Hydroxychloroquine-based COVID-19 Treatment, A Systematic Review of Clinical Evidence and Expert Opinion from Physicians’ Surveys

Key Words: hydroxychloroquine, azithromycin, antiviral, evidence

Abstract

During the current COVID-19 epidemic, most of the evidence is collected by treating physicians, most of whom do not report their results in peer reviewed journals.  Hence, there appears to be an especially broad gap between field experience and academic coverage of hydroxychloroquine-based COVID-19 treatments. The objective of this study is to bring field evidence into the academic literature.

Four relevant, non-academic surveys of physicians, in the US and globally, have been identified and checked for quality, statistical significance, coverage, and conflicts of interest. To avoid uninformed and unduly influenced opinions, only surveys conducted from April 4 to April 19 have been considered. These surveys were answered by thousands of physicians, who treated tens of thousands of COVID-19 patients.

The results: 85% of doctors said that hydroxychloroquine is at least somewhat effective for COVID-19. Hydroxychloroquine was the most utilized treatment for COVID-19 patients.  35%-40% of the doctors using the drug called it very effective or extremely effective against COVID-19. 65% of doctors said they would prescribe hydroxychloroquine for COVID-19 to their family members.

The author declares no competing interest.

No funding was provided for this work.

All relevant ethical guidelines have been followed.

Introduction

The largest body of knowledge of COVID-19 treatments is collected by practicing physicians, outside of research settings, and not reported in peer reviewed publications. The objective of this systematic review is to capture some of this clinical experience and bring it into the academic literature. The scope is limited to hydroxychloroquine-based treatments, administered in the early (viral) stages of COVID-19.

The most effective and popular COVID-19 treatment regimen, combining hydroxychloroquine with azithromycin, was introduced by Institut Hospitalo-Universitaire (IHU) Méditerranée Infection, directed by Didier Raoult.  The HCQ based treatment was presented at a March 16, 2020 conference (Raoult, 2020), and published a few days later as (Gautret, et al., 2020). It became instantly popular among physicians on March 20-21.

Many doctors and hospitals used this treatment from March 20 to March 27.  The treatment’s effects were observed and discussed with colleagues, from March 27 to April 4. Thus, starting around April 4, doctors who used or observed the use of any HCQ-based treatment were able to provide eyewitness testimonies. Many other doctors were able to give their expert opinions, based on the experiences of their colleagues and their professional knowledge. On April 20, the NIH COVID-19 Panel published guidelines that were adverse to HCQ treatment (The National Institutes of Health COVID-19 Treatment Guidelines Panel , 2020). On April 24, the FDA issued a warning (The FDA, 2020) concerning the drug’s safety. These events might have prejudiced some doctors against HCQ. The time frame chosen for this systematic review, April 4 to April 19, is selected to ensure that physicians had sufficient experience with HCQ but had not yet been prejudiced by external events.

Explanation of Methods

A physician’s answers to questions regarding the treatment s/he has used can be considered direct evidence. Corresponding statistics computed from the responses of N physicians, treating on average M patients, should have equal power and higher resilience than results of a randomized clinical trial conducted on N*M patients, in the absence of a systematic bias.

A physician’s choice of a certain treatment over another, indicates that the chosen treatment is considered more effective. A physician’s decision to implement a certain treatment rather than no treatment proves that the treatment’s effectiveness/risk profile is considered high enough. This can be considered indirect evidence.

A physician’s opinion about a treatment which he or she did not directly use in practice, but learned about from other physicians, can be considered an expert opinion.

Well implemented surveys can capture much of this evidence and expert opinions.

Methods

Surveys or polls of physicians were sought, using multiple search engines (DuckDuckGo, Bing, Google, Yandex), searching for ‘physician survey hydroxychloroquine’, ‘doctors survey hydroxychloroquine’, and similar combinations of keywords; no quotes; not limited by dates. The search was repeated many times, excluding previously found items.

Surveys or polls from three companies were found. Each of the three survey companies were researched and confirmed as reputable. A list of all relevant surveys and polls, done by these three companies, in the selected time frame, was compiled. This yielded four surveys from three different companies: Sermo (two surveys), InCrowd, and Jackson Coker. Sermo’s surveys appeared to be most professional and informative. No strong competing interests, that may have any bearing on the surveys, were found in any of the three companies.

Drugs used for other effects, other than antiviral, have been excluded from this review for the following reasons. High dose steroids are used during a cytokine storm. Acetaminophen, Ibuprofen, and Herbal remedies are used as symptomatic treatment. Vitamin D is not considered an antiviral treatment or an essential part of one. Bronchodilators are bronchodilators.

Results

Although the surveys posed different questions to different audiences, the results were congruent. Because CQ is hardly used in practice, CQ and HCQ are both referred to as HCQ.

Table 1. Summary of results

 J CSermo W3Sermo W4InCrowd
Polling DateApril 4-7April 6-9April 13-15April 14-15
Publication DateApril 8April 15April 23April 21
LocationUSAGlobalGlobalUSA
# doctors127140165500203
Recommended HCQ65% (1)n/an/an/a
# COVID-19 treatersn/a13371376 (3)203
Used HCQ / HCQ+AZn/a50%53%n/a
% HCQ users rating VEE (4)n/a40%35%n/a
Reported HCQ effectiven/a85% (5)n/an/a
Would give to patients’ %n/an/an/a30% (2)
Remarks  HCQ shortages 
  • Would give HCQ to their family
  • Would prescribe HCQ / HCQ+AZ to this percentage of their COVID-19 patients, on average. 30% is quite a high number, because most COVID-19 patients probably need no treatment, especially the patients of the surveyed physicians, about a third of whom are pediatricians. The numbers for plasma and Remdesivir are 21% and 16%, respectively.
  • This number includes physicians who used HCQ in outpatient and hospital ex/ICU settings.
  • VEE = Very or Extremely Effective (4 or 5 on the scale 0 – 5)
  • 2 or higher on the scale 0 – 5

Notice that except for Jackson Coker, surveys’ results were published about a week after they had been conducted, so their results could not influence each other.

Sermo Week 3

(Sermo W3, 2020)

Survey Period: April 6-9

Published on April 15

Country: Global

N = 4016 – the total number of physicians surveyed, including those who have not treated COVID-19

Effectiveness:

The top treatments used or seen to be used by physicians and reported as very or extremely effective among COVID-19 treaters include:

Table 2. VEE Treatments

Hydroxychloroquine                          n=875 (40%)

Plasma from recovered patients      n=363 (46%)

Percentage of physicians to report that HCQ/CQ is at least partially effective (scoring 2 or higher on the scale 0 – 5) against COVID-19:

Table 3. Physicians rating HCQ/CQ at least partially effective

Global:         85%

US:                 81%

Italy:              94%

Spain:           91%

China:          88%

This data suggests that physicians in countries with more than average COVID-19 experience appreciate HCQ more than physicians in countries with less than average experience.

Usage

N = 1337 (the number of COVID-19 treaters out of the 4016 physicians surveyed)

SCREENING: COVID-19 treaters

Table 4. Medications physicians have used to treat COVID-19 patients

Drug%
Azithromycin or similar antibiotics58%
Hydroxychloroquine or Chloroquine50%
Anti-HIV drugs (e.g. Lopinavir plus Ritonavir)23%
Drugs used to treat flu (e.g., Oseltamivir)22%
None16%

Treatments used by less than 10% COVID-19 treaters are excluded here.

The survey did not include inquiries about drug combinations.  However, these numbers and well-known information from other sources suggest that in most cases when HCQ or CQ was prescribed, it was in combination with Azithromycin (AZ).

There were important differences in the perceived effectiveness of HCQ in the US as compared to the rest of the world. In the US, HCQ/CQ was used by 39% of COVID-19 treaters, compared to 75% and 83% of practitioners in Spain and Italy, respectively. Of note, Spain and Italy broke the rapid rise and started a rapid decrease in death rates around April 2-3  (Our World in Data, 2020).

Sermo Week 4

(Sermo W4, 2020)

Survey Period: April 13-15

Published on April 23

Country: Global

N = 1376 (after screening; 5,500 doctors were surveyed)

SCREENING: COVID-19 treaters

Effectiveness

N = 1376 (636 Non-Hospital physicians / 1045 Hospital physicians; except ICU only)

Q11. Effectiveness on patients outside hospital setting (Mild/Moderate): For patients you treat outside the hospital (mild/moderate in community setting), rate the efficacy of medications you have used to treat COVID-19.

NET: Very/Extremely Effective (Don’t Know Excluded)

Table 5. VEE Treatments

Non-HospitalHospital ex/ICU
n=636 (Q8)n=1,045 (Q9)
Hydroxychloroquine88 (38%)196 (31%)
Azithromycin79 (23%)126 (19%)
Vitamin C39 (26%)36 (19%)
Drugs to treat flu31 (24%)66 (26%)
Plasma23 (68%)63 (61%)
Zinc20 (25%)19 (20%)
Anti-HIV drugs19 (27%)71 (22%)
Remdesivir10 (27%)50 (34%)

Results ordered by the number of physicians who rated the drug Very/Extremely Effective in the more relevant, non-hospital group. (Results are listed only for drugs in Table 6 in the next section) Notice that percentages in parentheses exclude treaters who did not answer the question about each drug’s effectiveness. Effectiveness of HCQ was rated differently in different countries. In the US, it was rated below its rating in the rest of the world.

HCQ / HCQ+AZ is clearly in the league of its own, per number of physicians rating it as “Very or Extremely Effective”.

Usage

N = 1376 (636 / 1045 for Non-Hospital physicians / Hospital physicians, except ICU only)

SCREENING: COVID-19 treaters

Table 6. Share of COVID-19 Treating Physicians Who’ve Used Medication Within Setting 

Non-HospitalHospital ex/ICUComputed Average
n=636 (Q8)n=1,045 (Q9)
Azithromycin60%70%65%
Hydroxychloroquine40%66%53%
Drugs to treat flu22%25%23.5%
Anti-HIV drugs12%32%22%
Vitamin C28%21%24.5%
Zinc 17%11%14%
Remdesivir 6%16%11%
Plasma6%10%8%

Simple averages have been computed to reflect the higher probability that HCQ-based treatment was started early in non-hospital settings compared with hospital settings.

Given the low standalone effectiveness and broad use of AZ, it is likely that in most cases HCQ was used in combination with AZ. The relatively large percentage for physicians using and highly rating Zinc suggests that HCQ+AZ+Zn was used extensively.

Note 1

33% of treaters complained about HCQ shortages. For comparison, only 27% of the treaters complained about ventilator shortages. The number was 48% for Super Treaters (doctors who treated >20 COVID-19 patients) outside of hospital settings. It is reasonable to conclude that HCQ treatment results would have been even better if not for HCQ shortages, causing treatment delays.

Note 2

This survey captures the relevant results of treating about 25,000 – 30,000 COVID-19 patients (Q7).

InCrowd

(InCrowd, 2020)

Survey Period: April 14-15

Published on April 21

N = 203

Country: USA

Specialties: US Primary Care Physicians (61), Pediatricians (59), and Emergency Medicine or Critical Care Physicians (83)

SCREENING: Physicians who have or are currently treating 20 or more patients with flu like symptoms

Q11: For what percentage of your COVID-19 patient population would you prescribe each of the following treatments? If other, please specify.

The offered options are: Acetaminophen, Antibiotics (e.g. azithromycin, etc.), Bronchodilators, Hydroxychloroquine, Plasma (from recovered patients), Ibuprofen, Remdesivir, Antivirals, Chloroquine, Steroids (High Dose), Flu treatments (e.g. Tamiflu, Xofluza), Herbal remedies, Anti-HIV Drugs, Interferon-Beta, Other.

Table 7. Surveyed physicians would prescribe to this % of their COVID-19 patients

Drug%
Azithromycin etc.”  41%
Hydroxychloroquine or Chloroquine30%
Plasma21%
Remdesivir16%
Antivirals (non-specific)10%

Flu treatments (e.g. Tamiflu, Xofluza), Anti-HIV Drugs, Interferon-Beta, and Other scored 2%-7% each.

No answers were reported about the combination of drugs, but the numbers suggest that non-pediatric doctors would prescribe HCQ+AZ to ~40% of their COVID-19 patients. Many physicians using HCQ prescribe it only to those deemed at risk, so 30-40% is impressive.

Jackson Coker

(Jackson-Coker, 2020)

Survey Period: April 4-7

Published on April 8

N= 1,271

Country: USA, all 50 states

Reported margin of error is 3% with a 95% confidence level.

SCREENING: None. All physicians who elected to answer the survey, about 1% of the firm’s database of physicians. It was not established whether they treated or did not treat COVID-19 patients. It is likely that there was positive self-selection by doctors who treated COVID-19.

65% said they would prescribe drugs chloroquine or hydroxychloroquine to treat or prevent COVID-19 in a family member. 54% said they would prescribe it early, while another 11% said they would prescribe it if the disease becomes serious. 30% said they would prescribe chloroquine or hydroxychloroquine to a family member prior to the onset of symptoms if they had been exposed to the coronavirus. 11% said they would not use the drug.

73% of physicians practicing solo or with ownership stake in a practice, said they would prescribe HCQ/CQ to a family member. That means that more experienced physicians are more likely to prescribe HCQ. The share drops among critical care, emergency medicine, and hospitalists to 43%, 55%, 54%, respectively.

The lower usage of HCQ by critical care and emergency physicians can be explained by the fact that they are dealing with patients in a later stage of COVID-19, which might be characterized as a different illness, dominated by ADRS and multiple organs damage, rather than by viral infection.

Discussion

Only a small fraction of physicians use plasma, but they highly rate it.

Doctors’ wide-spread use and high recognition of HCQ+AZ treatment against COVID-19 is strong evidence, and, possibly, conclusive proof of the treatment’s safety and effectiveness.

Later Surveys

Sermo’s weekly COVID-19 surveys break the results down by regions, countries, and other useful categories. Sermo continued publishing surveys about doctors’ choices of COVID-19 treatments even after April 19. In May, they reported a decline in the use of CQ/HCQ and a rise in the use of Remdesivir.

InCrowd conducted a similar survey on May 29-31. It also reported a decline in the use of CQ/HCQ and a rise of Remdesivir, possibly for external reasons.

Jackson Coker has conducted no other related surveys.

Remarks

Some doctors started adding Zinc to the HCQ+AZ cocktail, as reported in (Risch, 2020). It is expected that additional experience in treating COVID-19, since the surveyed period, has increased the safety and effectiveness of multiple treatments, including HCQ-based ones.

Conclusions

85% of the globally surveyed physicians recognized HCQ as at least partially effective in treating COVID-19, according to Sermo W3. More than half of the surveyed US physicians would take the drug or give it to family members early or even before onset of symptoms, according to JC.

Aside from the rarely used plasma, HCQ / HCQ+AZ based treatments are preferred by physicians by wide margin over other drugs.  HCQ / HCQ+AZ based treatments are the most used, most recommended, and most highly rated by physicians treating COVID-19 at an early stage.

Personal Note

Except for this paragraph, this paper appears here exactly as it was submitted to medrxiv.org on June 30 (MEDRXIV/2020/143800). It was rejected today, on July 4: “We regret to inform you that your manuscript will not be posted. A small number of papers are deemed during screening to be more appropriate for dissemination after peer review at a journal rather than as preprints.

I felt this might happen when I saw medrxiv’s home page “Supported by Chan Zuckerberg Initiative“. Now, I submit it to an open peer review.

On a side note, speaking of New Paper Demonstrates Strong Efficacy of Hydroxychloroquine. Mortality rate cut in half!

there is an earlier peer-reviewed paper, confirming HCQ+AZ effectiveness:

Jean-Christophe Lagierab, Matthieu Million, Philippe Gautret, Raoult, Didier et al., Outcomes of 3,737 COVID-19 patients treated with hydroxychloroquine/azithromycin and other regimens in Marseille, France: A retrospective analysis, June 25, Travel Medicine and Infectious Disease https://www.sciencedirect.com/science/article/pii/S1477893920302817

References

FDA. 2020. FDA cautions against use of hydroxychloroquine or chloroquine for COVID-19 outside of the hospital setting or a clinical trial due to risk of heart rhythm problems. fda.gov. April 24, 2020. [Cited: April 24, 2020.] http://archive.is/xwOAc.

Gautret, Philippe , Lagier, Jean-Christophe and Raoult, Didier et al. 2020. Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial. International Journal of Antimicrobial Agents. March 20, 2020. https://www.sciencedirect.com/science/article/pii/S0924857920300996.

InCrowd. 2020. Novel Coronavirus COVID-19 Physician Tracking Report. InCrowdNow.com. April 21, 2020. https://incrowdnow.com/wp-content/uploads/2020/04/InCrowd-Novel-Coronavirus-COVID-19-Physician-Tracking-Report-Wave-4.pdf.

Jackson-Coker. 2020. Physicians Poll on COVID-19 Medications. JacksonCoker.com. April 8, 2020. includes https://jacksoncoker.com/about/in-the-news/physician-poll-on-covid-19-chloroquine-and-hydroxychloroquine/. https://jacksoncoker.com/landing-pages/physicians-poll-on-covid-19_medications/.

Our World in Data. 2020. Daily new confirmed COVID-19 deaths per million people, rolling 7d average, Spain & Italy. ourworldindata.com. 2020. [Cited: June 29, 2020.] https://ourworldindata.org/coronavirus-data-explorer?zoomToSelection=true&time=2020-03-09..2020-05-15&deathsMetric=true&dailyFreq=true&perCapita=true&smoothing=7&country=ESP~ITA&pickerMetric=location&pickerSort=asc.

Raoult, Didier. 2020. COVID-19, presentation at GENERAL ASSEMBLY AP-HM CARE AND DIAGNOSIS. mediterranee-infection.com. March 16, 2020. https://www.mediterranee-infection.com/wp-content/uploads/2020/03/COVID-19.pdf.

Risch, A Harvey. 2020. Early Outpatient Treatment of Symptomatic, High-Risk Covid-19 Patients that Should be Ramped-Up Immediately as Key to the Pandemic Crisis. American Journal of Epidemiology. May 27, 2020. https://doi.org/10.1093/aje/kwaa093.

Sermo W3. 2020. Sermo’s COVID-19 Real Time Barometer Study, Wave 3. Sermo.com. April 15, 2020. includes https://app.sermo.com/covid19-barometer, https://www.sermo.com/press-releases/sermo-reports-week-3-results-globally-17-point-increase-in-covid-treaters-who-have-used-hydroxychloroquine-33-50-and-azithromycin-41-58/. https://public-cdn.sermo.com/covid19/dd/c7f7/f7344a/344a00427889ec27e2b8df1c15/w3-sermo-covid-19-barometer.pdf.

Sermo W4. 2020. Sermo’s COVID-19 Real Time Barometer Study, Wave 4. Sermo.com. April 23, 2020. includes https://www.sermo.com/press-releases/sermo-reports-jury-is-still-out-on-remdesivir-31-of-physicians-who-have-used-remdesivir-rate-it-as-highly-effective-31-rate-it-with-low-effectiveness-38-rate-it-as-somewhere-in-the-middle/. https://public-cdn.sermo.com/covid19/c2/3aba/ba8889/88898d406a8a84a60947e34a56/sermo-barometer-banner-tables-wave-4.xlsx.

The National Institutes of Health COVID-19 Treatment Guidelines Panel . 2020. Coronavirus Disease 2019 (COVID-19). covid19treatmentguidelines.nih.gov. April 20, 2020. [Cited: May 1, 2020.] http://archive.is/gk3xt.

369 thoughts on “Hydroxychloroquine-based COVID-19 Treatment, A Systematic Review of Clinical Evidence and Expert Opinion from Physicians’ Surveys

  1. Don’t forget to treat early and include zinc (unless the objective is a poor outcome, in which case, adjust data as needed).

    • No one should wait to get sick to make sure they have plenty of every nutrient associated with immune system health.
      In fact, everyone should know the exact list of all essential nutrients for a human being, and have at least basic knowledge about the role each plays in our body.
      No one can be healthy without proper nutrition.
      It used to be easy.
      But modern food industry and marketing has made it hard for our own instincts…our nose, eyes, and tongue…to tell us what we need, what is good to eat, what is bad, etc.

      First biology class I took in college, first semester, human health and reproduction.
      Nothing Earth shaking, but detailed and specific knowledge replaced sketchy information with some fine detail but huge gaps.

      • Most people don’t know anything about proper nutrition, some a bit. But it’s not so easy to have a proper nutrition, there are many reasons, why. Learning at school is deplorable, missing time for several reasons is mainstream if you are working, or in case of parents, both are working to buy and prepare proper nutriotion in case they know at least a bit about.
        Fruits you can buy are mostly unripe with vitamine deficits, vegetables usually come from in general outleached grounds with some mineral deficits.
        Working indoors is one reason for vitamine D deficits.
        And if you have a look at at least the German Greens, they try to regulate the market for nutrition supplements, because they believe, they are not necessary, to high dosed etc.
        As usual, they have no clue of real life and it circumstances.

          • Poverty is a real killer. No healthcare systems and no proper food. The numbers for Africa are horrendous, but Germany is seeing kids malnourished.
            The US too. And elderly are systematically vitamin D3 deficient.

            The Greens will say let them eat green leaves, drink “natural” water.

            Note the recent report on COVID in sewage samples from mar-2019 – just imagine what bad water and sewage treatment will do!

          • The poor in America are the most overweight and obese population in the country. There is plenty of money for food, it’s just spent poorly.

        • “Fruits you can buy are mostly unripe with vitamine deficits, vegetables usually”

          Say what?
          Do you have evidence for this?
          Ripeness has to do with starch being converted to sugar, and the vitamins are already there.
          If the ground in which plants are grown do not have the nutrients plants need, they will not grow.
          Even small deficits in mineral concertation will make a plant look very obviously wrong.
          Spots, yellow…

          Are you really saying that buying fruits and vegetables is a fools errand because they are all crappy?
          Are you saying junk food is more affordable than wholesome foods?
          The opposite is true in both cases.
          Processed foods are expensive, calorie per calorie, compared to wholesome foods.

          Where I shop foods are fresh and ripe, unless it is one of the well known ones that cannot be picked and shipped ripe.
          Ripe bananas in the tropics will be mush before they get loaded onto the boat to ship them.
          Pineapple is far better when picked bright yellow, but they are too soft to ship at that pont.
          Except local ones in season, foods like tomatoes are picked green and ripened with ethylene gas to make them turn red.
          They have zero flavor.
          But all of these things have always been true.

          I have been involved in agriculture since the 1980s, and right now have dozens of fruit trees and plants.
          But most people do not even grow a garden for fresh greens and herbs during the times of year it is fast and easy to get a garden going.
          Laziness and ignorance are the problems, not leached soils and unripened fruit.

          • OMG

            Are you really saying that buying fruits and vegetables is a fools errand because they are all crappy?

            No, but they could be healthier, could have more minerals, even if not deficient for growing.

