I had a catheter ablation, I was given probabilities for every side effect. Then I could make the decision, is it worth the risk? So when you list a very uncommon side effect alongside very common ones, it ignores the most important factor a patient needs to ask: What is the risk? It is very misleading in my view, and can lead to patients making the wrong decisions, which is probably what is happening now.

  13. Clinical trials are used because of the need for a control group. Since there have been over one million cases in the US, there are plenty of patients not on the HCQ protocol to compare against.

    A separate, formal clinical trial is not needed. There are already plenty of control group participants – in hospitals and morgues.

  14. I’m just waiting for the anti HCQ warriors, and for what they call “arguments” 😀
    We have here the one and the other warlord 😀

  15. Unfortunately this article doesn’t mention a very grave and life endangering side effect of HCQ!
    Namely for people with a G6PD gene defect. This G6PD defect is especially wide spread in the population of Malaria affected countries since it makes the carrier immune against Malaria. But the side effect is that some food (like peas or beans) and some drugs cause life endangering haemolysis (dissolution) of red blood cells. Nowadays due to globalization and migration and especially in the US with its high share of Afro-American population this G6PD gene defect is also wide spread in northern countries. Especially from the US there were already reports mentioning a higher share of dead people with Afro-American ethnicity amongst the CoVid deads, compared to their share of population.

    HCQ and all of it’s derivates are clearly on the blacklist with “high risk” for G6PD deficiency affected people. Treating CoVid infected G6PD people with HCQ can kill them without even being noticed by doctor. Since a serious CoVid infection already leads to a lack of oxygen in the blood and HCQ triggered haemolysis reinforces it… with deadly outcome.
    So giving a general recommendation for HCQ-treatment is very dangerous. It might be a good curing drug for people without G6PD defect, but for those with the defect, it’s most likely a secret killer.

    Here is a good article of a German virologist explaining (in English) the risk of a HCQ-treatment, especially starting from the subtitle “A hint from New York” which also shows a global map of the G6PD defect frequency: https://multipolar-magazin.de/artikel/covid-19-a-case-for-medical-detectives

  16. I don’t know about you but after reading this, suddenly fish-tank cleaner is looking pretty tasty.

    • They are investigating that woman with murdering her husband. They think that she poisoned him and then made up the story for the police.

  17. The primary reason for a clinical trial is to have a control group. But with over 1 million cases in the US, there are plenty of patients who did not receive any HCQ treatment that could serve that purpose.

    There is no shortage of control group candidates already – in hospitals and morgues.

  18. Mr. Leo Goldstein,
    Have you any info on the quinine sulphate tablets which are meant for leg cramps, available without prescription ? Thanks.

    • Importantly, sulfur ions also have antiviral activity.
      “Organosulfur compounds like quercetin and allicin are associated with inhibition of viral infection. These chemicals can hinder virus attachment to host cell, alter transcription and translation of viral genome in host cell and also affect viral assembly. Quercetin can affect entry and attachment of Enterovirus and Influenza virus on host cell. This compound also has ability to inhibit RNA polymerase which is necessary for viral replication. Quercetin also inhibit process by which virus alter signalling pathway in host cell. Organosulfur compounds like allicin, diallyl trisulfide and ajoene are main chemicals which impart antiviral property to garlic. It is known that allicin can pass through phospholipid membrane of cell and can further contribute in inhibiting viral multiplication.
      Considering numerous studies which corroborate antiviral effect of onion and garlic, this paper recommends consumption of these plants as a safe alternative to prevent virus infection.”
      https://pharmascope.org/index.php/ijrps/article/view/1738/2428

      • I’m not sure what you mean by sulfur ions (sulfide?).

        Quercetin is not a sulfur compound and none of those compounds you mentioned are ionic. I’m not discounting what you are saying other than some the chemistry you are claiming is not correct.

          • I just did.

            The article is garbage from a garbage journal. I found several factual errors in just the first paragraph, and the grammatical errors are inexcusable. I guess that why is scores so low.

        • Eat lot of garlic, it’s good for social distancing too, no other major side effects known.
          “Garlic contains diverse organosulfur compounds such as S-allyl-l-cysteine, diallyl disulfide, diallyl trisulfide, ajoene, and allicin, which have potent antioxidative, antibacterial, antiviral, and anticancer properties
          https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3491620/

    • Freshens breathe and whitens teeth too.
      I use it instead of salt on my eggs, and I never been sick a day in my life!

    • I understand there is also a relationship with Bill Gates and vaccine development that may affect the view of a cheap generic easily manufactured treatment.

  19. In my limited view, the best known side effect of HCQ treatment is, that prople recover.

  20. According to dr Wodarg from Germany, a pneumologist/epidemiologist and former politician and above all the first in Europe anyway to voice a protest against the Corona panic (wodarg.com , recommended) chloroquin has a major drawback because it may be the cause of hemolysis and subsequent death in people with a deficiency in the enzyme G6PD. Possibly many humans are deficient in this enzyme to make them better resistant against malaria. People in malaria infested countries are often dark skinned and this would be the explanation why in New York many black people die in this pandemic. Not of Corona, but because of their inability to handle chloroquin. See: https://multipolar-magazin.de/artikel/covid-19-a-case-for-medical-detectives

    • It’s hardly being used.

