FDA Revokes Approval of Hydroxychloroquine for Covid-19

Hydroxychloroquine
Hydroxychloroquine. By Fvasconcellos – self-made by Fvasconcellos., Public Domain, Link

Guest essay by Eric Worrall

The FDA has just revoked emergency approval of HCQ for Covid-19 patients, a decision criticised by President Trump. IMPORTANT – a tweet provided by MP puts a different spin on today’s events.

Hydroxychloroquine: US revokes emergency approval of malaria drug for Covid-19

Food and Drug Administration says drug is unlikely to work against coronavirus and notes heart risks.

Guardian staff and agencies
Tue 16 Jun 2020 10.19 AEST

US regulators revoked the emergency authorization for malaria drugs championed by Donald Trump for treating Covid-19, amid growing evidence they don’t work and could cause serious side effects.

The Food and Drug Administration (FDA) said on Monday the drugs hydroxychloroquine and chloroquine were unlikely to be effective in treating the coronavirus. Citing reports of heart complications, the agency said the drugs’ unproven benefits “do not outweigh the known and potential risks”.

Trump criticized the FDA decision. “I took it and I felt good about taking it. I don’t know if it had an impact, but it certainly didn’t hurt me,” Trump said on Monday.

Trump said there had been “great reports” out of France, Spain and other places, without offering any evidence or further explanation. France is one of the countries that has already stopped using the drug for Covid-19 patients.

In a separate announcement, the FDA also warned doctors against prescribing the drugs in combination with remdesivir, the lone drug currently shown to help patients with Covid-19. The agency said the anti-malaria drugs could reduce the effectiveness of remdesivir, which the FDA cleared for emergency use in May.

The drugs can cause heart rhythm problems, severely low blood pressure and muscle or nerve damage. The FDA reported on Monday that it had received nearly 390 reports of complications with the drugs, including more than 100 involving serious heart problems. Such reports represent an incomplete snapshot of complications with the drugs because many side effects go unreported.

Read more: https://www.theguardian.com/world/2020/jun/15/hydroxychloroquine-coronavirus-fda-emergency-authorization

The FDA are correct that there is no definitive proof Hydroxychloroquine works, but many doctors who have tried it have been impressed.

There has been an unseemly scramble to try to claim Hydroxychloroquine does not work, including a now retracted study based on questionable data.

The apparent irregularities surrounding oversight of Hydroxychloroquine, a drug which was widely used for decades in Malaria prone regions, in my opinion undermine the credibility of the entire medical oversight establishment.

h/t Gary Ashe – The Association of American Physicians and Surgeons filed a lawsuit 2 weeks ago to overturn the FDA restrictions on hydroxychloroquine.

h/t MPIMPORTANT It appears the Guardian may have misinterpreted the actions of the FDA, or perhaps I misinterpreted what the Guardian was trying to say. It appears that doctors are now free to provide Hydroxychloroquine however they see fit.

296 thoughts on “FDA Revokes Approval of Hydroxychloroquine for Covid-19

  1. “The FDA are correct that there is no definitive proof Hydroxychloroquine works, but many doctors who have tried it have been impressed.”
    There has been now a huge amount of testing, some faulty. If it works, some proper evidence would have emerged. There is nothing.

    • Hydroxychloroquine was used in the tropics as an anti-malarial by millions of people for decades. If adverse reactions were a serious problem you would think some evidence would have emerged.

      • “If adverse reactions were a serious problem you would think some evidence would have emerged.”

        Cardiac arrest is a serious problem. From the New York study:

        “A greater proportion of patients receiving hydroxychloroquine + azithromycin experienced cardiac arrest (15.5%) and abnormal ECG findings (27.1%), as did those in the hydroxychloroquine alone group (13.7% and 27.3, respectively), compared with azithromycin alone (6.2% and 16.1%, respectively) and neither drug (6.8% and 14.0%, respectively). In adjusted models with those receiving neither drug as comparison, cardiac arrest was more likely in patients receiving hydroxychloroquine + azithromycin (adjusted OR, 2.13 [95% CI, 1.12-4.05]; E-value = 1.31), but not hydroxychloroquine alone (adjusted OR, 1.91 [95% CI, 0.96-3.81]) and azithromycin alone (adjusted OR, 0.64 [95% CI, 0.27-1.56]), and also in patients taking hydroxychloroquine alone vs azithromycin alone (adjusted OR, 2.97 [95% CI, 1.56-5.64]; E-value = 1.81).”

        Then there was the Brazilian study that had to be abandoned because the high dose regime was harmful.

        • Not exactly a double blind study. There is evidence Covid causes blood clotting problems, which likely increases the risk of cardiac arrest. And its likely NY doctors had a tendency to administer HCQ to the sickest patients, wherease there is anecdotal testimony HCQ works if administered early.

          Given HCQ has been used for decades without a massive outbreak of cardiac problems, and given Covid is known to cause blood clotting disorders, which in some cases were severe enough to have resulted in strokes and amputations, I think the evidence suggests Cardiac abnormalities are most likely caused by Covid, not the HCQ.

          Note I’m not saying the case is closed on the effectiveness of HCQ – but IMO the opposition to HCQ stinks.

          • “And its likely NY doctors had a tendency to administer HCQ to the sickest patients”
            The test regime was started as soon as possible after hospital admission – for HCQ median delay 1 day. It was not conditional on patients’ condition.

            “Note I’m not saying the case is closed on the effectiveness of HCQ”
            There is no case for, except gossip. Just criticism of the case against, and that case just grows and grows.

          • “There is no case for, except gossip.”

            Dr. Seigel, Fox News Channel’s medical consultant says the HCQ treatment saved his 95-year-old father’s life when they used it as a last resort. But that’s just gossip.

            A doctor in Dallas said she treats all her patients with the HCQ treatment from the sickest to the mildest cases, and in all cases she thinks HCQ helped her patients, saying in some cases their conditions reversed in a matter of hours after taking the drugs. But that’s just gossip.

            The most prominent doctor in California with regard to Lupus and prescribing HCQ said in his 40 years of presribing HCQ, he had never had a case where a patient had a reaction to the HCQ that required hospitalization. But that’s just gossip.

            And then there’s the doctor from New York who has treated thousands of patients with HCQ and the doctor in France who has done the same. But that’s just gossip.

            Well, all I can say is, if I got the Wuhan virus, I would demand that I be given HCQ as soon as possible. And this new FDA ruling makes that much easier.

          • Dr. Seigel, Fox News Channel’s medical consultant says the HCQ treatment saved his 95-year-old father’s life when they used it as a last resort. But that’s just gossip.

            A doctor in Dallas said she treats all her patients with the HCQ treatment from the sickest to the mildest cases, and in all cases she thinks HCQ helped her patients, saying in some cases their conditions reversed in a matter of hours after taking the drugs. But that’s just gossip.
            Yes, it is gossip. No controls, so it is gossip.

            There are plenty examples where gossip – or how it is called in science “anecdotal evidence” – didn’t survive a randomized controlled trial. Everybody in the life sciences knows that. There are just some that ignore it and report it anyway.

            That is why doctors are not necessarily scientists. You don’t need to design and perform scientific experiments to get your M.D. You also don’t need to understand how science works. You have to memorize books. That’s all.

          • Nick says: “The test regime was started as soon as possible after hospital admission – for HCQ median delay 1 day. It was not conditional on patients’ condition.”
            On the contrary, these were HOSPITALIZED patients to begin with. Only the sickest are hospitalized. And who is most apt to be the sickest? The elderly (most of the deaths) with weak hearts, etc.
            AFAIK there has yet to be a proper study released which tests HCQ early on, the time when physicians familiar with it expect it to work. Early on, where remdesivir was tested and where Tamiflu works for the flu, the rule of thumb being that antivirals tend to work only early in infections. (I discount the negative online recruited mail-order “study” of prophylactic use.) My understand is there are multiple pending proper early-on studies to come out in the next few months.

          • Nick S:
            “There is no case for, except gossip.”

            Tom Abbott:
            “Dr. Seigel, Fox News Channel’s medical consultant says the HCQ treatment saved his 95-year-old father’s life when they used it as a last resort. But that’s just gossip.

            A doctor in Dallas said she treats all her patients with the HCQ treatment from the sickest to the mildest cases…”

            Ron:
            “Dr. Seigel, Fox News Channel’s medical consultant says the HCQ treatment saved his 95-year-old father’s life when they used it as a last resort. But that’s just gossip.

            A doctor in Dallas said she treats all her patients with the HCQ treatment from the sickest to the mildest cases…”

            Is this bots gossiping?

          • @Nick Stokes
            No, just blockquote gone wrong. Let’s try again:

            Dr. Seigel, Fox News Channel’s medical consultant says the HCQ treatment saved his 95-year-old father’s life when they used it as a last resort. But that’s just gossip.

            A doctor in Dallas said she treats all her patients with the HCQ treatment from the sickest to the mildest cases, and in all cases she thinks HCQ helped her patients, saying in some cases their conditions reversed in a matter of hours after taking the drugs. But that’s just gossip.

            That were my two cents:

            Yes, it is gossip. No controls, so it is gossip.

            There are plenty examples where gossip – or how it is called in science “anecdotal evidence” – didn’t survive a randomized controlled trial. Everybody in the life sciences knows that. There are just some that ignore it and report it anyway.

            That is why doctors are not necessarily scientists. You don’t need to design and perform scientific experiments to get your M.D. You also don’t need to understand how science works. You have to memorize books. That’s all.

          • Having taken it daily for over ,7 years ( age when started 42 ) no problems in New Guinea

          • General Stokes: “Is our new weapon successful?”
            Adjunct: “Sir, commanders throughout the front line report that it is routing the enemy!”
            General S: “Dammit, man! I need RCT data from West Point, not gossip!”

          • Adjunct: “And we are equally successful at most front lines and even more successful at others with different new weapons”.

          • Ron, what new weapons besides high dose vitamin C IV, ClO2 IV, proning, non-invasive ventilation, anti-clotting drugs in some cases have been equally successful? Being strong and healthy enough to endure paralytic/comatizing drugs and lung baro-trauma from being intubated, as well as toxic anti-viral drugs, are not treatments, much less equal treatments.

            btw use of anti-clotting drugs for pulmonary microthrombosis is not new. They were used nearly 50 years ago for influenza.

          • @icisil
            HCQ does not have randomized controlled trial backed up evidence. Remdesivir and dexamethasone have, anti-coagulants are on their way.

            So they are better as long as HCQ is not proven to outdo them.

            I don’t think it will. The Zn ionophore cellular data is very weak. I’m working on lysosomal biology and the papers are most likely misguided in their interpretation.

            Any inhibitor of lysosomal vATPase results in Zn accumulation in lysosomes due to inhibiting the antiporter activity of lysosomal Zn transporters thereby trapping Zn in lysosomes and depleting it from the cytosol working as a Zn sink. No ionophore effect.

            Chloroquine does not even have the chemical properties to act as a ionophore because it is structually not capable of complexing divalent cations. Quercetin has those properties and Clioquinol as well.

          • In reply to:

            “There is no case for, except…. Your comment is factually incorrect. Are you interested in stopping the Covid virus or just playing politics.

            Political Evil people purposely ‘Tested’ to get a negative result by testing HCQ without the Zinc Sulfate.

            Are you calling the orthodox Jewish Doctor who successfully treated 700 of his orthodox patients a liar with HCQ and Zinc Sulfate. Why this not evidence?

            Here is peer reviewed evidence that HCQ is a zinc ionophore (HCQ enables the positive Z+2 ion to get in to our negative cells)

            And a tiny amount of zinc (Z+2) has been shown, in vitro, in peer reviewed studies, to stop the Covid virus from connecting to the ACE-2 connector molecule in our cell by making that molecule slightly positive.

            https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2973827/

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

            Chloroquine Is a Zinc Ionophore

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

            Our cells are negative so the zinc cannot get in natural. The Jewish doctor subscribed Zinc Sulphate along with HCQ. It work on 700 patients.

            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/

            The problem is everything is political. And the Democrats hate Trump and want to win the election at all costs, including riots.

            85% of the Population does not have serious covid symptoms. What we need to fix the problem with the remaining 15%.

            It is a peer reviewed fact that regardless of sex or age ‘Vitamin’ D deficient people are 19 times more likely to die from Covid, than “Vitamin’ D deficient people.

            ‘Vitamin’ D is a proto hormone that our body produces to turn on and off genes to control our body. Very dark skin people require 10 times as much UVB exposure to produce the same amount of ‘Vitamin’ D as white skin people.

            There is peer reviewed evidence that 82% of the US Black population and 42% of the US general population is ‘Vitamin’ D deficient …. (Simple blood sample and blood test. This is a fact not a theory.)

            And using the same definition of ‘Vitamin’ D deficient and normal…..

            ‘Vitamin’ Deficient people regardless of sex or age are 19 times more likely to die and have serious Covid cases as ‘Vitamin’ D deficient people.

            Correcting the population’s ‘Vitamin’ Deficiency also reduces the incidences of Type 2 diabetes by more than 50%….

            Which explains why the incidence of Type 2 diabetes is so high for dark skin people.

            Also correcting the population ‘Vitamin’ D deficiency reduces the incidence of breast cancer by more than 70%, reduces the incidence of muscular sclerosis by 60%, and a bunch of other good things.

            https://www.sciencedirect.com/science/article/pii/S0960076015300091?via%3Dihub

            Incidence rate of type 2 diabetes is >50% lower in Grassroots Health cohort with median serum 25–hydroxyvitamin D of 41 ng/ml than in NHANES cohort with median of 22 ng/ml

          • We are all in this together. There is a natural solution to Covid which makes sense as 85% of the population do not have serious covid symptoms.

            This is the link to the peer reviewed study that shows regardless of sex or age ‘Vitamin’ D deficient people are 19 times likely to die of Covid than Vitamin D normal people and Vitamin D insufficient people are 12 times more likely to die of Covid.

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

            https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3585561
            Quote from the paper:

            Vitamin D Insufficient Patients 12.55 times more likely to die

            Vitamin D Deficient Patients 19.12 times more likely to die

            This is the link to the study that shows 82% of the US Black population and 42% of the US general population is Vitamin D deficient.

            Coronavirus: Black African deaths three times higher than white Britons – study
            https://www.bbc.com/news/uk-52574931
            https://www.bbc.com/news/uk-52492662

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

            This another good thing that correct the Vitamin D deficient.

