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.

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June 16, 2020 2:09 am

“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.

Reply to  Eric Worrall
June 16, 2020 3:46 am

“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.

Reply to  Eric Worrall
June 16, 2020 4:14 am

“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.

Tom Abbott
Reply to  Eric Worrall
June 16, 2020 4:50 am

“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.

icisil
Reply to  Eric Worrall
June 16, 2020 5:01 am

You need to engage your mind. Doctors’ firsthand reports are not gossip.

Ron
Reply to  Eric Worrall
June 16, 2020 5:52 am

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.

Peter
Reply to  Eric Worrall
June 16, 2020 6:45 am

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.

Reply to  Eric Worrall
June 16, 2020 7:58 am

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?

Ron
Reply to  Eric Worrall
June 16, 2020 8:53 am

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.

Reply to  Eric Worrall
June 16, 2020 9:04 am

“No, just blockquote gone wrong.”
Sorry, Ron, I see what happened. That makes sense. I agree with you.

george Tetley
Reply to  Eric Worrall
June 16, 2020 9:39 am

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

icisil
Reply to  Eric Worrall
June 16, 2020 10:01 am

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!”

Reply to  Eric Worrall
June 16, 2020 10:30 am

– good God!

“As soon as possible after HOSPITAL ADMISSION.” You just bolstered Eric’s point – and thoroughly debunked the “study.”

Ron
Reply to  Eric Worrall
June 16, 2020 10:36 am

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

icisil
Reply to  Eric Worrall
June 16, 2020 12:05 pm

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.

Ron
Reply to  Eric Worrall
June 16, 2020 2:28 pm

@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.

William Astley
Reply to  Eric Worrall
June 16, 2020 3:07 pm

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

William Astley
Reply to  Eric Worrall
June 16, 2020 3:28 pm

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

icisil
Reply to  Eric Worrall
June 16, 2020 3:56 pm

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.

Ron
Reply to  Eric Worrall
June 16, 2020 5:07 pm

@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.

TedM
Reply to  Eric Worrall
June 16, 2020 7:59 pm
Hivemind
Reply to  Eric Worrall
June 17, 2020 5:11 am

“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.

Nicholas McGinley
Reply to  Eric Worrall
June 27, 2020 9:35 pm

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.

Richard (the cynical one)
Reply to  Nick Stokes
June 16, 2020 5:01 am

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

Tom in Florida
Reply to  Nick Stokes
June 16, 2020 5:11 am

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.

Gary Pearse
Reply to  Tom in Florida
June 16, 2020 7:01 am

A lethal dose of milk will kill you.

Reply to  Tom in Florida
June 16, 2020 8:01 am

“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?

Tom in Florida
Reply to  Tom in Florida
June 16, 2020 8:33 am

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.

Reply to  Tom in Florida
June 16, 2020 9:02 am

” 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.

old engineer
Reply to  Tom in Florida
June 16, 2020 2:56 pm

Tom In Florida-

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

Nicholas McGinley
Reply to  Tom in Florida
June 27, 2020 9:40 pm

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.

Robert W. Turner
Reply to  Nick Stokes
June 16, 2020 6:47 am

Soooo dumb.

RobUK
Reply to  Nick Stokes
June 16, 2020 7:32 am

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.

Reply to  RobUK
June 16, 2020 9:40 am

If they give the dose of an other drug, hydroxyquinoline…..

Reply to  RobUK
June 16, 2020 1:15 pm

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.

Crispin in Waterloo
Reply to  RobUK
June 16, 2020 2:18 pm

Doses are discussed. HCQ is never used without zinc (if you want it to work).
https://www.conservapedia.com/Vladimir_Zelenko%27s_coronavirus_treatment

From the horse’s mouth:
https://www.youtube.com/watch?v=gJ6gUuMTGXU

Zelenko’s success: >1450 patients. 4 admitted to ICU, 2 deaths. He is in NY City as are all his patients. How has the rest of NYC done with this disease?

The usefulness of Vitamin D is discussed here at MedCram

Reply to  RobUK
June 16, 2020 5:51 pm

” 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.”

Nicholas McGinley
Reply to  RobUK
June 27, 2020 9:51 pm

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.

Nicholas McGinley
Reply to  RobUK
June 27, 2020 9:56 pm

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?

Reply to  Nick Stokes
June 16, 2020 8:29 am

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 😀 😀 ?

Reply to  Nick Stokes
June 16, 2020 8:32 am

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 😀 😀 😀 ?