            Do The Proportions Of Nutrients Change In Fruit As It Ripens?
            Updated on: 23 Apr 2020 by John Staughton

            When you go to the grocery store and re-stock your house with fruits and vegetables, it’s hard not to feel like you’re making a heathy choice for the week ahead. As we all know, fruits and vegetables are a critical part of a healthy diet, and provide a wide range of essential nutrients, from key vitamins and minerals to antioxidants, sugars and dietary fiber.

            I’d be happier if these were snacks memeHowever, as that week progresses, your fruit may continue to ripen, often changing color or firmness over time. Bananas are perhaps the best and most visually demonstrative example of this, but all fruits undergo a ripening process (sometimes on the vine, and sometimes after being picked). This has led many people to wonder whether those physical changes in a fruit also affect its nutritional content. In other words, is there a nutritional difference between ripe and unripe fruit?
            Why Do Fruits Ripen?

            Before we dig into the details of what happens during ripening, we should take a look at why the process occurs at all. First of all, a fruit is effectively a container for the seeds of a plant, and develops from a flower. Basically, when a flower releases its pollen, this is done in order for other plants to be fertilized. Pollen is taken from the male part of a plant and brought to a female part of the plant. When this is completed, fertilization can begin and the flowers will begin to drop off.

            Fertilization leads to the development of plant seeds, which need to be protected as they develop. The fruit that develops around the seeds will provide this protection, while also acting as the distribution tool for the seeds to grow. For example, after fertilization, a fruit will begin to grow around the seeds, but that fruit is said to be “underripe” until the seeds are fully developed and capable of growing into another plant if given the right soil and climatic conditions.

            Two weeks ago, I was in a bear’s stomach. memeThe ripening process is a form of growth, as well as a defense mechanism. When a plant is unripe, it will often be sour, overly fibrous, or even toxic to consume. Animals won’t want to eat that sort of fruit, and will therefore leave it alone. Once a fruit becomes “ripe”, it will often be sweeter, more colorful, and generally more appealing to a potential consumer. When the animal eats this sweeter, more attractive fruit—whether it is a bird, squirrel, bear, human or any other creature—it will then deposit those seeds elsewhere, after they pass through their digestive tract or are disposed of on the ground. By that point, the seeds will be viable and can grow into a new plant!
            What Does Ripening Do To A Fruit?

            As mentioned above, the ripening process often consists of a change in color, firmness and sweetness, all of which can signal that a fruit is ready to be eaten. Those physical changes are also reflected in a nutritional shift, primarily an increase in sugars. Many underripe fruits have a high starch content, which can make the fruit bitter or inedible, but as the fruit ripens, those starch molecules are converted into sugars.

            The easiest example of this is a banana; green and underripe bananas do not have the recognizable sweetness and softness of a ripe banana. The conversion of starch into sugar gives the banana a higher percentage of sugar, as well as a better texture for eating and including in recipes. Sugar content is the most notable nutritional change between unripened and ripened fruit, but it’s not the only one. Vitamin C, for example, has been shown to increase as you allow peppers and tomatoes to develop to full ripeness.
            In many other fruits, the antioxidant concentration will also improve as a fruit ripens. Considering that these are critically important nutrients for our body’s defenses, particularly against cancer and other forms of oxidative stress, getting more antioxidants in ripe fruit is definitely a good thing!

            Source
            An other with more examples

            Food is not what it used to be. In the past, food was not necessarily always better and certainly not made of wood. But the ingredients tasted different. More intense. More. Radishes were hotter, tomatoes were more sweet and sour and the cauliflower, well, it tasted more like cauliflower. Something seems to have squeezed the taste out of our food over the last few decades.

            This impression is more than a feeling, because the composition of our food has changed measurably over the past 50 years. A glance at various editions of corresponding overviews of the chemical composition of our food shows drastic changes: Oranges now contain only one-eighth of vitamin A, broccoli supplies 80 percent less copper, tomatoes have lost three-quarters of their calcium1. Wheat has lost up to half of its mineral content since 18422.

            Donald Davis, a biochemist at the University of Texas, reports an average total mineral loss of 5 to 40 percent in fruits and vegetables4. A similar trend is evident for vitamins and protein. The proportion of protein in chicken has fallen by around a third – at the same time the proportion of fat has doubled4.

            Accordingly, the market for dietary supplements is flourishing and their effects are not always obvious. However, in experiments with rats, Davis found evidence of subtle changes through better nutritional supply: “The rats supplied in this way ate less, but grew slightly better “5 The observations continued to include better wound healing, better regeneration and effects on sugar consumption.
            This supports the thesis that people in Western societies are starving to death despite the spread of obesity: energy supplies are amply ensured, but there is a lack of micronutrients (vitamins and minerals). It is part of the normal bodily functions to report hunger in this situation, some people perceive this as ravenous hunger. This is therefore not only the result of incorrect sugar management. It is a logical consequence: you have to eat more to get the same amount of nutrients.

            Is this a reason to get food supplements quickly? Hardly. This observation should not cause panic among those who eat a variety of fresh foods, because they are usually well supplied despite weakening plants. However, people with a rather monotonous diet based on pre-processed food and those living in areas with poor food supplies are faced with this development.

            Beyond the purely reductionist perspective of nutrientism, there is also a worrying look at taste, which is directly linked to the nutrients it contains. Taste is not only the driving force behind nutrition, but an expression of our culture and thus of our identity. That is why people in the better supplied regions also need a solution to this problem. We are not all in the same boat in this respect, but we are in a small fleet called humanity. And even for those at the top, the wind will no longer be enough at some point.
            First we need to understand the cause of the phenomenon. Since plants draw their nutrients from the soil, it is often hastily argued that the cause is leached soil7 . It is true that conventional agriculture, including the Green Revolution, has led to massive fertility loss and soil degradation worldwide, especially in the last 50 years. Anyone who has bought and eaten the goods produced in this way is responsible for this damage, and in the final analysis we all are. However, a differentiated consideration points to more than depleted soils.

            Davis cites an environmental dilution effect. Intensive fertilization and irrigation lead to higher yields, but “the ability to produce or absorb nutrients could not keep pace with the rapid growth,” as agronomists have known since the early 1980s8.

            Breeding varieties with higher yields, better pest resistance and increased climate adaptation also leads to a genetic dilution effect: higher-yielding varieties thus contain proportionately fewer nutrients under the same growth conditions.

            The use of crop protection products also reduces the amount of antioxidants. Organically produced foods contain more of these secondary plant substances, which is attributed to the greater stimulus for the plant’s self-protection.

            If soil fertility, environmental and genetic dilution effects and the use of pesticides are the reason for the declining nutrient content of our food, then the signs clearly point to the methods of agriculture as the cause. The methods of conventional agriculture.

            However, this finding does not release the consumer, the consumer, from responsibility. “Eating is an agricultural act, we are all farmers by proxy,” explains farmer and author Wendell Berry. We may hand over the work and pay for it, but we are responsible for the production. We “can only eat if land is farmed in our name somewhere in some way.”

            Source, German

            Not everybody has a garden as we have it, and is able to grow the plants they want or need, as you state at least correctly.

          • Don’t get your shorts in a twist. The “nutrients plants need to grow” and the “nutrients animals/omnivores/humans need to get from those plants” are not identical. Large Venn overlap, but not 100%. Commercial farmers must cater to the plants’ needs. It’s up to us humans to look out for the rest. Laziness is not necessarily the problem with city beehive dwellers. Ignorance and misinformation propagated by FDA and DoAg surely is a problem.

          • You want more ?

            In 1927 a study at King’s College, University of London, of the chemical composition of foods was initiated by Dr McCance to assist with diabetic dietary guidance. The study evolved and was then broadened to determine all the important organic and mineral constituents of foods, it was financed by the Medical Research Council and eventually published in 1940. Over the next 51 years subsequent editions reflected changing national dietary habits and food laws as well as advances in analytical procedures. The most recent (5th Edition) published in 1991 has comprehensively analysed 14 different categories of foods and beverages. In order to provide some insight into any variation in the quality of the foods available to us as a nation between 1940 and 1991 it was possible to compare and contrast the mineral content of 27 varieties of vegetable, 17 varieties of fruit, 10 cuts of meat and some milk and cheese products. The results demonstrate that there has been a significant loss of minerals and trace elements in these foods over that period of time. It is suggested that the results of this study cannot be taken in isolation from recent dietary, environmental and disease trends. These trends are briefly mentioned and suggestions are made as to how the deterioration in the micronutrient quality of our food intake may be arrested and reversed.

            A Study on the Mineral Depletion of the Foods Available to us as a Nation over the Period 1940 to 1991
            Full study

          • New government statistics show fresh fruit and vegetables are not as good for us as they were 60 years ago. The report, by nutritionist and chiropractor Dr. David Thomas, shows the content of natural minerals, such as iron, calcium, copper and magnesium, has decreased by up to 76 per cent since 1940. The growth of intensive farming methods, which use artificial fertilizers to get plants to grow bigger and faster, is blamed for the decline.

            Dr Thomas said: “The findings suggest that our diet is now far less nutritious than it was 60 years ago. It is likely that levels of a whole host of other trace elements which have proven benefits to health and whose absence can create disease conditions, have also been depleted. “Nowadays you need to eat three times as many oranges as you would have done in 1940 to get the same amount of iron. Dr Thomas compared statistics for the mineral content of fruit and vegetables in 1940 with the latest figures from 1991.

            In the vegetables the level of magnesium had dropped by nearly 25 per cent, calcium by 46 per cent and sodium by 50 per cent, while copper levels had slumped by more than 75 per cent. In fruit, sodium had dipped by 27 per cent, iron by 25 per cent and copper by 20 per cent.

            A lack of iron can impair intellectual functions, while calcium is vital for strong teeth and bones, particularly in children. A shortage of magnesium can lead to neurological and heart problems.

            Although modern intensive farming allows fruit and vegetables to grow faster as they receive lots of nutrients, it does not necessarily create produce with the same amount of minerals as in previous generations. A greater number of crops growing in one area means less nutrients from the soil per plant.

            Mike Lean, professor of nutrition at Glasgow University who is also a director of the Health Education Board for Scotland, said: “Advice at the moment is to eat a minimum of five portions of fruit and vegetables combined every day. Maybe we should be eating considerably more than that.

            New UK Study Shows Decline in Fruit
            and Vegetable Mineral Content
            This section is compiled by Frank M. Painter, D.C.

            Enough ?
            Go in your garden and play around 😀

          • Nicholas,
            Almost everything you say is correct. There are a lot of greenies out there who will tell you something was better in the past. Food is one of them They usually give organics a pass from such judgement. I still remember as a kid watching some of the neighboring farms that grew organically. Unlike us, those farmers wore environmental suits suits while working the fields, and rode in enclosed tractors with AC – still in those outfits. Because what they were spraying on those fields was more safer than what we were using…?! There is a reason organic food does not usually look as good as “Non-organic” food (an oxymoron, as any chemist knows). When organic food does look as good as non-organic, check the nation of origin. It’s usually China. They don’t allow American inspectors on their farms.

            American farmers have been rotating crops since the 40’s. I understand that some areas of the world don’t do that. DON”T EAT THEIR FOOD!

            My wife is an animal rights activist. I remember her showing me a photo a couple of years ago of a guy who had gone into a wolf or coyote den to kill the pups. He then posed with his trophies. I told her that photo was ancient. She contacted the source (ASPCA donation drive). They confirmed that the event had taken place in the 1940’s, and the man worked for the Government. They had no newer pictures, but assured her the Government was still doing this, and her donation could help stop this barbarous activity.

            The data about American-farmed food having fewer minerals is just as valid. We did prefer the food Grandpa and Uncle Bob had grown versus the grocery store – it was fresher. Greenie scientists extrapolate the mineral content from the past using models. Hm. Who else does that?

            And to this day, I will not touch “organically-grown” food. The stuff they can put on it is dangerous. Just look at those environmental suits. They are not to protect the food from the farmer.

          • @Yirgach
            We use so called powdered limestone, hornshavings and compost from our heap.
            And we add smal pieces of wood charcoal remaining from last BBC.

    • So 85 % of doctors globally used HCQ but only 43% in America. I think if I ever got sick I would ask who my doctor voted for before handing myself over for treatment. Just sayin’

  2. My GP has said he will prescribe the HCQ /Azith/ Zinc group if I contract Covid-19 particularly after being tested. I am in the senior citizens age group. When I spoke to him about this treatment it was like “You may very well say that but I could not possibly comment” and so he agreed to write a prescription if the time came, because he is fully aware of the survival rates from it.

  3. NMG will tell us in thousands of words that the studies are all flawed and/ or meaningless, because he just found a study that…..

    • I am all up in your head, aren’t I?
      Cupcake, you have no idea how big that makes me smile.

      • You ? 😀 😀 😀
        Don’t be to proud of yourself as if I mention you in a positive way.
        You are the best example of what a negative one is 😀

      • Pretty sure you don’t exist anywhere in reality.

        And…Leftist never smile….that was a leftist lie. Leftists always lie.

        • I’ll have to take your word for it.
          One thing is for sure and everyone knows it: @$$holes will be @$$holes.

          Thanks for my daily reminder.

      • Nicholas: Perhaps Krishna is being too kind, so that you misinterpret, as you are want to do.

        When people see cockroaches, rats, house flies, and bats at a wet market, the informed look in disgust because of what’s in their heads.

        That is how in our heads…

    • It also tells everyone you have no idea what people are saying, because you do not listen, do not read, do not recall…
      In any case, this is not a study, it is a survey.
      Might as well call a poll a study.
      John Cook called his “work” a study too.
      But this is from April, when no one knew as much as they do now.
      I happen to know that they are still polling people.
      I have not looked at them for a while, but I will now go and see how polls from right now look.
      Not because I find them to be highly compelling, but because obviously what people think now is derived from more information and experience than ones taken last April.
      Have you learned anything new since April?

        • Gans
          I don’t feel that you are contributing anything substantive to the dialog. Your forte seems to be insults to those who hold a different opinion. How about trying to attack the statements with logic and facts instead of attacking the person?

          It has been my experience that Nicholas has contributed more in the way of information and analysis than most here. I wish I could say the same about you. I wouldn’t be any more ignorant if you had never posted anything.

          Let me ask you a question. What are the chances that some obscure doctor who published early, that no one had heard of before the pandemic, would come up with the right dosage of a drug never before used for this disease, and the right amount of time to take the drug? Consider that the dosage and amount of time to take a drug are usually an essential part of early trials for new treatments. Now this doctor just might be Sherlock Holmes’ smarter brother — Shear Luck — but, it seems improbable to me. HCQ just might turn out to be the best thing in the world for COVID-19; however, at this point in time, the evidence for that is very poor. Those who promote it based on anecdotes and small, non-random trials are not scientists. They are in the same category as those who avoid black cats and throw salt over their shoulders after spilling some.

          • “What are the chances that some obscure doctor who published early, that no one had heard of before the pandemic, would come up with the right dosage of a drug never before used for this disease, and the right amount of time to take the drug?”

            Well a doctor should be able to understand how to get information on a drug that has been around for over 60 years. So I don’t but that assertion. Sars was like 1.5 decades ago and there is a plethora of medical information about Chloroquine at known safe doses that were proven to be effective.

            The bad studies, most of which failed, show the worst of society. The people who want there not to be a cheap cure are evil at best. I am not saying I know which people are evil…

          • HCQ+ is cheap, safe and has some evidence it helps if taken early, Clyde. Why don’t you just jump on a different TDS horse? My review of the study “proving” HCQ causes heart troubles showed it was a pile of steaming ideological crap. Any supposed scientist or medical practitioner supporting it is/was a liar.

            After my WuFlu diagnosis yesterday, I will be taking HCQ+ one way or another. At age 72, I’ve learned my reasoned judgement is usually right-on. Listening to ideologues or representatives of special interests (as you apparently are one or the other) always gets one in trouble or costs one alot of money (even poverty), usually both. And death is not an uncommon outcome.

            I’ve closely followed the arguments on every side of the various ChiCom virus and WuFlu debates since day one. They have all degenerated into ideological debates driven by misinformation from ChiCom, WHO and other politicized sources. The mere fact that those sources do not clearly inform reviewers that the results from their studies are based on application of HCQ to near-terminally ill patients indicates they are deliberate propaganda.

            Screw off, Clyde.

          • But Dave:
            Can’t you just be patient, and wait another 4 months? There’s a respirator there you can use too…

            Of course that was sarcastic… Be well, and good luck sir. Keep up the vitamin D too.

          • Thanks, Mario! Sarcasm aside, at no time is anybody shoving that tube down my throat. I’ll do everything in my power to avoid that fate. Clyde has no common sense.

          • I as one would not dare! 🙂 You are a fighter… and you will be fine, I can (unscientifically) feel it.

          • You might be more correct than you know, Mario. If I ever get a chance, it would be fun to tell you how I went back to Fresno, CA a week later to successfully retrieve my stolen, future-champion Pug dog. I usually accomplish what I truly set my mind to. I appreciate your good feelings towards me, Mario.

          • Hey, I would love to take that off line. Would be a great story to hear. Your situation certainly gives you a pass by the way, on your colorful language… and that your responses are well reasoned, regardless of whether people agree with your thought process. I just so happen to align…

          • If you mean with “obscure doctor” Didier Raoult, than be aware that he isn’t certainly not as obscure as you belive. He is what everybody calls a specialist and / or expert
            And his studies and trials are based on earlier successful trials of treatment in China.
            So he had a base for dosage and time amount.
            And in the beginning, they were always testing the viral load and find out, how long to treat.
            Btw. these studies have been discussed here iin earlier times and, as published on google docs, days later, they disappeared.

          • Dave Fair,
            Right on! All the stuff I have seen corroborates what you said. All this anti-HCQ propaganda is TDS on steroids. We old folks should use it immediately and don’t forget the zinc.

          • But you old folk tend to be Trump voters, that is motivation enough to believe the opinion articles disguised as science… [disclaimer OK I have always gravitated towards older folks, shoveling snow as a kid, talking to older neighbors and grandparents when I could. The wisdom attracted me. I am 55, I am getting close myself… can’t wait!]

            So they poo poo good anecdotal and better than anecdotal results because they did not follow a practice that someone needs to fund at great expense, while people die. And then if a study is funded, and runs filled with bad data that will later need to be retracted… that’s fine. Because it’s on CNN, and the MSNBC, NYTimes or the CDC or WHO said so.

          • Biden notwithstanding, old folks are not stupid nor easily mislead. My reference to HCQ+ means a combination of HCQ, AZ and zinc. It seems to be the ideal combination in the relevant studies.

            Even at age 72, I did not seek to take HCQ+ until yesterday’s diagnosis of WuFlu. I think its use as a prophylactic should be saved for those in higher risk categories; the elderly with high blood pressure, diabetes, heart problems, obesity, etc. Having said that, I also believe that people should use their own judgement on taking HCQ+.

            Good luck, Dan. Hopefully we come out of this politicized mess stronger as a people.

          • Breaking news moving world markets.
            Experimental treatment reduced mortality by 62% in vivid patients:

            “- Data Presented Includes a Comparative Analysis of Clinical Recovery and Mortality Outcomes from the Phase 3 SIMPLE Trial Versus Real-World Cohort of Severe COVID-19 Patients Receiving Standard of Care —

            — Traditionally Marginalized Racial/Ethnic Groups Treated with Remdesivir Had Similar Clinical Outcomes as Overall Patient Population —

            FOSTER CITY, Calif.–(BUSINESS WIRE)– Gilead Sciences, Inc. (Nasdaq: GILD) today announced additional data on remdesivir, an investigational antiviral for the treatment of COVID-19, adding to the available body of knowledge on treatment outcomes with remdesivir. The data are being presented at the Virtual COVID-19 Conference as part of the 23rd International AIDS Conference (AIDS 2020: Virtual) and include a comparative analysis of the Phase 3 SIMPLE-Severe trial and a real-world retrospective cohort of patients with severe COVID-19. In this analysis, remdesivir was associated with an improvement in clinical recovery and a 62 percent reduction in the risk of mortality compared with standard of care. “

        • Back when I had to worry about being doxxed at work for being wrong on global warming, I used the handle Menicholas.
          Since then I have used my name.
          Something on your mind, boder?

          One might think that anyone who wonders about that probably has sock puppets.
          Are you concerned I slipped a comment in under your nose?

      • You didn’t realise, the poll was about studies, and I spoke about these studies, never mind 😀
        But you tell me, I don’t read, nice 😀 😀 LOL

      • Nicholas
        I read a poll that said Hillary will win the 2016 election. Must be true! 🙂 Funny how climate skeptics disparage consensus, but those pushing HCQ use it as their main support.

        There have been so many different drugs tried, all showing some apparent benefit, that I think anyone with an open mind should consider the placebo effect as playing a role in all this.

        • Is there any consensus about HCQ ??
          Not really, or did I miss s.th. ?
          Btw, in questions of climate, there is s.th. like a skeptical consensus 😀
          You can’t compare the one with the other if you are open minded (enough) 😀

          • I do not know about concensus, but I have noticed that ever since I made some comments that you disagree with about HCQ, you have not stopped saying my name, and making dumb replies to every comment I make.
            Today the only thing on your mind, hours before I got here, was what I was going to say.

            One thing you never do, and I mean NEVER…EVER…is read a comment, and then respond to someone in an intelligent manner, even if you disagree with them, even if they just have a random question.
            Ever.
            You have no idea how to read something, consider what is being said, and offer some thoughts in the manner of a conversation.

            I liked you better back when you were a credulous, gullible, admittedly scientifically illiterate, and more or less a somewhat pleasant person.
            Remember the day you learned that malaria was not a virus?

            https://wattsupwiththat.com/2020/03/17/an-effective-treatment-for-coronavirus-covid-19-has-been-found-in-a-common-anti-malarial-drug/#comment-2940060

      • In early April, the doctors knew the outcomes they had seen, and there was no political motivation to push results one way or the other.

  4. No idea what to think about infos coming from Turkey, where everybody with symptoms is treated with HCQ, and have a lower death rate than Germany, in total and in relation to population.

    • Erdogan, while trying for a new Caliphate in Libya, threatened to allow infected migrants through. I’ll withhold judgement on any Turkish stats.

  5. Goldstein publishes more of his personal interpretation of studies of studies of medical rumours here on WUWT. Can also be interpreted as 85% of physicians administering HCQ feel it is a positive psychological crutch at fairly low cost for patients wanting the best meds possible, even if they don’t really work. Pretty soon we should be up to the indisputable 97% consensus that it does something good/bad which we have heard before.
    Just search on “HCQ ineffective” for an instant Goldstein rebuttal…..

    • Just compare the differences in protocols the studies you prefer in contrast to the studies of L. Goldstein or mdman above linked.

      • Maybe you could say exactly what it is you want to say?
        What protocols are you referring to?
        Which are the good ones, and why?
        Which ones are not as good, and why?
        Are you capable of that sort of communication?
        Or are you just a little girly man who pretends to know sh!t from shinola after a few months of internet echochambering?

        I think the warnings about the estrogenic properties of all that quercetin you are gobbling up has had the desired effect.
        Growing tits yet, or is it all behavioral at this pint?