      The blacks that are dying are like others dying. They have other underlying illnesses, are overweight, etc. Poor diet of course contributes to all of this.

    • “….chloroquin has a major drawback because it may be the cause of hemolysis and subsequent death in people with a deficiency in the enzyme G6PD…”

      Given that it has been prescribed for around 70 years now, I suspect that we would have noticed that effect a long time ago if it were a major one, and we would have specified prescription standards to allow for it…?

  21. I am not medically qualified and this is not medical advice:

    During an informal conversation with a staff member of my anti-coagulant clinic I was told that quinine does not mix well with warfarin. I have no further details.

    • A red herring study. Infection is irrelevant. Progression to disease is the only relevant metric.

    • While that study involved 14,000+ medical records, reading to the very end of the table of data reveals that of the 14,000 only 107 had been on hydroxychloroquine or chloroquine for other medical purposes. And that is qualified with the following statement:

      “…the basic methodology of the study, which is based on a computerized database, which might be incomplete. For instance, the duration and the reason of the treatment, as previously mentioned, are lacking.”

      About 1300 of the 14,000 had tested positive for Covid-19 and of those ten had taken HCQ/Chloroquine prior, while 97 of the non-Covid subjects had also taken the drugs. Given those numbers, they concluded they could find no benefit.

  22. Fauci won’t support the hydroxy cocktail unless blah blah.
    from NCBI, a branch of the National Institutes of Health (NIH), in 2005.
    most authors are CDC:

    Aug 2005: NCBI: Virology Journal: Chloroquine is a potent inhibitor of SARS coronavirus infection and spread
    Conclusion
    Chloroquine is effective in preventing the spread of SARS CoV in cell culture. Favorable inhibition of virus spread was observed when the cells were either treated with chloroquine prior to or after SARS CoV infection…

    Severe acute respiratory syndrome (SARS) is an emerging disease that was first reported in Guangdong Province, China, in late 2002…
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1232869/

  23. MedCram – an excellent source on what is going on- just had all its shows on chloroquin removed by you tube. There is some evil stuff going on in our country. They are still available on their website.

    https://www.medcram.com/

    • “MedCram – an excellent source on what is going on- just had all its shows on chloroquin removed by you tube.”
      Really? The ER doctor who is a Medical School teacher about ventilators is about as expert as you can get. He, himself, takes an OTC set of PreExposurePrep including Quercetin and Zinc. Also NAC (cytokine storm prophylactic). OTC. Order online. Get it in 2 days. If it is good enough for the ER expert it is good enough for me.
      HCQ is not a cure. It is a PostExposure prophylactic which inhibits (but does not stop completely) viral growth. This should, it is hoped, lead to a milder (read survivable) case. HCQ has well-known effects. Medical doctors are trained to take all (side or intended) effects of a drug when prescribing to an individual patient.

  24. In UK my NHS GP practice now offer HCQ treatment at an early stage, if you have temperature and a cough you are prescribed it! Apparently this is what GP are being told to do.
    You have to register with a central NHS website as they are keeping track of what happens.

    • Thanks, John. Interesting information. Can you say approx where is your GP practice based? Did you ask them, or did they circulate this info to you?

  25. A number of talking points….
    VitD3 is a proven stimulus for the immune system and dark skinned people are lacking this essential vitamin when they live in the far northern hemisphere also obese people tend to store VitD3 in the fat so it is less effective…now check which patients have worse outcomes ref Covid19.
    Hydrochloroquine basically allows zinc into the cells to prevent Covid reproduction so for any significant results zinc is necessary as a supplement as well.
    Since we are not allowed to buy Hydrochloroquine it is possible to buy Quercetin which also allows zinc to penetrate the cells….with no side effects at all!
    So, to protect yourself take 4000iu Vit D3 daily to improve the immune system and at the first sign of Covid symptoms take 500+mg Quercetin and 50 mg Zinc daily.
    You can find more details of this on line.

  26. Virol J. 2005; 2: 69.
    Published online 2005 Aug 22. doi: 10.1186/1743-422X-2-69
    PMCID: PMC1232869
    PMID: 16115318
    Chloroquine is a potent inhibitor of SARS coronavirus infection and spread

    Martin J Vincent,1 Eric Bergeron,2 Suzanne Benjannet,2 Bobbie R Erickson,1 Pierre E Rollin,1 Thomas G Ksiazek,1 Nabil G Seidah,2 and Stuart T Nicholcorresponding author1
    Author information Article notes Copyright and License information Disclaimer

    Conclusion
    Chloroquine is effective in preventing the spread of SARS CoV in cell culture. Favorable inhibition of virus spread was observed when the cells were either treated with chloroquine prior to or after SARS CoV infection. In addition, the indirect immunofluorescence assay described herein represents a simple and rapid method for screening SARS-CoV antiviral compounds.

    • There is no viability data for the cells. No bright field picture.

      Untreated cells have a distinct separation of cytoplasm vs. nucleus, CQ-treated cells are balled up which is an indicator of toxicity.

      What makes the paper even more dubious is the picture duplication between Fig1 und Fig2. The picture for the untreated cells is the same.

  27. The stock price for Gilead, the patent holder of remdesivir, has gone from $63.20 on Jan 31 to a high of $83.99 on April 17. It has since leveled off in the $80 range.
    Any questions?