            Correcting our Vitamin D deficient has been shown to reverse prostate cancer growth and Vitamin D has been shown to turn on gene that stops inflammation, which is how the prostate cancer grows. Actually inflammation is how most cancers grow which explains why correcting the Vitamin D deficiency reduces the incidence of breast cancer by 70%.

            Finally, Missing link between vitamin D prostate cancer

            https://www.sciencedaily.com/releases/2014/10/141022164052.htm

          • RCTs are like bullshit peer review. Remdesivir is crap; they had to move the goal posts to give it some positive spin. I don’t hear a lot of doctors singing Remdesivir’s praises (in fact I don’t hear any), but there are a lot of doctors singing HCQ’s praise. That’s all I care about – what doctors who can actually heal people think. When it comes to uncharted territory, I really don’t give a crap what clinicians who only know how to robotically follow protocols think.

          • @icisil
            Are you just frustrated by the factual evidence?

            Remdisivir works exactly when you would think it should work. Applying to late and you don’t see any beneficial effect, same thing people claim over and over for HCQ only that you don’t have controlled evidence for any beneficial effect at any time.

            Dr. Seheult uses remdesivir and it works. He is very open-minded but stresses that you need randomized controlled trials. So that applies for HCQ as well.

            I don’t think HCQ works for COVID-19 and I don’t think even if it works in some way it works in the way people claim.
            Cause it can’t. It’s just not a Zn ionophore. Regardless of this one and only PLOS One paper. Ask an organic chemist if it can. Spoiler alert, the answer will be no. That’s why I bet there was no chemist at all among the reviewers of that very paper. They would have spotted this.

            What probably will work is treating Zn insufficiency in patients cause it is important for proper endothelial cell function, erythrocyte integrity and could suppress the inflammatory response in infected endothelial cells.
            But elevating Zn blood levels too high will be detrimental because then Zn could trigger coagulation.

            As always, the dosage counts.

          • “after hospital admission”

            The treatment needs to start as soon as possible after infection. As soon as symptoms appear, at least. If you wait until they’re so sick they need hospital treatment, you’ve waited too long. In my opinion, this was by design, in order to prove HCQ didn’t work. But it’s also possible that it was a byproduct of the fact the researchers only worked in hospitals. By all means, argue that it was simple incompetence.

          • It is pretty clear that CQ and HCQ are largely harmless to most people at the doses prescribed for malaria prevention, treatment, and for lupus.
            It is also clear it is not safe for some percentage of people, perhaps a small percentage.
            Many lupus patients cannot take it.

            And it is also clear that lots of things have effects in vitro that simply do not translate into therapeutic efficacy in sick people.

            Most people who get Covid recover, including many elderly and those with other conditions.
            Most get either very mild or no symptoms.

            Even most elderly survive, so one person, no matter the age or circumstance, means nothing.
            For ever doctor reporting good results, there are entire hospitals full of doctors who have tried and abandoned it as a useful therapy.

            There is a growing mountain of scientific evidence it does not treat or prevent the disease, although there is also a large amount of bad data.
            I noted back in the early days of this that the truth is the first casualty of any conflict.
            This one is no different.
            All of us skeptics know that people who have become outspoken advocates cannot be trusted as reliable sources of unbiased information. This is as true for HCQ as it is for AGW.

            It does not work, and a great many people have squandered a lot of credibility by claiming they know different.
            Successful antivirals are very rare. Viruses are the ultimate chemical weapon in the war of life. They have been at it for billions of years, and are very good at it.
            People are not very good at many things, such as discerning objective reality based on their gut instincts and hearsay.

        • “Because the (deliberately excessive) high dose regime was harmful.” Designed to fail? Clearing away a low profit impediment to a highly profitable patentable vaccine?

        • Nick,
          You know very well that the poison is in the dose.
          I have taken methotrexate for over 7 years with no harmful effects. Protocol requires me to have blood work which includes liver/kidney function tests every 90 days while on the drug. Nothing abnormal, in fact, most of my tests are right down the middle.
          My dose is 15 mg/week taken in one dose. Now, if I were to take 30mg/week I would have serious side effects. If I were to take 30mg for 3-4 days in a row I would most likely be dead.

          • “You know very well that the poison is in the dose.”
            You could take less. But the point is that the dose tested was both ineffective and dangerous? So should it be more, or less?

          • Nick,
            Are you subscribing to the “if a little is good, more is better” formula? Sounds like it.
            The PROPER dose of medication is effective. More or less may not be. Until trials determine the proper dose, any study using only one dose is inconclusive.
            I will use my personal example again. I started with 25mg/week of methotrexate. That caused some uncomfortable side effects. We lowered the dose to 20mg/week and that still caused some side effects. We lowered it to 15mg/week and the side effects went away and that dose did the job. I prefer to use the lowest dose possible so we lowered it again to 10mg/week. That was too low and did not do the job so we went back to the 15mg/week. For me the optimal dose is 15mg/week. Perhaps it is lower or higher for others as the recommended range is from 7.5mg/week to 25mg/week.

          • ” For me the optimal dose is 15mg/week.”
            You can jiggle the dose if you are moving between ineffective and safe vs effective but dangerous. But if you have a dose that is both ineffective and dangerous, there is no direction to move.

          • Tom In Florida-

            Sorry, but they are not talking about methotrexate, but rather plaquenil. Both are prescribed for rheumatoid arthritis, often together.

          • For any drug or even things that are food, there are people who cannot ingest it without doing harm to themselves.
            Some people are virtually immune to almost any poison, and some people cannot take medicines generally regarded as safe.
            There are entire books full of examples of these facts.

        • High dose to the most ill is safe according to the UK Recovery study, they gave 2,400mg on the first day, 9,600 over the course I believe, the normal dose is 400mg for 5 days, so it is totally safe at a safe dosage.

          • My rheumatologist has me on 400 mg/day of hydroxychloroquine for psoriatic arthritis. Although I also have atrial fibrillation, my cardiologists have had no problems with that. The only side effect that I need to be monitored for is a quite rare incidences of eye damage.

            I don’t know if this gives me any protection from COVID-19 or not. But if it does, that’s nice.

          • ” He is in NY City as are all his patients.”

            He practised in Kiryas Joel, in Orange County about 70 miles from NYC. But things have not gone so well:

            “Dr. Vladimir Zelenko, an Orthodox Jewish doctor who rose to fame in March while promoting a cocktail of drugs he claimed had successfully treated coronavirus – including one that President Donald Trump said Monday he is taking himself, despite the drug’s potentially dangerous side effects – has announced that he is leaving the Jewish community where he has practiced medicine for decades.

            In a video shared by the Orthodox news site Yeshiva World News, Zelenko announced he would leave Kiryas Joel, the town north of New York City where, until the coronavirus pandemic, he was known as a beloved community doctor.

            “Things have happened,” he said speaking directly to the camera. “I’ve decided that it’s time for me to move on. I’m not sure yet what I’m going to do.”

            The announcement comes after Zelenko was accused by community leaders of spreading disinformation about the rate of coronavirus infection in Kiryas Joel, leading to discrimination against residents of the village. Zelenko is also being investigated by a federal prosecutor over his claim that a study of the drugs he promoted had won approval from the Food and Drug Administration.”

          • Zelenko is a quack who insisted he had a cure before he had any evidence.
            For one thing, how did one person keep up with the subsequent history of 1400 people over a matter of days?
            It is published with his story that he saw no patients…he did everything by phone and computer.
            So how on Earth did one person treat hundreds of people a day for a couple of weeks and keep track of them all?
            Entire studies using large numbers of people have a nearly impossible time keeping up with everyone, even when the numbers are a fraction of 1400+.
            Anyone who bought that crap is a gullible fool.
            And I am sick of not saying it.

          • This entire episode is a case study in how many people will make up their minds about something based on flimsy and even zero evidence, if they want to believe it or it is in line with some ideology they subscribe to.
            Right down to the part about how many people are simply mentally incapable or emotionally unable to even see that they were wrong or admit it even if they see it.

            Sound familiar to anyone?
            Any other subject anyone can think of where they know this is true?

        • https://www.bbc.com/news/world-europe-52831017

          Chief doctor Nurettin Yiyit – whose art work is on the hospital walls – says it’s key to use hydroxychloroquine early. “Other countries are using this drug too late,” he says, “especially the United States. We only use it at the beginning. We have no hesitation about this drug. We believe it’s effective because we get the results.”

          On a tour of the hospital, adding and subtracting protective layers as we go, he explains that Turkey’s approach is to “get ahead of the virus”, by treating early and treating aggressively. They use hydroxychloroquine and other drugs, along with blood plasma and oxygen in high concentrations.

          Gossip 😀 😀 ?

        • https://www.middleeasteye.net/news/hydroxychloroquine-coronavirus-turkey-lancet-study-who-trial

          Many Turkish medical doctors, in response, cautioned the public about the Lancet study and the WHO decision, saying that it was too early to throw the drug out of the treatment models.
          Bengi Baser, a cardiologist and medical sciences professor, told MEE that hydroxychloroquine has been used since the 1930s and there wasn’t any major health concern if used within the safe dosage.
          “I haven’t seen any of my coronavirus patients who received this drug having any heart issues,” she said. “Among them there were patients who had a stent put in their hearts or had chronic heart diseases.”
          Baser and others said that Turkey used the drug as an anti-viral treatment in the early stages, to disrupt the replication of the virus in the body.

          Gossip 😀 😀 😀 ?

        • I suppose I should dig up the original study to see what really happened but medical “research” is often on the same level of fascination as Dr. Seuss. Based on what Nick quoted, “In adjusted models with those receiving neither drug as comparison, cardiac arrest was more likely in patients receiving hydroxychloroquine + azithromycin (adjusted OR, 2.13 [95% CI, 1.12-4.05]; E-value = 1.31), but not hydroxychloroquine alone (adjusted OR, 1.91 [95% CI, 0.96-3.81])”, therefore hydroxychloroquine alone did not affect cardiac arrest. The apparently inconsistent findings amongst treatments suggests more slipshod medical research which needs to be taken with many grains of salt.

          • “therefore hydroxychloroquine alone did not affect cardiac arrest”
            Not very good news, since people seem to insist that it is only the arresting combo of HCQ+AZ that works. But you don’t seem to have looked at what “In adjusted models” or “adjusted OR” meant. They are just statistical interpretations of the original data. For HCQ alone, the value of 1.91 didn’t quite reach the 95% significance level (2). That doesn’t mean that it didn’t affect cardiac arrest. There were more arrests (13.7% vs 6.8%). There remains just a very faint possibility that that was due to chance. You can’t base a FDA recommendation on the proposition that there is a faint chance it won’t help make your heart stop.

          • For HCQ alone, the value of 1.91 didn’t quite reach the 95% significance level (2). That doesn’t mean that it didn’t affect cardiac arrest. There were more arrests (13.7% vs 6.8%). There remains just a very faint possibility that that was due to chance.

            So it’s important to follow objective methods unless those methods disagree with the desired outcome. Then it’s OK to discard the statistical test and apply the objective standard of “a very faint possibility.”

            How 2020.

          • “Then it’s OK to discard the statistical test and apply the objective standard of “a very faint possibility.””
            No, it is the statistical test that says there is a very faint possibility. About 0.028, where the conventional cut-off is 0.025.

            But the converse is that it is very likely (but not certain) that HCQ alone caused cardiac arrest. And that is not a recommendation.

        • Adverse events in the NY study:

          I read the entire study, including where they noted 7 or 8 limits of their study.

          NOWHERE in the study was DOSE mentioned.

          Kind of odd, eh?

          Almost as if….

      • It has been used since 1946 by millions of people! Currently it is being used by 46,000 people in the VA!

        But to make matters more interesting, the Association of Physicians and Surgeons on June 2, 2020 sued the FDA for “irrational interference of access” to hydroxychloroquine in the US District Court for the western district of Michigan!

        It appears the FDA is suppressing use of the drug because it is cheap and it threatens the sale of billions of dollars for a new vaccine, should one ever emerge! So far, the vaccines have been all promise with very little benefit while the FDA ignores clinical results where thousands have gotten relief from the covid-19 virus using hydroxychloroquine with zinc!

        Doctors maintain that their pharmacists have no business asking for what purpose the drug is being prescribed for that is a violation of the physician’s role in treating patients!

        Some Democrats would rather some people die rather than prove President Trump correct! They would also rather see whole cities lose their business districts and kill and murder cops and other innocent people in order to keep President Trump from being re-elected! (BLM and antifa have replaced the KKK as the Democrat’s militant faction!)

        Democrats are vile and criminal! Change my mind!

        • The drug is a zinc ionophore it works in exactly the same way for all RNA viruses, that means the common FLU, no more vaccines just a 5 day course same as flu.

      • UK’s RECOVERY (Randomised Evaluation of COVid-19 thERapY) clinical trials.
        In an interview on Tuesday, Raoult scathingly called RECOVERY ‘the Marx Brothers doing science’. He runs through the defects: lack of positive diagnosis, failure to discriminate different stages of the disease, the huge dosage, lack of virological follow-up, and the shocking mortality – which is when his simile ceases to be funny.
        Internet sleuths also got to work on the very heavy doses of the drug that were given – 2400 mg in the first 24 hours, a ‘dose fit for a gorilla’ as one critic had it.
        In France 1800 mg in a day mandates hospitalisation as a poisoning.
        https://conservativewoman.co.uk/the-marx-brothers-do-science/

    • To be fair those promoting the use of the drug have specified a particular protocol that none of the studies have followed.

      1. Early administration.
      2. paired with Zinc.
      3. it a safe dosage.

      Looking at it from that standpoint “it” hasn’t been tested.

      the recent RECOVERY trial gave insanely high dosages.

      my hope was that it would be properly tested and reasonable folks could assess for themselves
      in connection WITH THEIR DOCTOR

      Long ago I had to take off label drugs to kill a super bug.
      it was me
      it was my doctor.
      we decided.

      no politicians of either stripe.

      my body my choice

      • “To be fair those promoting the use of the drug have specified a particular protocol that none of the studies have followed.”

        Not early on. Most of the initial promotion was based on the paper of Didier Raoult, and studies tried unsuccessfully to reproduce that. I don’t know of anyone who has actual tabulated results showing success with such a protocol.