          • You never wrote about quercetin?
            Is that what you said?

            *rolls the eyes*

            Steroids was part of the protocol that was changing over time.
            You babbled something about comparing the protocols.
            Try to keep up.
            Was it a three drink lunch again?

    • DMacKenzie
      July 7, 2020 at 7:03 am

      It is a free choice world, supposedly… so if by any chance you consider a treatment for COVID-19, at some point in time,
      please don’t take QHC, and maybe better do consider a seasonal flu vaccination, best a cocktail one, for a further boosting of your immune system, when at it.

      It will be great if you manage to persuade also likes of Fauci and Billy Gates of this world to take the same route.

      It will be and make it easier for all concerned, I think.

      cheers

      • Whiten, everything you mentioned doesn’t do anything substantial for Covid19, or any coronavirus for that matter, so my choice WILL be to NOT take them for that purpose. The annual flu vaccine is worth it for flu. In Didier’s original HCQ study of 26 patients, 6 quit the treatment due to adverse reaction to the HCQ. Like you say, free choice…..

        • Get back to us if you catch the ChiCom virus’ WuFlu, DMacKenzie. Let us know what you think of HCQ+ then. Since my diagnosis, I don’t have a sense of humor about high-minded rationalizations.

          • I haven’t lost faith in my immune system. All the studies point to quite high recovery rates. /s

        • @DMacKenzie No, 6 did not quite due to adverse reactions to HCQ.

          Maybe you need to re-read the study if you even did in the first place.

          Here are the reasons :
          “Six hydroxychloroquine-treated patients
          were lost in follow-up during the survey because of early cessation of treatment. Reasons are
          as follows: three patients were transferred to intensive care unit, including one transferred on
          day2 post-inclusion who was PCR-positive on day1, one transferred on day3 post-inclusion
          who was PCR-positive on days1-2 and one transferred on day4 post-inclusion who was PCRpositive on day1 and day3; one patient died on day3 post inclusion and was PCR-negative on
          day2; one patient decided to leave the hospital on day3 post-inclusion and was PCR-negative
          on days1-2; finally, one patient stopped the treatment on day3 post-inclusion because of
          nausea and was PCR-positive on days1-2-3.”

          Besides, that was only his very preliminary study, that he shared with the world, so others could also help determine if they would have similar results. Unfortunately, it would seem, they went on attack to try to discredit him instead of doing science.

          He followed up with a study of 80 patients, then with another of over 1000 patients, and finaly with one of 3700+ patients.

          This is the last one.

          https://www.sciencedirect.com/science/article/pii/S1477893920302817

          • CBeaudry,
            Death and/or ICU 93 2.5 35 1.1 58 9.4 <0.001 37 17 <0.001 3 3 0.1149 13 9.5 <0.001 5 3.1 0.0449
            It’s a fine study, and I do not wish to denigrate the work that many people put into it…..
            But look at, for example “Death and or ICU” numbers…..in percentages there is just no real difference whether 2.5 people out of a hundred died or 1.1 died or 3.1. There are many possibilities why sick people don’t recover and a percent doesn’t cover it. Also note the recovery times. Again a day is really insignificant. I’ve waited longer than that in hospitals to be released.

          • You are right, D McKenzie.
            Any differences in the CFR can be easily shown to be either statistically insignificant, or the result of triaging patients prior to treatment.

            If 100 people get the virus, and the ones who get very sick go to an ER, and the ones who get somewhat sick go to an outpatient care physician, and the outpatient care physician treats all of those people, then the results of that treatment cannot be compared to the set of all people who got the virus.
            Because the worst off ones were removed by going to the ER!

            And this is one of the reasons why without blinding and randomization, comparative studies about effectiveness OR efficacy are not scientifically valid.
            There are many decades of examples of the proof of this.

            It has been correctly state here and on other threads on this topic many times.
            Many of the people who refuse to accept this principle are not operating on the level of science, but on the level of political considerations, or refusal to be persuadable.

            Perhaps the most powerful force operating on many people regarding this and other such issues is pride and ego.
            There are a lot of people in this world who do not wait for enough evidence to be available before making up their minds about some important issue.
            If and when they have grabbed onto position or view or opinion which is factually incorrect, they will not be willing or able to admit it or to change their mind.

            Too many people have made up their minds without all the facts in hand.
            They are now doomed, and we with them, to remain locked into ignorance of the truth.

          • Thanks for the link, the results:
            “Conclusion

            Although this is a retrospective analysis, results suggest that early diagnosis, early isolation and early treatment of COVID-19 patients, with at least 3 days of HCQ-AZ lead to a significantly better clinical outcome and a faster viral load reduction than other treatments.”

            The current issues is the on going TDS DNC talking points along with the cancel crowd rampant activities on anyone that publishes HCO-AZ positive results. Yesterday my local newspaper used an AP (DNC talking points) article that was unbelievably slated to discredit HCO: https://www.ksl.com/article/46774017/brazils-president-bolsonaro-tests-positive-for-coronavirus
            Need less to day they did not publish my post about their use of DNC talking points.

          • HCQ advocates are saying hard core conservatives, such as myself for example, are suffering from TDS.
            Now the claim is that any result contrary to what HCQ fans want to believe, is DNC propaganda?

            The upshot is, anyone who is not a leftist needs to hitch their wagon to a favorable outcome of clinical trials for HCQ curing COVID?

            I sure hope this does not represent a widespread attitude.

        • DMacKenzie
          July 7, 2020 at 4:38 pm

          Many, you have no idea how idiotic, brain dead zombie, silly crazy stupid, this statement of yours is:
          “The annual flu vaccine is worth it for flu.”

          Completely stupid in steroids.

          One of them givens is a natural proper persisting conditions, the other is simply a clause of stupidity in steroids.

          Seasonal flu is a natural cyclic persistence, in consideration of at very least, of 100+ different viral infection diseases, periodic, seasonal, where the stupid humanos like you and me, but not only, are periodically subjected to the natural force of more than 100+ different viral infections disease’s force… of nature, of the life condition.

          How much your silly seasonal flu vaccination against such does cover!

          Tell me, 2%, 5%, or maybe 10%, at most!

          Tell me stupid.

          How does it suppose to work?

          How much the flu vaccines work or impact against the natural force and power of seasonal flu.???

          Let me tell you… nada, nilch zilch.

          Only thing such vaccines do is upset the equilibrium of life, by causing an IDS condition in the prospect of herd immunity.

          That the only worth of seasonal flu vaccines!

          The main life code in the core of this novel corona virus, is far far much older than me you, Fauci, Billy Gates, or even all of us put together at 7 to 8 billion humanos.
          Is millions and millions of years older than humanity itself.

          Has being there many many millions of years before humanity.

          You sillies think it can be stopped or blocked and controlled by face masks or insane lockdowns….please do think again.

          cheers

          • Seasonal flu is a natural cyclic persistence, in consideration of at very least, of 100+ different viral infection diseases

            Wrong. You are confusing common cold viruses with influenza. Completely different viruses.

          • Ron
            July 8, 2020 at 7:24 pm

            Ron, completely failing your point made!

            All them little badies are “seasonal”, or are them not?????
            And related to the same organ almost all.
            Ron!

            cheers

          • @whiten
            What season is then the best vor SARS-CoV-2?

            Summer? Like the southern states are showing right now.

            Winter? Like in China.

            Spring? Like in Europe.

            The cold and flu do not damage your f***ing kidneys and clotting your blood to induce strokes and thrombosis.

          • Ron
            July 9, 2020 at 1:24 pm

            The cold and flu do not damage your f***ing kidneys and clotting your blood to induce strokes and thrombosis.
            ——————-

            Exactly “little dancing boy”. 🙂

            A condition or syndrome called IDS does that, easy.
            Especially badly and deadly when non natural in origin.

            Good.

            You going around and still coming around, with your “dancing”.

            🙂

            cheers

          • Ron
            July 9, 2020 at 1:24 pm

            Summer? Like the southern states are showing right now.

            Winter? Like in China.

            Spring? Like in Europe.
            ———————

            Ron, the main point of the questions you posed is simply matter of dumbness and illiteracy.

            Not understanding the point of “panic”.
            Will be the same with the consideration of seasonal flu versus this new corona virus.

            The difference in the clause is the panic… instilling of fear, by any means possible.

            If panic the same as per normal seasonal flu, the picture will be the same, dummy.

            Simply choice of tracing it or not as for more panic to be produced.

            Whichever way considered, the further tracing of this novel corona virus as happening, persist only due to panic and fear… it is not any more in its peak infectious disease epidemic vector for almost all countries or herds in consideration.

            It is simply basically applied as a scare mongering story, at this stage, Ron.

            Can you understand this simplicity!!!!!

            If the same method approach applied for seasonal flu epidemics, and followed ever so thoroughly the same picture will arise.
            Is not like we ever done this before for seasonal epidemic influenza…
            it is a first, in only one aim, scare the shite out of you, and with no regard or responsibility… Ron.

            Some record like this about a seasonal epidemic influenza does not exists there yet because we never before this went so far as becoming so crazy, insane and self destructive.

            cheers

  6. Hmmm, since this hydroxychloroquine treatment for Covid-19 first appeared for me at least on Dr. Roy Spencer’s webpage March 18th and sometime later we found out that hydroxychloroquine is routinely prescribed for Rheumatoid Arthritis & Lupus, it would be interesting to see the rates of Covid-19 infection for those Lupus and Rheumatoid Arthritis patients compared to the population at large.

    • That’s also the data I want to see, Steve, does the group already under treatment with hydroxychloroquine show clear evidence of protection against either incidence or severity of Covid-19?

    • Zhong et al. Lancent Rheumatology, 10.1016/S2665-9913(20)30227-7 (Peer Reviewed)
      COVID-19 in patients with rheumatic disease in Hubei province, China: a multicentre retrospective observational study
      Rheumatic disease patients on HCQ had a lower risk of COVID-19 than those on other disease-modifying anti-rheumatic drugs, OR 0.09 (0.01–0.94), p=0.044 after adjusting for age, sex, smoking, systemic lupus erythematosus, infection in other family members, and comorbidities. 43 patients with rheumatic disease and COVID-19 exposure.

        • That “only 20 out of 65,000” is a smoking gun if true but I’m afraid the gun was loaded with blank cartridges.

          Chiusolo was just repeating — possibly originating — some rumor that was mysteriously circulating in the beginning of May. That round 65,000 number was suspicious in itself… I thought then, if she knows the precise number of patient positives and presumably has access to an accurate number of patients, why only share such a preposterous estimate as “65,000”?

          It may be she misspoke during the interview or was misquoted by the Jerusalem Post. Derek Lowe consulted the Global Rheumatology Alliance directly on May 4 articleand they were tracking only 11,762 patients worldwide. He was unable to source the 20/65000 ratio.

        • “Yes and in Italy a survey of 65000 lupus & arthritis patients, only 20 caught COVID-19.”
          The link is to a newspaper report only, and it is completely wrong.

          From Science:
          “The number is completely fictional. As mentioned here in the comments, the president of the Italian Rheumatology Society was contacted directly and states that this number is completely wrong, that the society is monitoring 150 patients in its registry, 20 of whom are taking hydroxychloroquine. The 65,000 number is bogus.”

    • Earlier in the pandemic, I listened to a doctor explain (can’t remember who or where sorry), that they could not find a single lupus patient who had contracted COVID-19. He had put out an appeal to try to find one out of the 2 million or so lupus patients in the US who had the virus.

    • It’ inexplicable why such data hasn’t been collected and collated. It’s very likely easily available.
      I am currently doing my own study where n=1=myself.

    • I posted about this last night.
      People with lupus are getting it, in high numbers.
      And when they do, it is bad.
      Here is a link to one of the posts I made.
      And here is the link to a regirstry of 600 patients with rheumatic disease who are infected.
      45% wound up hospitalized, so far, and 9% are dead…so far.
      There was no protective effect from being on HCQ when they got sick.
      There were two groups that had a protective effect…those taking biologics, as they are called.

      Anti-TNF drugs worked the best, they were protected, but only partially.
      People taking anti-IL-6 drugs were also protected, but not as much.

      Here is the link, and this is what good data collection looks like:
      https://ard.bmj.com/content/annrheumdis/79/7/859.full.pdf

      • You can’t make the statement there is no protective effect. What was the state of their health… Lupus is an auto-immune disease… whereby treatment quells the misguided immune system.

        If you understood how HCQ and Zn worked you would know that is slows viral replication in the presence of ample Zn, which gives your “functioning” immune system time to respond.

        Two parts, get it?

        If you cared about providing information, why do you treat every issues like a biased hack?

        • I did not originate the statement.
          I was summarizing one of the results of the work I linked to.
          It is right in the first paragraph of the paper.

          Here is the text:
          “Results A total of 600 cases from 40 countries were
          included. Nearly half of the cases were hospitalised
          (277, 46%) and 55 (9%) died. In multivariableadjusted models, prednisone dose ≥10mg/day was
          associated with higher odds of hospitalisation (OR
          2.05, 95% CI 1.06 to 3.96). Use of conventional
          disease-modifying antirheumatic drug (DMARD)
          alone or in combination with biologics/Janus Kinase
          inhibitors was not associated with hospitalisation
          (OR 1.23, 95% CI 0.70 to 2.17 and OR 0.74, 95% CI
          0.37 to 1.46, respectively). Non-steroidal antiinflammatory drug (NSAID) use was not associated
          with hospitalisation status (OR 0.64, 95% CI 0.39 to
          1.06). Tumour necrosis factor inhibitor (anti-TNF) use
          was associated with a reduced odds of hospitalisation
          (OR 0.40, 95% CI 0.19 to 0.81), while no association
          with antimalarial use (OR 0.94, 95% CI 0.57 to 1.57)
          was observed.”

          The information that is the basis of that summary is extensively documented ands described in numerous tables of data.
          That is what the data says.
          It is not what I say, and your assertion that ” I cannot say it” is nonsense.

        • mario: I urge you to reconsider this. McGinley’s only agenda is to live up to the creed, “first, do no harm.” He has been ultra cautious re: hcq, but he explains himself and cites his sources. You seem like a reasonable guy, read his posts and tell me where he is wrong. He demonstrated a clear understanding of how the “two parts” work in a lab. He hasn’t seen good evidence (he doesn’t make Mr. Stokes’ error of re-defining “evidence” to suit a whim) that it works in the field.
          P.S.- Not that he needs me to step in, one thing you must grant is that McGinley stands his ground. In any event, he doesn’t deserve to be insulted.

          • Hi Paul: Thank you for your ability to craft a gentle missive.

            If you are responding to my statement, “You can’t make the statement there is no protective effect.”
            I could restate it as, “You can make any statement you want.” Not that I am the decider of who should have opinions. 🙂

            There is no “proof” that HCQ and Zn at the prescribed levels and duration we are talking about causes widespread harm or does not have a protective effect. One can argue about that all day long, so that will not be resolved by this response.

            There is plenty of “evidence” that HCQ and Zn have a protective effect.
            One can argue about whether or not HCQ is defined as an ionophore or not all day long. I have only seen evidence that it is called an ionophore by doctors in the field. It is not clearly defined how it can be determined, hence the debate.

            The evidence that there has been a protective effect has been shown in many cases.

            The debunking of the dangers of HCQ for Covid patients has also been widely circulated. The debate will go on and not be settled here.

            So it goes back to “First do no harm”, the Hippocratic oath. I am glad you brought this up.

            That does not mean, do nothing! I think there is strong evidence that in this case, there is much more harm being done, by not using HCQ and Zn early on, as prescribed.

            Look at it as a probability. Doing nothing… you get what we have. Supplying HCQ and Zn early on has shown no harm, and has shown better outcomes fewer deaths.

          • These are the people that have been much discussed…people with diseases like RA and lupus, and other conditions of a similar nature called rheumatic disease, collectively.
            The status of this group of people has been much talked about, and it is now obvious most of the talk has been based on erroneous information.
            In other words, people are saying a lot of stuff that is not true about people who have been taking HCQ, and using the misinformation to invent a bunch more misinformation.
            So, no w there are multiple data sets of these specific individuals.
            Interestingly, many people with such diseases take some of the other types of drugs that are being used to treat covid patients.
            And a sample of 600 people with these conditions, of which lupus appears to be the second most common, and who have also contracted COVID-19, has been closely examined and a whole bunch of information about their condition and situation is compiled.
            This is not based on what anyone wants to think, or believes to be the case, or was hoping would be found to be the case, or anything like that.
            This data is all gathered based on actual people and what they took and how they have fared after contracting COVID 19.
            Some might view it as extremely valuable information from which a wealth of insight might be gleaned.
            Of course, that would be people who would like to have factual information, no matter what it tells us.
            The type of person who is of a scientific bent is one example of who might want to get data of a factual and unbiased nature.
            Others might seek to dismiss it, and give it no weight, or make excuses for why it is not important, or relevant, even if such efforts were transparently biased.
            I am not at all sure what would motivate anyone to do so, but here we are.

            So, these people are already taking this stuff.
            IL-6 blockers.
            HCQ.
            Anti-TNF drugs.
            Steroids.
            And there is what happens to these people, compiled in detail.
            Summarized and analyzed.

            Anyone can see that we have people in this country who have appointed themselves professional obfuscators.
            Exactly why will be a question for the ages.

          • Thank you Paul.
            I really do appreciate someone who defends the person getting ganged up on.
            As Rud has aptly put it, I am interested in popularity contests.
            We have people with whom I have had little to agree with over many years on this site, with whom I am now in almost full agreement on at some aspects of what is happening with this pandemic.
            I have no problem or qualms about standing up next to these people and supporting them on that which we can agree on.

      • There’s a very significant difference between the Italian study as posted by A C Osborn, and the BMJ article Nicholas McGinley posted. The italian study reported that very few of the patients taking HCQ were diagnosed with WuFlu. The BMJ article looked only at patients that had already been diagnosed with WuFlu.

        • “The italian study reported that very few of the patients taking HCQ were diagnosed with WuFlu.”
          It was not a study, but a nonsense newspaper report
          From Science:
          “The number is completely fictional. As mentioned here in the comments, the president of the Italian Rheumatology Society was contacted directly and states that this number is completely wrong, that the society is monitoring 150 patients in its registry, 20 of whom are taking hydroxychloroquine. The 65,000 number is bogus.”

        • Mike,
          You are correct.
          I have no confidence in the Italian study, since it has been refuted by people within the community of people represented.
          I am going to stick to opining on information that stands up to scrutiny as being legitimate.
          I am not saying the Italian study is accurate or has any value or not.
          What it appears to be is an estimate of the number of people with the disease, vs the number that have been heard from that report taking HCQ and then getting Covid.
          But it is very obvious that most people who have these conditions have not volunteered their information.
          It is unclear why anyone would consider this a useful way to determine infection rates.

          I agree with you when say there is a difference between what is being compiled.
          The BMJ study is very clear on how the data is sourced.
          After a call went out for patients to enroll in a worldwide registry, those who responded were contacted through their doctors, who supplied the information that was compiled.
          So they are not trying to make any observations of overall infection rates.
          What they are doing is looking at the set of people that have enrolled in the registry, which was voluntary.
          They then separated out all of these individuals who had contracted COVID-19.
          It was not limited to lupus patients.
          It was limited to all people with what is classified as a rheumatic disease.
          This is a group of diseases with certain aspects in common, and for whom the same types of medications are often found to relieve symptoms.
          They are regarded as incurable and lifelong conditions, often progressive, sometimes severe, sometimes mild. Typically with recurrent flare ups and then remission periods of more mild symptoms.
          These diseases are disorders of the immune system.
          Some have called them autoimmune diseases in the past.
          But the understanding and the description of the etiology has evolved and become more refined over time.
          That phrase is not as commonly applied any more.
          In any case, there was for some reason a focus on lupus patients in the online scuttlebutt regarding these people.
          I think we should look at the whole set of these patients and not focus on one subset of them.
          Because what was germane to the topic at hand was that we have a population who have been on long term courses of the medications we now need to know more about.

          In other words, there is not any obvious rationale to only consider lupus patients, and not all people who were already taking these drugs when they got COVID.

          In any case, whether we look at them all, or just the lupus patients, we have individuals who were on HCQ, and others who were not.
          Some of them were taking these other drugs.

          Since what we are concerned about is COVID and what helps and what may help and what is not being shown to help, we should look at everyone in the set of patients, and later we can decide who and what medications are relevant.

          Cast a wide net, and then sort the information.

          So this comparison in the BMJ report is not answering the question of “How many lupus patients got COVID?”
          It is looking carefully at people who took one or more of these group of medications, and other people who did not take any of them but who had the same underlying conditions.

          We can now compare lupus patients who took a malaria drug and then got Covid, to lupus patients who did not take a malaria drug and then got Covid, and examine the data for similarities or differences in how they fared upon getting the disease.

          It seems logical that this methodology has a good chance of eliminating self reporting biases.

          We do not need to know how many people have these conditions all over world, what the underlying rates of disease was in those places, etc. That gets cumbersome and impossible to parse right out of the gate.
          For one thing, people with these diseases, particularly lupus, are known to be very careful about avoiding sick people…they are very susceptible to infectious diseases because they are on immunomodulating drugs.
          i.e., they take drugs that shut down part of the immune system.
          When they get sick, it is often very much worse for them than a healthy person.

  7. Which one of the usual suspects who defend science consensus will say this study doesn’t mean anything?

    • Yes there does seem to be a divergence of opinion on several areas of scientific doubt where the consensus follows the government money which follows the establishment opinion. Epicycles anyone?

  8. Goldstein, did you know that a survey of climate scientists proves nothing about the climate?

    • Climate scientists live in a virtual world playing with numbers. Doctors actually heal people. Real world results are hard to argue with, but you’ll try.

      • icisil
        Get real! Results have to be turned into numbers that are impacted by confounding factors such as demographics. The only way you get around that is by stating “I know a doctor who claims he has cured people.”

        • I wrote a post earlier… you’re talking past each other.

          Yes, numbers are great. But when no one will do a true double blind placebo based study (and it’s been months now) due to politics… and while the studies that have been done use bad data… or use the drug in a way it is KNOWN not to be effective, we are left to use our common sense.

          That is, it appears that taking a safe drug at a low dose has nearly zero downside risk and is shown to dramatically reduce effects of the virus.

          Meanwhile, people are dying and we are arguing past each other.

        • CS, the only thing that matters is that people don’t progress to serious illness. How do you rationalize the Texas doctor treating his infected nursing home patients with HCQ, and the vast majority did not get seriously ill or die? That is a highly unusual occurrence in that context, or demographic. To say that is meaningless is meaningless.

        • Clyde,
          Oh, yeah?
          Well, my niece’s teacher’s cousin’s step father heard that there was a person who once knew a doctor who said he never heard of that happening.

  9. This confuses me. if there are lots of doctors who consider HCQ as being an appropriate treatment, why is the literature FULL of studies showing it to be of either no value, or positively harmful?

    if the answer is that politics is driving these findings rather than dispassionate science, then I am all adrift – because I cannot then believe ANY published finding – either supporting or refuting this drug….