  28. Just an aside concerning Doxycycline. It was mentioned briefly in the article as a milder antibiotic. I was on a long term course of doxy, 200 mg per day, but stopped because one of the side effects is a mild dry cough. Since a dry cough is now stigmatic, the reaction of people nearby is fear. I also wanted to be sure any cough might be a sign of something else rather than a side effect of the doxy. I will resume the treatment when the time is right.

  29. Here are the COVID-19 cases and deaths of France and Turkey. Turkey gives HCQ at the onset of symptoms. France does not.

    https://twitter.com/Covid19Crusher/status/1257921469914517505/photo/1

    Here are the total cases and deaths in Morocco. Morocco started giving HCQ at onset April 8th. Notice a change in the graph?

    https://twitter.com/Covid19Crusher/status/1257986586999996419/photo/1

    We can put together a package of a 6-10 day course of HCQ/Zn and give them to anyone who has symptoms as early as possible. The drugs are extremely safe and cheap. If given early it shortens the time of infection and transmittal.

  30. Here’s a study on something that I’ve been convinced from the beginning is a significant factor in disease progression: glutathione deficiency. Glutathione is the primary antioxidant in the epithelial lining fluid of the lower respiratory tract (where coronavirus does its damage), that protects against pathogens, pollutants and reactive oxygen species (ROS).

    Coronavirus infection causes increased ROS in the lungs by decreasing ACE2’s anti-inflammatory counter-regulation of ACE. There’s a medcram video explaining this.

    ROS degrades hyaluronan (HA, a high molecular weight polymer that forms a gel to protect the lungs) into smaller pieces that cause inflammation and possibly cause the hyaline membrane formation seen in covid patient chest x-rays and CT. Autopsies have revealed over-accumulations of a gel like substance in patients’ lungs that may be HA.

    I have suspicion that HA may be responsible for the unusual hypoxemia (low O2) with hypocapnia (low CO2) seen in covid patients. I would love to know the gas diffusion properties of HA in comparison to the proteinaceous and fibrotic materials in ARDS and pneumonia patients, who have hypoxemia and hypercapnia (high CO2). CO2 is 20x more diffusable than O2 in the lungs. Do covid patients have silent hypoxemia (low O2/CO2) because HA hinders O2 diffusion while allowing CO2 diffusion? Whereas the proteinaceous and fibrotic materials in ARDS and pneumonia patients’ lungs hinder diffusion of both?

    N-acetylcysteine (NAC) supplement increases glutathione levels (glutathione precursors are cysteine, glycine, and glutamine), but glutathione supplements don’t work so well. Hospitals often use NAC as standard treatment, but they also use other things that deplete glutathione like acetaminophen (paracetamol) and anti-viral drugs.

    Endogenous deficiency of glutathione as the most likely cause of serious manifestations and death from novel coronavirus infection (COVID-19): a hypothesis based on literature data and own observations
    https://www.researchgate.net/publication/340917045_Endogenous_deficiency_of_glutathione_as_the_most_likely_cause_of_serious_manifestations_and_death_from_novel_coronavirus_infection_COVID-19_a_hypothesis_based_on_literature_data_and_own_observations

    • A little research on glutathione reveals that it is naturally produced by the body, but that production decreases with age. Environmental pollution also lowers the level of glutathione in the body.
      A correlation with COVID-19 and more severe cases affecting the older population and those living in crowed cities with even slight levels of air pollution may to be real if glutathione deficiency is indeed a factor.

      • Basically, any kind of oxidative stress depletes glutathione (GSH). One study I read found that alcohol abusers’ lungs had 80-90% less GSH than normally found in healthy lungs. Alcohol damages the liver where GSH is synthesized, plus it consumes GSH as it is detoxified. Alcohol abusers are prone to get a pneumonia condition called alcoholic lung. They say the cause is unknown, but I suspect that it’s at least partly due to GSH depletion.

    • Hey, thanks for this info.

      On the side, one of the many things I do to mitigate an OA knee, I religiously take a liquid HA suppliment (low molecular weight?).

      I always worry wether suppliments like this realy are absorbed and do any good.

      Comments on this one?

      • I don’t know anything about HA supplements.

        btw I was wrong about HA being high molecular weight. It’s a long chain molecule.

  31. I have found that if you ask the naysayers of the cheap well tested drugs, “what do you think of remdesivir” ? the naysaying turns to approval, it becomes the only drug that effectively saves lives. Now there is a great deal of profit for Gilead and it has been noticeable while the promotion and priming by Gilead has pushed up their share price. Seems to me that “follow the money” may account for paid influencers to permeate sites to put down any cheaper 10c a tablet effective treatment, and it seems the CDC and WHO is also full of active pro big Pharma profit lines.

    yep follow the money…

    • Besides following the money you have to follow the political gain. The virus is viewed as a tool to defeat him by the Deep State. A cure is the LAST thing that they want to see until after the election. In their eyes 10s of thousands of dead is a small price to pay for his defeat.

  32. One thing you never hear is the health cross sections of those that die in the ICU. Almost all (at least in the west) are obese with hypertension or diabetes (which most obese people have) or are over 70 with hypertension or diabetes.