        • “I don’t know of anyone who has actual tabulated results …”

          Maybe you could contact Surgisphere, I hear that Dr. Sapan Desai has a huge database from hundreds of hospitals. 🙂

        • @NS

          We also have little to no evidence from clinical trails of mask wearing either. Yet the same people are talking out of both sides of their mouths these two subjects. The Earth’s atmosphere has and will also be a petri dish of life.

          We have little to no evidence from a double blind clinical trials of most of the nutrient RDI / RDA and yet we told these are gospel.

          But I guess that Medical Gospel is higher calling because it is from the Church of Consensus Science. Hey at least you are consistent.

      • Well said, Steven.
        I don’t know why this simple protocol- that seems to be what is most successful in anecdotal evidence- has not been tested in trials.

      • Hydroxychloroquine and Zinc With Either Azithromycin or Doxycycline for Treatment of COVID-19 in Outpatient Setting… Clinical Trial Identifier NCT04370782 Source

        This clinical trial is currently underway at St Francis Hospital, New York with an estimated primary completion date of 30 September 2020…

        The study “cocktail” and dosages mirror that of the most widely accepted/preferred according to the publicly available anecdotal evidence…

        Hydroxychloroquine 400mg twice a day (BID) on day 1, followed by 200mg BID for days 2-5
        Azithromycin 500mg on day 1, followed by 250mg once daily for days 2-5
        Zinc sulfate 220mg once daily for 5 days

        In the meantime: Consult with your physician then decide for yourself as this regimen appears to be the most promising, the drugs are readily available, the dosages are prescribed within historically accepted safe levels, and remember, starting sooner appears to be decisively more effective than waiting until the the disease progresses …

    • “Proper” is the key word in your response. There is an abundance of evidence from doctors around the world that HCQ has helped their patients recover from, or not progress to, serious disease, but that evidence is not “proper” to the establishment that wants to control the framing so that its treatment paradigm prevails. That says everything about them, and provides insight as to why the medical establishment is the 3rd leading cause of death (at least) in the US. It doesn’t give a damn about patients’ well-being, but is only concerned about maintaining the appearance of helping patients by using “proper” treatments, even if those treatments harm patients. They have abandoned the precept primum non nocere (first, do no harm) for “We’ll treat them no matter if it ki!lls them”.

      • This is indeed a sad indictment of the profession. There is little doubt that a political battle is being waged where the medical industry (pharma companies and medical organisations , etc.) and the line medical practitioners are not actually on the same side.

        The appalling Lancet and NEJM event where “hit piece” studies were published and withdrawn has tarnished the research journals. The VA study was also nothing less than “hit piece” journalism.

        One has to ask what is the motivation?

          • Both, or more properly, all three.

            Democrats – Orange Man Bad.
            Big Pharma – $$$$$.
            MSM – “See? Medical industry says Orange Man Bad”…

            My 90+ year old father has had a heart attack, a quadruple bypass, a mild stroke due to blockage of one carotid artery, and an arrhythmia, and he’s been on HCQ for years for Lupus. He called his doctor and was told to go ahead and take zinc, too.

            It is GARBAGE that HCQ is somehow dangerous. Some criminal Democrat governors have blood on their hands, purposely forbidding useful drugs for political reasons which undoubtedly resulted in deaths which should have been avoided.

    • I tend to agree that more benefit should be evident but too many of the studies appear to be associated with staggering levels of incompetence. This is a French report on a UK RECOVERY trial at Oxford.

      http://www.francesoir.fr/politique-monde/recovery-trial-brexit-and-overdose

      Among a number of the authors observations, this

      The mortality rate of the control group (23.6%) is very high compared to the 12.7% observed by Rosenberg et al. in Jama on severe hospitalized patients. This rate is 18.1% in France and 12.9% in Bouches-du-Rhône (department where Professeur Raoult is located)

      While it tells us nothing about the effectiveness or otherwise of HCQ, the mortality rates of hospitalised patients are a huge concern. But, that aside, there is a strong suspicion that the professor leading the study ( Martin Landray) has confused hydroxychloroquine with hydroxyquinoline. Read the article. It’s been picked up by several people.

      • ” But, that aside, there is a strong suspicion that the professor leading the study ( Martin Landray) has confused hydroxychloroquine with hydroxyquinoline. “

        There is no strong suspicion. There is ridiculous speculation by the anonymous author, based on dosage levels. He says only:
        “I think he confused hydroxychloroquine with hydroxyquinoline.
        “This man, who calls himself a doctor, is incompetent and dangerous.” This is scandalous. “

        Doesn’t sound very detached and professional. In fact there were two principal investigators, Prof Horby and Prof Landray, and many colleagues. It was a major grant funded project, and so had already been through grant review. There was ethics committee approval. It is unlikely that all these people were confusing hydroxychloroquine with hydroxyquinoline.

        • How can you be “detached” knowing that the whole study design was based on GROTESQUE confusion between hydroxyquinoline and hydroxychloroquine which is only possible way to interpret the researcher’s explanation of the huge hydroxychloroquine dosage?

          Please try to keep up. There is a huge scandal here. You don’t have to agree with Didier Raoult on everything, or on anything else… you can’t disagree with him on that study, or on the Lancet hoax.

        • 8-hydroxyquinoline can actually build a complex with Zn and act therefore as a ionophore so it is even way more likely to work than HCQ. So Mr. Landray might know what he is doing to really test the Zn hypothesis.

          Btw, clioquinol is an 8-hydroxyquinoline derivative.

    • Question, Mr. Stokes: would you ban the use of HQC for covid & would you want to see doctors lose their licence to practice medicine if they go ahead and prescribe HQC?

      Second, can you look a person with covid in the eye and say, “no, you can’t have HQC?”

      Reported effectiveness by individual doctors if documented, is not gossip, it’s the results from individual doctors — and, as we’ve seen, so-called “studies” are not always reliable.

      • “Question, Mr. Stokes: would you ban the use of HQC for covid”
        HQC reverts to its previous status, as a drug recommended by the FDA for treatment of various conditions. They decline to recommend it for Covid, saying that there is no evidence that it works. And indeed, there is no evidence that it works.
        People are demanding that they recommend it anyway.

        • Mr. Stokes: There IS evidence that it works, but you move the goalpost by re-defining the word “evidence” as it suits you. Do you have a double-blind study proving AGW? No, but you’ll tell us there’s “evidence” of it, and you won’t be bothered that “evidence” means two different things to you depending on the subject. This subject has exposed you as closed-minded, isn’t that a bad thing in science?

    • I have seen several doctors’ descriptions of their trials. At least one was in preparation for peer-reviewed publication. Experience with thousands of patients indicates that this drug only works in early stages and should be discontinued if the disease progresses. It may well be harmful in later stages of COVID-19, and that fact was used in an infamous trial, with dead patients. Those researchers should be tried for murder.

      Nick Stokes, this post is so disingenuous as to be an obvious troll post. Usually, you are classier than that. We all know you are a troll. You do such a good job about climate that I am glad to have you here.

      COVID-19 has such a low death rate overall, that this Filthy Drug Advocacy ruling may not do much harm–but the drug is needed for comorbidity patients if caught early enough.

      Remdesvir is indeed more effective than HCQ at the Filthy Drug Advocacy’s actual purpose–to make money for drug companies by making it look like they are screening drugs carefully to keep us all safe. They are part of Big Pharma’s SALES arm. The reports I have seen about Remdesvir suggest that it is more dangerous than HCQ–but it costs many times more, and that is why FDA promotes it.

      • Nick Stokes, this post is so disingenuous as to be an obvious troll post. Usually, you are classier than that.

        No, he really isn’t. The times he’s “classier than that” are the exception, disingenuousness, intellectual dishonest, and obvious trolling are the norm with him.

    • Here is a transcription of the Statement from Health and Human Services Secretary Alex Azar, in the Tweet referenced above by Israel Anderson:
      Alex Azar: Just to clarify your statement there, I don’t think was quite accurate in respect of what the FDA action was. The FDA at the request of BARDA, which is an agency within HHS withdrew an “Emergency Use Authorization” for a product that we had acquired into the nation stockpile by Bayer of Chloroquine that was manufactured in Pakistan. The EUA (Emergency Use Authorization) was restricted for hospital use – in-patient hospital use of the product. With the FDA finding that they don’t see enough data to support hospital-based use for those with the most extreme cases of patients who’ve been hospitalized, they took that restriction off; they took the Emergency Use Authorization off.
      At this point, Hydroxychloroquine and Chloroquine are just like any other approved drug in the United States – they may be used in hospital, they may be used in outpatient, they may be used at home, all subject to a doctor’s prescription. In fact, the FDA’s removal of the Emergency Use Authorization takes away what had been a significant misunderstanding by many that made people think that somehow it could only be used in a hospital setting (and we’ve tried to make that clear throughout).
      It’s a drug, it’s approved in the United States, has been for decades. If a doctor wishes to prescribe it working with a patient, they may prescribe it for any purpose that they wish to do so, and this actually removes a potential barrier to them.
      President Trump: So it actually uncomplicates it. So your [the reporter’s] question was very inaccurately stated.
      Alex Azar: [The FDA announcement] said “the data in the hospital setting was not supportive.” We continue to study it in outpatient settings as well as preventive. That data’s not yet in.

      • boffin77 – interesting that the removal of EUA is portrayed as removal of a restriction. My understanding is that an EUA is the opposite of a restriction – it is allowing use where it had not been allowed. All of the FDA statements seem to run contra to the portrayal too: the FDA keeps saying that any benefits of the drug are outweighed by its potential harm. There seems to be no doubt that the FDA is opposed to HCQ. If the drug can in fact still be prescribed by doctors, I would suggest that this is in spite of everything the FDA and others have done to prevent its use, and that no credit whatsoever is due to the FDA.

        • “interesting that the removal of EUA is portrayed as removal of a restriction”
          Azar has to do that to keep the President from going ballistic. It worked.

          Of course it is no such thing. HCQ simply reverts to its ongoing status as a licensed drug that any doctor can prescribe for anything. But now he can’t say the FDA advised him to.

          • Consider the telling example of a simple comparative search. HCQ trials in the US HCQ (56 as of 6/16) … and those HCQ+ZINC (only 3). One is Zelenko’s St. Francis outpatient study in progress.

            53 ZINC-less trials. Could it be one of those Corona tragedies where so many of our greatest minds blundered under pressure? Or designed to fail?

            Since 2010 the in vito study, in 2020 since March 23 and April 7 Zelenko’s first very public letters, on April 8 Trump’s strident claim

            TRUMP 4/8/2020: “In addition [to hydroxychloroquine] the azithromycin and ZINC — they [probably Zelenko] say ZINC — you should add ZINC. Now, it’s all — has to be recommended by doctors, physicians. But they say ZINC. I want to throw that out there because that’s where they seem to be having the best result. So you add the ZINC and the azithromycin.”

            I only quote Trump to note ZINC mentioned 5 times in one paragraph. The message was out there. So what happened?

            There are compelling reasons for HCQ+ZINC as of Trump’s announcement,

            1. The most obvious is the proposed RNA transcription inhibition mechanism proven in the lab in 2010. This is not proven in patients aside from (only recently! shameful!) emerging studies that show that by merely adding zinc, a statistical significant reduction in mortality was seen. Should this not have been the default in crisis, if the ZINC would not further harm the patients?

            2. HCQ contains NO ZINC, but is a powerful ZINC ionophore. What (aside from any anti-viral property) is the effect of administering a powerful ZINC ionophore to sick patients who may be ZINC-deficient, with NO supplement of ZINC? Is this not just causing ineffectiveness but actual harm? I have been emailing researchers in the field to ask this question. The issue of whether ZINC-less treatment with an ionophore is in itself harmful, is a question not many can answer because (to my research) a few have used ionophores to effect an increase in cellular ZINC uptake (such for prostate cancer to selectively cause apoptosis) but no one cites an ionophore given alone as possibly depleting ZINC or given for that purpose. Or maybe because no one in their right mind might want to do this. But in this COVID ZINC-less treatment doctors are doing this. Are they sufficiently vigilant for the effects of ZINC deficiency? And might some ill effects be unfairly attributed to HCQ?

            3. Dr. Zelenko claimed that HCQ with ZINC works. Which is not reason in itself to embrace it blindly, but a certain few Obama holdovers in the Trump Administration not merely ignored Dr. Zelenko’s March 23/April 7 letters, but may have actively steered HCQ trial and treatment NOT to include ZINC. Consider this in addition to the claims made in the AAPS v FDA lawsuit.

            4. A documented symptom of COVID is loss of smell and taste. This is a symptom of ZINC deficiency also. Could depletion of ZINC be a first symptom of the disease for these people? I am particularly concerned about this cohort.

          • “Of course it is no such thing. HCQ simply reverts to its ongoing status as a licensed drug that any doctor can prescribe for anything. But now he can’t say the FDA advised him to.”

            Exactly. To keep the issue simple, the FDA can approve a drug for a condition in one of two ways:
            regular FDA testing, which requires a specific set of studies, culminating with controlled trials,
            or
            Some emergency approval status, probably put into law as we tried to figure out how to address AIDS before it was HIV.

            Since HCQ was already FDA-approved for some other condition, any doc has been fine to prescribe it “off label” as he or she sees fit. No FDA approval needed.

            A lot, possibly most, prescribing is done “off label.” Not a big deal.

            It makes sense to have govt interfere in the abortion issue, since there is a very good scientific consensus that human life begins at conception, and so if we have abortion it should be under certain circumstances. Similar to how Essure was pretty regulated before they finally pulled it off the market.

            It does not make sense for the government to interfere in the HCQ safety issue; docs and pharmacists are well-versed in knowing how to look up possible treatments for a condition, and how to figure out dosages, and how to assess contra-indications. This is what they do. And do all day.

            Strange that the Progs scream for the govt to get out of the doctor-patient relation in abortion
            (what there is of it in abortion – very little to none – the doc usually strolls down the hall to the next room and does the abortion after asking the supporting staff a couple clarifying questions and is done within 15 minutes or less)
            but suddenly when Orange Man Bad suggests HCQ and the Public Health Establishment and Big Pharma see a fortune go up in smoke before their eyes, marching orders go out to the Prog faithful to beg and demand government interference in the doctor-patient relation, which more than likely actually exists in the case of Covid-19.