    • Look at the protocols of the different studies, you see why there are diffetent outcomes.
      Late use versus early use, as so often discussed here, but my impression is, shortage in remembership seems to be mainstream here.

    • Why would you listen to anyone or anything that is not actually healing patients? If doctors say HCQ is helping their patients, why would you not at a minimum consider what they say is true?

    • This is a poll dated April…early April.
      Worthless.
      Who cares what people thought back then?
      Get current opinions from the same people and see how it has changed.
      Besides, the people that matter are not a survey of random doctors, but the ones that work with patients in critical care situations.
      Back around then my very busy doctor told me he had yet to get back a single positive test result.

      • You have it backwards. The ones to listen to are the ones who can keep patients from progressing to critical care. I think the general consensus is that HCQ doesn’t do well for critical care patients, so why would we listen to critical care specialists about HCQ?

    • Follow the money Geezer. Treatment cost of HCQ–about 7 dollars. Treatment cost with Gilead’s remdsiver (sp?) about 2400 dollars. Ask about the financial ties to Gilead certain CDC officials have among others.

      • Rolling a patient on their side (prone position) is an effective treatment for low blood oxygen. How much does that cost?

      • “Follow the money Geezer…”

        Oh, that certainly makes me suspicious of Remdesivir. But it tells me nothing about the efficacy of HCQ. And the more people offer that kind of argument, the more suspicious I get about ALL the trials…

        I think that, as a society, we have successfully undermined Science. I suspect that social media has had a large part to play in this – allowing the worst tribal instincts of humanity free play….

        • Good doctors are not scientists; they are healers. Beware the doctors who are only scientists.

        • He is flat out lying about the price of remdesivir.
          It has been established that 5 days is as good as 10 days.
          1 vial will cost $320.
          But no one has bought any yet.
          Gilead gave away the entire supply in existence, and since it takes 6 months to make a single dose, they are not yet in possession of any to sell.
          But, it will be ready soon.
          Trump has secured the entire supply for the US government, through to September production.
          By December they think they will have made enough for a couple million people.
          It saves 5 days off of an average hospital stay.
          That translates into a $12,000+ savings per patient.
          Every jackass who refuses to get it will cost us all a big fat pile of cash.
          Meanwhile, hundreds of clinical trials are ongoing, in every country, and every state, and almost every large and medium size city. Meaning it is free.
          Trials for other drugs vs standard of care will now mean other drug vs remdesivir.
          IOW…no one will get placebo anymore in any trial.
          It would be unethical.
          SoC is remdesivir.
          I seem to recall everyone is supposed to have insurance.
          And also that the government has said no one is gonna get charged for any treatment related to getting COVID.
          Did that get rescinded?

          Go to any business news site and enter remdesivir in a search, and this info will be there.
          Except the clinical trial parts…go to clinicaltrials.gov for that info.
          Any day now, Gilead will begin clinical trials for an at home inhaled version of remdesivir.
          Anyone who thinks they have the virus can get it for free in any one of many clinical trials, or another usage called expanded access…all free.
          In fact, clinical trials pay participants for their time.
          Many of the trials are giving remdesivir and another drug.
          I would enroll in remdesivir plus the anti-IL6 drug trial, if I had it.

          Here is a link set up to go directly to the 40 trials with remdesivir.
          They added one since yesterday.
          Number 11 on the list is remdesivir plus Tocilizumab (anti-IL6 monoclonal antibody)

          But what do I know, I am just a moron troll.

          • How can Remdesivir be the “standard of care” when it is virtually brand new and nobody knows what side effects may be waiting. There have been no proper trials over any time period of about 6-8 months as it was only rushed out of development last year. (that is my understanding, sorry if anyone can correct me).
            The main claim for remdesivir seems to be as you said – reducing hospital stays by about 5 days. Knowing it is usually used for more serious cases, does this mean that patients die sooner? Statistics can be used in many ways!

            One can stand up and say trial this, trial that, studies show etc. but this is a situation where people are dying in significant numbers and many within two or three weeks of realising they are ill.
            In this situation I am for going early with what are impressive results with HCQ and Zinc sulphate and including azythromycin if there is indication that pneumonia infection is present (although it may be late in the day for best results in that case). Obviously under a doctor who can check for possible heart contraindications.

            The pushing of remdesivir, given the complete lack of long term safety and underperformance v. HCQ etc seems highly irrational.

            The cost comparison also raises concerns of propriety in my mind.

            SteveT

      • The notion that “big pharma” would let much of its current and future customer bases die-off on the odd chance that one of them would come out a with a new COVID-19 treatment is not following the money. They’ve lost lots of seniors and future seniors with 3-4 scripts. Remdesivir is a $1B development. They’ll make that back by the end of Sept if things go ideally-well. If not, then the future of the drug is uncertain. And everyone else besides Gilead was a loser in wasting research money but not hitting it big.

    • One of the most disgusting aspects of the COVID pandemic has been the ruthless jockeying by drug companies and their agents to push their own drugs and actively bad mouth possible competitors without regard for the good of the public.

    • Dodgy
      You asked, “… why is the literature FULL of studies showing it to be of either no value, or positively harmful?” It is the same reason that about half of peer-reviewed, published studies can’t be replicated in the medical field. That is why large samples of random subjects have to be used, and confounding factors such as co-morbidities have to be accounted for. Early results from ad hoc clinical trials, with a disease that a large proportion of those infected have mild to no symptoms, used only in the early stages, should be expected to have good results. That is why so many different drugs appear to have some efficacy. What is even more critical is that those not in need of hospitalization, or just some palliative care for a few days, are not the important ones. It is those, for whom HCQ is not recommended, that are most in need of effective treatment. At this point in time I wouldn’t give much credence to any of these early ‘studies.’ It is understandable that a physician who can monitor his/her family members would, out of desperation because of the lack of alternatives, consider prescribing HCQ if a family member showed signs of possible COVID-19. If they get well, it might have been HCQ or it might have been an inherent resistance to the virus. It is like the drunk blowing a whistle to keep the pink elephants away. The real test is if people who are seriously ill can be cured. Anything less is Witch Doctor medicine.

      • BS, Clyde. The severely ill are dying at prodigious rates NOW, no matter the treatment! The real test is to find out how to keep people from becoming severely ill. Your ideological stance is ugly. F**k off.

      • P.S., Clyde. With my recent diagnosis of WuFlu, this is personal now. So, again, F**k off, Troll.

    • In reply to ‘Dodgy Geezer’:

      Dodgy, look at motive. Who win and Who would lose to hide a very effective Covid treatment from the American people?

      If people are lying, trying to hide a very effect Covid treatment, that is criminal/an attack on the US people and the lying needs to be called out. Particularly as this appears to be organized lying.

      Six US Michigan Hospitals, financed by the Henry Ford foundation are not going to lie about the fact that 2541 patients….

      ….Treated with HCQ/AZ plus zinc within 48 hours of admittance to the hospital …

      (that is not early treatment, that is earlish treatment, a doctor in New York treated 500 of his patients as soon as Covid symptoms were detected, his results is a reduction in the covid death rate by a factor more than 10.)

      ….were 71% less likely to die of Covid, as compared to the patients that did not get the treatment. Interesting there was not a single heart attack in the treated group, while one Fake HCQ study alleged that 25% of those treated with Covid died of heart attack and there was a reduction in outcomes for the HCQ treated patients.

      Dodgy Geezer, science stops working when organized paid groups of people have agendas and lie and take over the media. This is different than a single incorrect study.

      We do know that the Lancet study that lied and that presented false data has been withdrawn….

      We also know that company that supplied the data for that study has refused to supply source data and is not returning phone calls.

      Science also works because there is only one correct answer. A group of doctors in Michigan are not going to lie about the effectiveness of HCQ. There going to do what they are told and they are going report unfiltered results.

      Six different hospitals, Michigan hospitals treated 2541 patients and their evidence based results are….

      Early treatment of Covid patients (the earlier the better) with Hydroxychloroquine and Azithromycin plus zinc reduced the covid death rate as compared to untreated patients by a 71%.

      https://www.ijidonline.com/article/S1201-9712(20)30534-8/fulltext

      Treatment with Hydroxychloroquine, Azithromycin, and Combination in Patients Hospitalized with COVID-19

      Results
      Of 2,541 patients, with a median total hospitalization time of 6 days (IQR: 4-10 days), median age was 64 years (IQR:53-76 years), 51% male, 56% African American, with median time to follow-up of 28.5 days (IQR:3-53).

  10. April?
    It is now July.
    Might as well look at polling data to help decide about an election.

    In the world of climate skepticism, we regard people who try to reason by citing surveys as the most unscientifically minded people in the arena.
    This is no different.
    Data from polling two months ago has zero weight, and can even be taken as obviously biased, towards when less was known.
    Look at how the Henry Ford Health System data was skewed by a sequential survey of patients.

    • It’s a world of difference. One is an abstraction that has nothing governing interpretation; the other is the personal appraisal of highly skilled professionals.

    • Salute!

      c’mon, NickMc…..

      I do not recall the cosmic “peer(brotherin law) reviewed, double blind, clinical trial that resulted in the FDA to recant on emergency use of the malarial drugs.

      All we got to use is testimony from many practitioning doctors and what they did and what seemed to work.

      Wanna do a serious study of HCL and its “helpers”?

      How can we round up few thousand folks of all races and colors and blood types and underlying medical conditions and then expose them all to the bug in very controlled environmental conditions and then separate the infected from those that did not seem to suffer? Then we examine all kindsa things for both groups, but we start a HCL+ regimen on the infected ones. Then we look at those poor souls for blood type, race, underlying conditions, etc as we watch them die or recover. And how many had heart rhythm problems or whatever that can be traced to the HCL? Guess we should have also taken another thousand off the street with no Corona problem and had them take the HCL like I did not of my own free will years ago. How many of them died or had debilitating problems compared to Advil or the myriad of drugs advertised on TV for problems most people might have and didn’t have the problem from the guy in front coughing?

      My not so humble opinion is the FDA caved to the deep state and ignorant, politically motivated mass media.

      As with thousands of ads on TV, all the FDA had to do was include that famous line at the bottom of the screen warning about side effects that may occur in a very tiny of people, and relate that to the veteran numbers of we millions that ingested the damned HCL for years and croaked.

      Gums rants….

      • I have no idea what you are trying to say Gums.
        What I am saying is very clear: April was three months ago.
        Since then a lot of new information has come to light.
        Since then many more people have been treated.
        Those polls are still being done, so why not report the up to date ones?

        Who wants to guess what they say?
        I already checked.

        • Salute!

          No problem, NickMc

          I am trying to make the point that there has been no super duper study or trial that makes taking the malaria prophylactic some kinda death sentence.

          The malaria compounds have been used and studied for eons.

          As with all the new, magic drugs advertised on every TV channel three times and hour, its warning would be that only 1 person in 100,000 might have indigestion, and anyone with an existing heart problem and high blood pressure should consult their doctor ( do not know how you got the HCL without seeing your doctor, but gotta put that in the add to mitigate lawsuits).

          That is my point Nick.

          The damned malaria stuff seems about like Advil, and should be treated the same.

          If the stuff helps, then great, but the FDA and certain media should not discourage its use as long as the warning we find on every label states that the efficacy has not been proven to CURE covid-19 and that no other compound has been proven to cure the virus attacks upon your body.

          There is a lotta difference between asserting some chemical or drug will CURE a disease versus suggesting a possible use of an existing compound that has been thru the rigorous testing to get approval by the FDA for widespread use without special scrutiny.

          I do not find an assertion that HCL plus other stuff could cure the corona virus attack. All I can find is that it MAY reduce the severity or shorten the problem.

          back to the bbq, as the damned critters can not fly and don’t smoke or heat or breeze.

          Gums sends…

      • Wanna do a serious study of HCL and its “helpers”?

        There are still more than 100 studies enlisted for HCQ in the U.S alone at the moment, other countries are doing trials as well, so I guess at some point we will have sufficient data for one or the other outcome.

        Disclaimer: I would really like to see a comparison Zn alone/HCQ alone/HCQ+Zn.

    • RE: “Look at how the Henry Ford Health System data was skewed by a sequential survey of patients.”

      Please provide evidence for your allegation. Weren’t you the one dismissing Leo’s submission and touting a ‘sequential’ survey of doctors opinions. Memory refresher: “Get current opinions from the same people and see how it has changed.” D’OH!
      Do as I say, not as I skew?

  11. Unfortunately, doctors can be extremely close-minded, especially with anything that might go against their training, and anything smacking even remotely along the lines of preventive and/or natural or non-pharmaceutical. I realize a lot of that is to protect themselves from lawsuits, but it means that it can be difficult to accept what they say at face value.

      • Yeah, I am pretty sure he’s one of are old time frauds, Brandon Gates, Griff, Tony Mcleod or one of the other name changing frauds, the writing style is familiar i just haven’t put my finger on it yet but I will.

        • boder
          I don’t see the similarity in the writing styles. Ask Anthony if they are the same people.

        • I am pretty sure you are a jackass, Boder.
          Gates does not come round here no more.
          Last time he was here was the time I argued him straight into a tonic-clonic seizure.
          I am not sure when that was…
          After this time I pantsed him and stole his lunch money:

          https://wattsupwiththat.com/2015/04/26/inquiry-launched-into-global-temperature-data-integrity/

          Last time I saw Tony, was that time he lost a $1000 bet with me, that every one here witnesses, regarding his inane opinion on Arctic sea ice.
          How do I know you are not him? He was nearly as unpleasant as you, so I am suspicious…

          Do not think I am forgetting about that money, Tony!

        • the writing style is familiar i just haven’t put my finger on it yet

          Alright, you caught me. It is I and he is me.

          It was fun while it lasted . . . 🙁

          • Speaking for myself, I am way too quick and nimble for him to ever gets his greasy fingers in me.
            I have to take a shower.

  12. OT — when I get a severe illness, I have a symptom that hasn’t been discussed — severe whining (at least that’s what my daughter says). Will hydroxychloroquine control that symptom?

    BTW, I had a dental appt. scheduled for this afternoon, and I got a call from the dental office saying they cancelled it because my dentist wasn’t feeling well. I asked about covid-19, and the staff told me they don’t know — he’s going to be tested for it — and this is the second time he’s been tested. Earlier this year, one of his dental hygienists quit, because she was paranoid about catching covid-19. We talk a lot because my family has been going there for over 30 years. And dental problems is one of my major malfunctions, and I help them stay in business.

    • +42^42. Old military saying: When in doubt, whip it out. The HCQ+, that is. Was diagnosed with the ChiCom virus’ WuFlu yesterday evening after developing symptoms a few days ago. Will be contacting my primary care Dr. this afternoon. Will certainly demand HCQ+ treatment. Will go outside the VA if necessary. F**k St. Nicholas.

      BTW, it was in fighting the Asian Marxists that I got my combat wounds, which wound up prepaying my healthcare. What goes around.

      Never deal with societies that follow Marxism, eat weird wild animals, live in close proximity to pigs and ducks and unhygienically slaughter animals in inner cities. Whatever the costs, limit Chinese travel, move manufacturing of most things back to the USA and destroy the ChiCom monster economically as well as militarily.

      • God bless you for your service:
        I will hope the your last sentiment is never to be needed, having to use our military, except as a show of strength by being strong… Get well fast and let us know how you are doing with treatment.

        Our Nicholas comes more than once a year, unfortunately.

          • Thank you for your sentiment, Mario. I’ve been called many things when dealing with numerous controversial business and political issues over the decades, but inspirational is a new one! When opposing popular (but bad) ideas, the most common description was antisocial asshole.

            Sadly, the Woke brigades don’t want to listen to reasoned experience. It will take at least another generation for the inexperienced (and those who won’t read history or who actually misinterpret history) to make enough mistakes to learn the lessons of history and the bad outcomes of good intentions. Humans are not perfectable; centralizing power to force perceived (usually political or religious) perfection always turns out badly. Democratic free markets usually shake out the bad ideas; not perfectly, but better than anything else.

            Ideological movements always eat their own. The currently pervasive cancel culture, made more toxic by technology, is now dragging down its own idols of old. It will continue to drive society into waring camps and it will not end well for the common man. E Pluribus Unum, the motto of the US, is the great idea of American democracy. Tearing it down will destroy us.

          • Amen that Dave. I learned later in life why I was usually the one taking a counter view to many arguments… and that realization was eye opening to me. You speak cogently, and sound fortified with experience when you counter in an argument. It shows.

  13. Since HCQ is a prescription drug let’s look at OTC.
    IF one of the reasons HCQ works is because it is a zinc-ionophore allowing zinc to go inside the cells from the bloodstream, there are a number of OTC products which are zinc-ionophores. The one I take, along with a Zn supplement, is Quercetin.

    • I’ve been doing the same. Quercetin is found in red apples and other food stuff. I’ve been eating an apple for breakfast for years now–apple a day keeps the dr away. I read about the need for zinc in a healthy immune system back in Feb. and started that supplement then, along with upping my Vit.C &D. added the quercetin supplement just recently as I figured the amount in a single apple wasn’t all that much, and what the hey–doesn’t cost very much, and assume that the VA won’t be prescribing HCQ as a preventative anytime soon.
      Never get a flu shot, don’t use anything that brags on killing 99.9% of germs, and the only issue I have is some mild seasonal allergies. Got all the health conditions associated with my age (74), but never get sick, and intend to keep it that way with a strong and healthy immune system –not vaccinations.

        • And the Finns – a 20-year fermented herring empties the entire block, pronto.

          Still, I wonder if anyone has checked the vitamin content of fermented herrings. I’ll bet we are in for a surprise!

      • Elderberry is highly effective against human coronavirus NL63, one of the three known
        coronaviruses to enter cells through the ACE2 “back door.” It directly stops the attachment of
        the virus to ACE2, so probably does the same for the new coronavirus as well. Since viruses
        need to hijack our cells in order to multiply and spread, and since if they don’t do that they
        eventually die, blocking the entry of the virus into the cell destroys its ability to multiply, spread,
        and survive.
        Elderberry’s effects aren’t limited to blocking the ACE2 back door. It also destroys the lipid
        envelope of avian infectious bronchitis virus, a coronavirus that infects chickens and other birds,
        and in humans it is effective against the flu, which isn’t a coronavirus at all. None of these
        viruses enter cells using ACE2. Still, its ability to directly block the use of ACE2 as an entryway
        means it has the potential to nip the new coronavirus in the bud and prevent it from ever
        establishing an infection in the first place. As a result, it deserves a place as a preventative and
        first line of defense against the new coronavirus.

        • Hi ‘don rady’,

          Hey Don, please do not make stuff up. Elderberry is not highly effective against Covid.

          Regardless of sex or age, Vitamin D normal people, blood serum 25(OH)D levels less than 20 ng/ml are 19 times more likely to die from covid than vitamin D deficient people 25(OH)D blood serum levels less than 30 ng/ml.

          Researchers know that because they measured the 25(OH)D levels in the blood.

          4000 UI/day per person is required to raise the US populations 25(OH)D levels above 30 ng/ml.

          82% of the US black population, 69% of the US Hispanic, and 42% of the US general population is Vitamin D deficient.

          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

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

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

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

          Vitamin D Insufficient Patients 12.55 times more likely to die

          Vitamin D Deficient Patients 19.12 times more likely to die

          It is interesting that chemical ‘Vitamin’ D actually changes our body at a cellular level.
          The cells in people who are Vitamin D normal have upgrade changes at a cellular level which are made to enable our body to stop internal inflammation and hence all common cancers, to increase the core body system strengthening the spine and warming the core (this explains why people lose 20 to 40 lbs when they correct their Vitamin D deficient and why some people are clumsy)…

          … Vitamin D also actives a system that protects the brain… which explains why Vitamin D deficient people suffer long term brain damage. Their IQ is actually lower. Very sad and hidden from those most affected.

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

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

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

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

      • …and intend to keep it that way with a strong and healthy immune system –not vaccinations.

        Ehm, vaccinations are way more likely to boost the immune system than the opposite so that doesn’t make any sense at all. That is actually where possible side effects are originating from and why there is the hypothesis about TBC vaccination and protection from SARS-CoV-2 in the first place.

      • The liposome assay would actually be the gold standard to prove any ionophore property of HCQ.

        As one can see from the 3D structure for quercetin and epigallocatechin-gallate both fulfil the criterium of negatively chargeable prosthetic groups in close proximity to work as an ionophore for divalent cations:

        https://chem.nlm.nih.gov/chemidplus/structure3D/viewer/117-39-5

        https://chem.nlm.nih.gov/chemidplus/structure3D/viewer/989-51-5

        It would be very informative to test these in cell culture against SARS-CoV-2 replication for the Zn hypothesis. Or clioquinol as this is not known to have antioxidant properties that could confound any finding but is a well established Zn ionophore.

        • @mario lento
          Yeah, I know but nobody really tested it with the virus AFAIK yet.

          Quercetin is somewhat “problematic” in this instance cause it has a lot of other potentially beneficial effects in the context of a viral infection…

          – antioxidant
          – anti-inflammatory
          – autophagy-inducing
          etc.

          … though the data is not completely uncontroversial.

          So to prove the action is through an ionophore effect it would be better to use another ionophore with as less as possible off-target effects.

          • Oh, yes, I was just showing a chart which claims observation ionophore activity of several substances.

            quercetin does seem to help with tamping down (I will use the term misguideded) macrophages so it helps in autoimmune (allergies) disease. What I do not know is if it suppresses all immune response or selectively reduces improper immune response.

    • I was taking Quercetin + Zinc gluconate daily until I got a script for HCQ. I’ve convinced my wife to take it.

        • Oysters only work with Guinness. Many a festive proof of that. They get their oats in volumes!
          An uncle, MD, surgeon, swore by it.

        • Krishna: [this is personal] I have been taking a Saw Palmetto prostate formula which has pumkin seed, and recently I found it had 15mg of Zn per capsule of which I was taking three times per day for some 4 years. It works great for flow.

          I also had been taking Ca/Mg/Zn w/D because it’s a good mixture of minerals. (I take lots of other supplements and powdered juiced veggies).

          So I recently reduced the dosage of both of these products since I don’t want to be taking so much Zn…

          I think that taking 30mg Zn/day is still a bit over the top still…

          Anyway, after I started taking 1500mg day of supplemental Quercetin, with NAC, I noticed my lungs (exerciser induced bronchitis) and sinus sensitivity vanished.

          It seems the Quercetin brought everything together for me…

          Over the years, I used to get sick for weeks and then feel crappy for months. Over the past 4 years, when something bad goes around, I either miss it or get it for a couple days…

          With the Quercetin, and EGCG I am sort of looking forward to the flu season to test out my immunity… Oh, and my Vit D is 62ng/mL with K (I do not supplement K) is off the charts >2,500pg/mL

      • Grumpy
        One of the common arguments for the use of HCQ is to make zinc more readily available to the body. Many people are convinced that using zinc gluconate is effective in aborting viral infections that cause colds. If an ionophore is necessary for the bio-availability of zinc, why isn’t it included in the OTC zinc gluconate? Even allowing for the fact that zinc gluconate might be more effective in conjunction with an ionophore, it appears that sufficient zinc can be acquired to be effective, even in the absence of an ionophore, without becoming toxic. A lot of hand waving to rationalize something that may or may not work for COVID-19. I remain agnostic and await high quality trials.