BCBill
Reply to  Nick Stokes
June 16, 2020 11:54 am

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.

Reply to  BCBill
June 16, 2020 4:22 pm

“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.

tsk tsk
Reply to  BCBill
June 16, 2020 7:47 pm

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.

Reply to  BCBill
June 16, 2020 8:25 pm

“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.

TheLastDemocrat
Reply to  Nick Stokes
June 17, 2020 11:06 am

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….

Reply to  TheLastDemocrat
June 17, 2020 1:33 pm

Dosages are all tabulated in Supplement 2.

RockyRoad
Reply to  Eric Worrall
June 16, 2020 4:00 am

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!

RobUK
Reply to  RockyRoad
June 16, 2020 7:48 am

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.

Neo
Reply to  Eric Worrall
June 16, 2020 11:08 am

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/

Reply to  Nick Stokes
June 16, 2020 3:21 am

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

Reply to  Steven Mosher
June 16, 2020 8:07 am

“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.

Rick C PE
Reply to  Nick Stokes
June 16, 2020 8:31 am

“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. 🙂

Reply to  Nick Stokes
June 16, 2020 12:19 pm

Even what is good can be amelorated, isn’t it ?

JEHILL
Reply to  Nick Stokes
June 16, 2020 1:18 pm

@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.

Bret Highum
Reply to  Steven Mosher
June 16, 2020 8:27 am

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.

John Endicott
Reply to  Bret Highum
June 16, 2020 9:29 am

three words “orange man bad”.

ex-KalifoorniaKook
Reply to  John Endicott
June 16, 2020 1:08 pm

Bingo, Mr. Endicott.

rbdwiggins
Reply to  Steven Mosher
June 18, 2020 1:54 pm

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 …

icisil
Reply to  Nick Stokes
June 16, 2020 4:16 am

“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”.

icisil
Reply to  icisil
June 16, 2020 5:48 am

How do you say this in Latin?

“Treat, no matter if it kills.”

Reply to  icisil
June 16, 2020 10:06 am

Facies nulla re nisi occidit. google 😀

icisil
Reply to  Krishna Gans
June 16, 2020 10:33 am

This should be the new hypocritic oath of medicine:

Supra omnia, tractare, non materia mali (Above all, treat, no matter the harm)

DrDweeb
Reply to  icisil
June 16, 2020 6:02 am

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?

MarkG
Reply to  DrDweeb
June 16, 2020 6:48 am

“One has to ask what is the motivation?”

Orange Man Bad.

coaldust
Reply to  MarkG
June 16, 2020 8:23 am

No, the motivation is $$$$. HQC is too inexpensive to be allowed to succeed.

BobM
Reply to  MarkG
June 16, 2020 9:47 am

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.

John Finn
Reply to  Nick Stokes
June 16, 2020 5:57 am

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.

Reply to  John Finn
June 16, 2020 8:33 am

” 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.

niceguy
Reply to  Nick Stokes
June 16, 2020 4:27 pm

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.

Ron
Reply to  Nick Stokes
June 16, 2020 4:35 pm

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.

James F. Evans
Reply to  Nick Stokes
June 16, 2020 7:48 am

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.

Reply to  James F. Evans
June 16, 2020 8:37 am

“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.

Slyrik
Reply to  Nick Stokes
June 16, 2020 9:06 am

That doesn’t answer the question… Are you an aspiring politician by any chance?

paul courtney
Reply to  Nick Stokes
June 16, 2020 11:04 am

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?

Clyde Spencer
Reply to  James F. Evans
June 16, 2020 9:19 am

James,
It is HCQ (HydroxyChloroQuine)

James F. Evans
Reply to  Clyde Spencer
June 17, 2020 8:05 am

Mr. Spencer: yes, I reversed the letters, my oops.

Esther Cook
Reply to  Nick Stokes
June 16, 2020 8:33 am

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.

John Endicott
Reply to  Esther Cook
June 16, 2020 9:26 am

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.

boffin77
Reply to  Nick Stokes
June 16, 2020 9:10 am

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.

Editor
Reply to  boffin77
June 16, 2020 1:47 pm

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.

Reply to  Mike Jonas
June 16, 2020 6:34 pm

“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.

Hocus Locus
Reply to  Nick Stokes
June 16, 2020 9:34 pm

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.

TheLastDemocrat
Reply to  Nick Stokes
June 17, 2020 12:20 pm

“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.

boffin77
Reply to  boffin77
June 16, 2020 7:10 pm

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.

boffin77
Reply to  boffin77
June 17, 2020 11:55 am

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.