    The obese group is Peter paying the piper where they put themselves at risk. Even the younger people who die are obese. The older group is just a consequence of aging. CV19 gets in a nursing home and wipes out half the population and some of the staff (where a lot fall into the obese category). This also occurs annually with the Flu in nursing homes though certainly not on the scale of CV-19.

    So basically out of 100 people getting CV-19, 20 will be symptomless or asymptomatic, 60 will make it through on their own, 20 will go to the hospital, 10 of those will go to the ICU and 5 of those will die. Treating the 80 with symptoms as early as possible matters. It shortens the time for the 60 not going to the hospital and would no doubt increase the odds of getting the 20 going to the hospital either not having to go and if they go, not having to go into ICU. Why people displaying symptoms were told to just stay at home and ride it out is beyond me.

    • They’re just accumulating their deaths now rather than later this summer. Flattening the curve was never going to reduce the area under the curve. Unless Sweden’s health system is overwhelmed (it’s not) then what’s your point?

      • brians356-

        Exactly the point I have been making to family and friends, since the beginning of the “stay home” orders. Unfortunately with most of them, their eyes just glaze over, and they change the subject.

        I think this is the result of the abysmal math education in our public schools. They don’t understand that if the virus’ characteristics don’t change and there is no effective treatment, then it doesn’t matter how much the curve is “flattened,” the area under the curve will be the same. Which means the same number of people will get the virus.

        Most people seem to think that “flattening the curve” means that fewer people will get sick and fewer will die. We see this in local and state officials statements about loosening restrictions and opening the economy. They say “okay, we will open up businesses again, but if the number of cases goes up, we’ll have to shut down again.” Absolutely no understanding of how epidemics work. Of course the number of cases will go up. Your comment is perfect : “unless [the] health system is overwhelmed… then what’s your point”?

  33. “Hache, G. & Raoult, D. e. a., 2020. Combination of hydroxychloroquine plus azithromycin as potential treatment for COVID 19 patients: pharmacology, safety profile, drug interactions and management of toxicity.. Mediterranee Infection, 22 April.”

    Looked at it. Interesting data about serum concentration of HCQ:

    0.46 µg/ml.

    MW of HCQ is 335.87 g/mol makes 1.37 µM.

    That is some useful information.

    Here is the in vitro study that started all the hype:

    https://www.ncbi.nlm.nih.gov/pubmed/32020029

    They claim their EC90 is 6.90 µM.

    That is significantly off from what you get in the serum.

    But that is not the issue I have with this and other in vitro studies I found.

    1) All the studies are using Vero-6 cells as a model. That is an aneuploid kidney monkey cell line. Not even from a rhesus monkey. People like to use it because it is easily infected but the concentrations used in these cells are not telling you something about the effectiveness and more important anything about toxicity for not immortalized cell lines.

    2) The lowest really effective concentration in the studies (MERS, SARS, SARS-CoV-2) in Vero-2 cells is 10 µM (which they used for the western blot). That one is toxic for non-immortalized human cells even for short exposure.

    3) From the way the drugs were applied there could be a direct extracellular effect on the virus. Actually, the results point into this direction.

    4) Vero-6 cells and a lot of other cell lines are not very efficient to measure replication of the SARS virus:

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1075706/

    I don’t know how well that translates for SARS-CoV-2 but the study addresses NOT the replication which is THE mode of action people are claiming is affected by Zn2+ and HCQ.

    Looked at this reference too:

    “J. e. a. Xue, “Chloroquine Is a Zinc Ionophore,” PLOS ONE, 2014.”

    The authors used 100 µM of chloroquine. That is ~100x more than the concentration that could be measured in patient’s plasma. This is highly toxic to non-immortalized/non-cancer cell lines.

    But there is another issue:

    Chloroquine inhibits proton pumps in lysosomes. That is well known. The effect of Zn2+ accumulation in lysosomes could just be through this effect as H+/Zn2+ antiporters are crucial in lysosomal Zn2+ homeostasis.

    General impairment of lysosomal function is shown in the paper by accumulation of marker protein LC3B.

    This paper below shows that bafilomycin A, a well known very specific proton pump inhibitor for lysosomes, induces Zn2+ accumulation in lysosomes as well:

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4095854/

    The authors also show that Zn2+ transporters and their inhibition are the mechanism how Zn2+ accumulates in lysosomes. NOT a ionophore funtion.

    Another thing caught my eye:

    LC3B is also a marker for impaired autophagy.

    But other peer-reviewed publications have shown for SARS that the opposite, enhanced autophagy, is beneficial for fighting of the virus. There is indeed a pre-print paper that the same seems to apply to SARS-CoV-2:

    https://www.biorxiv.org/content/10.1101/2020.04.15.997254v1

    The authors suggest to use niclosamide as a candidate for treatment of SARS-CoV-2.

    Conclusion:

    The evidence that chloroquine works the way most people here think it does (as a Zn2+ ionophore) is not well supported by direct biological data. There is a high likelihood the reported property to be a Zn2+ ionophore was a misinterpretation of results and insufficient understanding of cellular Zn2+ and lysosomal homeostasis.

    The direct data on virus replication is basically non existent and directs more to an impairment of infection but with a chloroquine concentration not achieved in serum.

    It might still be there is a possibility a combination of Zn2+/HCQ has beneficial effect through unknown mechanism. But that needs to be determined.