      • Mike J: yes, that struck me as strange as well. I wonder if this EUA was a way to legally protect doctors using HCQ for “for those with the most extreme cases of patients who’ve been hospitalized?” There seems to be widespread agreement that HCQ is not helpful for the “most extreme cases,” so this EUA was perhaps a mistake if that’s what its goal was. Also there is no indication that the EUA promoted that HCQ should be used with Zinc, although there seems to be a widespread consensus that HCQ’s value is as an ionophore for Zinc, and the Zinc is what heals the patient.
        There is an ABC news clip of a Dr. A. Cardillo ER Specialist in LA explaining the need for Zinc at about the 22s mark here: https://www.youtube.com/watch?v=eVs_EWVCVPc . Dr. Cardillo however thinks HCQ/Zn is useful for the very ill; he says “every patient I have prescribed it to has been very very ill and within 8 to 12 hours they have been symptom free.” Truly anecdotal evidence, not scientific, and the shelves behind him have (literally) five sets of “hear no evil, see no evil, speak no evil” statues so I’m not sure how seriously to take him.

        • I saw a comment suggesting that COVID may actively deplete zinc. This would explain the reported symptoms of loss of taste and smell sensations. This would also explain chilblain symptoms in some children.

    • Stokes you are a complete idiot.
      France has and is using it. Do you notice the death rate there? But they use it properly with an anti-biotic and zinc at early stages of the disease. Not in ridiculously large doses, by itself and at the latest stages of the disease which all these ‘tests’ have done.

        • Mr. Stokes- Looks like a cherry picked story at the time the Lancet study emerged, shown within hours to be faked in a manner that should be a stench in the nostrils of anyone who respects the scientific method. Not a stench for you, though?

          • “Looks like a cherry picked story”
            How so? The claim was
            “Stokes you are a complete idiot.
            France has and is using it.”

            I point out that France has in fact banned it. Are you saying that it isn’t banned?

          • I’m saying the article dated May 27th was the French reaction to a false study published by the Lancet, don’t know about France but in U.S. the press loudly announced suspension of HCQ trials based on that study and started them again a few days later when the study was debunked with surprising speed. To anybody who tries to act on data, the biggest part of that story was the patently false data used, but not to you. That’s what I’m saying.
            Are you saying it’s still banned in France? What do you mean, “banned” (I find discussions with you must begin by defining terms)? “Cause the article above doesn’t say it’s banned in U.S., is it really banned in France? How’s that French doctor doing his study, offshore?

          • ” To anybody who tries to act on data, the biggest part of that story was the patently false data used, but not to you.”

            Let me wearily repeat, the claim that I was responding to was
            “Stokes you are a complete idiot.
            France has and is using it.”

            The fact relevant to that, which I quoted, is that France has in fact banned it. You then say I’m cherry-picking, because you think France should not have banned it. So it goes here.

            I cited an AFP report. Here is another which seems to be a bit more specific about the action:

            “The French government on Wednesday revoked a decree authorising hospitals to prescribe the controversial drug for Covid-19 patients after France’s public health watchdog warned against its use to treat the disease.

            The government’s decision comes two days after the World Health Organization (WHO) said safety concerns had prompted it to suspend use of the drug in a global trial.”

            Here is a report from just yesterday saying that the WHO trials are suspended.

      • Well actually saying HCQ failure studies are due to no zinc, no azythromycin, too early, too late, too many comorbities, vitamin C, vitamin D, (the list of quack cures for CoVid is almost as long as the quack cure list for the common cold by now)….are actually the trappings of pseudo-science and failed faith healers, psychic surgeons and the like, OK, homeopaths too….

    • Right.
      There always be crazy believers.
      Especially when the POTUS toutes its use.
      It simply don’t work.

    • Stroker:
      Nations with the highest rates of malaria where HCL use is common, all had very low rates.of Covid-19.

      Many doctors have prescribed HCL as.a preventative for patients, and themselves.

      Where are the fueld studies asking them whether they were satisfied with the results?

      One anecdote means little, but 1,000 anecdotes is a field study.

      HCL combined with zinc and vitamin D has worked much better than HCL alone — to prevent C19, not to help people already very sick.

      Trump talked way too much about C19 — the only useful suggestion was about HCL , a cheap generic drug with few side effects.

      If Barack Obama had suggested HCL, you leftists would have declared him a genius !

  2. Doctor Horby, Professor of Emerging infectious Diseases ““One of the key lessons we should learn historically is that making treatment decisions based on observational data is not the way forward,” he said.”

    Ww must trust the models.

      • I assume you know who Horby works for?
        Oxford University, the same Oxford University that is developing a COVID-19 Vaccine with AstraZenica.
        Did you look at the study design?
        It is designed to test Drugs in isolation, which is in direct contradiction of what the Medical Profession say works.
        ie Drugs in combinations with added vitamins and minerals.
        It was a study designed to fail, like many others.

        • “Oxford University, the same Oxford University that is developing a COVID-19 Vaccine with AstraZenica.”

          It is also the same Oxford University that has been testing another cheap and widely available drug Dexamethasone. And unlike HCQ, it actually seems to have testable clinical effects. It really helps people, says the trial.

          • Yes, Dexamthasone does seem promising and for whatever reason what I’ve read about it isn’t pushing my internal alarm bells.

            But …

            “The following side effects are common (occurring in greater than 30%) for patients taking dexamethasone:

            Increased appetite
            Irritability
            Difficulty sleeping (insomnia)
            Swelling in your ankles and feet (fluid retention)
            Heartburn
            Muscle weakness
            Impaired wound healing
            Increased blood sugar levels. (Persons with Diabetes may need to have blood sugar levels monitored more closely and possible adjustments to diabetes medications).

            The following are less common side effects (occurring in >10%) for patients receiving dexamethasone:

            Headaches
            Dizziness
            Mood swings
            Cataracts and bone thinning (with long-term use)

            http://chemocare.com/chemotherapy/drug-info/dexamethasone.aspx

            So, you’ll possibly end up with a fat, irritable, sleep-deprived patient with heartburn. But they’ll likely be alive. Good from the humanitarian point of view. Not so sure about the economic benefit. I’m guessing that most people still won’t want to get on an airplane.

          • “It is also the same Oxford University that has been testing another cheap and widely available drug Dexamethasone.”

            Dr. Seigel was pretty enthusiastic about this drug and reports of its effectiveness, on Fox News earlier today.

          • Dexamethasone helps seriously ill people – the ones in hospital on ventilators. It works by ameliorating the cytokine storm – the overreaction of the immune system that is often the direct cause of death. It doesn’t help people in the earlier stages of the disease and cannot be used as a prophylactic. In fact since dexamethasone works by quieting the immune response, taking it in the early stage of the disease would be dangerous as it could delay your immune response and make it more likely that you will need hospitalisation.

            HCQ+Zn is an antiviral. Antiviral drugs inhibit and slow reproduction of the virus early on to give the immune system a better chance to get ahead of it. That makes them useful for prophylaxis and early treatment of people who are not yet seriously ill. But antivirals are of little use for seriously ill hospitalised patients. And for those patients HCQ could be dangerous since Covid-19 is known to cause heart problems and HCQ may exacerbate that.

            Tests that look at treating the seriously ill in hospital with the aim of reducing death rates will probably find dexamethasone to be helpful and HCQ to be useless and potentially dangerous. Tests that look at drugs for prophylaxis and early treatment with the aim of reducing hospitalisation rates are likely to find HCQ + Zn helpful and dexamethasone to be useless and potentially dangerous.

  3. No-one’s ever going to mistake me for a scientist and I’m flummoxed fairly quickly by anything medically technical, so I must invest my trust in experts. That should include The Lancet, but this latest retraction, followed by complaints of the influence exercised upon them to accept papers of dubious integrity by pharmaceutical companies, suggests that investment of trust would be unwise. The anecdotal evidence supporting the use of Hydroxychloroquine is not restricted to one doctor in one country and the paper featured by The Lancet is essentially fraudulent, so, bearing in mind the “criminal” complaint from The Lancet, the questioned begged is should those responsible be facing criminal charges? If lives are lost because pressure has been brought to bear on those conducting trials to stop what they’re doing, to protect pharmaceutical profits, criminal investigation should follow.

    https://vaccineimpact.com/2020/editors-of-the-lancet-and-the-new-england-journal-of-medicine-pharmaceutical-companies-are-so-financially-powerful-they-pressure-us-to-accept-papers/

  4. Sorry, Nick, but you’ll have to do better than that!

    The fact remains that none of the reported studies has specifically tested the actual combination of drugs that is meant to provide some benefit against the corona virus. That combination has been clearly specified……Hydroxychloroquine plus azithromycin plus Zinc………..

    Since the role of hydroxychloroquine in this case is allegedly as a zinc ionophore, its effect is clearly dependent on the presence of sufficient levels of zinc. It is well-documented that many older people have reduced levels of zinc. Zinc is the actual material that is meant to interfere with viral RNA replication so one might posit that insufficient zinc means limited benefit.

    Azithromycin (or doxycycline, as a possible substitute) are antibiotics but their main effect in this scenario is supposed to be their anti-inflammatory action which again is well-documented over decades.

    Hydroxychloroquine is also already known to have immuno-modulatory effects in the treatment of lupus and some other conditions and is a very safe drug used for a very long time.

    So, no Nick, there have been no published studies that have shown this combination of drugs to be effective. Most of the studies have used hydroxychloroquine alone and often at the wrong stage of the disease (too early or too late) and often at doses not recommended by those who promote the drug.

    It’s important that the correct formulation is properly tested. There are many drugs which ONLY work in combination and show little benefit if used alone. Classic examples are cotrimoxazole and amoxycillin/clavulanate as well as the now famous PreP combination of antivirals used for HIV prophylaxis.

    • “That combination has been clearly specified…”
      No, it hasn’t. Didier Raoult’s paper, describing a very small sample with no controls, had no zinc. Patients already hospitalised. This was the basis for the initial hype, from the President down. It seems to me that each time a test failed, some new specification was added. You should have started treatment earlier! You should have added zinc!

      This can go on forever. The situation facing the FDA is that there is no evidence, despite trials.

      • “You should have started treatment earlier.”

        I love this.

        Nurse: the patient is nearly dead on the ventilator.
        Doctor: let’s try this Trump treatment.
        Administration: as long as they can pay go ahead.
        Nurse: it didn’t work.
        Doctor: damn Trump
        Administration: print the invoice
        Nick: here is another piece of quality data

        • In the UK individual patients do not pay – even for the most expensive drugs – strange isn’t it:

          “The most expensive drug was adalimumab – used to treat arthritis, costing £416 million.
          While ranibizumab, a popular medication used to help ease macular degeneration, was responsible for nearly £249 million of the NHS’ budget.”

          No cost for treating with zinc+hydroxychloroquine+azithromycin+VitD+ vitC+etc+etc.

          It is cheap, but unproven, but dangerous . It is not prescribed for covid19 in the uk. Stranger still! Perhaps it doesn’t work?

          This must seem odd to a country that bankrupts people who need insulin

          • It’s almost like here in Canada where junkies get their needles from gov for free, while diabetes have to pay for their own needles. I had to pay over $8k for sight saving eye surgery here in Canada in 2011. They refunded me about $600. I went into debt over that.
            Every year of my whole adult life I’ve read stories in our media of sick children and young adults needing to go to USA for life saving/altering medical treatment/surgeries that are not available here. Your country actually DENIES children from seeking medical help elsewhere.

            Wonder where they’re going to go when USA adopts our inadequate HC system…

          • “This must seem odd to a country that bankrupts people who need insulin”

            The UK has high insulin costs? They should look at what Trump is doing for insulin prices:

            https://www.cms.gov/newsroom/press-releases/president-trump-announces-lower-out-pocket-insulin-costs-medicares-seniors

            “Today, under President Trump’s leadership, the Centers for Medicare & Medicaid Services (CMS) announced that over 1,750 standalone Medicare Part D prescription drug plans and Medicare Advantage plans with prescription drug coverage have applied to offer lower insulin costs through the Part D Senior Savings Model for the 2021 plan year. Across the nation, participating enhanced Part D prescription drug plans will provide Medicare beneficiaries access to a broad set of insulins at a maximum $35 copay for a month’s supply, from the beginning of the year through the Part D coverage gap. The model follows on the Trump Administration’s previously announced 13.5 percent decline in the average monthly basic Part D premium since 2017 to the lowest level in seven years.”

            end excerpt

            President Trump got very little credit or mention for this in the Leftwing Media. Lies of Omission.

            But the people who need insulin appreciate Trump’s actions to lower the costs. They didn’t miss the significance. Some people were paying hundreds of dollars per month for their insulin. In the future, they will pay $35 per month. That’s a big difference, especially for poor people. That’s a “food on the table” difference.

          • The uk has one of the worst death rates in the world as a percentage of people with the illness, double that of the US

          • Almost true. Actually prescription charges are at a flat rate about £9 per item to those who pay taxes, and free to those who don’t. This results in the perverse situation of NHS prescriptions for paracetamol (after a free visit to the doctor) so the non-taxpayer can get it for free while the taxpayer is happy to spend less than 50 pence at the supermarket. Here in the UK, Chloroquine/Hydroxychloroquine were non-prescription over the counter medications which could be purchased by anyone at a pharmacy – until February/March when they were specifically unlicenced for use for treatment of COVID-19. This has effectively made them prescription-only. https://www.gov.uk/government/news/chloroquine-and-hydroxychloroquine-not-licensed-for-coronavirus-covid-19-treatment
            The patient not paying generally results in really expensive drugs being rationed – once they are out of trial and approved for clinical use.

        • No it was POTUS suggesting injection of disinfectants be tried. And many of the Cletus’s of the world believing it could kill the virus. so er admissions for bleach ingestion increased

          • That remains a carefully cultivated falsehood. Potus used the word ‘like’ which means he was using a metaphor. In a cackhanded way no doubt, but he did not say that people should inject themselves with anything. That it ended up in the MSM as such was simply due to creative listening by dodge journalists.

          • I think it was you that told people to do it…see how easy it is to spread falsehoods?

            Shame on you.

          • Ghalf runt: My guess is, you don’t know any “Cletus” types, and you are bigoted against them from your ignorance. Just think, if “Cletus Lives Matter” becomes the meme in five years, your post here will cost you your career even if you’re a top prof at U. of Chicago! Try not to be a bigot.

          • ‘Ed Zuiderwijk June 16, 2020 at 8:25 am
            That remains a carefully cultivated falsehood. Potus used the word ‘like’ which means he was using a metaphor. In a cackhanded way no doubt, but he did not say that people should inject themselves with anything. That it ended up in the MSM as such was simply due to creative listening by dodge journalists.’