Reply to  Nick Stokes
June 16, 2020 12:24 pm

Nicks comments at least are good for very interesting follow-up comments and discussion.

Should be appreciated 😀

JimW
Reply to  Nick Stokes
June 16, 2020 1:29 pm

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.

Reply to  JimW
June 16, 2020 6:12 pm

“France has and is using it.”
Nope!
27 May: “The French government on Wednesday banned treatment of Covid-19 patients with hydroxychloroquine”

paul courtney
Reply to  Nick Stokes
June 17, 2020 11:53 am

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?

Reply to  paul courtney
June 17, 2020 1:22 pm

“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?

paul courtney
Reply to  paul courtney
June 18, 2020 7:27 am

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?

mario lento
Reply to  paul courtney
June 18, 2020 11:58 am

I love your questions Paul Courtney.

Reply to  paul courtney
June 18, 2020 12:52 pm

” 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.

Reply to  Nick Stokes
June 16, 2020 1:58 pm

The evidence has emerged. The pseudo-scientist establishment elected to ignore it.

https://twitter.com/DefyCCC/status/1272908612348923905

DMacKenzie
Reply to  Leo Goldstein
June 16, 2020 10:23 pm

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….

Reply to  Nick Stokes
June 16, 2020 2:35 pm

Pays to look at the video above!

Phil's Dad
Reply to  Nick Stokes
June 16, 2020 7:05 pm

Your statement, Mr Stokes, applies equally to CAGW.

Alex
Reply to  Phil's Dad
June 16, 2020 10:46 pm

Well, yes.
One has to be blind on both eyes not to see the CAGW.
As many here are.

Alex
Reply to  Nick Stokes
June 16, 2020 10:43 pm

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

Reply to  Nick Stokes
June 17, 2020 6:31 am

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 !

lee
June 16, 2020 2:22 am

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.

A C Osborn
Reply to  lee
June 16, 2020 3:11 am

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.

Chaswarnertoo
Reply to  A C Osborn
June 16, 2020 4:26 am

If true, these Drs should be struck off.

Robert W. Turner
Reply to  Chaswarnertoo
June 16, 2020 7:31 am

So much of this is taking place and the bad actors are doing it with impunity.

Reply to  A C Osborn
June 16, 2020 9:21 am

“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.

Don K
Reply to  Nick Stokes
June 16, 2020 12:10 pm

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.

Tom Abbott
Reply to  Nick Stokes
June 16, 2020 7:02 pm

“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.

Ian Hawthorn
Reply to  Nick Stokes
June 17, 2020 10:40 am

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.

Chaswarnertoo
Reply to  lee
June 16, 2020 4:25 am

Let’s ignore reality, just like climate ‘science’…

David Guy-Johnson
June 16, 2020 2:25 am

Good.

Hamish Hossick
June 16, 2020 2:36 am

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/

Phil Rae
June 16, 2020 2:41 am

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.

Reply to  Phil Rae
June 16, 2020 3:17 am

“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.

Derg
Reply to  Nick Stokes
June 16, 2020 3:47 am

“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

Ghalfrunt.
Reply to  Derg
June 16, 2020 4:57 am

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

Derg
Reply to  Ghalfrunt.
June 16, 2020 5:38 am

Are you the one who told people to drink bleach?

ldd
Reply to  Ghalfrunt.
June 16, 2020 5:55 am

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…

Tom Abbott
Reply to  Ghalfrunt.
June 16, 2020 6:59 am

“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.

Robert W. Turner
Reply to  Ghalfrunt.
June 16, 2020 7:10 am

That’s right, patients do not pay, the money comes from generous fairies.

Bob boder
Reply to  Ghalfrunt.
June 16, 2020 7:22 am

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

Paul C
Reply to  Ghalfrunt.
June 16, 2020 8:24 am

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.

Chaswarnertoo
Reply to  Nick Stokes
June 16, 2020 4:28 am

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

Ghalfrunt.
Reply to  Chaswarnertoo
June 16, 2020 5:52 am

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

Ed Zuiderwijk
Reply to  Ghalfrunt.
June 16, 2020 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.

Derg
Reply to  Ghalfrunt.
June 16, 2020 11:22 am

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

Shame on you.

paul courtney
Reply to  Ghalfrunt.
June 16, 2020 11:22 am

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.

Joel Snider
Reply to  Ghalfrunt.
June 16, 2020 12:21 pm

‘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.

