An HCQ post making the rounds

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  • Wed, Jul 29, 2020 - 08:21pm

    #11
    denalizen

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    Reply To: An HCQ post making the rounds

“I detect a non-scientific bias in denalizen’s comments that throw dirt on hydroxychloroquine.”

Your detector is fouled.  Or do you not mean to peg me as having a non-scientific bias?  Not clear.

 

  • Wed, Jul 29, 2020 - 09:18pm

    #12
    Island girl

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    An HCQ post making the rounds – the doctors

With regard to the post referenced by denalizen – the statements only seem reasonable because the original video has been banned so you can’t assess the author’s criticisms in context.

Having seen the video, I offer these observations for your consideration.

The author mentions health risk of HCQ treatment. These doctors are talking about early treatment in a regimen that lasts about a week.  That is not the kind of situation that is relevant to the risk outcomes the author mentioned. People with lupus and RA take this drug daily for years. That was an inflammatory statement.

The author seems somewhat dismissive of the sub specialties represented among the speakers. Moreover, the author claims that the anecdotal evidence of Zn/HCQ/AZT efficacy might relate mostly to patients, like children, “would have gotten better anyhow”. I wonder how the author got access to the patients’ medical files.

In point of fact, the pediatrician presented data on morbidity and mortality in children in the natural course of the disease, not as a consequence of treatment.  And the psychiatrist talked about lock down effects on domestic violence and suicide rates.

The author dismisses the AAPS (American Association of Physicians and Surgeons) as “not a medical board”. How is that pertinent? No one made that that claim. It’s an association of physicians and surgeons. Last I checked, the AMA (American Medical Association)  describes itself as Americas largest “association of physicians”.

The AAPS organization is an alternative to the AMA, which is heavily influenced by pharma. For perspective,  I searched AMA’s website and the top post on HCQ is the statement that FDA warns against use of HCQ outside of clinical trials. That post is dated April 28, 2020. Crickets on anything that has happened since then. These doctors, by contrast, mention the Henry Ford Hospital study, Dr. Harvey Risch’s review paper, and other recent findings in their press conference. Draw your own conclusions about who is more informed and who is more willing to advocate strongly to evaluate an off-patent drug that may be of benefit to patients.

The author says there are “more promising” drugs like Remdesevir that decrease mortality, but fails to mention that the decrease did not achieve statistical significance. By contrast, in the Henry Hord Hospitals study of HCQ (which was observational, not prospective), mortality was halved and the result was statistically significant even after correcting for possible confounding factors like steroid use. This is not mentioned.

Lastly, the author cherry-picks the credentials of some of the speakers for scrutiny. But interestingly fails to mention something that ought to be highly significant in terms of expertise. Dr. James Todaro, a member of the group, was one of the earliest voices relentlessly asking the right questions and thereby exposing the Lancet study on HCQ as a fraud.   By that measure, this doctor is a lot more credible than the editors and peer reviewers at this most prestigious medical journal; more astute than many in the medical community; and certainly more diligent than the denizens in the media, all of whom were, in effect, snookered.  Just another piece of evidence that  doctors in this group are not afraid to say that the Emperor isn’t wearing any clothes.

 

  • Thu, Jul 30, 2020 - 09:44am

    #15
    Island girl

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    An HCQ post making the rounds – the saga continues

Cross-post

Today, the Governor of Ohio issued a statement asking the pharmacy board to rescind its decision blocking th dispensing of HCQ.

In related news, Dr. Simone Gold, who organized the conference at which Dr. Immanuel spoke, has hired lawyer Lin Wood to represent her against those who are impugning her credibility. Lin Wood secured settlements against CNN and the Washington Post on behalf of the Covington Catholic student who was maligned in the press and social media.

If Dr. Gold files a lawsuit, I suspect that lots of conflict of interest will emerge in the discovery phase. I also suspect that the social media platforms censoring the group may be held liable if the weight-of-the-evidence shows that early Zn/AZT/HCQ can reduce morbidity. Not to mention the civil suits that would result if it turns out the economic damage may have been mitigated by aggressive early treatment. We shall see. Just getting a sense the dam may break…

  • Thu, Jul 30, 2020 - 10:02am

    #16
    drbrucedale

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    Comment on the HCQ post cited by Denalizen

Hi Denalizen:

In your post, I am not sure how much is your response to the criticism of HCQ and how much is the writing of someone else that you are responding to. So I am writing as if it were you who wrote it. I apologize if I have the authorship wrong, but I honestly don’t know who wrote the criticisms of HCQ that are on your post that started this thread. So, with apologies if I have this wrong, here is my response to the critique of HCQ you cited.

“I am going to assume that you are an honest person, but perhaps a somewhat ignorant and careless one. Unfortunately, those are the two most generous adjectives I can apply to your post that started this thread.

Let me give some of the evidence for “ignorant and careless”.

Your post cites three articles supposedly relevant to the effectiveness of HCQ.  Here they are:

https://www.nejm.org/doi/full/10.1056/NEJMoa2019014
https://www.acpjournals.org/doi/10.7326/M20-4207
https://academic.oup.com/…/doi/10.1093/cid/ciaa1009/5872589…

 

The first article deals with hospitalized patients. We have known for months that HCQ is not effective on hospitalized patients.  You were apparently ignorant of that fact. The effectiveness of HCQ on already seriously ill patients is irrelevant to its potential effectiveness of HCQ when given early on in the disease progression.