        • “I remain agnostic and await high quality trials.”

          Meanwhile 4 months have gone by and potentially, 70k fewer deaths at no risk by not waiting. It’s called being pragmatic.

        • Clyde Spencer:
          I am also somewhat agnostic. But, my thinking is that Quercetin is cheap, and the zinc gluconate is free through my health plan, and the combo is doing no harm, so why not take it…

    • Where are you finding a zinc supplement? All the pharmacies and supermarkets around here have been out of stock since February.

      • Been buying my supplements at a local “health food” store. Costco on line or amazon should work also.

      • Online at Walmart and Amazon. Some items ship free by themselves, but most everything does with $25-35 order.

    • Yes, also EGCG, in green tea, so I add green tea extract. I am careful now not to overload on Zn because being in balance is also important. Cu competes with Zn and is also crucial to a well functioning body.

  14. Yes, the article relies on surveys, and some of them go back in time. But the published information is mounting in support of HCQ+. And the efficacy is proving out both pre- and post-exposure. Diagram showing HCQ role in relation to disease stages:
    https://www.palmerfoundation.com.au/wp-content/uploads/2020/06/Covid-stages.jpg

    Previous posts provide examples of HCQ treatment along with other proven medicines (eg. Azithromycin) and supplements (eg. Zinc. vitamins C and D). Summarized in the chart above is the role of HCQ+ according to the progression of the disease Covid19.

    HCQ Prevents Covid19

    The first column on the left is sometimes called PrEP, or pre-exposure to the virus SARS CV2. Now we are getting studies confirming that HCQ plays an important prophylactic role in blocking the virus from taking hold when someone is infected. The Times of India June 19, 2020, article is HCQ beneficial as preventive drug: SMS doctors told ICMR.
    https://timesofindia.indiatimes.com/city/jaipur/hcq-beneficial-as-preventive-drug-sms-docs-told-icmr/articleshow/76453826.cms
    My synopsis: https://rclutz.wordpress.com/2020/07/07/hcq-proven-first-responder-to-sars-cv2/

  15. Conclusion: 11% of American Doctor respondents had severe TDS.

    So, having a personal physician that suffers from TDS should be considered a predisposing condition (a co-morbidity of sorts)…increasing the likelihood of death by Covid-19.

  16. Am I right in thinking that the majority of the anti-hydroxychloroquine propaganda originates in the United States?

      • Please note that the WHO (ChiCom) study was for severely ill WuFlu patients only. Propaganda is always carefully worded. Such leftist/Marxists propaganda is particularly effective on the susceptible like St. Nicholas.

        HCQ+ is recommended for prophylaxis and early symptoms’ treatment only. Once one hits the hospital, outcomes are primarily random and depend on one’s personal characteristics.

        Thank the Donald for getting us out of the WHO. Also, F**k the UN and all its subsidiaries such as the IPCC, UNESCO, etc.

          • Henry, your severe TDS is on display; you failed to reference a follow-on study that debunked your citation. All you had to do in scroll down your article to find the follow-on study. Propaganda is ugly. You are ugly; screw off, twit.

          • Well done. Henry, like the LEFT, will erase history to change outcomes. They seek a predetermined outcome, not truth. So sad.

          • Political ideology is ugly, Mario. The Democrat Left is willing to kill thousands to put a demented old man in as President of the US. At times, I am tempted to believe that the long-term health of America’s democratic free market experiment needs a good dose of short-term Marxism/Socialism government insanity to remind liberals of how we got to be the most successful democracy on the planet. Without a supermajority Senate, they might not do much long-term damage.

          • I hate to admit, I fantasize about that.

            But guess what. Trump is allowing, and I say that thoughtfully, allowing the Democrats to reveal themselves. He could clean up the cities stat. But then the media would pull a Simon or a Henry, and say Trump is a fascist against mostly civil protest. So let them suffer their consequences. You don’t hear anymore calls for Gov Cuomo as president after his (let’s call it neglectful homicide) murdered old people. He initially tried to blame everything on Trump, who over delivered.

            So, Trump is handing over the Marxist to those who vote for it.
            We can see where all the carnage is.

            Trump is so brilliantly owning the libs, that they take the bait.

            America is Watching…

            PS – My full name no spaces, at gmail is my personal email address.

          • Yes sir! Meanwhile Nick the Mck is making up stuff about me, out of whole cloth, which is evidence he has nothing. He’s been exposed…

          • Mr. Fair, the drug does not prevent COVID-19. The drug does not cure COVID-19. There are now well over half a million deaths attributed to the virus. The drug has failed to help anywhere in the world so take your “TDS” and shove it you know where.

          • Henry, since I never said HCQ+ prevents or cures the ChiCom virus nor its resultant WuFlu, I surmise your reading skills are on par with your reasoning skills. Since there are worldwide studies showing the drug combination has helped numerous people possibly avoid an ugly death, you are either ignorant of that fact or a liar.

            Again, since my diagnosis of WuFlu, I have no sense of humor left in dealing with obvious Trolls like you. I will take HCQ+. If you catch the ChiCom virus and develop the WuFlu, get back to us on WUWT if you change your mind about taking HCQ+. Until then, I heartedly suggest you F**k off; you have no idea as to what you are talking about and could mislead the gullible.

          • P.S., Henry: My anger with you and your ilk is showing up in my comments on WUWT. It results in them being thrown in temporary moderation, slowing my responses. Anyway, you are still a twit, no matter the trouble I get into with the Moderators.

          • Mr. Fair, this virus is not political. This virus doesn’t care about socialism nor does it care about capitalism. This virus is a global phenomena. India is the largest manufacturer of HCQ, and it’s case load is growing very fast. There is no “TDS” in India, so tell me, how come the physicians in India haven’t stopped this virus with all the HCQ they make?

          • Henry if you contracted Covid and your doctor prescribed HCQ + zinc would you take it?

            If he/she didn’t prescribe would you take HCQ + zinc ?

            If not what would you do?

          • Mr. David Fair…
            .
            .
            Calling the virus “ChiCom virus” and the resulting affliction “WuFlu” betrays your lack of scientific/medical acumen. The proper name of the pathogen is SARS-CoV-2 and the resulting disease is called COVID-19.
            ..
            When and if you start using the proper scientific and medical nomenclature, we can continue this discussion.

      • WHO Stop investigating HCQ.

        Why does the WHO Stop investigating HCQ? Why is there fake HCQ research? Fake ‘research’ is sciency stuff written and published, to push an agenda.

        Why was there a FAKE Lancet HCQ study that alleged that HCQ caused 25% of the covid patients to die of heart attacks and showed no benefit.

        ‘IT’ is the
        The global phenomena ….. …..to hide the fact that early covid treatment, with low dosage HCQ/AZ plus zinc with reduces the covid death rate by more than a factor of 10 and reduces hospitalization by 84% with zero heart attacks.

        We all know, that everything that the WHO, does is approved by China. No surprise.

        It is a fact that China is the most powerful country (there are no checks and balances in China, people disappear, there is no defence) in the world and you are just a single person, from a small country, and you like the gravy train, what would you do?

        From China’s standpoint, if the US takes years to find out that HCQ/AZ plus zinc reduces the death rate for covid by more than a factor of 10 and reduces hospitalization by 84%, if the treatment is started early,…

        Then China wins and the US loses. All of the US loses. There is no left or right side, to US citizens dying and suffering needlessly.

        • The Lancet, editor Horton, is British. And they want Hong Kong back with Sen. Cruz doing his antifa cameo.
          It takes years for Americans to notice that.

    • Salute!

      Direct hit, COMMIE!
      It appears, without peer-reviewed truth studies, that certain political tribes and many folks down in the swamp fear for their jobs and influence upon society, I opine.
      All must realize that anything that comes outta the mouth or tweet of “orange man bad” must be countered or attacked.

      No mystery why U.S. media and info has little info about other country failures and successes with malaria compounds that might actually help your cells to fight this virus.

      Remember, the “science is settled”, so do not try any home remedies that have not gone thru three years of “clinical” trials.

      Gums sends…

    • Commie B,

      I always enjoy your comments.

      Someone said somewhere on TV that hcl is broadly in use, well understood for treatment of other diseases, low risk, easily available, inexpensive and could work. He followed up with “what do you have to lose?” Simple logic, right?

      That’s when the “new treatment” skidded off into the political ditch. The 97% scientists started blathering uninformed opinions. Governors started outlawing treatments. Federal agencies issued newly discovered warnings. Then it spread to other countries like an out of controlled virus. People started dying from TDS complications. Strange times.

    • Somewhere I heard (so a statistical study is needed) that there has been a slight increase in deaths due to heart attacks because some people are afraid to get medical help when they first feel such symptoms because they have more fear of the corona virus. (Obviously such a fear would have to be inferred or obtained from a person who actually heard it from the now-deceased heart attack victim.)

  17. A curious “paper”. No author stated up front; I presume it is Leo Goldstein. Publication status? Well, there is a note:
    “Except for this paragraph, this paper appears here exactly as it was submitted to medrxiv.org on June 30 (MEDRXIV/2020/143800). It was rejected today, on July 4: “We regret to inform you that your manuscript will not be posted. A small number of papers are deemed during screening to be more appropriate for dissemination after peer review at a journal rather than as preprints.“”

    Medrxiv is an unrefereed preprint server, so it is indeed one of a small number to have been rejected.

    And so who exactly is recommending HCQ? Four surveys are quoted, but only one (Sermo W3, April 15) gives doctors rating its effectiveness. The survey claims 4016 respondents, but, it turns out, only 1337 have treated Covid, and of those only half used HCQ. And many speak well of it. But that is barely enough time for the results to have come in, since the article claims “It became instantly popular among physicians on March 20-21”.

    • https://c19study.com/

      The studies that have negative results have “late stage trial” or some similar phrase. Starting treatment late is known to fail so why are they doing it?

      53 studies (32 peer reviewed).

    • I read this site because I believe climate change is exaggerated. I have no idea how it has become a forum for political discussion regarding the present administration and possibly the next one. Wear a damn mask and stick to the science.

    • 1) HCQ+AZ treatment gives results within a week – and sometimes within a few days.

      2) So, there are 1,337 C19 treaters, selected randomly, more or less. Half of them used HCQ, and majority of them consider it effective, very effective, or extremely effective. And what is on the other side?

      Can you find a single doctor, who used or saw HCQ+AZ used for C19 early without positive effect?

      3) Two studies of Sermo and the JC study asked doctors opinions.

  18. Of course we could all line up to be guinea pigs in the fast tracked Moderna vaccine trial like this unfortunate sot did:

    https://childrenshealthdefense.org/news/modernas-guinea-pig-sickest-in-his-life-after-being-injected-with-experimental-vaccine/

    And why does the person who wants to vaccinate everyone with a vaccine he will make a killing off NOT VACCINATE HIS OWN KIDS?

    https://www.uspoliticsandnews.com/why-didnt-bill-gates-vaccinate-his-own-children/

    My SWAG is that they are fast tracking it and throwing caution to the wind because it will become a solution looking for a problem shortly.

  19. The opinions of doctors regarding what treatment works is largely controlled by confirmation bias. The DES (diethylstilbestrol) story tells it all. DES is a synthetic progestin with prominent androgenic effects given to women who threatened to abort. Doctors swore by it for 17 years after it was proven in double blind trials to be ineffective. Then a cluster of rare nasty vaginal/cervical cancers started showing up in young women. Turned out to be due to in utero exposure to DES. Further investigation found that the women had histories of male level of activity in childhood and there was a large increase in the frequency of homosexuality. It is one of the classic pieces of evidence that hormones during early development alter brain development.

    The point here is that a physician who has done something and sees a positive result attributes the result to his/her action. When the result is negative, it is attributed to the treatment being too late or the pathology to great. In the case of the WuFlu, it is apparent that virtually all people without gross comorbidities will recover. Thus most doctor’s experience is with survival. Therefore, whatever they did was effective against something the media kept saying was terribly lethal.

    Doctor’s opinions are NOT evidence for much of anything. My big bitch is the quacks (consultants) who want to put my husband on drugs that reduce ‘cardiovascular events’ but do not decrease all cause mortality. All without considering what effects side effects have on quality of life. As with COVID 19, this is done by trying to scare the patient into submission.

  20. The Swamp is fighting as hard as possible to hide this super good HCQ/AZ plus zinc early treatment data.

    Why the heck is it taking the USA so long to start using HCQ/AZ plus zinc as the standard early treatment for Covid? Evidence based, scientifically sound decisions.

    How many people have to die, of Covid, for Politics? Is there anyone on the Left that has the courage to speak for the people, rather than the PARTY?

    When is the fake news and PBS going to report this astonishing paradigm changing data HCQ/AZ earlier covid treatment outcome?

    HCQ/AZ plus, Zinc early treatment resulted in a 84% reduction in hospitalization as compared to the current standard covid treatment….

    …. And a reduction in covid deaths, of more than a factor of 10, as compared to the standard treatment. MORE THAN A FACTOR OF TEN.

    The earlier, treatment is started, the better.

    This study and others shows, HCQ/AZ plus zinc drastically reduce viruses count.

    If the virus does not replicate it cannot do damage. Giving HCQ/AZ plus zinc, to people after the virus has replicated does not help.

    https://www.preprints.org/manuscript/202007.0025/v1

    COVID-19 Outpatients – Early Risk-Stratified Treatment with Zinc Plus Low Dose Hydroxychloroquine and Azithromycin: A Retrospective Case Series Study

    Therefore, the odds of hospitalization of treated patients were 84% less than in the untreated group.

    One patient (0.7%) died in the treatment group versus 13 patients (3.5%) in the untreated group (odds ratio 0.2, 95% CI 0.03-1.5; p=0.16).

    There were no cardiac side effects.

    • Some of them still have not accepted that Trump won.

      Some would watch their grandmother die rather than concede that Trump is right.

      • Nah, Leftist will make sure that only OTHER people’s grandma would die. Take that to the bank… sarc/…

        If in 2019, someone said, and I am winging it here:

        “THE USA would lock down the country, prevent businesses from opening, arrest people who go out in the sunshine at parks or who go to church –while forcing infected people to go to be confined within most at risk populations against there will, all while instigating and endorsing riots and mass destruction, removing historic statues, painting Marxists slogans in front of City Hall, Trying to pass mail-in-only voting, while at the same time devising fake medical studies to scare people away from treatments of a disease”

        One would be right to respond: “Tinfoil Hat Conspiracy Theory”

        Yet, here we are.

    • +42^42, Bluecat, regarding any topic. One finds nonsense on WUWT, like anyplace else.

      • Brilliant. The man who think we can inject disinfectant knows best. During a pandemic he fires the group who are working to overcome this problem. I wonder why? Maybe he wants to distract from his olympic level poor decisions. And I see Trumps “best fwend” Jair Bolsonaro has tested positive for the coronavirus. What an irony that the man who called it a hoax now has it. He will be fine though he has taken Dr Trumps advice and started on hydroxychloroquine.

        • So, you support the following:

          * WHO lied about where it found out about coronavirus

          * The health organization took China’s word for it that the virus appeared in late December, when it started earlier.

          * The health organization chastised Trump for instituting a travel embargo on China early in the pandemic

          * WHO took China’s word for it when it claimed that the virus did not travel from person to person

          * The health organization lavished praise on China for reacting quickly to the virus when it had not

          * WHO praised China for releasing the genome sequence for the virus, though it took a crucial 17 days to do so and under much pressure

          * WHO is so cozy with China that it removed Taiwan from a map and included it as part of China

          Good news as that your ilk are being exposed and erased, largely through the efforts and leadership of one strong man with the help of a wonderful team of patriots. America is watching, and your team is being exposed. You are a stain. I know, I could not resist the ad hominem metaphor…

          • “Good news as that your ilk are being exposed and erased, largely through the efforts and leadership of one strong man”
            Yes well that “strong” man has to lift his popularity somewhat (https://projects.fivethirtyeight.com/trump-approval-ratings(https://projects.fivethirtyeight.com/trump-approval-ratings/) before he can erase me.
            And by the way the WHO were not the only ones praising China. I seem to recall Twumpy saying how great they were at the start of the pandemic.

          • Simon, you are the perfect self eraser. You’re in a class by yourself… a perfect barometer. If you occasionally said something reasonable, you’d be less reliable a measuring device.

          • Only until President Trump learned the facts about ChiCom and WHO duplicity, Simon. Your TDS is tedious.

          • “Only until President Trump learned the facts about ChiCom and WHO duplicity…”
            It’s true he did change his tune on China, but that was because he made maybe the single most damaging call in US history…. to minimise the threat of the pandemic. Now we are at 133,000 deaths (and counting). So Trump is doing what Trump does… blaming someone else. His behaviour now is so predictable, you don’t have to be Einstein to see this coming.
            First rule of the Trump playbook. When things are going well, it is all his doing. When things go wrong… it is someone else’s fault.

          • Simon, as I have proven before, is an inverse barometer for truth. So he is batting 1000.

            Translation from Simon: “I know you are but what am I?” I was guilty of similar behavior at 6 years old, until I learned more words for which to argue my side of the story.

        • Yes he should fire Fauci, but it’s a chess game. Trump’s using his power effectively… and balancing where he gets the attacks to come from. First show Trump Right Fauci Wrong…

        • “Trump’s next move needs to be to fire Fauci. That guy is diametrically opposed to the well-being of America.”
          Let me change that for you ….Trump’s next move needs to be to fire Fauci. That guy is diametrically opposed to Trump. He tells the truth.
          I mean he did say don’t open too early. Florida and Texas wouldn’t listen. Now look what has happened. But Trump will fire him, because that’s what Trump does when someone is being too honest. Although having said that, that is not always true. Didn’t he fire Flynn?

          • What’s happening in FL and TX is that deaths are plummeting and “cases” are increasing. I put cases in quotes because it’s a meaningless number when positive antibody tests and prospective covid cases (no PCR) are included in the case count. Plus testing has ramped up exponentially, so of course positive test results are increasing, but that’s entirely meaningless because those people are not progressing to serious illness. That’s why Fauci needs to be fired – he’s trying to equate positive test results, and other meaningless data, with illness.

  21. There’s a reason there’s a lack of quality randomised controlled trials in this area.

    HCQ works in early treatment. In London where I practice, the epidemic raged during March and early April and tailed off thereafter. The peak of transmission was week 3 in March. The PRINCIPLE trial is the only one in the UK looking at early treatment with HCQ. My GP Surgery is enrolled in this trial, but it did not start recruiting GPs let alone patients until the first week of April. By the time they were ready to recruit patients (close to the end of April), we weren’t seeing any patients in general practice with new Covid-19 illness. We have had zero recruits to date from our patient population.

    The care pathway for the UK NHS was essentially:

    i) stay at home if you’re sick
    ii) if you have to call someone, call 111
    iii) 111 says stay at home unless you’re acutely breathless or chest pain in which case we’ll arrange a 999 ambulance to take you to A&E
    iv) A&E admits you if O2 <92%. Otherwise they send you home without testing

    So one of the reasons the UK was abysmal and a dead loss for research into early-stage treatment for Covid-19 was that the NHS care pathway prevented Covid-19 patients from seeking medical advice during the early stage of illness. This is the main reason why my GP Surgery saw so few patients in March. It was only once they'd developed ARDS and later stage viral pneumonia that they were deemed 'worthy' of hospital admission. Clap that, NHS!!

    The Principle Trial is well designed but got going too late. No country has yet managed to complete such a trial in sufficient numbers. This is partly due to local factors (like the UK's godawful NHS) but also because the epidemic moved through populations so rapidly.

    So faced with a fat-tailed event with high risk of harm, high uncertainty on efficacy of treatments and no RCTs, what should one use. Nassim Taleb 'analysed' the Raoult series back in mid-March and compared it to neighbouring Marseilles hospitals under the following assumptions:

    – the hospitals are under identical conditions
    – the non-Raoult hospitals are the representative benchmark

    https://i.imgur.com/L7UilVV.jpg

    Using a probabilistic approach that is completely alien to innumerate medics, his Monte Carlo and binomial distribution approaches determined that Raoult's results were significantly different from the rest of Marseilles. That approach operating under that uncertainty has now been vindicated by:

    – Raoult's ever-growing series, including outcomes when adjusted for age and other risk factors. compared to the rest of France
    – countries using HCQ early (much lower death rates, much fewer cases)
    – countries/ states that switched to HCQ after poorer outcomes prior (e.g. Turkey)

    There's no uncertainty now that HCQ works during the early stages of the illness.

    On a personal note, I prescribed it off label for a few patients back in March including two who had had previous respiratory ITU admissions. Their SaO2 and general condition improved within 16 hours. It was a more dramatic turnaround then I've seen with antibiotic treatment in general practice.

    • I’m curious… before covid, what would have been your diagnosis in those few patients with low SaO2? Or is this the first time you have ever seen that?

    • Thank you for that MDMan. Finally some sense from a UK medic.

      How can the UK justify ‘protecting the NHS’, when noone is protecting the patients.

      The UK approach to just leave the disease alone until you need hospital is quite simply staggering.

      Yes, it ‘protects’ the NHS from 80-90% of people who dont need anything, but it is a virtual death sentence for the people who effectively end up going to hospital far too late.

      So, hypothetially, if i had symptoms this afternoon, my approach would be to ring my GP and demand HCG plus antibiotics.

      What do you think would happen? Lets hope i dont find out ever.

      • One way or another herd immunity always eventually develops. The percent of the public that need to be immune for herd immunity to exist depends on the population density and the extent of precautions taken. If precautions slacken, cases will increase according to the R value (number of persons an infected person infects) with the slackened precautions. Case rate will increase until R again becomes less than 1.

        Unfortunately, the science is being fogged by the profoundly biased msm and extant TDS.

  22. Want to take out the TDS element out of this thread and inject a bit of real new science.

    I noted in a guest post some months ago on Wuhan virus that U Mn and McGill were starting a well designed classic rdb clinical trial of HQC as prophylaxis post severe known exposure. Those results were just published in NEJM. All here can read the the trial design and results as a pdf at NEJMao2016638. Clear Answer: HQC did NOT work. Explains why all the symptomatic HQC stuff —except the newish Michigan Ford hospital system retrospective—did not work either.

    Now the potential flaw is that zinc was not part of the protocol, same flaw as the many other HQC alone doesn’t work reports. So we still dunno about HQC or other ionophores (like the flavenoid quercetin) plus zinc as prophylactic and/or therapy.

    As for these opinion surveys. Largely worthless. Here is why. We know most recover by themselves with or without HQC. Per CDC, US CFR is 0.4% ofsymptomatics, and 0.26% after adding estimated asymptomatics. About twice a normal flu and a bit worse than a typical severe flu season with mismatched vaccine. Those that do not recover (fatalities) are overwhelmingly over 65 and/or with comorbidities: obesity, diabetes, hypertension. Unless the opinion surveys also controlled for these factors —and this guest post proves they did not—they provide no meaningful information and are therefore essentially worthless.