            Appealing to the bigotry of the progressives and their knee-jerk response – Half-Runt is case in point.

        • Dear Nick, why are you on the wrong end of every argument?

          Hold on there! I think I remember something, maybe 4-5 yrs ago, a single point he made, maybe, that I thought was reasonable…..

      • Actually what they should be doing is doing everything possible to find out why it does, or might, work instead of digging for any reason that it doesn’t. Doctors who know how to heal should be listened to over doctors that only know how to follow protocols.

      • That sample isn’t that small anymore. It comprises now several thousand people. It has the same outcome: mortality divided by a factor 5 compared to other hot spots in France, especially at Paris.
        All the studies claiming a risk of using hydroxychloroquine are plagued with methodological issues.

      • So just drink your fluoridated water and take your lipitor like the wise and infalible FDA says.

        • The study did show that Lipitor was effective at reducing cholesterol. Further, the FDA was honest enough to point out that people who had high cholesterol and took Lipitor died at a younger age than those who took the placebo. Pfizer’s response that those taking Lipitor just needed to take more….

      • Mr. Stokes: “no evidence.”

        Wrong (and I could use a stronger word).

        Individual doctors’ results, if documented is evidence.

        I’m sorry, but you have to be called out for intellectual dishonesty.

        • Strange how it all looks from here. Nick Stokes is the one looking for hard evidence, as always it seems, and so many posters (besides abusing him) are betting on anecdotal stuff, the kind of thing that, if they were consistent, would have them believing that AGW was real beyond doubt. I see contrarians at work all over the shop in these pages, and very few really sceptical minds. Nick Stokes and Steven Mosher are amongst that few, and it’s a pleasure to come here and read their contributions. Their patience and self control in the face of sustained abused by right wing zealots who constantly mistake their prejudices for objectivity, and their fantasies and paranoia for facts, is nothing short of astonishing.

          • jim hogg: Nick Stokes does not have, nor does he seek, hard evidence of AGW. On HCQ, all of a sudden, evidence is not evidence because….. he says so? “How it looks from here” may be the problem.

      • Actually, Nick, you have it the wrong way round….Let me just redraft your last sentence which SHOULD read

        “The situation facing the FDA is that there are no trials , despite evidence.”

        There……fixed it!

    • Exactly. Nothing on pubmed shows a clinical trial of the combo treatment applied at the early, or onset, of the disease.

      Follow the money. With the FDA, CDC and the industry, it’s always follow the money. Hydrocholoquine + zinc + azithormycin has been used literally thousands of times world wide. That number of patients far exceed nearly all clinical trials listed on pubmed. Thousands of clinical outcomes Trumps a few clinical trials, especially by biased and conflicted researchers (see below).

      A great example, and on point, is the FDA/ADA treatments for diabetes which excluded diet for decades and promoted a host of drugs from metformin to insulin. The most effective, and curative for type 2 diabetes is simply changing the diet to low carb without industrial seed oils. Tens of thousands of patients in clinics have successfully reversed and/or cured their type 2 diabetes with diet alone. Only this year has the ADA included low carb as a treatment option. Simply put: the Golden Rule applies.

      In the case of HCQ combo, you have two factors that have joined:
      1. Government researchers have huge conflict of interests and have been well documented ranging from direct grants/funding to being allowed to own patents for their government funded research. Even Fauci own patents. Example, Moderna, the vaccine CV-19 RNA hoped for cure manufacturer has joint research projects with Fauci’s group with many in the group holding patents directrly related to the joint research.
      2. Destroy Trump no matter the consequences.

      • The HCQ+Zn+Azi issue is statistical. It is astonishing that there seem to be no studies that actually test what is claimed to have worked in practice. Why is it so?

        Azithormycin obviously also has a direct preventative effect on non-viral opportunistic pathogens in immuno-compromised Covid19 patients.

        This is ongoing research re azithormycin and cholesterol and inflammation

      • Exactly, follow the money.

        Remdesivir, the only “approved” treatment, that was approved despite very tepid results, just happens to be still under patent so the big pharma company that produces it can reap huge benefits. I wonder if Fouchi owns stock in that company?

        Hydroxychloroquine, azithromycin, and Zinc are all beyond their patent protection and are freely and cheaply available from multitudes of manufacturers. No one’s going to get rich off of those.

        • The “results” from a trial that switched it’s study methodology midway through and then ended the study before statistically significant results were determined and simply claimed success. That’s the only supporting evidence for remdirival, and the only other trial I have seen is out of China and found it to be ineffective.

        • The Remdesivir “approval” is only on an “emergency” basis. It is not actually “approved”. They are working on it. The whole point is to give Gilead’s product a chance to prove itself – not looking too good so far. Improvements are small and, depending on who you ask, it is about half as effective as early HCQ+zinc. Maybe a bit more than half as effective. It is very expensive.

          The whole institution of government agencies in the USA has arisen to try to convince the world that HCQ+Zinc “doesn’t work and may be worse than nothing”. Fortunately other nations are not listening (much) and the US doctors are themselves suing the FDA (as a group). Something like 10 of the members of the top level panel that ruled against HCQ have connections to Gilead. Why were they not excused?

          Someone above asked about the cost and it is about $12 for a treatment with HCQ+Zn.

          Vitamin D is a strong influencer so any trial has to also look at the deficiency of the 1,25 version because it matters. Populations with chronic vitamin D shortage include all the people in Southern India and BAME populations in general in the northern hemisphere. MedCram showed the results of a test of the correlation of vitamin D deficiency and morbidity from COVID-19. Very interesting. It is complicated at the molecular level.

    • Think of it this way, the FDA and MSM treatment of HCQ is the same thing as saying that condoms do not prevent pregnancy!

      How is that? Simple, giving a condom to an already pregnant person(being PC here) does not help in ‘treating’ the pregnancy.

      Same as giving HCQ to a person already suffering from full blown COVID.
      The time for prophylaxis has passed so there will not be a benefit from using it now!

      The whole thing is a classic example of misdirection where ‘curing’ a disease is mixed up with ‘preventing getting’ the disease in the first place.
      I wonder if they’ll try the same approach if a vaccine has been developed, i.e. stating that the vaccine is not a cure for the disease and therefore should be avoided at all cost.
      Probably depends on wether Trump endorses it.

      Stay sane,
      Willem

      • Your analogy could go even further.

        The hospitals weren’t just handing the pregnant woman a condom.

        Intubation & then prophylactic HQC.

        Prescribe day after pill & then provide condom … “sorry, the condom didn’t prevent the pregnancy AND it also caused the death of your baby.”

        (and if you ask Nick Stokes, he’ll tell you that all studies that involved pregnant women show that condoms don’t prevent that previous pregnancy.)

    • Phil
      Pretty good summary. Even my dog knows this. I don’t know where nick has been hiding.
      It is clear that covid is not yet fully understood, but there are clear stages of the progression of the disease.
      The Hql + zinc is for treating the early stages.
      Once the virus is causing lung problems there’s a different treatment
      If the virus is causing blood clotting problems there’s a different treatment again.
      The virus main target is the ace2 receptor.
      The ace2 receptor has a role in many functions.
      Geez, I’m just a stupid civil engineer and can understand this.

      • Something interesting I learnt about these randomised trials of various treatments for covid.
        If mortality of placebo is 18%
        And mortality of drug x is 15%
        Then drug x will save 1 in 33 patients. This is huge for doctors.
        I don’t think real doctors working in the icu expect a magic bullet. They will try anything if it helps even a little bit.

        • Hovever, depending on the number of subjects, even though drug x is effective, the RCT results may be evaluated to be below the level of significance. So what is huge in terms of saving lives (especially for those patients saved) is insignificant as far as statistical evaluation of the trial is concerned. Even more so with observational trials, or those where a control cannot be used because it would be unethical to not treat some patients with an known safe effective regime.

    • Exactly and why would you expect a zinc ionophore without zinc to be of any use after the virus is well established. These researches are treating patients as lab rats, shameful.

  5. The 2 studies they are relying on are rather peculiar. One compared HCQ versus a placebo and found that people in close contact with infected people were just as likely to catch Covid-19 as those on the placebo. Strangely very few were actually tested for Covid-19, instead their symptoms were appraised and adjudged to be Covid-19 or not. Even if you are happy with this approach, HCQ isn’t supposed to be a vaccine or a cure, it is supposed to reduce the chance of high viral load in the lungs and therefore serious complications. Since only 2 people in the trial ended up being hospitalised (one from each arm of the trial) and no description of the severity of these 2 oatients, the numbers are too small to provide any evidence one way or the other about HCQ in protection from serious illness.

    The second trial involved seriously ill patients, both arms of the study had a 25% mortality rate. Once again HCQ isn’t expected to have any positive effect once your lungs are seriously infected by the virus.

    I’m surprised that the FDA is using the results of these trials to justify the withdrawal since they are as valid as saying that a vaccine doesn’t work because it has no effect on critically ill patients. You need to actually test a drug in its expected effective point of operation in a disease. Neither of these trials do that and the results are as expected.

  6. An article I read yesterday that maybe points to an issue the FDA overlooked. Where’s the Zinc?

    https://www.zerohedge.com/political/fda-revokes-emergency-authorization-hydroxychloroquine

    The studies I have heard that show success all use a combination of HCQ, Zinc Sulfate and a Z pack. Articles I’ve read show a per treatment cost of $1.00 for HCQ while Remdisivir could be priced at $4,500.00 per treatment. So I wonder, who has stock in Gilead and expects to see their stock turn a hefty profit. One could almost see a parallel to Oil bad, Windmills good.

    • Harry,

      This is eerily similar to the situation with climate where the elites consider the models to be reality while having no actual understanding of actual reality. This is the same where the elites think the studies are the reality with no understanding of actual reality!

      Your comments are dead on accurate. I am reminded of the implement company service rep who told me I wasn’t getting all the wheat into my combine because their studies showed I needed to run the combine head closer to the ground! Huh? The wheat heads are at the top of the stalk, not the bottom. I raised the head so I would leave wheat straw I could bale and use for bedding. The actual problem turned out to be in the separator in the combine. Once again, to the elites the model is the reality because they have no understanding of reality.

    • Yep, someone linked to it above. They claimed they were giving the same dose of HCQ that was used for treating Amebic infection, which HCQ is not a treatment for. It proves he was confusing it with hydroxyquinolines.

    • They should be on trial rather than conducting trials. Specifying five times the maximum dose of a medicine known to be toxic in high doses (but omitting zinc, and antibiotic from the protocol). Then after early interruption of the trial, saying that patients didn’t show significant improvement (but some survived) after we poisoned them.

      • Make sure you do a search on:

        The Association of American Physicians and Surgeons

        to find out who they are exactly

    • Be fair, if the left didn’t have double standards they wouldn’t have any at all.

    • This is yet more evidence that we need to completely abolish many alphabet agencies and replace them with something that falls under the checks and balance system of government that our nation was founded on.

  7. Someone with statistical skills needs to find a place where malaria is endemic and the CCP Virus is or has recently been infecting people and run some numbers.
    This should provide evidence as opposed to the unsubstantive claim we see here that hydroxychloroquine (HCQ) is ineffective against the CCP Virus.
    I find it difficult to view the other claim that a drug that has been widely used for many years prophylactically against malaria with minimal heart function concerns having been raised before now but is now suddenly very dangerous as more than propaganda.
    The only question for me is who’s propaganda this actually is.

      • This could do with an update now that it is 3 month later. It’s not only the incidence but also the severity that are of interest.

      • “the results are simply amazing: those countries with malaria have virtually no COVID-19 cases, and those countries with many COVID-19 cases have little to no malaria.”
        Roy’s post has not lasted well. Here is a map of distribution of malaria. Brazil, Colombia, Peru, India are very badly afflicted with Covid-19 (and malaria).

    • Many of African descent have a genetic G6PD deficiency, and can die if given Chloroquine.

      Initially, I was skeptical, or perhaps bemused, by the claim chloroquine was an effective treatment because it is hemolytic, and the last thing patients starved for oxygen need is a drug that causes hemolytic anemia (Sidenote: ribavirin causes severe anemia and was heavily used during the SARS outbreak, and is being used to a lesser extent for Covid-19(84), with no success, and likely harm, in both cases.)

      I just found out, though, that HCQ does not cause hemolytic anemia. So that’s good news

      Hydroxychloroquine, on the other hand, does not induce hemolytic anemia in people with G6PD deficiency despite the molecular similarity to chloroquine.

      https://www.medpagetoday.com/infectiousdisease/covid19/85552

      • 1 in 13 of African-Americans has sickle cell trait which increases the risk of venous thromboembolism and pulmonary embolism.

        And in which disease are these major causes of death again?

  8. In 1945 to 1948 while in Burma, we all took a deriveient of quenine. It was used by the army from 1942 .

    While in Papua New Guinea all the white folk, took this same drug.

    Could it be a case that as its well out of patient the drug cartel cannot make much bu producing it.

    VK5ELL MJE

  9. The only thing clear at this point is that any treatment must be on patent in order to meet the requirements for use.

    • Rob_Dawg June 16, 2020 at 3:27 am
      The only thing clear at this point is that any treatment must be on patent in order to meet the requirements for use.
      ————————-
      what a silly thing to say.
      In the uk :
      Labour has pledged to create a publicly-owned company to make cheap versions of medicines the NHS needs but cannot afford, such as Orkambi, which is denied to thousands of children and young people with life-shortening cystic fibrosis.

      Patients with cystic fibrosis in England will now have access to three new drugs on the NHS, following an agreement between the manufacturer and the government.
      While details of the two-year deal with Vertex Pharmaceuticals are being kept confidential, NHS England announced on 24 October 2019 that patients are guaranteed access to Orkambi (ivacaftor/lumacaftor), Symkevi (tezacaftor/ivacaftor) and Kalydeco (ivacaftor) within 30 days.
      The drugs can be prescribed for all current licensed indications, as well as future licence extensions. It is estimated around 5,000 people will benefit…
      he deal may bring an end to the three-year battle between Vertex and the government over access to the cystic fibrosis combination treatment, Orkambi, which the company had priced at £104,000 per NHS patient per year.
      NICE ruled in 2016 that the product should not be made available on the NHS on the grounds that its cost was not justified by the benefits of the treatment.
      https://www.pharmaceutical-journal.com/news-and-analysis/news-in-brief/nhs-england-strikes-deal-with-orkambi-manufacturer/20207244.article

      • Ghalfrunt. – The information you cite talks of a three-year battle. In other words it took a massive amount of effort to overcome just one case of vested interest. So Rob_Dawg’s statement, which you regard as silly, actually looks pretty reasonable.