DrDweeb
Reply to  Chaswarnertoo
June 16, 2020 6:07 am

That’s a good question. It’s almost like he has no other purpose.

beng135
Reply to  Chaswarnertoo
June 16, 2020 8:38 am

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…..

John Endicott
Reply to  beng135
June 16, 2020 9:16 am

I’m sure his pay masters docked his salary for that.

ex-KaliforniaKook
Reply to  beng135
June 16, 2020 1:52 pm

I remember that instance, Beng! It was rather obvious, though.

ex-KaliforniaKook
Reply to  beng135
June 16, 2020 1:56 pm

I remember that post, Beng! Of course, his point was rather obvious.

icisil
Reply to  Nick Stokes
June 16, 2020 4:28 am

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.

Gerald Machnee
Reply to  Nick Stokes
June 16, 2020 5:22 am

As with climate Nick only quotes one side.

Agamemnon
Reply to  Nick Stokes
June 16, 2020 5:23 am

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.

Robert W. Turner
Reply to  Nick Stokes
June 16, 2020 6:54 am

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

ex-KaliforniaKook
Reply to  Robert W. Turner
June 16, 2020 2:00 pm

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….

James F. Evans
Reply to  Nick Stokes
June 16, 2020 8:04 am

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.

jim hogg
Reply to  James F. Evans
June 16, 2020 9:00 am

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.

paul courtney
Reply to  jim hogg
June 16, 2020 11:27 am

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.

John Endicott
Reply to  James F. Evans
June 16, 2020 9:14 am

intellectual dishonesty is pretty much Nick’s stock and trade.

Phil Rae
Reply to  Nick Stokes
June 16, 2020 11:59 pm

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!

cedarhill
Reply to  Phil Rae
June 16, 2020 4:34 am

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.

DrDweeb
Reply to  cedarhill
June 16, 2020 6:15 am

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

Reply to  cedarhill
June 16, 2020 6:41 am

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.

Robert W. Turner
Reply to  Sailorcurt
June 16, 2020 9:06 am

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.

Crispin in Waterloo
Reply to  Sailorcurt
June 16, 2020 2:33 pm

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.

Barry Cullen
Reply to  cedarhill
June 16, 2020 6:54 am

… and the number of deaths! There, fixed it for ya.

Willem69
Reply to  Phil Rae
June 16, 2020 4:42 am

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

DonM
Reply to  Willem69
June 16, 2020 10:15 am

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.)

Waza
Reply to  Phil Rae
June 16, 2020 4:42 am

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.

Waza
Reply to  Waza
June 16, 2020 4:57 am

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.

Paul C
Reply to  Waza
June 16, 2020 7:42 am

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.

Waza
Reply to  Paul C
June 16, 2020 11:46 pm

Paul
Good points

RobUK
Reply to  Phil Rae
June 16, 2020 7:42 am

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.

harry
June 16, 2020 2:42 am

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.

michael hart
Reply to  harry
June 16, 2020 4:46 am

Add to that the poor diagnosis of COVID infection. High numbers of false positives and false negatives in the tests only multiplies the uncertainty in any of these trials.

Like you, I see a medical (and political) establishment that is making a poor job of reacting aggressively to a supposed global health crisis. During emergencies, ways have to be found to improve and speed up existing methods/protocols. I don’t see much convincing evidence for that, whichever way the evidence actually points for hydroxychloroquine+zinc treatments.

Robert W. Turner
Reply to  harry
June 16, 2020 8:21 am

That’s why I put more credence in the real world vs “peer reviewed research.”

https://www.youtube.com/watch?v=eVs_EWVCVPc
https://www.youtube.com/watch?v=NJYSsJN431I
https://www.youtube.com/watch?v=XqWxlH29_i4
https://www.youtube.com/watch?v=iGcZ_DTdRWw
https://www.youtube.com/watch?v=FczpFtz5q-0
https://www.youtube.com/watch?v=cp6cib258FE
This could go on all day…

Or maybe we should believe an alphabet agency, with seemingly no individual consequences for their advice or decisions, that also said that banning travel from China where the outbreak started would somehow make the problem worse.

David Baird
June 16, 2020 2:50 am

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.

Gerald Machnee
Reply to  David Baird
June 16, 2020 5:24 am

Which drug was invested in by some of the medical “experts”?

Tim Gorman
Reply to  David Baird
June 16, 2020 5:49 am

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.

Wayne
Reply to  David Baird
June 16, 2020 6:11 am

I noted the plug for Remdisivir.