    • Rud: Did you mean to write this? [I refer to the brackets in your quote below]

      “I noted in a guest post some months ago on Wuhan virus that U Mn and McGill were starting a well designed classic rdb clinical trial of HQC as prophylaxis [post severe known exposure]”

      My response would be, what do you mean by post severe exposure? How long after? And does that mean after the patient was severely ill, and how long after that?

      • Mario, its in the referenced paper. Criterion was >10 minutes to a (later) confirmed symptomatic case with no PPE. Enrolled within 1 day of exposure. Primarily immediate family or care providers. Presumably all indoors. N>800.

    • Rud
      Hopefully, you have enough credibility here that you won’t be attacked as ruthlessly as McGinley.

      • Thanks for the thought. I care only about truth, so do not care about WUWT popularity. Doubt CtM would ban me for posting a new peer reviewed paper saying Leo is probably just wrong—no different than his last HQC post. See my comment to it there.

      • At this point Mario is trying to dox me, asking around for personal info about where I live and work.
        I am reviewing the law now.
        He seems to have cross the line.

        • McGinley: You wrote: “At this point Mario is trying to dox me, asking around for personal info about where I live and work.”

          That’s another bald faced lie! It’s now about the 10th time you claimed I wrote something that is 100% a lie.

          You’re the one that brought up doxxing, and I referenced you saying that just like I am responding now.

          Everyone here knows you have made up fake names and I had asked about what you do, because you seemed to act like a doctor. I got the answer, you are a teacher… of what I don’t know.

          Your dishonest blasphemy should get you put into a corner somewhere for a time out.

    • HCQ+AZ have antiviral effect against Wuhan coronavirus. Given early (in the viral stage of the disease) they prevent coronavirus’ replication.

  23. I have an auto immune disorder, related to ankylosing spondylitis and lupus and have been taking all sorts of meds for 26 years, including a moderate dose of steroids daily that entire time.
    It was interesting to find out in June that patients receiving steroids fared much better than those who did not receive steroids.

    This is thought to be from the reduction in inflammation(in the lungs) and also the suppressing/modulating of the immune system which steroids cause. In COVID patients the immune system can go berserk, setting off a cytokine storm.

    https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2767939

    There are several things that we know about HCQ with certainty. One of them is that its been given to hundreds of millions of people world wide, mostly for malaria with very few side effects. So it’s proven to be safe if used properly.

    Another thing is that it reduces inflammation. This is why its also given to patients with lupus and other forms of arthritis, with significant benefits and improvements in health/inflammation.
    https://arthritis-research.biomedcentral.com/articles/10.1186/s13075-019-2040-6

    So in using it with COVID patients, we already know that its safe and that it WILL reduce inflammation in at least some patients……….that’s what the drug does.
    With that being the case, one assumes that if inflammation in the lungs from COVID is adversely affecting patients and outcomes, then HCQ, with its anti inflammatory PROVEN benefits should help at least some patients by reducing inflammation.

    You can find results in recent studies that are all over the place about this drug. Which ones to believe and which ones not to believe? Some completely contradict each other.

    However, medical doctors should/do understand how HCQ works and the clear anti inflammatory properties and the long proven safety. This is why they are prescribing it to so many patients.
    Their patients would/will be dead or recovered if they wait around for the wishy washy, incompetent, corrupt and political FDA to decide on a final position with regards to HCQ.

    • Yeah, HCQ has anti-inflammatory properties.

      So how should it help patients with that in the early phase of a viral infection exactly? Wouldn’t it be a bad idea to give it too early then cause it would suppress the immune response upon infection making things worse? Wouldn’t same apply to a prophylactic use? Making people more vulnerable? Aren’t people with lupus not more prone to get infections cause the drugs are suppressing the immune system?

      Like steroids do and are therefore contraindicated in the early phase of infection, doctors have been hesitant to use them in the early pandemic because of that and they seem to have no benefit in people with mild symptoms. As one would expect with their mode of action.

      • Ron I explained this mechanism of action in an earlier quest post months ago.
        HQC itself in RA/lupus acts by raising cytosol Ph. This causes lysosomes to ‘leak’ their enzymes. Those enzymes in turn reduce the cellular signals beaconing autoimmune response proven in vivo.

        In Wuhan, this same Ph lysosome leakage changes the shape of the cell wall ACE2 receptor the virus uses to lock on. Change the lock, the viral key works less well. Unfortunately, not Less well’ enough to matter for prophylaxis.

        The second mechanism is quite different. HQC is a zinc ionophore. Helps zinc enter the cell, where it is well established zinc will then inhibit viral replication. (Not the only zinc ionophore—quercetin flavenoid is perhaps better ignoring bioavailability issues solved by formulation or dosing). So HQC plus Supplemental zinc is a potential double whammy. Unfortunately NOT properly tested to my knowledge.

        • This part has me more excited.
          The second mechanism is quite different. HQC is a zinc ionophore. Helps zinc enter the cell, where it is well established zinc will then inhibit viral replication. (Not the only zinc ionophore—quercetin flavenoid is perhaps better ignoring bioavailability issues solved by formulation or dosing). So HQC plus Supplemental zinc is a potential double whammy. Unfortunately NOT properly tested to my knowledge.

          Nothing I disagree with here either. It should be more tested, but in the meanwhile, there are loads of benefits with quercetin that I have experienced in general since taking it now for 3 months. Never in my life have my sinuses been open without need for 12-hr nasal spray 4 times times per day…

          • It might be the NAC doing that. I take it almost every day and my lungs and sinuses feel so much less clogged. Less boogers too. NAC does thin out mucus.

          • Thank you! I did a non scientific thing and took a combo supplement with Stinging Nettles, NAC and quercetin. Not a lot of quercetin in that so I take two 500mg doses of quercetin single sup’ on top of that. what’s a little money when I have my large nose clear and lungs clear.?.?

        • Rud,

          The second mechanism is quite different. HQC is a zinc ionophore. Helps zinc enter the cell, where it is well established zinc will then inhibit viral replication.

          I have repeatedly explained why those two statements are false:

          HCQ is not a Zn ionophore. It simply cannot be a Zn ionophore cause it lacks the chemical properties to be one in the first place. The one and only PLOS One study about that does a misinterpretation of their results. HCQ traps Zn in lysosomes which was taken up via endocytosis. Bafilomycin A and knockdown of ZnT2 and ZnT4 show the same trapping effect in another study but the authors are smarter and are not claiming bafilomycin A would be a Zn ionophore.

          The inhibitory effect of Zn on viral RDRP was only shown with unphysiological concentrations on purified protein in a test tube. There is no direct evidence of intracellular elevated Zn concentrations having an effect on SARS-CoV RDRP and viral replication in cells.

          In Wuhan, this same Ph lysosome leakage changes the shape of the cell wall ACE2 receptor the virus uses to lock on.

          This is pure speculation on your part, I guess? Haven’t seen any study proving that.

          What most people don’t know: the applied concentrations of HCQ in viral in vitro studies are 1) very toxic to non-transformed primary cells and 2) pharmacological not possible to achieve in blood plasma at all by at least the factor 50.

          • Well, then you have apparently not researched the Medical literature as I did before my first of several guest posts on this topic.
            You want to disagree with me, then counter with betters the references I previously provided.

          • Ron, Rud,
            I am agnostic about the lysosome/pH issue.

            But I have to say, just to be clear…I have looked very carefully for the source of the assertion that HCQ is a ZI.
            I started off, three months ago, asking questions about the evidence that taking zinc and an ionophore was a antiviral.
            I found many references to “HCQ” is a zinc ionophore (ZI) assertion.
            It was only when I traced the references for that assertion back to the source material, that I saw something very peculiar.
            One person after another had given a reference to chloroquine(CQ) research which appeared to demonstrate that CQ is a ZI, as a source for the assertion that HCQ is a ZI.
            And this was from some seemingly authoritative people.
            No one wants to look at it carefully, though.
            I am glad Ron has, because this is important.
            I am not getting very close to sure no one has any evidence that HCQ is a ZI.
            I have looked at lists of all known ZIs, and even all ionophores.
            I have read the chemistry of what makes a molecule a ZI, or a ionophore in general.
            Wikipedia has an article on them.
            A search engine query gives plenty of material to read, and many examples of ionophores and which cations that they can transport.
            They are important molecules so a lot of very careful and obviously costly research has gone into the subject.
            Many new antibiotics have been found by first screening large numbers of known molecules for ionophoric activity.
            The other day I read carefully the newish paper by Zelenko, et al.
            I am not in the habit of opening and looking at every reference and footnote.
            It is the only way to catch it when someone is making unsupported references and then having them published.
            And it is getting through a lot.
            Anyhow, in Zelenko’s report, it is acknowledged that HCQ being a ZI is only a supposition. No basis for believing it is likely to be a valid supposition is given.

            Many people are basing a lot of what they believe on the proposition that HCQ is a zinc ionophore.

            Can be and Ron be the only two people who think this is important, given that it seems to be a substantial portion of the rationale being offered for a whole lot of research and a whole lot of oftentimes people getting a certain medical treatment rather than another.

            I want nothing more than the people here and elsewhere who are serious scientists to make sure they are not basing a whole structure on a bad foundation.

            And I think all serious scientists want that as well.

            The question of zinc ionophores being a proven mode of action for an effective antiviral therapy is an important one.

            Just imagine what it means if this has gone on for this long and with this many people around the world doing all this work, with all those lives in the balance, and the underlying basic premise is a false inference based on pretty much nothing?

          • Typo in this sentence:
            “I am not getting very close to sure no one has any evidence that HCQ is a ZI.”

            Should be:
            “I am now getting very close to sure no one has any evidence that HCQ is a ZI.”

          • Several in-vitro studies have explored the antiviral effects of chloroquine and hydroxychloroquine with respect to SARS-family coronaviruses. Spurred by the SARS-coronavirus-19 (SARS-CoV-1) outbreak in 2002-2003, researchers demonstrated that, when exposed to increasing concentrations of chloroquine, SARS-CoV-1 replication in infected Vero cells was inhibited. Similar studies were performed in early 2020 using SARS-coronavirus-2 (SARS-CoV-2), demonstrating a similar inhibitory effect on viral replication by both chloroquine and hydroxychloroquine, suggesting these two agents may be useful for this novel coronavirus.

            Hydroxychloroquine has several proposed mechanisms of action with regard to SARS-CoV-2 inhibition. In vitro studies have demonstrated this medication’s ability to raise the endosomal pH, disrupting a key step in viral replication. This pH change also interferes with the formation of the surface receptor that SARS-Cov-2 binds to when infecting human cells. Additionally, chloroquine (and by extension, hydroxychloroquine) has been shown to increase cellular intake of zinc, suggesting a potential role as in inhibition of viral reverse transcriptase, though the exact role of zinc in human SARS-CoV-2 infection remains unclear. Given these various pathways through which hydroxychloroquine may inhibit SARS-CoV-2 infection and spread, this medication has been explored as a potential agent for treatment, as well as for pre- and post-exposure prophylaxis.

            Source

            Also a worth reading

          • Rud,

            please be so kind and show me another study than this one from Xue at al. showing that HCQ is a zinc ionophore:

            https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0109180

            Is there anywhere another? This is exactly the one I criticized above.

            Are there more than those three in vitro studies from China, two from the same group from Wuhan, that describe an effect on viral replication in Vero6 cells?

            https://academic.oup.com/cid/article/doi/10.1093/cid/ciaa237/5801998

            https://www.nature.com/articles/s41421-020-0156-0

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

            Is there any paper that shows efficacy of HCQ in other cell types?

            I would also very much appreciate if you could name a real data study about ACE2 and hydroxychloroquine. I know there is this study:

            https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7128678/

            but that is only in silico modelling.

            And btw, does anybody else see the irony that data from China, Wuhan, is basically the foundation of the HCQ hype?

          • In epidemiology there are two similar yet argot. Efficacy. Effectiveness.
            Effectiveness: It appears to work in a clinical setting.
            Efficacy: We know why and how this compound is effective.

            Perhaps it is acting as a ZI, maybe not.

            However, it shows high effectiveness *even though we don’t know why.* So we have no proof of efficacy.

            Effectiveness: Doctors report dose, side effects and results.
            Efficacy: The chemistry is known and proven with clinical trials.

            When a drug appears to work ethical physicians do not do trials. Withholding a medication which can lead to death is not wise. Even when its efficacy is unproven.

          • “Additionally, chloroquine (and by extension, hydroxychloroquine) has been shown to increase cellular intake of zinc, …”

            And that is all there is.
            Chloroquine has been shown to.
            HCQ is “by extension” assumed to be so.
            By people who have offered no rationale or chemistry based reason for that assumption.
            HCQ is in all probability not a zinc ionophore.
            There is no valid reason to think it is.

            No one who has said it is, has posted any evidence to back up what is a empty assertion.

        • Rud, thank you for all of the fine work you have provided WUWT over time, as well as this latest work on the ChiCom virus and its resultant WuFlu.

          Given your information on the studies and your clarifications, I am not dissuaded from taking HCQ+ given my recent diagnosis of WuFlu. The addition of Zinc to the mix seems to be the wild card in the studies. Also, with Mario’s and your additional information, I will be investigating the addition of Quercetin to my regimine.

          Thanks to all of you who have provided useful information here on WUWT. Given all that, I am no longer going to argue about my taking HCQ+ on this Thread. And all you TDS Trolls can screw off.

          Finally, does anyone have additional information about the possible benefits of EGCG?

          • EGCG has been said to be a stronger Zn ionophore than quercetin. I have been taking it for the general benefits of it. But after I started taking quercetin with NAC, my sinuses have cleared for the first time in my memory… and my bronchitis seems to have vanished. Quercetin is great for inflammation. This post by Medcram shows quercetin. The video gets going at 1:30 into it. It’s short.

          • I should add that at: 7:50 in the video, you see a chart showing EGCG but I do not know why he did not mention it’s use. And I correct it’s underneath Quercetin in the graph. Maybe it has fewer studies… also, it appears that CoQ10 is also on that graph, which I take too but just for it’s wide antioxidant properties and claims it helps with enabling the heart to better use energy from glucose.

            My hope is that when I am your age, I function well enough to tag a dog back… 🙂

          • Thanks again, Mario. I’ll be in touch by email pretty soon. I’m done with this WUWT Thread.

        • I have been combing through info about known ionophores, and what structural properties make a molecule able to shuttle metal ions through a cell wall.
          They are related to chelating agents, and there are a few types.
          Many antibiotics are ionophores…they open up pores in the membrane of bacteria as a mechanism of action.
          I have found exactly two quinolones that are ionophores.
          The subject is research extensively.
          The research that showed CQ is one was rather recent, around 2009-2009.
          I have found exactly zero references to HCQ as an ionophore.
          I do not think any such finding exists.
          And since it is a far safer and more commonly available alternative to CQ, I am sure it has been screened for activity as an ionophore.
          Ions can only be shuttled by an ionophore that has a very specific set of properties, and most of the ionophores are very specific to one or a few cations of a certain size.
          It does not follow from any principle of chemistry that similar molecules will have the same properties in the world of biochemistry.
          The opposite is true.
          Tiny changes have huge effects on the shape and stereoisomeric shape of a molecule.
          Adding the OH group to chloroquine alters it’s shape and properties dramatically.
          Look at the safety profile, elimination half life, and melting point differences for the two.
          They are starkly different.

          I am not ready to say HCQ is categorically not a ZI, but every reference to that being the case is recent, and makes references that trace back to research on a different molecule…CQ, not HCQ.
          I have been going over the history and especially the recent evolution of this set of what can only be called “beliefs”.
          And the more I look, the more I see conflation of disparate bits of information, shifting goalposts and storylines, a hodge-podge of reasons for justifying one poorly outlined hypothesis, and what looks more and more like an idea springing fully formed out of nowhere but whisper down the lane internet confabulation.
          Over 30 years I watched warmistas behave badly, like bad people, act in bad faith, exaggerate, etc, and all the while they constantly had to change the logic, change the justification, change the underpinnings, come up with new explanations, use every disingenuous way they could think of to avoid any actual look at the complete set of relevant facts…
          Everything changed, constantly, and seamlessly, except for the conclusion.
          The conclusion had to stay the same, because that was the only thing being defended.
          I see a fast motion microcosm of the same sort of thing here.

          First it was chloroquine, because it had antiviral properties, had to do with lysosomes, cell wall config, ACE2 receptors, intracellular pH, etc.
          A lot of mechanisms, each with a faction.
          For quite a while no one had mentioned HCQ.
          But anyone questioning whether CQ was the cure was attacked viciously.
          I was just looking at a thread from March…dozens of people were saying it was over, done deal, the cure, government has to buy chloroquine for everyone in the country, pronto.

          But then the story began to morph. Zinc ionophore, have to add Zpak…no, it could be any antibiotic…no, only zpak…then people started to conflate any quinine derivative, they were all the same metabolically after all (eye roller), then HCQ popped up, and CQ was okay too.
          They are the same was how it was explained.
          Or close enough.
          The some big name advocates got a lot of press and attention with big hand wavy pronouncements. That Rigano guy…the doctor from Sanford. Oh, wait, he is a lawyer who peddles bit coin, Sanford disavows him and his supposed research. Now we know he was a total fraud. Didier Raoult went from ridiculing concern about the virus to having the cure and hard data to prove it, in a matter of day! Wow!
          Good thing, cause that Rigano thing was about to get the big spotlight.
          Raoult had The Cure…we swear, and everyone needs to jump on board.
          But the paper he put out in record time was a fraud…he had one patient die and three go to ICU, and he wrote them out of his study, never mentioned them, and said in plain language he had 100% success.
          Around when his fraud came to light, and was hand waved away but not very convincingly, here comes Zelenko!
          Same story…was ridiculing concern on early March, had invented the cure by mid March, and had treated, personally, 669 people by himself and cured them all in the space of ten days.
          Trust him, would he lie? He no need no stinking documentation.
          Good thing, because he had none, and has produced none.
          Around the time he was being investigated by the Justice department and on the way to being disowned by his close knit community, the panic was in full bloom, and the whole shebang had taken on a life of it’s own.
          No more talk about CQ, or ACE2, or pH … Now it was HCQ (oh, okay, maybe a little CQ maybe, meh!). Now it was HCQ, it was Zn++, it was ionophore, zinc kills virus, malaria drugs are antivirals (huh?), and so is Zpak! huh?
          Then why does doxycycline work better in the previous 15 years of clinical trials? Okay, works better is a little strong. Failed to work, but less dangerously.
          15 plus years? Wait, what?
          Yes, there are 15 years of clinical trials using CQ and/or Zpak against everything one can think of. Cancer. Lot’s of separate viruses. At least one trial compared CQ and Zpak to CQ and doxycycline.
          It never had any success against anything. But it was not for lack of trying.
          Why?
          I did not hear one single reason for why those drugs work against COVID that did not imply that they would work against viruses in general.

          By now, we have people all over the map, but as long as they agree HCQ is the cure, none of the advocates seems concerned that the various regimens, and why this trial and then that trial got the results they did, had the same people arguing, depending on which “fact” they were defending, that you needed to have the zinc. Trial failed because no zinc.
          You needed to have all three…trial failed because all three.
          You need to treat early, trial failed because they were already sick.
          It is an antiviral.
          No, it cures cytokine storm.
          No, antiviral…that is why it will not work late and you need the zinc.
          If it was cytokine storm and anti-inflammatory that did the track, you do not need zinc.
          Bacterial secondary infection comes late in disease progression, weeks after the person has mild symptoms in most cases…but it cured people by giving 5 days of antibiotics, either before or just after any serious symptoms developed.
          A 100% novel theory of how an antibiotic can “cure” viral pneumonia…give it before it happens, and only for 5 days! No one bats an eyelash or misses a beat.

          From the beginning, the people and the specific protocol and even the exact drug used have been sequentially discredited and then replaced with another rationale or another advocate.

          Raoult flat out lied, committed research fraud, or at the very least he was shockingly disingenuous to claim what he claimed.
          Zelenko turns out to have worked at his computer, and did telehealth…he had cancer and a lung removed recently, and is high risk, and could not see anyone…but he said he SAW 669 people in ten days.
          The drug was almost impossible to get, and some states had banned prescriptions outside of a hospital or for people who had been getting it. But Zelenko says he treated 669 people by himself, and they were all cured. What that could mean after first five days and then 10 days was not anything his fawning faithful cared about.
          He has never given any further info on those 669, or produced documentation, or explained how he could have known the subsequent history of 669 people after they logged off his computer screen?
          He was investigated and kicked out of his community.
          Chloroquine was shown to be too toxic and not effective at the highest level that could be induced in a persons bloodstream. The in vitro result was from a amount that would be toxic in a person.
          HCQ is called an ionophore. Maybe it is, but if so, where is a shred of evidence?
          Where is the research on antiviral effect of ionophores?
          That ionophore research was regarding chloroquine and zinc for inducing apoptosis to treat cancer!
          There was other research that showed chloroquine could kill SARS1 in vitro, but that drug failed in vivo in animal models.
          But there was never any research that combined these two research dead ends (dead ends because no one has treated a single cancer patient successfully with CQ or HCQ, or showed zinc and either one of them killed virus in vivo.
          100% unjustified conflation of two disparate lines of inquiry.

          Now this retrospective from Henry Ford health in Michigan.
          It is a dead cat bounce, or at least I hope so.
          Dozens of hospitals, the CDC, the NIH, WHO, France, Sweden, the USA, hundreds of separate doctors, the VA, the US Army…all have announced bans, said they have given up after trying and trying to have success with them.
          Even Henry Ford Health put out a study last month showing the opposite of the one from this past week.
          Those same hospitals used remdesivir, plasma, and also IL-6 blocker, and steroids, to treat patients and had a drastic improvement between the March 10-20th group, and the March 21-29th group.
          This latest study never mentioned those hospitals had used plasma or remdesivir during that interval. But they said the patients were a sequential cohort of everyone admitted between March 10 and May 2!

          The ER doctors in Wuhan were interviewed as soon as that city opened back up, and asked about their treatments. They said very emphatically they had abandoned the malaria drugs because they did not help and were dangerous for some people.
          As of May 2, the US standard of care for COVID-19 is remdesivir.
          A large randomized and blinded clinical trial showed a 33% reduction in fatalities in patients getting steroid drugs.
          Large studies and a long list of patients and doctors have reported the IL-6 blocker to be the superior was to treat cytokine storm.
          Large reductions in mortality have attended usage of ECMO machines, being less quick to use mechanical ventilation and the required induced coma.
          Death rates are down every where we look, concurrent with discontinuation of HCQ and CQ.

          As surely as large increases in deaths were precisely concurrent with widespread adoption of malaria drugs in Belgium, France, Germany, Switzerland, the USA, Sweden, and many more places.

          The early rationales evaporated.
          The early advocates discredited.
          The best studies have showed a contrary result.