    • Ron,
      In reply to: “The authors used 100 µM of chloroquine. That is ~100x more than the concentration that could be measured in patient’s plasma. This is highly toxic to non-immortalized/non-cancer cell lines.”

      This is an in vitro test to determine mechanism not dosage. The Hydroxychloroquine dosage to get the Zinc into our cells is much lower.

      And there is field data. There is a doctor in New York that treated 700 patients with a clinically normal dosage of Hydroxychloroquine and only had one death and the death occurred when the person stopped the treatment.

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

      And this doctor treated 700 covid patients with and had only one death.
      This is the Jewish physician that treated 700 sick covid patients with Hydroxychloroquine and Zinc supplements with close to 100% success rate.

      https://techstartups.com/2020/04/03/updates-from-dr-vladimir-zelenko-now-treated-700-coronavirus-patients-with-99-9-success-rate-using-hydroxychloroquine-zinc-sulfate-and-z-pak-1-outpatient-died-after-not-following-protocol-exclusi/

      • @William Astley
        “This is an in vitro test to determine mechanism not dosage. The Hydroxychloroquine dosage to get the Zinc into our cells is much lower.”

        That is an unproven claim. Where’s the data?

        You also missed my point that the data doesn’t even proof that chloroquine is a Zn2+ ionophore. It just corroborates the finding that inhibiting lysosomal protein pumps leads to accumulation of Zn2+ in them. Bafilomycin A or knockdown of ZnT2 or 4 does the same. No ionophore function.

        “And this doctor treated 700 covid patients with and had only one death.
        This is the Jewish physician that treated 700 sick covid patients with Hydroxychloroquine and Zinc supplements with close to 100% success rate.”

        Information from the article is complete meaningless. No age distribution and co-morbidities given.

    • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4182877/

      Chloroquine is an established antimalarial agent that has been recently tested in clinical trials for its anticancer activity. The favorable effect of chloroquine appears to be due to its ability to sensitize cancerous cells to chemotherapy, radiation therapy, and induce apoptosis. The present study investigated the interaction of zinc ions with chloroquine in a human ovarian cancer cell line (A2780). Chloroquine enhanced zinc uptake by A2780 cells in a concentration-dependent manner, as assayed using a fluorescent zinc probe. This enhancement was attenuated by TPEN, a high affinity metal-binding compound, indicating the specificity of the zinc uptake. Furthermore, addition of copper or iron ions had no effect on chloroquine-induced zinc uptake. Fluorescent microscopic examination of intracellular zinc distribution demonstrated that free zinc ions are more concentrated in the lysosomes after addition of chloroquine, which is consistent with previous reports showing that chloroquine inhibits lysosome function. The combination of chloroquine with zinc enhanced chloroquine’s cytotoxicity and induced apoptosis in A2780 cells. Thus chloroquine is a zinc ionophore, a property that may contribute to chloroquine’s anticancer activity.

      PLoS One. 2014; 9(10): e109180.
      Published online 2014 Oct 1. doi: 10.1371/journal.pone.0109180

      • @Krishna Gans

        I was discussing exactly this study above. Here my quote:

        “The authors used 100 µM of chloroquine. That is ~100x more than the concentration that could be measured in patient’s plasma. This is highly toxic to non-immortalized/non-cancer cell lines.

        But there is another issue:

        Chloroquine inhibits proton pumps in lysosomes. That is well known. The effect of Zn2+ accumulation in lysosomes could just be through this effect as H+/Zn2+ antiporters are crucial in lysosomal Zn2+ homeostasis.

        General impairment of lysosomal function is shown in the paper by accumulation of marker protein LC3B.

        This paper below shows that bafilomycin A, a well known very specific proton pump inhibitor for lysosomes, induces Zn2+ accumulation in lysosomes as well:

        https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4095854/

        The authors also show that Zn2+ transporters and their inhibition are the mechanism how Zn2+ accumulates in lysosomes. NOT a ionophore funtion.”

        And further:

        “The evidence that chloroquine works the way most people here think it does (as a Zn2+ ionophore) is not well supported by direct biological data. There is a high likelihood the reported property to be a Zn2+ ionophore was a misinterpretation of results and insufficient understanding of cellular Zn2+ and lysosomal homeostasis.”

        Having a result is one thing, knowing all the possible explanation for it and designing further experiments to clarify which one is the most likely another.

  34. Here in the interior of BC there are virtually no cases with most of the cases being in Vancouver. Haven’t had this long a period with minimal work as the hospitals are supposed to be emptied in anticipation of the tidal wave of SARS-2 patients who will arrive any time now. My January prediction was that overall health and nutritional status would be determinents of who would do poorly. In many ways, SARS-2 looks very similar to 2009 H1N1 where young people who died in ICU were morbidly obese poorly controlled diabetics. SARS-2 has many different properties, but did find an interesting paper looing at role of Selenium in viral infections. Low Se levels worsen viral infections and I’ve been telling my patients to take 100-200 micrograms of Se daily along with Vitamin D3 2000-5000 units daily (depending on their summer sun exposure), and to have Zinc ready for when they need it.

    Zinc has a long history of being used to treat viral infections and I recall Zinc lozenges being widely touted to treat common cold (perhaps it only treats the Corona virus related colds) and many of my patients swore by it but others had no benefit. With Zinc, it’s important to take it 3-4x/day with onset of symptoms and then stop. This would also be when people would start Hydroxychloroquine/Azithromycin.