Paul Thursten
June 16, 2020 2:53 am

Coincidentally this from (Twitter) James Todaro reporting on a study that gave near lethal does of HCQ.
“As unbelievable as it sounds, it appears the RECOVERY trial confused hydroxy*chloroquine* (HCQ) w/ the drug class hydroxy*quinolines*”

https://twitter.com/JamesTodaroMD/status/1272542546758074369

Robert W. Turner
Reply to  Paul Thursten
June 16, 2020 8:30 am

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.

Paul C
Reply to  Paul Thursten
June 16, 2020 2:50 pm

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.

Gary Ashe
June 16, 2020 2:55 am

They are being sued by 6000 leading experts.

If ever you need to understand pure evil in a none religous way, the progressive left are all you need look at.
They are a manifestation of pure evil, they will virtue signal ”care” all day long yet they are pure evil.

https://www.thegatewaypundit.com/2020/06/association-american-physicians-surgeons-sues-fda-irrational-interference-access-life-saving-hydroxychloroquine/

Steve Case
Reply to  Eric Worrall
June 16, 2020 4:41 am

Make sure you do a search on:

The Association of American Physicians and Surgeons

to find out who they are exactly

KPR
Reply to  Steve Case
June 16, 2020 5:37 am

Wikipedia is against these guys. So, I guess, they should be okay.

icisil
Reply to  Steve Case
June 16, 2020 5:43 am

That would be physicians and surgeons.

Robert W. Turner
Reply to  Steve Case
June 16, 2020 9:16 am

They are a group of practicing M.D.s that are “against the government”. So they have fully functional brains and a grip on reality?

Chaswarnertoo
Reply to  Gary Ashe
June 16, 2020 4:30 am

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

Robert W. Turner
Reply to  Gary Ashe
June 16, 2020 9:00 am

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.

June 16, 2020 2:59 am

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.

Steve Case
Reply to  Michael Keal
June 16, 2020 8:38 am

Try this link:

Roy Spencer Ph.D

Some COVID-19 vs. Malaria Numbers: Countries with Malaria have Virtually no Coronavirus Cases Reported

Robert W. Turner
Reply to  Steve Case
June 16, 2020 9:21 am

That’s interesting, but could also be due to their lack of VDI.

Ed Zuiderwijk
Reply to  Steve Case
June 16, 2020 9:45 am

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.

Reply to  Steve Case
June 16, 2020 6:44 pm

“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).

Walt D.
Reply to  Michael Keal
June 16, 2020 10:33 am

Senegal?

kramer
June 16, 2020 3:20 am

May 26:
India backs hydroxychloroquine for virus prevention
https://medicalxpress.com/news/2020-05-india-hydroxychloroquine-virus.html

kramer
June 16, 2020 3:21 am
icisil
Reply to  kramer
June 16, 2020 5:37 am

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

Ron
Reply to  icisil
June 16, 2020 5:31 pm

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?

June 16, 2020 3:23 am

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

Rob_Dawg
June 16, 2020 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.

Ghalfrunt.
Reply to  Rob_Dawg
June 16, 2020 6:00 am

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

Editor
Reply to  Ghalfrunt.
June 16, 2020 2:06 pm

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.

Carl Friis-Hansen
June 16, 2020 3:29 am

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.

icisil
Reply to  Carl Friis-Hansen
June 16, 2020 4:36 am

Starts at 38:56

Ghalfrunt.
Reply to  icisil
June 16, 2020 5:06 am

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

icisil
Reply to  Ghalfrunt.
June 16, 2020 5:41 am

Yeah I noticed that too. Clinical talk, I guess, for something I don’t understand

Ghalfrunt.
Reply to  icisil
June 16, 2020 6:03 am

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

icisil
Reply to  icisil
June 16, 2020 7:14 am

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.

John Endicott
Reply to  icisil
June 16, 2020 9:12 am

obtuse is ghalfrunt normal M.O.

DonM
Reply to  Ghalfrunt.
June 16, 2020 10:26 am

percent and volume (through rate adjustment) … two different things you idgit.

ozspeaksup
June 16, 2020 3:39 am

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.

Ghalfrunt.
Reply to  ozspeaksup
June 16, 2020 5:08 am

ozspeaksup June 16, 2020 at 3:39 am
hydroxychloroquine is not an antibiotic!!!!!!!!!!!!

Ed Zuiderwijk
Reply to  Ghalfrunt.
June 16, 2020 7:56 am

He meant Doxo instead of AZ.

ozspeaksup
June 16, 2020 3:41 am

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.