  10. Some days ago acommenter here on WUWT pointed out a video titled “NYC Epicenter Nurse Tells All …”
    In that video she talks about another state where all COVID-19 patient recovered, taking HCQ, Zinc Sulfate and a Z pack.

      • she gives 100% o2 then may sometimes gives them a rush of more o2 if necessary 105%o2 perhaps!

          • clinical talk?
            Its maths. If she thinks she’s increasing o2 to greater than 100% then the hospital has a problem

          • I think you’re just being obtuse and doing the usual thing of trying to find fault. What she’s most likely referring to is a boost in flow rate at 100% O2. She’s obviously referring to a high flow oxygen treatment where both the percent O2 and flow are adjustable.

  11. not hard to figure out
    the FDA is a pay to play and the companies making it off patent arent going to fork over millions on an old off patent drug to be reasessed for a new use
    FDA manages to screw up every “trial/assessment” of any non pharma money spinner, ie Vit C etc
    the only one they approved Ive heard of was Synthetic B6 patented by merk? and then Merk tried to have ALL natural product and supplements using natural forms halted
    nice guys theyre not.
    how the hell remdesivir got passed is explained by cash
    ditto the near useless many adverse events tamiflu and friends
    theyve admitted remdesivir als has adverse events but as an injectable youre going to wear it longer , with a pill you can stop immediately.
    personally id go for Doxy as safer abiotic in the triple therapy
    az in combo with Hq might up boths worse efects
    but for a week or less use the nasties should be manageable for most
    and again its not insane high doses which the trials trying to fail it were using alone or with also high AZ.
    your entire pharma reg system is shot and crooked, controlled BY the pharmas and your docs and hospitals BY the health companies for profit not for care or health.
    free market sounds good but when its free to loot control manipulate and force others out?
    nope.

  12. ps
    Aussie TGA follows your FDA wont approve useful meds used for decades elsewhere if the FDA hasnt approved it.
    outragously biased as well to pharm over other options. as much use as teats on a bull for anything remotely resembling deep research, they just accept what pharmas andfda say
    ditto for the gmo approvals
    rubberstamping like good lil sheepies.

    • What a boomer. How easy it is to misunderstand something. Even the President misunderstood it the first time around.

      • What a baby! Do you like name-calling, you obsequious geek? Load it up and I’ll fill a page of names, Carl!

        • I am sorry. I meant bummer, in the sense that “how irritating, we misunderstood the message”.
          At least I found the video clip convincing and I can see that Eric Worrall did too.

          I fail to see where name-calling comes into play.

    • How curious that this move by the FDA is being hailed as removal of a restriction. The FDA in removing EUA said they removed it because the drug was dangerous. I think there’s some misrepresentation going on. If the drug is now available for general use, that is in spite of the FDA not thanks to the FDA. Honest doctors are fighting tooth and nail to keep treating their patients with cheap life-saving drugs, against powerful forces who will do anything, including killing people, for their own ends. That’s my interpretation anyway.

  13. “The drugs can cause…severely low blood pressure and muscle or nerve damage. ”
    I find this sentence interesting.
    I recently started taking HCQ as a treatment for cutaneous lupus. At no time during any of my conversations with the prescribing rheumatologist did she mention low BP or muscle and nerve damage as possible side effects. These were not listed as possible side effects in the monograph I received from the pharmacy, either.

    • Forgot to mention that I’m taking the same dosage as is used for SARS-2 treatment: 400mg/day.

    • The most prominent Lupus doctor in California, a Dr. Wallace, said he had never had to send a patient to the hospital over adverse reactions to HCQ, in his 40 years of medical practice.

    • Grumpy

      Double check the list of possible side-effects. I experienced the problem. The problem is, everyone reacts differently to HCQ. It is impossible to predict who will experience side-effects, which ones they will be, and how severe they will be. The list of known side-effects is long! In any event, it is reasonable to expect that people with co-morbidities may be less tolerant of what is essentially a toxin to parasites, and is commonly recommended at dosages that are about one-half of the LD-50.

      All of the denials of side-effects reminds me of someone claiming that, because they have never personally observed a bank robbery, claims about bank robberies are obviously bogus. If they are particularly paranoid, they will append their claim with it being a conspiracy to justify increased charges to customers to cover non-existent robberies.

      • You must try to understand, that it’s not known, if these “side-effects” are based on HCQ or Covid 19 itself, because it’s known, that CoV produces blood clots affecting f.e. the heart, it’s muscles etc.
        In so far, it’s to simplistic to condemn HCQ as the one reason.

      • Thank you for sharing your personal experience, Clyde Spencer.
        As I wrote, neither my doctors nor the info packed with the pills mentioned BP, nerve or muscle problems.
        After posting, above, I did more thorough research and found those side effects listed. Something more for me to watch out for.

  14. the FDA also said margerine was better for you than butter … that one thing alone has killed more people than covid ever will … a grain of salt required with any FDA recommendation …

  15. Harvey Risch addressed these issues in his article at Journal of American Epidemiology. The numb of the issue will sound familiar to those following the climate alarms.

    “The clash in scientific worldviews is that basic and clinical scientists seem to feel that biological and drug-development evidence for medication use in non-human and nonoutpatient contexts can be extrapolated to recommendations for outpatient use without benefit of RCT evidence but don’t accept epidemiologic evidence without RCTs, whereas epidemiologists have had career experience with laboratory and animal evidence that did not hold up under epidemiologic study, but do reason by including all types of epidemiologic study designs and derive causal conclusions in the standard way following Hill’s Aspects (26) on the basis of strong totality of evidence, sometimes even without RCT evidence. There are contexts where each approach is valid. However, it is not my point to say that remdesivir has little evidence to support its potential outpatient utility, only efficacy considerations that have not been addressed and that could lead to lack of efficacy under general use, but that HCQ+AZ has been directly studied in actual early high-risk outpatient use with all of its temporal considerations and found empirically to have sufficient epidemiologic evidence for its effective and safe employment that way, and that requiring delay of such general use until availability of additional RCT evidence is untenable because of the ongoing and projected continuing mortality.”

    Risch makes the case that doctors are following results in the field, with a healthy skepticism of solutions that work in the lab.

    His article is Early Outpatient Treatment of Symptomatic, High-Risk Covid-19 Patients that Should be
    Ramped-Up Immediately as Key to the Pandemic Crisis
    https://academic.oup.com/aje/advance-article/doi/10.1093/aje/kwaa093/5847586

  16. If Hydroxychloroquine kills people who are about to die, nothing is lost. If the correct dosage only has a very small potential to delay that and facilitate a recovery, the precautionary principle requires its use to be approved and to leave the decision to the patient and his/her physicians.

  17. 12 Jun: Conservative Woman UK: The Marx Brothers do science
    By Edmund Fordham
    (Dr Edmund Fordham is a physicist, and not a physician…He was an Independent parliamentary candidate in the General Election. This article is not medical advice. It is however political advice)
    LAST Friday, hard on the heels of the retraction by The Lancet of its now-notorious paper purporting to show that hydroxychloroquine not only did not help Covid-19 patients, but actually made them worse, came the termination of the hydroxychloroquine ‘arm’ of the UK’s RECOVERY (Randomised Evaluation of COVid-19 thERapY) clinical trials. A huge embarrassment was conveniently overlain by news from Oxford University that sorry, hydroxychloroquine really isn’t any good. So even if The Lancet paper was fake, ‘a political hit job’ as one American doctor had it, Oxford’s clinical trial showed the same result.

    Professor Martin Landray, MB ChB, PhD, FRCP, FHEA, FASN, FBPhS, FESC, Professor of Medicine and Epidemiology at Oxford, and deputy chief investigator of the RECOVERY trial, was interviewed by the increasingly astute France Soir. It began well: the trial termination was triggered by a request from the Medicines and Healthcare products Regulatory Agency who were bothered about safety (reasons not explained). In consequence the study was ‘unblinded’, that is, results were revealed. Finding no significant difference between treated and untreated patients, they called off the trial, with Oxford triumphantly announcing that hydroxychloroquine was no good for Covid-19, at least for hospitalised patients.

    Since those following the issue already knew that no anti-viral was likely to help very sick late-stage Covid-19 patients, this wasn’t news. The trial design had already been savaged within days of launch; the results were no surprise. Internet sleuths also got to work on the very heavy doses of the drug that were given – 2400 mg in the first 24 hours, a ‘dose fit for a gorilla’ as one critic had it. Quizzed about this, Landray defended the dosage, twice, as being usual for other diseases such as amoebic dysentery. Say again?…

    In an interview on Tuesday, (Professor Didier Raoult, director of the University Hospital in Marseille) scathingly called RECOVERY ‘the Marx Brothers doing science’…
    With a destructive lockdown ongoing, and the worst deaths per million in the world after Belgium, the UK needs far better than clinical trials run by the Marx Brothers. Wake up, Oxford, and rediscover your empirical inheritance…
    https://conservativewoman.co.uk/the-marx-brothers-do-science/

  18. Here are items under the heading “HXQ” in Judith Curry’s Covid discussion thread: Part IX at https://judithcurry.com/2020/06/14/covid-discussion-thread-part-ix/ :

    Senegal confirms its selection of hydroxychloroquine as a treatment with preliminary study showing hospitalisation’s length of stay of 13 days without HCQ, 11 HCQ alone and 9 HCQ+Azithromycin. https://francetvinfo.fr/monde/afrique/societe-africaine/covid-19-le-senegal-confirme-l-option-de-l-hydroxychloroquine-sur-la-base-d-etudes-preliminaires_3947713.html…

    Spain: “we implemented a … treatment outside the hospital with hydroxychloroquine plus azithromycin … associated with a reduction in the burden of hospital … successful in terms of the number of patients who have developed serious complications.” https://www.medrxiv.org/content/10.1101/2020.06.10.20101105v1

    Indonesia will publish a clinical study showing efficacy of combinations of various antibiotics with hydroxychloroquine or Kalestra. They have done exceptionally well against COVID-19 so far. https://jakartaglobe.id/news/indonesia-claims-five-drug-combinations-effectively-reduce-novel-coronavirus

    Turkey, which uses hydroxychloroquine early for treatment of Covid-19, reports that ICU cases have dropped from 200 in April to 50 today.
    https://turkishpress-com.cdn.ampproject.org/c/s/turkishpress.com/turkish-health-minister-briefs-who-on-virus-measures/?amp
    .
    India’s health ministry guidelines for Covid-19 treatment now say hydroxychloroquine should be used as early in the disease course as possible and should be avoided in patients with severe cases. https://newsroompost-com.cdn.ampproject.org/c/s/newsroompost.com/india/health-ministry-issues-fresh-clinical-management-protocol-for-covid-19-patients/525911.html/amp

    UAE will not use hydroxychloroquine on severe cases any more, but still on mild and moderate patients. A few data points on a new promising stem cell treatment that reduced recovery time from 22 days to 6 days for serious cases. https://gulfbusiness.com/uae-reports-603-new-cases-stops-use-of-hydroxychloroquine-for-serious-covid-19-patients/

    • Roger,
      You remarked, “UAE will not use hydroxychloroquine on severe cases any more, …” But, it is the severe cases who are most in need of efficacious treatment. The mild, and ever moderate, cases are highly likely to resolve on their own with minimal intervention. Not all cases proceed to a level of severity that needs extreme effort to be kept alive. That is the weakness in recommending HCQ to all with early symptoms. They may well recover without introducing them to the risk (albeit low) of HCQ side-effects. It may well be akin to sprinkling holy water on those with a cough. But, without proper trials, we may never know. Promotion of HCQ by medical laymen is not in the best interests of society.

      • Clyde Spencer : This is the most unintelligent statement I have ever heard from someone on this site.
        You wrote: “But, it is the severe cases who are most in need of efficacious treatment. The mild, and ever moderate, cases are highly likely to resolve on their own with minimal intervention.”

        The claim and recommended use is that the drug (with Zn) PREVENTS most patients from becoming severe. That is what HCQ claim is. It does so by preventing further replication. Preventing replication after having a trillion plague the body is too late – since the other factors are now going to overwhelm.

        So in your world, pouring water on a small fire is useless because the fire will most likely not grow. But if it does grow and the house is engulfed in flames, water is useless and therefore should never be used for small fires that might not grow.

        Respond to me by stating that you understand now. Else, your turkey is now cooked, stick a fork in it.

      • “Roger,
        You remarked, “UAE will not use hydroxychloroquine on severe cases any more, …” ”

        Actually, I was just pasting what was posted on the Climate etc. site, which in turn was just paraphrasing what the UAE press release said.

  19. FDA memorandum referenced the following:

    Boulware DR, Pullen MF, Bangdiwala AS, et al. A Randomized Trial of Hydroxychloroquine as Postexposure Prophylaxis for Covid-19 [published online ahead of print, 2020 Jun 3]. N Engl J Med.