    Another factor that will increase inflammatory response is ratio of omega3/6 fatty acids (w3/w6). US diet is notoriously high in w6 fatty acids and this is associated with high levels of inflammation. w3 fatty acids (found in fish oil) are anti-inflammatory and are converted to resolvins which reduce inflammation produced by pro-inflammatory prostaglandin and other inflammatory mediators produced from w6 fatty acids. I’ve used high dose w3 supplementation in patients with traumatic brain injury to speed up recovery. Morbid obesity is associated with a chronic inflammatory state which is worsened if the same person has diabetes. Unfortunately, the only cure for morbid obesity is to stop eating carbs and go on a high protein, saturated fat diet and exercise which is heresy in the US where saturated fat is considered poison. Some of the far milder effects on population in Japan and Korea are likely due to those populations consuming far more fish and seafood which result in less baseline inflammation.

    The one other drug that’s been used in some of the trials I’ve seen is Atorvastatin which lowers cholesterol as a side effect, but primarily modifies cyclo-oxygenase to produce resolvins instead of inflammatory prostaglandins. It’s part of our stroke protocol here and also ASA is added which also modifies cyclo-oxygenases to produce resolvins.

    Another factor, which no longer surprises me, is that people who have recieved influenza vaccine are more likely to have a more severe case of SARS-2. I find the US preoccupation with vaccination somewhat puzzling as vaccination associated side effects, when done on a mass scale, often outweigh any potential benefit. When Bill Gates is pushing a coronavirus vaccine I immediately get very suspicious as anyone who came up with a POS like windoze and hopefully his plans to rake in more billions from a very unlikely to be usefull vaccine will meet the same fate as when he claimed that internet explorer was an integral part of the windoze OS around 2000.

    There’s also a lot of inter-individual variability with SARS-2 and having time to delve into virology for the last month has been fascinating in terms of how advanced molecular biology has become and the ease with which viral modification can be done with gain of function experiments for some rather nasty virii.

    Have handed out packets of hydroxychloroquine and azithromycin to patients I consider at high risk. Interestingly, the center for disease control in BC is strongly cautioning doctors to not use this “experimental treatment” but lots of doctors have stocked up themselves and are using this treatment despite being told they shouldn’t.

    Doxycycline was mentioned as a possible antibiotic to use, and was one I was considering as it’s also a metaloprotease inhibitor and for years people have been trying to synthesis a molecule that just keeps metaloprotease inhibition and not antibiotic effect which is bacteriostatic instead of bacteriocidal. 15 years ago I had patients in Vancouver asking me for prescriptions for minocycline for their rheumatoid arthritis as they believed that it was a chronic infection. Did try it on one patient and she had significant reduction in her symptoms and objective signs of improvement; very interesting and it turns out the metaloprotease inhibition resulted in a decrease in inflammation and improvement of symptoms. Told her at the time that it seemed to be working but I didn’t think she had a chronic infection. Have to look at the other systems that every drug affects some of which we don’t know about yet when they’re used.

    • “Doxycycline … a metaloprotease inhibitor ”

      ACE and ACE2 are zinc metalloproteases. Do you think doxycycline inhibits them? There is speculation that ACE inhibitors keep the RAS from swinging too hard towards the ACE/AngII/AT1R inflammatory axis when coronavirus damages the ACE2 anti-inflammatory axis.

      • That’s a very good question which I can’t answer, but most of the medical literature dealing even remotely with SARS-2 is no longer behind paywalls (I guess that’s one benefit of the lockdown – keeps people like me from going crazy).

        Normally I only am concerned with run of the mill ACE receptor and first time I heard about ACE2 was in February when found it was binding site for SARS-2. Have a _lot_ of reading to do in this area to catch up as, clinically, we don’t need to concern ourselves with it. ACE2 seems to be concerned with remodelling of myocardiam and pulmonary arteries (and likely most of the vasculature) and can either raise or lower bp so, for the moment, I know it’s there and have a deeper dive into that area planned when virology has become too confusing/boring. One interesting finding that came out in a single paper was that SARS-2 will infect endothelium of blood vessels and this has been seen in histology of patients who’ve died of SARS-2. Endothelial dysfunction is present in a lot of people with hypertension and I can see ACEI as being detrimental as they’re non-specific protease inhibitors and one of the ways I can tell if someone is septic if their usual bp is poorly controlled and they come in very hypotensive – result of bradykinin and similar small peptides. ARBs don’t have that side effect.

        I can’t see any harm in trying Doxycycline as it’s well tolerated and people are on it for months or years for chronic infections or for acne. Someone being on and ACEI might just indicate that they have significant endothelial dysfunction. Nutritional status is huge and, despite my making recommendations to the GP’s that take care of people in extended care about them coming in VitD deficient, the next time they come in to hospital, they’re hypophosphatemic and hypocalcemic with elevated PTH (the rapid way of diagnosing VItD deficience as VitD assays take weeks to come back) and not on VitD. Black population needs much higher doses of VitD given that time is takes for them to produce adequate VitD is proportional to darkness of their skin.