          And yet the advocates are now frothing at the mouth with rage at any suggestion that they were ever wrong.
          They do not acknowledge any result or fact point that casts a dim light on the malaria drugs, and act like there have not been several large trials that used the gold standard and showed no benefit.
          Now they see themselves fighting evil.
          Conservative stalwarts are called left wing murdering trolls for disagreeing with a hypothesis that has failed to be validated.
          And meanwhile, these same people have nothing to say for the obvious successes.
          Are they talking about ECMO?
          Are they acknowledging the great results seen from IL-6 blockers, or steroids, or the more modest but clearly positive news about remdesivir?

          Oh, hell no!

          And that is where we are.

          There is a mountain of data in the pipeline, and more new possible drugs and vaccines being trialed every day.
          Successful antiviral therapies in the past have started with one drug that had some effect, usually modest. The finding another drug with another mode of action and testing them in combination.

          • In reply to:
            Nicholas McGinley’s comment:

            “Now this retrospective from Henry Ford health in Michigan. It is a dead cat bounce, or at least I hope so.

            Dozens of hospitals, the CDC, the NIH, WHO, France, Sweden, the USA, hundreds of separate doctors, the VA, the US Army…all have announced bans, said they have given up after trying and trying to have success with them.”

            ‘Nicholas’,

            Six different Michigan hospitals treated 2541 patients and their evidence based results are….

            Early treatment of Covid patients (the earlier the better) with Hydroxychloroquine and Azithromycin plus zinc reduced the covid death rate as compared to untreated patients by 71%.

            I do not understand why this great, good news, Covid treatment breakthrough is a ‘dead cat’ bounce.

            Why has the Lancet study that ‘alleged’ negative Covid results, withdrawn and the data from that fake study has disappeared and the ‘company’ that provided the fake data is not returning phone calls?

            Science cannot work if people lie and have an agendas.

            https://www.ijidonline.com/article/S1201-9712(20)30534-8/fulltext

            Treatment with Hydroxychloroquine, Azithromycin, and Combination in Patients Hospitalized with COVID-19

            Results
            Of 2,541 patients, with a median total hospitalization time of 6 days (IQR: 4-10 days), median age was 64 years (IQR:53-76 years), 51% male, 56% African American, with median time to follow-up of 28.5 days (IQR:3-53)

            Science Research: On People’s Side
            HCQ with azithromycin reduced deaths by 71% compared to no treatment. 2500 patients, no heart attacks. 6 Michigan hospitals.

            Fake Research: Fake Research should result in criminal charges.
            Lancet HCQ ‘study’ had 25% heart attacks and worse outcomes. Logical Reason: Lancet patients were near dead when they were given HCQ to start the study. HCQ treatment cannot reverse damage.

            Second possible explanation, Key Lancet negative Covid study database has disappeared and Lancet has removed the study and apologized. ‘Company’ that had database not responding to calls.

            The great HCQ/AZ plus Zinc results makes sense as HCQ is a zinc ionophore and zinc stops the virus from replicating.

            Our body’s have a natural means to get the zinc into our cells to stop the class of viruses that must connect to the ACE-2 connector to replicate.

            Vitamin D deficient people have a 19 times greater chance of dying from covid than Vitamin D normal people, regardless of sex or age. Vitamin D is a proto hormone that modifies our cells.

            Nicholas,

            I know you are interesting in ways to reduce the Covid death rate in the US.

            Did you know that?

            82% of the US black population, 69% of the US Hispanic, and 42% of the US general population is Vitamin D deficient (25 (OH)D less than 20 mg/ml)

            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

            Vitamin D deficiency was defined as a serum 25-hydroxyvitamin D concentrations ≤20 ng/mL (50 nmol/L). The overall prevalence rate of vitamin D deficiency was 41.6%, with the highest rate seen in blacks (82.1%), followed by Hispanics (69.2%).

            4000 UI/day per person of Vitamin D supplements is required to raise the blood serum 25(OH)D of the entire US general population above 30 ng/ml.

            Did you know that regardless of sex or age that Vitamin D people deficient people 25(OH)D less than 20 ng/ml are 19 times more like to die from Covid than Vitamin D normal people?

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

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

            Vitamin D Insufficient Patients 12.55 times more likely to die
            Vitamin D Deficient Patients 19.12 times more likely to die

          • William: I love how clearly you summarize good information. It’s astounding how much energy there is put towards torturing the science to disclaim good news for society. The bold mischaracterization of the “dangers” of HCQ is deeply concerning.

            I have sat in court rooms where opposing sides have a vested interest in the outcome, so the motivation drives the reasoning. Reframe the facts into strawman arguments to obfuscate and confuse. A foundation of facts be damned. What happens is the storyline gets so complicated that people will end up choosing a side and appeal to the authority of their choice. “I trust the scientists”… which one?

          • I have not seen anyone talking about HCQ being dangerous.
            Recently.
            It is a very useful medication.
            It has a well know safety profile.
            But we must know, how useful is it for this purpose?
            I think someone who was upset about straw man arguments is now bringing up an objection that was not made, and refuting it.

            As for the Henry Ford Health System study, it is known to be the case that they treated patients during the interval of the retrospective study using treatments and drugs which are not revealed in the study.
            Among them are powerfully effective ones.

            The study purports to be all of the patients admitted from March 10th to May 2nd.

            During that time, they used many drugs this study chose make no mention of.
            You do not have to like it.
            But by their own published and publicly documented records, including a study of a subset of these same patients prove it to be the case.

            Refusal to acknowledge this information will not make it go away, but it is transparently obvious that ignoring it is a deliberate refusal to look at the facts.
            Facts.
            Not from me.
            From Henry Ford Health System.

            Here is what doctors there say about their use of HCQ:
            “Henry Ford Health System has continued its multiple clinical trials of hydroxychloroquine, including one that is testing whether the drug can prevent COVID-19 infections in first responders who work with coronavirus patients. The first responder clinical trial was trumpeted by Trump administration officials early in the pandemic.

            But the top infectious disease doctor at Henry Ford Macomb Hospital said he only treats COVID-19 patients with hydroxychloroquine if families insist. ”

            https://www.detroitnews.com/story/news/local/michigan/2020/06/10/health-systems-mixed-use-hydroxychloroquine-covid-19/5328358002/

            They only use it if the patient insists.
            And the other hospitals in that state have stopped using it.

            But wait, there is more, and this speaks directly to concerns about safety.
            Not from me.
            This is the director of infection prevention at Henry Ford Macomb.
            “There’s no good study to support benefit (of hydroxychloroquine), but certainly serious concerns about side effects,” said Dr. Nasir Husain, director of the Infection Prevention Program at Henry Ford Macomb. “

          • William,
            You asked:
            “Nicholas,

            I know you are interesting in ways to reduce the Covid death rate in the US.

            Did you know that?

            82% of the US black population, 69% of the US Hispanic, and 42% of the US general population is Vitamin D deficient (25 (OH)D less than 20 mg/ml)”

            Yes, I do know this.
            I took an active and vocal part in discussions about vitamin D many many months ago, on many article here on WUWT.
            I have repeatedly stated my astonishment at the lack of concern from many quarters about vitamin and mineral deficiencies.
            I have used supplements myself since the 1960’s, when my mom was a vocal advocate of the work of Adel Davis.

            I have expounded on the details of that vitamin at length, many times.

          • Adding the OH group to chloroquine alters it’s shape and properties dramatically

            You may be right, but after reading a lot I dare to say you are wrong.

            I will not dig 48 years back, telling that I learned a lot of chemics and med.-science, parts in French, most in German, but never in English, so my vocabulary may not be accurat.

            First of all, you can’t simply add OH, if there is no free connection.
            In HCQ, there was an exchange of one of CH3 groups with OH.

            There are several studies about CQ fighting against cancer, in one, they looked for Zn and realised an accumulation of Zn without understanding themechanism behind, but declared CQ as ionophore.
            There are studies about HCQ fighting against cancer, and there is a study comparing CQ and HCQ fighting against cancer.
            If you compare these different papers you may realise not very strong differences in the working mechanism to act, to say it realistic, the differences are negligeable.
            To say is too, they all wrote about different cancers.
            But if CQ is an ionophore, there is no reason, viewing the minor differences in working, that HCQ isn’t.
            As nevertheless layman my estimate, not guess, of the probability to be an ionophore is about at least 95%.

          • As nevertheless layman my estimate, not guess, of the probability to be an ionophore is about at least 95%.

            As somebody with organic chemistry and biochemistry as majors in his masters degree my estimate it is not an ionophore would be at least 99.9%. So what?

            Personally, I don’t think the difference in the one hydroxy group between CQ and HCQ makes any difference there because ionophores need a steric proximity of two negatively polar prosthetic groups to work for positively charged divalent cations and the hydroxy group doesn’t fulfil this criteria anyway. The rest of the molecule doesn’t do this either. Hence my opinion.

          • Krishna, you said:
            “First of all, you can’t simply add OH, if there is no free connection.
            In HCQ, there was an exchange of one of CH3 groups with OH.”

            You are wrong.
            Look again.
            If you still do not see, I can tell you in detail.
            But it is obvious for anyone who knows how to interpret a diagram of a molecule.

            Here it is again:
            Reference 3d interactive diagrams of the two:
            HCQ
            https://chem.nlm.nih.gov/chemidplus/structure3D/viewer/118-42-3

            CQ
            https://chem.nlm.nih.gov/chemidplus/structure3D/viewer/54-05-7

          • Yes, although it is easier to see the distinction when one uses diagrams with the same orientation.
            You do know how to read such a diagram, no?
            The lines are the carbon backbone of the molecule.
            Any of the bends in the line is the location of a carbon atom.
            Also, it is not shown but understood that every carbon has for covalent bonds.
            Any carbon atom represented, which is not bound to four other atoms, is understood to have hydrogen atoms bound to those carbons.
            Oxygen is understood to be divalent.
            If it is attached to a carbon by itself, as in a ketone, an aldehyde, an ester, or a carboxylic acid, is joined via a double bond, occupying two of the carbon atoms’ four bonds (not relevant here).
            It may be helpful to look at a diagram which shows the entire molecule including the hydrogens to make it more clear that the difference between HCQ and CQ is a SUBSTITUTION of a H for an OH.
            It is easier to see in a ball and stick that shows the hydrogens, such as the 3 d version I posted a link to, or this one:

            HCQ
            https://pubchem.ncbi.nlm.nih.gov/compound/3652#section=3D-Conformer

            CQ
            https://pubchem.ncbi.nlm.nih.gov/compound/2719#section=3D-Conformer

            If you do not see it is a substitution of an H for an OH…

          • “See 3 x CH3 (CQ) and 2 CH3 +OH (HCQ)”

            No.
            CQ is C18 H26 Cl N3

            HCQ is C18 H26 Cl N3 O

            Same number of everything, except one oxygen atom.
            Because the only difference is a substitution of an H for an OH

          • @Nicholas – PS
            btw, thanks to add “bonds ” and “divalent” to my voc. book.

            Should be better to dig a bit deeper in my memory instead of only scratching the surface.

          • Williams asks:
            “Nicholas,

            I know you are interesting in ways to reduce the Covid death rate in the US.

            Did you know that?

            82% of the US black population, 69% of the US Hispanic, and 42% of the US general population is Vitamin D deficient (25 (OH)D less than 20 mg/ml)”

            Good for you to be looking at this issue.
            Few have spoken about it.
            But one company has been studying this data and working to help treat all patients achieve the same level of survival.
            Today they presented some findings, showing evidence that their treatment ensures equality of outcome across disparate racial and ethnic groups.
            This is the first such finding I have seen of this nature.
            They also presented stats on the dose dependent interference of CQ and HCQ with their drug:

            “Additional new data on the safety and efficacy of remdesivir presented at the Virtual COVID-19 Conference feature subgroup analyses, including race and ethnicity of patients treated in the United States, and global baseline characteristics associated with improved clinical status, and concomitant use of hydroxychloroquine.

            In this study, 229 patients were enrolled at trial sites in the United States; clinical improvement was defined as a ≥ 2-point improvement on a 7-point ordinal scale. Among these patients, rates of clinical improvement at Day 14 were 84 percent in African American patients (n=43), 76 percent in Hispanic white (HW) patients (n=17), 67 percent in Asian patients (n=18), 67 percent in non-Hispanic white (NHW) patients (n=119) and 63 percent in patients who did not identify with any of these groups (n=32). Key efficacy and safety results with remdesivir treatment across race and ethnicity in the United States are included in the following table.

            NHW
            n=119

            Black
            n=43

            HW
            n=17

            Asian
            n=18

            Other
            n=32

            Mortality, Clinical Improvement and Discharge by Race – U.S. Patients Only at Day 14

            ≥ 2-point clinical improvement

            80 (67%)

            36 (84%)

            13 (76%)

            12 (67%)

            20 (63%)

            Discharge

            80 (67%)

            32 (74%)

            13 (76%)

            12 (67%)

            20 (63%)

            Death

            13 (11%)

            3 (7%)

            1 (6%)

            2 (11%)

            3 (9%)

            Among the 397 patients who received remdesivir treatment globally, Black race, age under 65 years, treatment outside of Italy and requirement of only low-flow oxygen support or room air at baseline were factors significantly associated with clinical improvement of at least two points at Day 14.

            Following the availability of in vitro data demonstrating chloroquine inhibits the antiviral activity of remdesivir in a dose-dependent manner, Gilead conducted an analysis of clinical outcomes with patients who were treated with both remdesivir and hydroxychloroquine concomitantly, versus patients who were treated with remdesivir and who did not receive concomitant hydroxychloroquine. Through a median follow-up of 14 days, the rates and likelihood of recovery were lower in patients who received concomitant hydroxychloroquine compared with patients treated with remdesivir who did not receive hydroxychloroquine (57 percent vs. 69 percent, covariate-adjusted HR [95% CI] 0.61 [0.45, 0.83], p=0.002). Concomitant hydroxychloroquine use was not associated with increased mortality in the 14-day analysis window. The analysis also showed that patients in the concomitant hydroxychloroquine group experienced overall higher rates of adverse events. After adjusting for baseline variables, this difference was significant for Grade 3-4 adverse events.”

            This announcement moved world markets significantly this morning.

            https://www.gilead.com/news-and-press/press-room/press-releases/2020/7/gilead-presents-additional-data-on-investigational-antiviral-remdesivir-for-the-treatment-of-covid-19

      • They searched globally, and found 17 immuno-suppressed lupus patients on HCQ, who developed C19. The study does not compare chances of lupus patients on HCQ to get C19.

        • @Leo Goldstein
          I suggest you should take the trouble and read a tiny abstract completely and carefully.

          The number 17 is from another study they were citing. There own data is this:

          As of 17 April 2020, we have now identified 80 patients with SLE and COVID-19 in the global physician-reported registry. Patients were predominantly female (72/80, 90%) and less than 65 years of age (69/80, 86%). Importantly, 64% (51/80) of patients with SLE were taking an antimalarial (HCQ or chloroquine) prior to infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (30% as monotherapy). Notably, 21.1% (121/573) of all reported patients with rheumatic disease in the registry were treated with an antimalarial prior to onset of COVID-19, yet 49.6% (60/121) required hospitalisation. In patients with SLE, frequency of hospitalisation with COVID-19 did not differ between individuals using an antimalarial versus non-users (55% (16/29) vs 57% (29/51), p=ns; χ2 test).

          They had 80 patients with SLE and 121 of 573 COVID-19 positive patients with rheumatic disease who took antimalarial prior to their infection. Yet, 60 (49.6%) required hospitalisation.

        • Leo,
          It has been two days since I showed you data on these patients.
          For one thing, it was not a search, it was a voluntary registry.

    • That’s great… but what confuses me is the death counts appear to be around 300 per week by June 20. Where is this from? We are at about 500/day in US now?

        • That’s interesting. The US CDC weekly “provisional deaths”shows an order of magnitude fewer deaths than World-O-Meter daily death count in the US. Is http://www.worldometers.info/coronavirus
          using a model? Their sources vary using local health departments and some other sources.

          So, now what to believe?

          • “So, now what to believe?”
            You could try reading what CDC actually says about their data. Above the graph they have a para highlighted in blue, with a bit (i) marker. It says:

            Note: Provisional death counts are based on death certificate data received and coded by the National Center for Health Statistics as of July 8, 2020. Death counts are delayed and may differ from other published sources (see Technical Notes). Counts will be updated every Wednesday by 5pm. Additional information will be added to this site as available.”

            In the caption to the graph is says that the data “do not represent all the data that occurs in that period.”

            In the notes, there is a section which says:
            “Why These Numbers are Different
            Provisional death counts may not match counts from other sources, such as media reports or numbers from county health departments. Counts by NCHS often track 1–2 weeks behind other data.”

            and then
            “Provisional counts are not final and are subject to change. Counts from previous weeks are continually revised as more records are received and processed.

            Provisional data are not yet complete. Counts will not include all deaths that occurred during a given time period, especially for more recent periods. However, we can estimate how complete our numbers are by looking at the average number of deaths reported in previous years.”

            The point is that data for any given week will continue to rise as more data comes in. Worldometer just gives the increment in total reported deaths, without reassigning to date of death. So each days figure is not subject to increasing as later data comes in.

          • Nick: Thank you for your detailed explanation. I did see that… and over the long term, there is time to catch up. It seems that they don’t catch up or a quite significant thing is happening with World O Meter… which makes me thing if the sources reporting to them have much higher numbers, this begs the question, how to US local sources give higher numbers… are they an estimate, do they use a model to calculate? Thank you for looking into this.

            I am asking the question because I have not put in the time and figured someone else may have. If I get too frustrated I will have to put in an effort myself, but do not want to duplicate the effort if someone knows.

          • @mario lento
            worldometers does not use a model for their updates. They have models for predictions available but their daily updates are not modelled. If you look at the country data for the U.S. here

            https://www.worldometers.info/coronavirus/country/us/

            you can see the column “source”. There is a link listed where their data comes from. That can be one or multiple sources.

          • Hi Ron: I do understand that they use predictive models for future outcomes. I am wondering how they have been able to show an order of magnitude more deaths than the CDC… given that the CDC has had time over the past to update for latency of reporting of deaths. At some lag, the counts should be updated to reflect all deaths reported and they seem not to be.

          • It is accepted by nearly everyone in numerous fields, economics, criminology, epidemiology…that accurate statistics from a given interval of time, are only going to be available after a considerable period of time.
            All such numbers are always revised for many months after the initial readings are given.
            It does not matter if it is employment data, economic activity, GDP growth, crime, flu deaths…none of it is considered usable for an absolute value in real time.
            Many of us have known this for years and years, because it has always been true, even when populations were smaller, economies were smaller, etc.
            Real time numbers are always taken to be preliminary estimates at best.

          • @mario lento

            I am wondering how they have been able to show an order of magnitude more deaths than the CDC…

            One order of magnitude would be 1.3 million vs. 130k. I think you meant something different.

            I don’t know how worldometers averages the data when there are different sources for one state but for Arizona e.g. they just take the official number from this website:

            https://www.azdhs.gov/preparedness/epidemiology-disease-control/infectious-disease-epidemiology/covid-19/dashboards/index.php

            Nothing else. This is just faster than the CDC. Probably weeks faster.

          • Ron: CDC are showing about 150 to 200 deaths per week now (note weekly not daily).
            So, Worldometer is showing about an order of magnitude deaths if you multiply the daily count to get weeks. Seems they get a complete count whereas the CDC does not get a complete count until some lag in time.

            This is the CDC data. https://www.cdc.gov/nchs/nvss/vsrr/covid_weekly/index.htm

            Scroll down to the graph of deaths. It’s stunning in the decline, which is artificial.

            But I did notice something… the older data on CDC site seems to have been updated to show the lagged data got back filled. The more recent data is not up-to-date yet, showing less deaths. That explains the steep slope of the downtrend to recent times.

            In summary:
            The more recent data is not complete, where as the older data has been updated to reflect all death’s reported.

            So this begs the question, how does Worldometer get the data immediately?

          • Taking all the available up-to-date state data and just summing them up?

            Doesn’t seem too complicated.

          • Ron: We’re going around in circles.

            Although I do wish for the declining trend in deaths to be steep… I question the CDC’s trend graph as misleading.

            The CDC’s trend graph shows the trend being steeper than reality. It’s because there is a lag in summing up the deaths, such that the date on deaths at time = to present are lower than they will be over time. The function is that yesterday’s deaths will increase from where they were and so forth for some period of time!

            They do not “directly” make this obvious, so I sought out to find an explanation. I figured it out, and think it’s useful information.

          • The CDC is not in the business of maintaining up to date stats on a website.
            That is not their job or mandate.
            They have had disclaimers since March saying that for up to dat info, check with states one by one.

  24. It’s appalling that this survey arbitrarily chooses to disregard the supplement with perhaps the strongest correlation to COVID-19. Vitamin D deficiency is a common link between cohorts with severe COVID-19 cases (elderly, Mediterraneans, African Americans), whereas high levels of vitamin D (Norway, Sweden, and Finland) have far less prevalence/severity. Multiple studies are showing this correlation. I don’t understand the unwillingness of medical experts to even consider vitamin D as a possible preventive and early stage therapeutic. I take vitamin D3 every and urge everyone I meet to do so.

    • It seems that the medical profession is averse to discussing nutrition in the context of infectious diseases.
      It is not one nutrient. It is all of them, in general.
      I am not so sure anyone who checks into a hospital is even tested for serum concertation of vitamins and minerals.
      They are not part of any routine blood work panel.

  25. I have not seen anyone talking about HCQ being dangerous.
    Recently.
    It is a very useful medication.
    It has a well know safety profile.
    But we must know, how useful is it for this purpose?
    I think someone who was upset about straw man arguments is now bringing up an objection that was not made, and refuting it.

    As for the Henry Ford Health System study, it is known to be the case that they treated patients during the interval of the retrospective study using treatments and drugs which are not revealed in the study.
    Among them are powerfully effective ones.

    The study purports to be all of the patients admitted from March 10th to May 2nd.

    During that time, they used many drugs this study chose make no mention of.
    You do not have to like it.
    But by their own published and publicly documented records, including a study of a subset of these same patients prove it to be the case.

    Refusal to acknowledge this information will not make it go away, but it is transparently obvious that ignoring it is a deliberate refusal to look at the facts.
    Facts.
    Not from me.
    From Henry Ford Health System.

    Here is what doctors there say about their use of HCQ:
    “Henry Ford Health System has continued its multiple clinical trials of hydroxychloroquine, including one that is testing whether the drug can prevent COVID-19 infections in first responders who work with coronavirus patients. The first responder clinical trial was trumpeted by Trump administration officials early in the pandemic.

    But the top infectious disease doctor at Henry Ford Macomb Hospital said he only treats COVID-19 patients with hydroxychloroquine if families insist. ”

    https://www.detroitnews.com/story/news/local/michigan/2020/06/10/health-systems-mixed-use-hydroxychloroquine-covid-19/5328358002/

    They only use it if the patient insists.
    And the other hospitals in that state have stopped using it.