MP
June 16, 2020 3:44 am

Never trust what MSM writes. Always check the source info

Removal of the emergency restrictions on Hydroxychloroquine is good news. It can now be prescribed everywhere

Source vid:

https://twitter.com/IsraelAnderson/status/1272626206823743488

Carl Friis-Hansen
Reply to  MP
June 16, 2020 3:58 am

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

RockyRoad
Reply to  Carl Friis-Hansen
June 16, 2020 4:05 am

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

Carl Friis-Hansen
Reply to  RockyRoad
June 16, 2020 4:39 am

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.

Editor
Reply to  MP
June 16, 2020 2:17 pm

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.

Grumpy Bill
June 16, 2020 4:06 am

“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.

Grumpy Bill
Reply to  Grumpy Bill
June 16, 2020 4:16 am

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

Tom Abbott
Reply to  Grumpy Bill
June 16, 2020 5:07 am

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.

Clyde Spencer
Reply to  Grumpy Bill
June 16, 2020 9:42 am

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.

Reply to  Clyde Spencer
June 16, 2020 11:09 am

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.

Grumpy Bill
Reply to  Clyde Spencer
June 16, 2020 11:54 am

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.

The Dark Lord
June 16, 2020 4:10 am

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 …

Van Doren
Reply to  The Dark Lord
June 16, 2020 1:37 pm

What are you talking about? Butter is one of the worst foods ever.

June 16, 2020 4:21 am

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

Reply to  Ron Clutz
June 16, 2020 4:38 am
Reply to  Ron Clutz
June 16, 2020 5:33 am

I meant “nub”, but “numb” also applies to the media treatment of this issue.

John Bruyn
June 16, 2020 4:44 am

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.

pat
June 16, 2020 4:58 am

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/

Reply to  pat
June 16, 2020 9:11 am

The used the dose for an other drug, hydroxychinolin, as mentioned above in a comment.

Roger Knights
June 16, 2020 5:23 am

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/

Clyde Spencer
Reply to  Roger Knights
June 16, 2020 9:52 am

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.

Reply to  Clyde Spencer
June 16, 2020 11:11 am

So you want to tell us, that all the Turkish patients cured with HCQ would have recoverd even without any treatment ?

mario lento
Reply to  Clyde Spencer
June 16, 2020 11:28 pm

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 Knights
Reply to  Clyde Spencer
June 17, 2020 4:09 am

“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.

pat
June 16, 2020 5:24 am

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

MP
June 16, 2020 5:31 am
Ghalfrunt.
June 16, 2020 5:49 am

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/

ResourceGuy
Reply to  Ghalfrunt.
June 16, 2020 6:27 am

It’s also not the only ionophore choice to use with Zn to block viruses.

John VC
Reply to  ResourceGuy
June 16, 2020 8:11 am

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.

Robert of Ottawa
Reply to  Ghalfrunt.
June 16, 2020 7:22 am

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.

Clyde Spencer
Reply to  Robert of Ottawa
June 16, 2020 9:59 am

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.”

n.n
Reply to  Clyde Spencer
June 16, 2020 10:30 am

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.

Reply to  Clyde Spencer
June 16, 2020 11:13 am
mario lento
Reply to  Clyde Spencer
June 16, 2020 11:35 pm

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.

icisil
Reply to  Ghalfrunt.
June 16, 2020 7:23 am

Dihydrogen monoxide is also a deadly poison.

John Endicott
Reply to  icisil
June 16, 2020 8:58 am

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

mario lento
Reply to  John Endicott
June 16, 2020 11:39 pm

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 🙂

TRM
June 16, 2020 5:55 am

https://www.thegatewaypundit.com/2020/05/president-el-salvador-announces-taking-hydroxychloroquine-says-world-leaders/

President of El Salvador Nayib Bukele has announced that he is taking hydroxychloroquine as a preventative measure against the coronavirus.
Bukele told reporters on Tuesday that “most world leaders” are doing the same and has questioned why world leaders are being advised to use it while the public is not.

ResourceGuy
June 16, 2020 6:16 am

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.

MP
June 16, 2020 6:23 am

14 case studies show good results in HCQ Prophylactic and Early Treatment for COVID-19

https://docs.google.com/document/d/1vDD8JkHe62hmpkalx1tejkd_zDnVwJ9XXRjgXAc1qUc/edit

ResourceGuy
June 16, 2020 6:24 am

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?

icisil
Reply to  ResourceGuy
June 16, 2020 7:20 am

“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.

David Lilley
June 16, 2020 6:47 am

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.