        It’s frustrating to not have had any direct contact with SARS-2 patients in hospital as it’s just so rare here in interior of BC. Where I work, no-one has died of SARS-2 in hospital and I suspect that by scaring people away from the hospital there’ll be a huge influx of people once things are back to something close to “normal”. I work in an area where people don’t see a doctor unless absolutely necessary (very refreshing after dealing with the opposite in Vancouver), and they will have been without medical attention for a lot longer than they usually are. OTOH, the overall death rate might have gone down since multiple studies of doctors strikes have shown a decrease in overall death rate which suggests that not tinkering too much with peoples physiology is likely beneficial.

    • “The center for disease control in BC is strongly cautioning doctors to not use this “experimental treatment”.
      Is the logic “no treatment is better than an experimental treatment” compatible with the Hippocratic Oath?

    • Funny … ‘Clyde’ has not chimed in here with his usual litany of warnings and cautioning those reading and posting to “not be their own prescribing physician”.

  35. Another report I read recently suggested that Zantac and PepcidAC had shown some positive results in treatment of patients with ChiCom-19. To me, this makes some sense, as H2 histamine blockers have been shown to play a role in reducing inflammatory immune reactions.

  36. Hi Leo. Have you looked at the correlation of serious covid symptoms and Vitamin D deficiency? 19 times more likely to have serious conditions. Deficient compared to Normal.

    Our body has a system to protect it against virus attacks. That explains why many people who have had covid are asymptotic.

    Zinc is also the likely natural means our body has to stop viruses from replicating. There is likely natural microbiological system, that requires higher levels of 25(0H)D to activate.

    That natural system that gets free Zinc into our cells which has been shown to stop the covid virus from replicating.

    The problem that natural system does not work as we are deficient in ‘Vitamin’ D, the prohormone that is used in 200 microbiological processes in the body.

    The first line of defense against Covid, should be correcting the Vitamin D deficiency that affects 42% of the UU population.

    This study and others show that people who are vitamin D deficient are 19 times more likely to die from covid and have serious complications as compared to people who are Vitamin D ‘normal’, 25(OH)D, 30 ng/ml which requires 4000 UI/day of Vitamin D supplements for most people to achieve.

    Patterns of COVID-19 Mortality and Vitamin D: An Indonesian Study

    https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3585561

    Vitamin D Insufficient Patients 12.55 times more likely to die

    Vitamin D Deficient Patients 19.12 times more likely to die

    4000 UI/day of Vitamin D supplements is required to raise the serum 25(OH)D above 30 ng/ml.

    For Vitamin D status, cases were classified based on their serum 25(OH)D levels:

    (1) normal – serum 25(OH)D of > 30 ng/ml,

    (2) insufficient – serum 25(OH)D of 21-29 ng/ml, and

    (3) deficient – serum 25(OH)D of < 20 ng/ml.

    This classification was based on existing literature. 16

    https://tahomaclinic.com/Private/Articles4/WellMan/Forrest%202011%20-%20Prevalence%20and%20correlates%20of%20vitamin%20D%20deficiency%20in%20US%20adults.pdf

    Prevalence and correlates of vitamin D deficiency in US adults

    Mounting evidence suggests that vitamin D deficiency could be linked to several chronic diseases, including cardiovascular disease and cancer. The purpose of this study was to examine the prevalence of vitamin D deficiency and its correlates to test the hypothesis that vitamin D deficiency was common in the US population, especially in certain minority groups.

    The overall prevalence rate of vitamin D deficiency was 41.6%, with the highest rate seen in blacks (82.1%), followed by Hispanics (69.2%). Vitamin D deficiency was significantly more common among those who had no college education, were obese, with a poor health status, hypertension, low high-density lipoprotein cholesterol level

    This is a chart that shows the diseases (cancers) that have been found to be caused by Vitamin D deficiency.

    https://www.grassrootshealth.net/wp-content/uploads/2017/05/disease-incidence-prev-chart-051317.pdf

    • That last chart is a bit scary; even Tribal East Africans (known to be far less susceptible to ‘modern’ diseases than ‘modern’ man) do not appear to have Vit D levels to be completely out of the woods.

      Then again, factor-in a less processed diet, lack of obesity, lifestyle factors, etc and one might anticipate why they tend to be in such rude health compared to us lot.

  37. Another trial claims positive results https://www.randombio.com/cq.html

    O

    Another observational study[1] came out the other day showing a highly significant effect of chloroquine in reducing the amount of SARS-CoV-2 virus. Details are here.

    Virus Kaplan-Meier curve from Huang et al
    Virus Kaplan-Meier curve from Huang et al. (2020) [1]

    It’s not the randomized placebo-controlled trial we’ve been waiting for, and the study is far from perfect, but their graph shows a highly statistically significant difference in the rate of clearance of the virus (see graph). The subjects were all moderately severely infected with SARS-CoV-2. No deaths were reported.

    This is only a few days after another trial from Wuhan Tongji Medical College[2] claiming that moderate doses of hydroxychloroquine produced highly significant reductions in mortality in severely ill COVID-19 patients. Details are here.