    But wait, there is more, and this speaks directly to concerns about safety.
    Not from me.
    This is the director of infection prevention at Henry Ford Macomb.
    “There’s no good study to support benefit (of hydroxychloroquine), but certainly serious concerns about side effects,” said Dr. Nasir Husain, director of the Infection Prevention Program at Henry Ford Macomb. “

  26. Hey Nicholas…

    You have Linked to Propaganda article … Absolutely no data… Just quoting people who say they would not use HCQ….

    Which is odd as the Michigan study 2541 patients found that HCQ/AZ plus zinc reduced the covid death rate by more than 50% and the covid organ damage by more than 70%.

    Anyway why ‘argue’ when you are absolutely incorrect. ‘Arguments’ just noise does not change the truth.

    The game is afoot!

    These macho type Presidents, may have exactly what is needed to defeat the SWAMP.

    Brazil could change the Covid picture if HCQ plus AZ works as expected to stop the spread of Covid.

    Brazil going to use HCQ/AZ in a big way to both treat covid patients and as covid prophylactic.

    https://www.reuters.com/article/us-health-coronavirus-brazil-hydroxychlo/special-report-bolsonaro-bets-miraculous-cure-for-covid-19-can-save-brazil-and-his-life-idUSKBN249396

    RIO DE JANEIRO/BRASILIA (Reuters) – Brazilian President Jair Bolsonaro has gone all in on hydroxychloroquine to help his coronavirus-ravaged country beat COVID-19. He has pushed his government to make the malaria drug widely available and encouraged Brazilians to take it, both to prevent the disease and to treat it.

    Now the far-right populist is putting his convictions to the ultimate test: Bolsonaro on Tuesday announced that he had tested positive for the disease and was taking hydroxychloroquine.

    Bolsonaro said in a televised interview that he had taken an initial two doses, in conjunction with the antibiotic azithromycin, and felt better almost immediately. His only regret, he said, was not using it sooner.

    “If I had taken hydroxychloroquine preventively, I would still be working” instead of heading into quarantine, Bolsonaro said.

    Later, in a separate video, he gulped down a third pill. He said he was aware of other treatments, but noted none of them had been proven to work.

    “I trust in hydroxychloroquine,” he said. “And you?”

    Brazil could change the Covid picture if HCQ plus AZ works as expected to stop the spread of Covid.

    Brazil going to use HCQ to both treat covid patients and a covid prophylactic.

    https://www.reuters.com/article/us-health-coronavirus-brazil-hydroxychlo/special-report-bolsonaro-bets-miraculous-cure-for-covid-19-can-save-brazil-and-his-life-idUSKBN249396

    RIO DE JANEIRO/BRASILIA (Reuters) – Brazilian President Jair Bolsonaro has gone all in on hydroxychloroquine to help his coronavirus-ravaged country beat COVID-19. He has pushed his government to make the malaria drug widely available and encouraged Brazilians to take it, both to prevent the disease and to treat it.

    Now the far-right populist is putting his convictions to the ultimate test: Bolsonaro on Tuesday announced that he had tested positive for the disease and was taking hydroxychloroquine.

    Bolsonaro said in a televised interview that he had taken an initial two doses, in conjunction with the antibiotic azithromycin, and felt better almost immediately. His only regret, he said, was not using it sooner.

    “If I had taken hydroxychloroquine preventively, I would still be working” instead of heading into quarantine, Bolsonaro said.

    Later, in a separate video, he gulped down a third pill. He said he was aware of other treatments, but noted none of them had been proven to work.

    “I trust in hydroxychloroquine,” he said. “And you?”

    • To William, if you’re not claiming to be a scientist, that does not make what you understand incorrect! Thank you for the information… sincerely, Mario. There is a lot that can be learned from you… and some others.

    • Look past the messenger to the message.

      I am not arguing, I am explicating.

      But when you say we need to believe something because our President needs to defeat the swamp, I agree about the swamp, I agree we have the right president.

      I completely disagree we need to decide what to believe regarding a medical treatment, based on any of that.
      It is ludicrous.

    • Beyond that William, you have studiously ignored every single bit of information I have presented.
      You do not refute it by logic, or by evidence, or even address it at all.
      You dismiss it without a word about the information.
      You can tell it is meaningless with a glance…it comes from a source you do not trust.
      But the source is the same hospitals and doctors you accept as the last word.
      We know for a 100% for sure and true fact that those hospitals used therapies that the recent paper chose to pretend do not exist.

      • Nicholas McGinley,

        Perhaps that is the problem Nicholas. I do not see a ‘point’ in your comments. You do not have a hypothesis that explains the observations.

        I do not ‘listen’ to you, because you do not have a hypothesis that explains the observations.

        There is sufficient observations to differentiate between hypotheses.

        We have peer reviewed observations that HCQ/AZ plus zinc when it is given to the covid patient as early as possible reduces the death rate by stopping the virus from replicating by working as a zinc ionophore.

        The Zinc ionophore hypothesis explains why Vitamin D deficient people are 19 times more likely to die from Covid, and Vitamin D insufficient people are 12 times more likely to die from covid.

        Vitamin D is also stopping the virus from replicating by creating a zinc ionophore which gets the Z+2 into our negative charged cells.

        2541 patients covid patients, six different Michigan hospitals were treated with HCQ/AZ plus zinc …

        That HCQ/AZ plus zinc treatment reduced the covid death rate by more than 50% and follow up scans showed a 70% reduction in lung damage…..

        And there was not one heart attack in the 2541 treated people.

        Kind of a good thing reduces the death rate by more than 50% and reduce lung damage. Great.

        This study found HCQ/AZ plus zinc worked if the treatment was started early, as the treatment works by stopping the virus from replicating.

        This is a quote from the Michigan study that states exactly what I summarized above to explains why the Michigan study of HCQ work while others did not.

        The difference has the HCQ can only work is it is used before the Covid virus has replicated.

        “Among a number of limitations, this study included patients who were initiated on hydroxychloroquine therapy at any time during their hospitalization.

        In contrast, in our patient population, 82% received hydroxychloroquine within the first 24 hours of admission, and 91% within 48 hours of admission.

        Because treatment 13 regimens likely varied substantially (including delayed initiation) across the 25 hospitals that contributed patients to the study, it is not surprising that the case-fatality rate among the New York patients was significantly higher than in our study.”

        Some HCQ studies gave HCQ to near dead people. HCQ stops covid by stopping the virus from replicating. It cannot repair covid virus damaged people. When people are near death HCQ can cause heart attacks.

        We also know that regardless of sex or age Vitamin D deficient (blood serum 25(OH)D 30 ng/ml.

        Vitamin D supplements 4000 UI/day is required to raise the US population blood serum level above 30ng/ml.

        Vitamin D is a proto hormone that adds functionality to our cells. In this case is appears Vitamin D creates a Zinc ionophore which enables a tiny amount of Zn +2 into our negative charged cells.

        I has been shown in vitro that zinc stops the virus from replicating in our cells.

        This above explanation explains why the covid death rate correlates directly with how Vitamin D deficient the person is before getting covid.

        Vitamin D deficient people had a 19 times greater chance of dying and Vitamin D insufficient people who were less Vitamin D deficient had a 12 times less chance of dying than…

        … than Vitamin D normal people.

        That is an amazing range of death rates.

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

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

        Vitamin D Insufficient Patients 12.55 times more likely to die

        Vitamin D Deficient Patients 19.12 times more likely to die

        • Based on the observations, as Trump says, What have you got to lose?

          No evidence that treatment will cause nasty problems. There were spurious indications, but they have been debunked. There is significant evidence HCQ and Zn reduces death. There are way more factors too, and you listed many of them William.

          I say, do the inexpensive safe treatment and do a proper placebo double blind study with the proper implementation of HCQ and Zn.

          By all means, the precautionary principal should be do what has been shown to work and gather more information. Even the Do No Harm doctrine has been tortured to incorrectly mean, “don’t treat unless you can prove it works…” while knowing that people will die before the proof is agreed upon.

          The rest of the scientific debate is healthy, and we will all learn from each other. But first PREVENT the death with what works while mitigating risks as best possible.

          I am disgusted with the torturous reasoning behind driving policy that prevents treatment.

  27. I am going to repost a comment I made back in April.
    Anyone can read it and see I have been very consistent.
    I have continuously gone back and reread what I am others were thinking and talking about since this started:

    “Nicholas McGinley April 24, 2020 at 12:39 pm
    “Then add a zinc ionophore plus zinc to one.”

    Whoa, wait a second.
    If you add two things to one dish, you only know that either one, or the other, or both, had an effect.
    You need to do a lot more than two dishes to narrow down if it is zinc, or the ionophore, or both, that had the effect.
    And even then you only know there was an effect…it does not prove any single hypothesis regarding the cause for the effect seen (or not seen).
    Confirmation bias can be hard to spot in our own thinking, so we have to be careful not to fool ourselves, as I know we are all abundantly aware.

    Besides for that, I have asked elsewhere and gotten zero response so far that I have seen, that the many assertions regarding HCQ being a zinc ionophore, have apparently all assumed this to be the case since CQ is one.
    Many articles with the assertion in many print and online media have even linked to the source for the assertion, and posted a link to CQ research, not HCQ, and nothing about why it should be assumed let alone proven that HCQ is, as well.
    Also, that research was not looking for antiviral effects, it was looking for anti cancer activity, or more precisely evidence for a reason to investigate such activity.
    What the research showed was, that zinc was introduced into lysosomes, which are not how this virus enters a cell.
    And the net outcome being researched was that this combination of zinc and CQ reduced autophagy, and stimulated apoptosis.
    IOW…it killed the cell, by inducing them to undergo programmed cell death.
    Adding zinc this way caused the cells to die, an important thing if you want to kill cancer cells.
    The research was done, BTW, on cancer cells.
    I can think of a lot of reasons not to assume a general systemic effect in a normal person who has a viral illness due to a finding in cancer cells in vitro.
    Here is a link to it:
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4182877/

    There is other research on chloroquine and on zinc ionophores, but none, as far as I have seen, showing the same for HCQ.
    Although they are not vastly different in terms of their diagrammed structure, they are very different in when one examines the three dimensional shape.
    It may well be an ionophore, but just because the molecules are similar and both work as an antimalarial is very weak evidence for such. Nonexistent really. It is cause to suspect it might be, but we should keep in mind that experts in the relevant fields do not assert that the zinc ionophore effect is a fact, or even a leading theory of why and how these drugs work.

    Small changes in structure can completely alter how molecules behave in the body or within a cell.
    I have seen where many commenters on WUWT that asserted without evidence that the two drugs are equivalent, and that one is transformed into the other inside the body, or than one is the metabolite of the other.
    These are both false.
    How different can a molecule be just by substituting a OH for one of the H’s?
    How different are methane and methanol?

    For anyone who thinks that is an exaggeration, when one substitutes an OH for an H in the chloroquine molecule to make hydroxychloroquine, the melting point of the molecule goes from ~289°C to ~90°C!
    And the toxicity data alone demonstrates they are nothing at all like metabolically the same.
    The lethal dose for both compounds varies depending on whether man, woman, or an animal, as well as mode of administration (and it varies hugely) but for example in a child the oral LDsubL0 (lethal dose low, the smallest amount that can cause death under controlled conditions) is just ~38mg/kg for chloroquine, but 600mg/kg for hydroxychloroquine.
    That is a huge difference.
    There are other thresholds listed separately for mental effect, cardiac one, etc.
    There is far more toxicity data for chloroquine than HCQ, and it varies hugely for a given affect and a given animal, but in no creature are the number similar.
    Pharmacology reference texts say zip about zinc ionophore as a mode of action for any therapeutic effect.
    And in fact more and more data is showing these drugs do not kill this virus in a person.
    As one might well have surmised (and some of us have) if this result is confirmed, it will match data for in vivo activity vs all the other viruses they two have been tested on.
    Any therapeutic value most probably is limited to immunomodulatory and anti-inflammatory effects.

    References include 3d interactive diagrams of the two:
    HCQ
    https://chem.nlm.nih.gov/chemidplus/structure3D/viewer/118-42-3

    CQ
    https://chem.nlm.nih.gov/chemidplus/structure3D/viewer/54-05-7

    And toxicological data here:
    HCQ
    https://chem.nlm.nih.gov/chemidplus/rn/118-42-3

    CQ
    https://chem.nlm.nih.gov/chemidplus/rn/54-05-7

    Physical properties here:
    HCQ
    https://chem.nlm.nih.gov/chemidplus/rn/118-42-3

    CQ
    https://chem.nlm.nih.gov/chemidplus/rn/54-05-7

    And detailed human health related data:
    HCQ
    https://pubchem.ncbi.nlm.nih.gov/compound/3652

    CQ
    https://pubchem.ncbi.nlm.nih.gov/compound/2719

    Finally, I want to point out that anyone who goes back and reads the many lengthy discussions about these drugs here over the past many weeks, will find that the original reports and rave reviews and assurances that this was the cure, the whole debacle would evaporate in a few weeks, CQ cured 100%, back slapping etc.
    Only later did the focus widen to include HCQ.
    And only gradually did speculations and assertions regarding zinc become part of the story.

    There was nothing about using it only at the early stages, or using it with an antibiotic or forget it, or using it with zinc or it is a bullshit study, and especially not that HCQ was THE drug, not that crap chloroquine.
    And yet reading now we have people saying all sorts of such things, and acting as if this is common knowledge and anyone who does not know it is a dope.
    I have ben reading over threads on the virus from the past two months, and the comments from people then and now are in very few instances and for very few people even slightly reconcilable.
    I am not gonna name any names (yet), but few of the most prolific commenters here have stuck to the same story or beliefs, and at no time was there any declarations that new knowledge has caused a rethink.
    Instead, glib assurances have morphed into other glib assurances.
    Again, I am not gonna start calling specific people out (right now), but it sure would be nice for some of the people to please tell those they are berating when between then and now they acquired such knowledge and such surety.

    I have seen some of the people here on other blogs and sites sneering at medical doctors about how stupid they are, given that this commenter has astutely and through pharmacological acumen and encyclopedic knowledge of biochemistry and microbiology, handily cured themselves of COVID 19…but this person can be found a about 5 weeks ago saying that MAYBE they perhaps might have had the virus back in early December, and that one possible reason for a mild case may have been green powders from Costco and some extra vitamin D, with no mention of ionophore or zinc at the time, or even more than a hint of a possibility that the illness might possibly have been COVID.

    A similar evolution has occurred in numerous individuals, such that the conversations we are finding now are a case study in moving goalposts, confirmation bias, and non-evidenced certitude that would make a Warmista High Priest blush with shame.

    On the other hand, some have shown and yet retain what IMO is a highly evidenced degree of scientific thinking and willingness to abide by new information and to stick to the evidence.”

    And here is a reply from Mr Steven Mosher to my comment.
    I hope he does not mind my reposting it here.
    (please tell me if you do, Steven)
    He restates what was on my mind and completes the thought very effectively:

    “Steven Mosher April 24, 2020 at 4:47 pm
    “Only later did the focus widen to include HCQ.
    And only gradually did speculations and assertions regarding zinc become part of the story.”

    yep.

    it is predictable. Once people decided, ahead of the evidence, that Chloriqine was a cure
    then they must defend it to the end.

    and every bit of data that falsifies their belief, must be bad.
    or they change their hypothesis.

    its HCQ
    wait
    with zithromician
    wait
    with Zinc
    wait
    only given early
    wait
    only given to those with no comorbidity
    wait
    only for men
    wait
    only given in dose x
    wait
    only given on a tuesday

    There is no bottom to the number of ways that data can be rejected and hypotheses can be amended to preserve a belief.”

    https://wattsupwiththat.com/2020/04/24/coronavirus-covid-19-and-rumination-6/#comment-2976711

    • “History repeats the old conceits
      The glib replies the same defeats
      Keep your finger on important issues
      With crocodile tears and a pocketful of tissues
      I’m just the oily slick
      On the windup world of the nervous tick
      In a very fashionable hovel

      I hang around dying to be tortured
      You’ll never be alone in the bone orchard”

      -E. Costello

    • Although they are not vastly different in terms of their diagrammed structure, they are very different in when one examines the three dimensional shape.

      That is a misinterpretation from the presented 3D pictures.

      What the 3D picture does not tell is the story about flexibility of conformation or degrees of freedom. Chloroquine and hydroxychloroquine are the same when it comes to that. They might differ in the most likely confirmation though cause of steric differences. I did not check this. Maybe they don’t even do this.

      • The 3 D structure is typically taken to indicate the conformation with the lowest energy state.
        Of course all of the usual rules of degrees of freedom apply.
        Consider how a single substitution on a single amino acid can alter the folding of an entire protein.

      • The 3 D structure is typically taken to indicate the conformation with the lowest energy state.
        Of course all of the usual rules of degrees of freedom apply.
        Consider how a single substitution on a single amino acid can alter the folding of an entire protein.

      • There are probably people who will take your remarks to be a dismissal of my comment.
        The particulars of the structure are not the point I was trying to make.
        I am not sure if you mean to dispute whether CQ is an ionophore.
        Certainly on research paper finding it to be so hardly proves it beyond doubt.
        This is, IMO, an unnecessary distraction, even if it is a valid argument.
        The people that did the research on CQ in 2009 no doubt knew that HCQ was a similar and far less toxic molecule.
        They were looking for molecules to test for anticancer activity.
        As such, it would behoove them to look for the least toxic version of whatever they wanted to look at more closely.
        The fact that no research has been offered to show that HCQ might be an ionophore is significant.
        At this point, I am moving on.
        No one has shown what has been asserted re HCQ, but no one who has made the assertion wants to even concede they are operating on a supposition.
        Not that it matters.
        What matters is what happens when people get a medicine.
        Lots of molecules have activity in vitro that does not translate into similar activity in vivo, and even fewer of the ones that do, translate into clinical efficacy in curing diseases.
        Antiviral activity is not enough to eliminate an infection.
        No one has even demonstrated in vivo activity, let alone viral elimination.
        Tens of thousands have gotten these drugs.
        Millions maybe.
        It is not clear any fewer have died as a result.
        It is clear that people getting them still die.
        It is clear that these drugs have been given to far more people than was warranted by evidence.
        I am pretty much done weighing in on this subject for now.
        I expect the people who are ardent in their beliefs for the value of this treatment will be the last people to move on.
        Many never will.
        We can see it very plainly and hear it in what they say.
        Reality does not enter into the equation.
        They know it, now they just have to convince everyone else.
        Proving it was never a requirement for them.

        Brad Keyes, where are you?

        • I am not sure if you mean to dispute whether CQ is an ionophore.

          As it was me who first brought up the fundamental chemical structure problems for HCQ to even be considered an ionophore… probably not? : )

          Your argument was just not scientifically valid. Any binding to another molecule, even water’s pH, could change the preferred conformation. And except of the -H location of the OH there is not a difference in the possible conformations and this is neglectible for the overall similarity.

          But in the general, I have to repeat something which did not get sufficient attention:

          Does anybody else see the irony that data from China, Wuhan, is basically the foundation of the HCQ hype?

          • I have said it several times.
            Chinese doctors in Wuhan are on record as dismissing CQ and HCQ beneficial treatments.
            They were the first to do so with finality.

          • I was talking about the pre-print about the Vero6 cell assay, later published on Feb 4th in Cell Research. That is where it started and it was a group from Wuhan.

            President Trump mentioned it at a press conference on March 18th.

  28. A factor in all this:
    I helped a nephew do a remodel on a 4 story building, each floor had 4~6 doctors, on the first floor was the doctor cafeteria and the second floor cafeteria for general employees. Every day a sales rep would arrive along with a catered lunch, a different manufacture each day. The food was unbelievable, like first class on a cruise liner, deserts alone were $10 worth of pasties a serving, main course and drinks another $15~$30. Every spare inch had cases of sample drugs… I didn’t notice any Hydroxychioroquine
    FYI: Everyone I was with in Vietnam took the dam pills, nobody died from the pills.

  29. Looking at the data from Louisiana vs. Orleans Parish

    https://experience.arcgis.com/experience/746f03e88d204a2b82a7b958ea744bba/?data_id=dataSource_3-LDH_Data_1126_386%3Anull%2CdataSource_3-Overall_2016_Tracts_5791%3Anull%2CdataSource_3-LDH_Data_1126%3Anull%2CdataSource_3-LDH_Data_1126_5410%3Anull

    I have a provocative claim to make:

    Drinking outside will saves lives!

    The numbers of new cases per day in Louisiana is going up very steep but not in Orleans Parish where it is allowed to drink outside from an open container.

    It’s time to change this legislation now everywhere!

  30. Thank you Mr. Goldstein!

    You hard work producing this piece, and all previous articles, is very much appreciated. Someday, hopefully someday soon, the truth will come out about HCQs early use in helping people LIVE though this disaster.

  31. As a health care professional and reader/critical appraiser of medical literature I was intrigued by this contribution to the literature – not because of the idea that HCQ may help Covid 19 but at the reported gullibility of the medical fraternity to quackery and non-evidence based medicine.

    Plus the author promoting opinion surveys as evidence or even a systematic review? Errr….no. It’s absolutely not evidence. It may be a form of consensus though…..

    I’m afraid Mr Goldsteins statement physicians choice is comparable to a RCT is absolutely wrong. There are many hierarchies for evidence in medicine which are based on one of the original and enduring which was proposed by Guyatt and Sackett way back in 1996 and can be summarised thusly (after Greenhalgh):

    1 Systematic reviews and meta-analyses of “RCTs with definitive results”.
    2 RCTs with definitive results (confidence intervals that do not overlap the threshold clinically significant effect)
    3 RCTs with non-definitive results (a point estimate that suggests a clinically significant effect but with confidence intervals overlapping the threshold for this effect)
    4 Cohort studies
    5 Case-control studies
    6 Cross sectional surveys
    7 Case reports

    You can see where this survey rates,

    A good study on a medicine is prospective, with randomised study groups, double-blind and contains a controlled group, with and active comparetor or a placebo. It contains sufficient numbers to provide sufficient power statistically. Diagnosis, outcome and measurements are standardised and assessors are blinded to randomisation.

    There is no convincing study in the world which has reported positively on hydroxychloroquine (with or without concomitant treatments). There is no favourable risk/benefit known.

    It’s true we are being let down by people rushing in to print or pre-print with poor studies (I found this summary clear – https://www.statnews.com/2020/07/06/data-show-panic-and-disorganization-dominate-the-study-of-covid-19-drugs/) and the WHO have discontinued studies in to this agent https://www.who.int/news-room/detail/04-07-2020-who-discontinues-hydroxychloroquine-and-lopinavir-ritonavir-treatment-arms-for-covid-19

    Everyone in the health field around the world would be very, very grateful for any crumbs of comfort against the Covid-19 virus, (while dexamethasone is probably useful in the ventilated patient, it’s not a prophylactic agent or treatment agent for those with less severe disease states) but there is little comfort out there.

    A review of surveys of opinion has no scientific validity in medicine – and it will certainly not inform my practice, or of any health care practitioners I know across the world, especially if New Zealand ever becomes significantly exposed to the virus in the future.

    Kia kaha
    (stay strong)

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