    Cohen MS. Hydroxychloroquine for the Prevention of Covid-19 – Searching for Evidence [published online ahead of print, 2020 Jun 3]. N Engl J Med. 2020;10.1056/NEJMe2020388. doi:10.1056/NEJMe2020388 26

    3 Jun updated 15 Jun: NYT: Malaria Drug Promoted by Trump Did Not Prevent Covid Infections, Study Finds
    The first carefully controlled trial of hydroxychloroquine given to people exposed to the coronavirus did not show any benefit.
    By Denise Grady; Sheila Kaplan contributed reporting
    The malaria drug hydroxychloroquine did not prevent Covid-19 in a rigorous study of 821 people who had been exposed to patients infected with the virus, researchers from the University of Minnesota and Canada are reporting on Wednesday.
    This type of study, in which patients are picked at random to receive either an experimental treatment or a placebo, is considered the most reliable way to measure the safety and effectiveness of a drug. The participants were health care workers and people who had been exposed at home to ill spouses, partners or parents.
    “The take-home message for the general public is that if you’re exposed to someone with Covid-19, hydroxychloroquine is not an effective post-exposure preventive therapy,” the lead author of the study, Dr. David R. Boulware, from the University of Minnesota, said in an interview.
    The results were published in The New England Journal of Medicine…

    A recent Lancet study reported increased risks of heart problems and death. Shortly after it was published, the World Health Organization suspended trials of the drug.
    But the Lancet data has been called into question. On Wednesday, the World Health Organization said it would resume the trials it had suspended…

    The new study included 821 people from across the United States and parts of Canada who had a either a high-risk or moderate-risk exposure to a person who had tested positive and was ill from the coronavirus. None of the participants had symptoms themselves…
    The participants, recruited online, ranged in age from 33 to 50, with a median age of 40…
    Not all the participants could be tested for the virus, because when the study was being conducted, there was still a shortage of test kits…
    An editorial accompanying the study pointed out some limitations…
    The editorialist, Dr. Myron S. Cohen from the University of North Carolina, called the results more provocative than definitive, and wrote, “the potential prevention benefits of hydroxychloroquine remain to be determined.”…
    https://www.nytimes.com/2020/06/03/health/hydroxychloroquine-coronavirus-trump.html

    3 Jun: NEJM: Hydroxychloroquine for the Prevention of Covid-19 — Searching for Evidence
    author: Myron S. Cohen, M.D.
    Boulware et al. now report in the Journal the results of a randomized trial testing hydroxychloroquine as postexposure prophylaxis for Covid-19.5 This is described by the investigators as a “pragmatic” trial in which participants were recruited through social media and almost all data were reported by the participants…

    This trial has many limitations, acknowledged by the investigators. The trial methods did not allow consistent proof of exposure to SARS-CoV-2 or consistent laboratory confirmation that the symptom complex that was reported represented a SARS-CoV-2 infection. Indeed, the specificity of participant-reported Covid-19 symptoms is low,6 so it is hard to be certain how many participants in the trial actually had Covid-19. Adherence to the interventions could not be monitored, and participants reported less-than-perfect adherence, more notably in the group receiving hydroxychloroquine. In addition, those enrolled in th
    e trial were younger (median age, 40 years) and had fewer coexisting conditions than persons in whom severe Covid-19 is most likely to develop,7 so enrollment of higher-risk participants might have yielded a different result…
    https://www.nejm.org/doi/full/10.1056/NEJMe2020388

  20. Chloroquine and hydroxychloroquine bind to melanin in the retinal pigment epithelium (RPE) and cause damage to the macular cones outside of the fovea. The drugs inhibit RPE lysosome activity, reduce phagocytosis of shed photoreceptor outer segments causing an accumulation of outer receptor segments. In response, pigment-containing RPE cells migrate into the outer nuclear and outer plexiform layers of the retina resulting in irreversible photoreceptor loss and RPE atrophy.[3] HCQ has a long half-life (about one month) and takes about half a year to achieve full elimination from the body; this is significant when managing minor side effects such as itching and corneal deposits and major ones such as retinal toxicity and explains continued maculopathy even after discontinuation of the medication. Corneal deposits (called vortex keratopathy or corneal verticillata) result from binding to cellular lipids and deposition of the drug in the basal epithelial layer of the cornea. Discontinuation of the drug usually causes the deposits to disappear over time.
    https://www.ncbi.nlm.nih.gov/books/NBK537086/

      • I first read about the HQC +zinc in an article by Bill Sarde back in late Jan,/early Feb> He mentioned that quercetin was also an ionophor for zinc, and that it is found in several foods including red apples. Since an apple has been part of my daily breakfast for years, I added a zinc supplement, upped my daily vit D and C a little, and went on with life as usual.

        The VA (my primary care) study I looked into used people already in critical care on ventilators, and gave them 4x the normal dosage. Not a relevant study at all. Also turns out that the rush to ventilators did more damage than helped. I my opinion, money is the issue–big pharma can’t control the price on a 70 year old generic.

    • It is in fact quite safe for the majority of people; it has been in wide use for decades.

      However it is Orange Man’s drug therefore also bad and, further, inexpensive and readily available so drug companies too will not like it.

      • Robert,
        Let’s say, for the sake of argument that “It is in fact quite safe for the majority of people; …” What if it were to become the drug of first choice for everyone who shows symptoms, and you were one of the ‘minority’ of people unfortunate enough that your statement doesn’t apply? Physicians are bound by an oath to “First, do no harm.”

        • Profile and monitor. The risk factors are known, including a separation of cause and effect attributable to the disease. HCQ+Zn+AZ is part of a Planned Pathogen (PP) protocol. Either way, it’s a choice (not Choice, which, contrary to the oath, has widespread physician backing, with nearly 100% excess mortality, and sometimes greater) in risk mitigation.

        • Clyde Spencer: Your logic then must proceed as follows. “No one should treat anyone with any kind of treatment that is not 100% without side-effects. No surgery, nothing with any risk, no matter how low. Take the aspirin and Tylenol off the shelf too, people die every year from these two widely beneficial drugs.

          Advice, to reduce the dilution of excellent posts here, think before you write such nonsense. When you know you don’t know what you’re talking about, pause and think, what harm can my baseless assertions do to the conversation.

          That said, there have been cogent statements against the use of HCQ and Zn, but your statements are not among them.

      • They haven’t banned Dihydrogen monoxide yet, despite all the signatures on all the petitions! It’s an outrage!!!! 😀

        • LOL: I worked developing low cost Cloud SCADA for the water industry, and they have banned the extraction of water in some wells, for overuse and for other reasons. OK… but the FDA has not banned it 🙂

  21. I fear we have descended into health policy bedlam. HCQ is an ionophore that works in combination with Zn to inhibit virus replication. So here are two basic questions: 1) Where is Zn mentioned in combination with HCQ in any of this policy ping pong? and 2) How are clinical results being impacted by use of HCQ with Zn in late stage critical care vs. earlier monitoring stages of infection? Early and mid stage treatment could save a lot of lives if the studies were rationally conducted and reported.

    Followup question: Is there a study or health guideline that says Zn with ionophores are ineffective at any stage of COVID-19 infection? I thought not.

  22. As in the case of AIDS, I guess we will not see consideration of drug combinations until well after the pandemic is in later stages of harm.

    Is it really that hard to study and report on HCQ with Zn and at what stage for best results? Does stress cause a human (health policy) mental tick to arise that can only focus on one thing at a time?

    • “As in the case of AIDS, I guess we will not see consideration of drug combinations until well after the pandemic is in later stages of harm.”

      That’s when they move to less toxic drugs that don’t ki!ll patients like the toxic drugs they initially give them do. Then when deaths drop they claim the less toxic drugs helped them. That’s what they did with AZT during AIDS. AZT would ki!ll any healthy person. Also they did it during SARS with ribavirin, another DNA chain terminator (aptly named “nukes”) like AZT.

  23. Everyone touts Germany as the shining light over their coronavirus response. As of yesterday (15th June) they had reported “only” 8,887 covid-19 deaths from a population of 83 million, which is significantly better than other western European nations. Countries such as the UK, France, Spain and Italy have reported 27,000 to 41,000 deaths. People have been asking how Germany has done it.

    Well, Turkey has a population of 84 million, almost the same as Germany, and has reported 4,825 deaths from 179,000 confirmed cases, comfortably better than Germany even allowing for the fact that the virus arrived in Turkey later. As soon as a patient comes to hospital reporting symptoms, even before the covid-19 diagnosis has been confirmed by testing, the patient is administered with hydroxychloroquine and azithromicyn. Any complications are dealt with by other drugs, for example, favipravir for pneumonia, tocilizumab for cytokine issues or an anticoagulant for coagulopathy.

    • ROFLMAO. See this data here? I wrote down a number and underlined it, solid, very solid.

      • My thoughts exactly. For someone who holds others to a high standard, Mosher doesn’t hold himself to any standard whatsoever.

        WRT to Sweden, it’s too early to tell if their approach is right or wrong. We won’t know until the pandemic has run its course, which it will do until there is either herd immunity or a vaccine. There may never be a vaccine or it may take a long time to become widely enough available, so Sweden may well end up being right over the long term.

        There have been numerous epidemiologists who have correctly pointed out that places that imposed strict lockdowns may well have gotten the virus under control (for however long), but in doing so, they did not achieve a sufficient level of herd immunity, so they are vulnerable to a resurgence. Countries like New Zealand, Denmark, Norway and Finland (among others) are examples. They will have to stay locked down until there is a vaccine, resulting in ongoing damage to the economy, massive unemployment, failure of businesses and unrestrained growth of debt.

        The supposed original point of “flatten the curve” was to prevent overloading the healthcare system. There are countless pictures that show the height of the “flattened curve” just touching a line representing the capacity of the healthcare system. However, the goalposts kept getting moved further and further to point where many places (such as Vancouver) are very slow to relax the restrictions, despite very few new cases and despite never coming close to overloading the healthcare system. Sweden stuck with the original claimed point of flatten the curve. They have had more deaths than some countries, but they have not overloaded their healthcare system, so the criticisms are unwarranted.

    • But Sweden may look worse than it is, because according to the article below it, unlike its neighbors, includes deaths WITH Covid-19 as deaths FROM Covid-19.
      ————

      “Sweden reports the number of people who die with COVID-19, not of COVID-19.

      “Even in a culturally and geographically similar country like Norway—celebrated for its low death rate—they do things differently. The Norwegians only count something as a COVID-19 death if a doctor concludes that someone was killed by the disease and decides to report it to the country’s public health authority.”

      https://reason.com/2020/04/17/in-sweden-will-voluntary-self-isolation-work-better-than-state-enforced-lockdowns-in-the-long-run/?utm_medium=email
      In Sweden, Will Voluntary Self-Isolation Work Better Than State-Enforced Lockdowns in the Long Run?
      There’s a lot of debate over the Swedish model of coronavirus response, but there are good reasons to think a Hippocratic approach to policy may pay off.
      JOHAN NORBERG | 4.17.2020 11:50 AM

  24. This whole sorry saga around these drugs that are saving lives will be a shameful burden the medical profession will have to carry for a long time.

    Politics and big pharma working together for mutuel benefit, while tens of thousands of their own citizens denied BY LAW access to effective medicine is a truly abhorrent deed.

    Hippocratic oath anybody?…….. ” I will prevent disease whenever I can, for prevention is preferable to cure”

    Below is a link to an interview in Nexus magazine with Professor Christian Perronne Head of the infectious diseases department of the Raymond-Poincaré hospital just outside Paris.

    It’s in french so you’ll have to chuck a google translate on the page, but he very clearly lays out his reasons for prescribing Hydroxychloroquine and Azithromycin.

    https://www.nexus.fr/actualite/entretien/perronne-hydroxychloroquine/

    Some excerpts:
    Have you had positive clinical results in your department since you generalized treatment with hydroxychloroquine and azithromicyne?

    Prof. Christian Perronne: It changed the situation. Even the doctors on duty and the nurses confirm that there are far fewer sick people in intensive care.

    What do you have to answer to all those who prefer to wait for the results of the studies and bet everything on the academic methodology?

    Prof. Christian Perronne: It is incomprehensible because, when they have the certainties, the final results, the epidemic will be over and everyone will be dead. We cannot pretend that we are in a time of peace….. but we have to move now! What do you care about having a placebo, a control group, if you heal a lot of people? Here we are in a war situation.

    How many people have you prescribed this drug to in your entire career?

    Prof. Christian Perronne: I have prescribed it to thousands of patients for 20 years. I had zero deaths. Sometimes I asked the advice of the cardiologist.

    • Out of the French text, an important part I found reading the French source::

      What do you have to say to all those who prefer to wait for the results of the studies and bet everything on the academic methodology?

      Pr Christian Perronne: It is incomprehensible because, when they have the certainties, the final results, the epidemic will be over and everyone will be dead. We can’t pretend this is a time of peace. I know some of the people who make up the High Scientific Council, they are AIDS experts, they reason as if we were dealing with a chronic AIDS epidemic. They say to themselves “we have the time, we do things well, we evaluate with the canons of methodology, etc.”. ». But we have to move now! What do we care about a placebo, a control group, if we cure a lot of people? Now we’re in a war situation. There are hundreds of deaths every day and still waiting for the results of the Discovery study, that’s all well and good, but no one will be treated in time by doing this. Normally, we have time to wait 6 months for an article to be published. But you can imagine during this epidemic, every time you have super important data, you have to wait for a newspaper to accept it, you lose 3 months, but it’s scandalous!

      Translated with http://www.DeepL.com/Translator (free version)

    • Sensible bloke. If you have to amputate a leg on the battlefield you don’t wait for academics to find out what the approved way of doing it is. You just use what is at hand and give it your best.

    • Also out of the French text, for our “side-efect-hunters”

      Then Raoult’s study came out, out of 24 patients. We immediately started giving hydroxychloroquine to the hospital in Garches for the medium severe forms. But some virologists had told us that we should use Kaletra instead, so my team let themselves be influenced and we prescribed it for a while, but it didn’t really feel like it was doing anything. As a result, a collegial decision was made at the hospital to place all patients with moderately severe forms, especially pneumonia, on azithromycin and hydroxychloroquine, under cardiac surveillance, respecting the contraindications. Care was taken to measure blood potassium (kalemia), check for drug contraindications and monitor the electrocardiogram. That is what we do systematically. One must be all the more cautious since it is realized that Covid-19 can cause cardiac damage, even without treatment. Self-medication, which is risky, should be avoided at all costs.

      Translated with http://www.DeepL.com/Translator (free version)

  25. These studies seem to fail for one of two reasons: 1) There is a political or financial stake in the failure or 2) The “scientists” conducting the analysis don’t understand the two mechanisms by which HCQ is hypothesized to fight Covid-19.

    The first of these two mechanisms is the raising of the intra-cellular pH which defeats the replication mechanism of SARS-Cov-2 which must lower the pH of the endosomes in order to replicate. This takes several days to accomplish and so is only helpful at presentation of first symptoms or as a prophylaxis begun days before infection.

    The second is that HCQ (and to a much lesser extent chloroquine) is a zinc ionophore and zinc is a key inhibitor of the intra-cellular replication process. In past studies, HCQ has been shown to be 3 X more effective moving Zn through the cellular membrane as CQ, so treating them as equal treatments is wrong. Also, the studies so far do not supplement the HCQ administration with extra Zinc which is another requirement for moving Zinc through the cell membrane (duh).

    If you are going to do a study on the efficacy of HCQ, at least take into account these basic facts about how it works and when to administer it. Don’t wait until someone is on the ventilator to give it to them and expect a positive outcome and don’t do bad science like the VA study that has been shown to have significant (p<.05) differences between the treatment groups in factors contributing to survival.