    Other studies have found no significant effect. What’s going on? Do these drugs work or not? Why is the science so confused? Several possible reasons:

    There are now many different strains of SARS-CoV-2 virus. Different sources give different numbers. The number increases daily. Here’s a phylogenetic map.
    Every study is using a different dose and measuring a different end point.
    Control groups, when they’re included, include a variety of other treatments that may obscure the results.
    Very few groups are doing proper randomized placebo-controlled studies.
    Nobody really knows the biochemical mechanism by which CQ and HCQ are supposed to work. The Yu et al. study points to an anti-inflammatory effect, while the Huang et al. study points to an effect on virus activation. There’s support in the literature for both possibilities.

    Is anyone convinced yet why we need randomized placebo-controlled clinical trials? Why couldn’t these things have been tested before it became an emergency?

    Here’s why. Treating infected patients is dangerous work. Studying the virus in the lab is even more dangerous, in more ways than one. A highly technical article on medium.com just came out describing how virus researchers have been introducing changes into viruses, usually but not always (he claims) creating non-pathogenic viruses. The goal is to identify features responsible for pathogenicity and to create knowledge essential for making vaccines. The author gives the impression of hubris in the field and claims, in contradiction to a number of reports in Nature and elsewhere, that the furin cleavage site in the SARS-CoV-2 DNA sequence looks out of place.

    The researchers are being careful and working in BSL-4 containment. If the medium.com author is right, this suggests a potential failure of institutional oversight. I’m on one such committee (though not with viruses) and there’s definitely a certain amount of pressure to assume that an accident won’t happen and the safety protocol will be followed if it does. They also know, we hope, that making a mistake is not an option.

    1. Huang M, Li M, Xiao F, Liang J, Pang P, Tang T, Liu S, Chen B, Shu J, You Y, Li Y, Tang M, Zhou J, Jiang G, Xiang J, Hong W, He S, Wang Z, Feng J, Lin C, Ye Y, Wu Z, Li Y, Zhong B, Sun R, Hong Z, Liu J, Chen H, Wang X, Li Z, Pei D, Tian L, Xia J, Jiang S, Zhong N, Shan H (2020) Preliminary evidence from a multicenter prospective observational study of the safety and efficacy of chloroquine for the treatment of COVID-19. MedrXiv preprint. doi: https://doi.org/10.1101/2020.04.26.20081059. Not yet certified by peer review

    2. Yu, B., Wang, D. W., Li, C. (2020). Hydroxychloroquine application is associated with a decreased mortality in critically ill patients with COVID-19 https://www.medrxiv.org/content/10.1101/2020.04.27.20073379v1.full.pdf 10.1101/2020.04.27.20073379 Not yet certified by peer review

  38. Hydroxychloroquine or gin and tonic. Gin and tonic, please and keep them coming.

    • I thought at least heparin was a standard medication for all severe ARDS patients? Why didn’t they do this? Or did they?

      Might this be a reason why the death rate in Germany is so low (and shockingly as well around 30%…)?

        • The EVMS protocol could improve survival rate but ~30% is already the rate for Germany so that might be as good as it gets.

          CFR of closed cases for Germany still 5%. Undetected cases are guessed to be 4-8x more so estimated IFR would be 0.625-1.25% which is in the same ball park as the Lancet study.

          There is no magic drug.

          • @Ron
            Do you know, why these people recovered ?
            Certainly you have no idea about, as everybody else, maybe you believe, all have been untreated 😀 – wishfull thinking 😀

  39. Due to the shortage of PCR Virus tests for SARS-COV-2, hospitals in Ohio did not order the tests unless the patient was being admitted into the hospital for diagnosis (or had known exposure).

    Consequently, hospital admission and treatment only occurred if the patient was already very ill.

    So, even if you had flu-like symptoms with pulmonary symptoms (shortness of breath or difficulty taking a deep breath…which are uncommon with influenza) you would not get tested or hospitalized if your doctor thought you would recover on your own. My doctor made a provisional diagnosis of Covid-19 for my late March illness, but she did not order the PCR Virus test. I was advised to go to the ER if breathing got more difficult (improved but still recovering 6 weeks later).

    I had asked about early HCQ treatment and was advised that Cleveland Clinic Foundation (CCF) doctors were “not encoutaged” to Rx Plaquenil for unapproved early Covid-19 treatment (I’m looking for a new doctor).

    Certain that I had Covid-19, I sought a Serum Antibody Test (when Roche’s very accurate test became available last week). That request was also denied.

    From the little information that’s available on HCQ studies…and just from common sense, HCQ therapies would be most effective when administered as early as possible…and with Zinc. The “tissue loading” aspect of Plaquenil would argue for having some on hand in case symptoms arise.

    None of that matters because the Plaquenil is not available until you are hospitalized. Optimizing HCQ therapy is currently impossible…at least in the land of the CCF.

    • This is true in my state also. I could have a nurse come to my house with no prescription for HCQ, would have to be in hospital

      I know why my Dr mentioned black market back in March

      My new quest, aquire HCQ in any manner possible just to be sure I can find some if needed, it is difficult.

      Anyone up for an outline on how to use dark web safely to buy hcq. Hate to take the trouble to do so, but what choice is there. Other ideas on how to aquire.

      As always, read about EVMS protocol, https://spectator.org/a-report-from-the-front/

  40. The media is intentionally ignoring the widespread use of HCQ+azithromycin + zinc by MDs in NYC . It has become the standard treatment for hospitalized cases and has been very effective. They don’t know or don’t want to know, and certainly don’t want the public to know.

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