    I hate to think what the human total of this bad and politically motivated science has been. (Not quite as high as the climate bad science, but still …)

  26. Dexamethasone should be included with anti-coagulation drugs to treat COVID-19:

    https://www.bbc.com/news/health-53061281

    Dexamethasone is cheap and globally available. Its anti-inflammatory effects are most likely the ones mediating the benefit which is not an overwhelming surprise.

    But it is still no “wonder drug” or “game changer” or a cure. It is significant in its benefit even for patients already on ventilators which is more than everything else so far (except anti-coagulants though the randomized control trial is still out).

    • It’s a steroid and used to treat the most severe cases, patients who are at death’s door.

      • Not surprisingly dexamethasone doesn’t work on people who don’t suffer from increased inflammation and don’t receive O2:

        https://youtu.be/ie5Oi8m_Rlo?t=187

        But the NNT is so low like with nothing else so far (except for anticoagulation but that is not out as a randomized controlled trial so far).

  27. Lockdowns … vehemently opposed by The Left to take ’em down, all evidence of their futility notwithstanding.
    Chloroquine … vehemently opposed by The Left as potentially dangerous. After 3rd decimal place.
    Masks … originally vehemently opposed by The Left as unnecessary and potentially harmful.

    I’m a scientist, both by profession and by nature.
    In a pandemic, using fairly widely reported, but almost entirely empirical ‘novel treatment’ …

    &dot; is humane
    &dot; is warranted
    &dot; has potential for much greater general good, than general setback.
    &dot; must be handled expeditiously, to thwart morbidity

    We’re in a strange new world, folks. A world where “doing anything at all to stop Trump” sets aside every pretense of scientific and rational thought. A world in which ever last crackpot conjecture to support this narrative is virally disseminated through most-every channel of social self-publishing. Copy, paste, copy, paste, forward, copy, paste.

    I really didn’t believe a few decades back, that the human social sphere could be so egregiously misguided by its own vocal politically motivated activists. Down to the girl in the dorm next door, on her smart phone, texting to her VacuumBook page or InstantShit account, publishing to hundreds-to-thousands of others. Who do the same.

    Madness!
    We are in that kind of world.

  28. Eric,
    “IMPORTANT It appears the Guardian may have misinterpreted the actions of the FDA, or perhaps I misinterpreted what the Guardian was trying to say. It appears that doctors are now free to provide Hydroxychloroquine however they see fit.”

    Pretty remarkable that this article and discussion can happen when there is said to be doubt about whether HCQ has been restricted or totally liberated. But the Guardian hasn’t misinterpreted. The FDA notification is here. It begins by explaining what an EUA is:
    “Today, the U.S. Food and Drug Administration (FDA) revoked the emergency use authorization (EUA) that allowed for chloroquine phosphate and hydroxychloroquine sulfate donated to the Strategic National Stockpile to be used to treat certain hospitalized patients with COVID-19 when a clinical trial was unavailable, or participation in a clinical trial was not feasible. The agency determined that the legal criteria for issuing an EUA are no longer met. Based on its ongoing analysis of the EUA and emerging scientific data, the FDA determined that chloroquine and hydroxychloroquine are unlikely to be effective in treating COVID-19 for the authorized uses in the EUA. Additionally, in light of ongoing serious cardiac adverse events and other potential serious side effects, the known and potential benefits of chloroquine and hydroxychloroquine no longer outweigh the known and potential risks for the authorized use.”

    Doctors can prescribe HCQ if they want, in the same way they could prescribe valium or nexium. They just can’t say they are following FDA procedure or advice.

    • And considering that demand for HCQ is soaring and manufacturing is ramped up, seems like doctors all over the world are using it. Just not in places with the outlier death counts it seems.

      • “seems like doctors all over the world are using it”

        Well, it means that enthusiasts like Gov DeSantis of Florida are buying it (1 million doses). But the doctors aren’t burdening their patients with it (only 20000 used).

  29. Cheap, widely available steroid called dexamethasone can improve COVID-19 survival, researchers say

    Researchers in England said they have the first evidence that a drug can improve COVID-19 survival: A cheap, widely available steroid called dexamethasone reduced deaths by up to one third in severely ill hospitalized patients.

    Results were announced Tuesday, and researchers said they would publish them soon. The study is a large, strict test that randomly assigned 2,104 patients to get the drug and compared them with 4,321 patients getting usual care.

    The drug was given either orally or through an IV. After 28 days, it had reduced deaths by 35% in patients who needed treatment with breathing machines and by 20% in those needing only supplemental oxygen. It did not appear to help less ill patients.

    “This is an extremely welcome result,” one study leader, Peter Horby of the University of Oxford, said in a statement. “The survival benefit is clear and large in those patients who are sick enough to require oxygen treatment, so dexamethasone should now become standard of care in these patients. Dexamethasone is inexpensive, on the shelf and can be used immediately to save lives worldwide.”

    “Dexamethasone must now be rolled out and accessed by thousands of critically ill patients around the world,” said Cammack, who had no role in the study. “It is highly affordable, easy to make, can be scaled up quickly and only needs a small dosage.”

    Steroid drugs reduce inflammation, which sometimes develops in COVID-19 patients as the immune system overreacts to fight the infection. This overreaction can prove fatal, so doctors have been testing steroids and other anti-inflammatory drugs in such patients. The World Health Organization advises against using steroids earlier in the course of illness because they can slow the time until patients clear the virus.

    https://eu.usatoday.com/story/news/health/2020/06/16/coronavirus-drug-steroid-dexamethasone-reduce-covid-deaths/3197420001/

  30. Surely they are addressing the wrong question.
    “If you are already infected, will HCQ + zinc cure you”.
    This is like showing that if you have a flu shot when you already have the flu, that it does not help”.
    The proper question should be.
    “If you do not have malaria or COVID-19 and you take HCQ and zinc, will it help you in preventing a severe
    infection?”
    You could also make tea out of Cinchona Bark, or let the bark seep in gin or rum. This apparently works well against plasmodium.
    Queen Elizabeth the Queen Mother used to swear by a good Gin and Tonic -” it’s always 5 o’clock somewhere in the empire!”

  31. Suffice it to say, the case against HCQ has been built in similar fashion to the case against CO2, or “carbon”. It is one built on ignorance, politics, lies, pseudo-science, and of course, money.

  32. Unless the law has changed, in California, a doctor could provide any licensed drug for any purpose, with the exception of controlled substances.
    Is there a California MD who can confirm this?

  33. FWIIW, much like HCQ controversy, there has never been a randomized, double-blind, placebo controlled study of the effectiveness of many interventions. For example, parachute usage, to overcome gravitational challenge, has _NOT_ been studied in a medically rigorous and scientific manner!!!

    Although details are at the link (https://www.bmj.com/content/327/7429/1459.full); the core message is that “As with many interventions intended to prevent ill health, the effectiveness of parachutes has not been subjected to rigorous evaluation by using randomised controlled trials. Advocates of evidence based medicine have criticised the adoption of interventions evaluated by using only observational data. We think that everyone might benefit if the most radical protagonists of evidence based medicine organised and participated in a double blind, randomised, placebo controlled, crossover trial of the parachute.”

    Almost forgot … heavy dose of sarcasm with tongue firmly in cheek (grin ^ grin)

  34. From the FDA announcement … “Of note, FDA approved products [i.e. HCQ] may be prescribed by physicians for off-label uses if they determine it is appropriate for treating their patients, including during COVID.” … in other words, an MD can still prescribe HCQ for whatever reason the MD wants to

  35. I forsee a sudden plague of suspected lupus cases breaking out all over the country. And malaria. You can never be too careful about malaria.

  36. So what should I take if I get COVID-19? I’m 73 years old, and would rather not cough my lungs out. I read somewhere that Pepsid AC may be beneficial, and more recently, another commonly used drug, but I can’t remember its name. For me, my favorite “magic bullet” I use when I start getting sick is diphenylhydramine (the active ingredient in Benadryl). I don’t have allergies, but if I take the maximum dose at the onset of cold symptoms, or other sicknesses, it seems to have a very beneficial effect. And it doesn’t make me sleepy.

  37. Littlepeaks, Watch the video. Call your representative.

    This is an interesting update of Dr Zelenko’s progress in getting his data for the HCQ with Zinc Sulfate treatment of Covid ill patients published. Zelenko has treated more than 700 of his sick patients with HCQ and Zinc Sulfate.

    Independent peer reviewed studies have shown the HCQ is a zinc ionophore (it enables a tiny amount of the Zn+2 ions into our cells and the Zn+2 ions have been shown to stop covid from connecting to the ACE-2 connector molecule in our cells and replicating.

    Two established, senior, German researchers have connected Zelenko and are directly working with Dr Zelenko to help him publish his results.

    P.S. Vitamin D deficient people have been shown to have a 19 times greater chance of dying from Covid or having serious covidn symptoms, as compared to vitamin D normal people. 4000 UI/day is required to correct the Vitamin D deficiency. A glass of milk has 100 UI in it. This finding explains why UK Black people are three times more likely to die from covid than white people. The death rate for covid correlates with how dark the patient’s skin is, as their severity of their Vitamin D deficient also correlates with the severity of their vitamin D deficiency. (See my comment above for details and links to peer reviewed papers.)

    • Thanks for the reply Ashley. I still go to a military treatment facility (I was grandfathered in) for health care, and I’m not sure if they have any restrictions for treatment. I do know that the post is paranoid about covid-19. I’ve been tested for vitamin D, and have plenty. I think part of it is that I spend a LOT of time outside in the sun, even in the winter.

    • “Two established, senior, German researchers have connected Zelenko and are directly working with Dr Zelenko to help him publish his results.”

      I suspect that he, like many so-called “local MDs”, is not well-positioned to write “studies” or even papers, that journals will accept. Hospital-based MDs are much better-positioned. Their duties are partly administrative. They have a “secretariat” in effect that can collect statistics. They have a larger number of patients on whom to collect statistics. They can often control the environment of the patient in a way that an out-patient doctor cannot. They can more easily and accurately measure patients’ statuses day-by-day. Their “affiliation” gives them “cred.” Their employer is more likely to encourage them to produce papers.

      Since hospitalized patients are the ones who benefit least from HXQ, but hospital-based doctors are the ones positioned and motivated to write studies, that would seem to explain why HXQ studies so far are not encouraging.

  38. Clyde Spencer: Your logic then must proceed as follows. “No one should treat anyone with any kind of treatment that is not 100% without side-effects. No surgery, nothing with any risk, no matter how low. Take the aspirin and Tylenol off the shelf too, people die every year from these two widely beneficial drugs.

    Advice, to reduce the dilution of excellent posts here, think before you write such nonsense. When you know you don’t know what you’re talking about, pause and think, what harm can my baseless assertions do to the conversation.

    That said, there have been cogent statements against the use of HCQ and Zn, but your statements are not among them.

  39. Hydroxychloroquine sulfate and some versions of chloroquine phosphate are FDA-approved to treat malaria. Hydroxychloroquine sulfate is also FDA-approved to treat lupus and rheumatoid arthritis.

    Does Hydroxychloroquine have Artificial Intelligence so that it can recognize the underlying illness being treated ?

    May be that could be the reason for Hydroxychloroquine not to adversely affect in treatment of Malaria, Lupus and Rheumatoid Arthritis and intelligently adversely affect in the treatment of COVID 19 !

    Because chloroquine phosphate and hydroxychloroquine may possibly help very sick patients, the FDA is allowing these drugs to be provided to certain hospitalized patients under an Emergency Use Authorization (EUA) issued March 28, 2020. Under the EUA, health care providers and patients are provided with information about the risks of these drugs. However, more data from clinical trials are necessary for us to determine whether chloroquine phosphate or hydroxychloroquine sulfate are safe and effective in treating or preventing COVID-19.

    In a Drug Safety Communication, the FDA cautions against the use of hydroxychloroquine or chloroquine for COVID-19 outside of the hospital setting or a clinical trial due to the risk of heart rhythm problems. Read more about the emergency use authorization for chloroquine phosphate and hydroxychloroquine sulfate for COVID-19.

    Q. FDA has approved HCQ to treat lupus and rheumatoid arthritis. Is it in Hospital setting ? If not why HCQ for COVID 19 should require Hospital setting ?

  40. Mods

    The following should be removed from my above post:

    “Because chloroquine phosphate and hydroxychloroquine may possibly help very sick patients, the FDA is allowing these drugs to be provided to certain hospitalized patients under an Emergency Use Authorization (EUA) issued March 28, 2020. Under the EUA, health care providers and patients are provided with information about the risks of these drugs. However, more data from clinical trials are necessary for us to determine whether chloroquine phosphate or hydroxychloroquine sulfate are safe and effective in treating or preventing COVID-19.

    In a Drug Safety Communication, the FDA cautions against the use of hydroxychloroquine or chloroquine for COVID-19 outside of the hospital setting or a clinical trial due to the risk of heart rhythm problems. Read more about the emergency use authorization for chloroquine phosphate and hydroxychloroquine sulfate for COVID-19.

    Q. FDA has approved HCQ to treat lupus and rheumatoid arthritis. Is it in Hospital setting ? If not why HCQ for COVID 19 should require Hospital setting ?”

  41. There is a danger in using HCQ to treat all patients who have Covid 19. There is speculation that those men who have G6PD (estimated to be about 400 million worldwide and to constitute 10% of the African American population are more susceptible getting Covid 19. But these are precisely those for whom the ingestion of Quinine can be highly dangerous.

    In the UK there is no evidence that any patients suffering from Covid 19 have ever been tested for G6PD which may be one of the reasons why the BAME population has been the most vulnerable.

    • Screening patients for glucose-6-phosphate dehydrogenase (G6PD) deficiency before prescribing hydroxychloroquine (HCQ) is unnecessary and may limit the beneficial use of the drug for individuals with systemic lupus erythematosus and other autoimmune diseases, a team of Duke rheumatology researchers reports.

      You are conflating HCQ and Quinine. They are not the same thing. That’s like saying eating salt will kill you because eating pure sodium (metal) is poison and would explode and burn in your mouth.

    • The BAME population is more susceptible most likely because of vitamin D deficiency. Getting outside and letting the sun shine on the skin at sun levels where our ancestors evolved from is beneficial… Dark skin at high latitudes require vit supplementation or a diet high in fatty fish.

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