Dr. Harvey Risch of the Yale School of Public Health makes this same point as follows in a very strong statement of support for the effectiveness of HCQ:

“More than 1.6 million Americans have been infected with SARS-CoV-2 and >10 times that number carry antibodies to it. High-risk patients presenting with progressing symptomatic disease have only hospitalization treatment with its high mortality. An outpatient treatment that prevents hospitalization is desperately needed. Two candidate medications have been widely discussed: remdesivir, and hydroxychloroquine+azithromycin. Remdesivir has shown mild effectiveness in hospitalized inpatients, but no trials have been registered in outpatients. Hydroxychloroquine+azithromycin has been widely misrepresented in both clinical reports and public media, and outpatient trials results are not expected until September. Early outpatient illness is very different than later hospitalized florid disease and the treatments differ. Evidence about use of hydroxychloroquine alone, or of hydroxychloroquine+azithromycin in inpatients, is irrelevant concerning efficacy of the pair in early high-risk outpatient disease. Five studies, including two controlled clinical trials, have demonstrated significant major outpatient treatment efficacy. Hydroxychloroquine+azithromycin has been used as standard-of-care in more than 300,000 older adults with multicomorbidities, with estimated proportion diagnosed with cardiac arrhythmias attributable to the medications 47/100,000 users, of which estimated mortality is <20%, 9/100,000 users, compared to the 10,000 Americans now dying each week. These medications need to be widely available and promoted immediately for physicians to prescribe.” (Bold added by me.)

https://academic.oup.com/aje/article/doi/10.1093/aje/kwaa093/5847586

Apparently you were ignorant of Dr. Risch’s statement, and also ignorant of the studies he refers to that support the effectiveness of HCQ.

The second article describes a study using quite high doses of HCQ but without added zinc. We likewise have known for months that zinc is needed for greatest effectiveness. In essence, HCQ is the gun that fires the zinc bullet into the cell. Also, because of inadequate testing, it appears that the sample size for people who received HCQ and were positive for Covid-19 was actually quite small, perhaps 77 people. Were you ignorant of the need for zinc?

The link to the third paper says that the “item requested could not be found”. Did you check that link before you posted your article?  If not, that was pretty careless, wasn’t it?

After mentioning these three articles, you say “Scientists have since studied more promising treatments, like Remdesivir, which have been shown to decrease mortality” and you cite another article to support your statement, again with hospitalized patients.

https://www.nejm.org/doi/full/10.1056/NEJMoa2007764

The problem is that the article does not really support your claim. The major effect of remdesivir claimed by the article was to reduce the time in hospital from 15 days to 11 days. Effect on mortality was not very significant, at least the authors did not claim it was significant.  Also you make no mention of the fact that over 20% of patients receiving remdesivir experienced “serious adverse effects”. (So did the patients receiving the placebo—apparently everyone with late state Covid-19 is pretty fragile…another big reason to keep people out of the hospital by an effective, outpatient treatment.)

Then perhaps your most “ignorant and careless” remark of all. You mention “liver decomposition” and “organ failure” as serious adverse effects of using HCQ. But these are the effects of the virus—not the HCQ used to treat the virus. Did you confound the two in a careless reading of the papers?

Over 70 years of world-wide experience with HCQ as have not identified either liver decomposition or “organ failure” as an effect of using HCQ.  The Veterans Administration alone administers 42,000 doses of HCQ per day: would that be happening if this drug really had such serious side effects?

Hell no.

Read this Wikipedia article about HCQ. There is not a single mention of liver or organ failure as a result of HCQ treatment over many decades. HCQ is approved for use through pregnancy to treat rheumatic disease, for heaven’s sake. So where did you get your idea that HCQ caused organ failure? A citation, please.

https://en.wikipedia.org/wiki/Hydroxychloroquine

At worst HCQ causes some retinopathy in long-term use. A week of treatment with with HCQ will not generate retinopathy, nor are there real issues with effects on the heart. You should read Dr. Louis Grenzer’s statement on the safety of HCQ.

https://www.hospicepatients.org/hydroxychloroquine-a-cardiologist-s-view-louis-grenzer-md-baltimore-md-usa-05-16-2020.html

Almost as bad is your statement “Currently, there is a pretty strong consensus in the international medical community that HCQ does not work as a treatment for COVID”.

You provide no reference for this statement because there is none.

In fact, many countries have used HCQ widely and effectively to treat Covid-19.  Chris showed two summary slides showing the case fatality rate for countries that use HCQ aggressively and those that do not.  Did you not consider those data?  I assume you are simply ignorant and careless on that point—not dishonest.

Costa Rica is perhaps a premier example of a country that has largely avoided unnecessary Covid-19 deaths by early aggressive treatment with HCQ. Their case fatality rate is about 3% of our US value. (Which is the advanced country, I wonder?)

Hydroxychloroquine: the drug Costa Rica uses successfully to fight covid-19

https://mobile.twitter.com/niro60487270/status/1252781648262729729

One more thing. You used ad hominem slurs to dismiss the work/video of Front Line Doctors. You provide not a single reference to support your attacks on them. Not a single one. This is a reputable group of trained doctors and health care personnel, not a fringe group as you would like us to believe.

Nor is it fair/reasonable/scientific of you to dismiss the presence of opthamologists and optometrists among that group of Front Line Doctors. Three MDs/eye care providers explain why HCQ is a valuable treatment for Covid-19 in this article, and why this fact is critical for eye care providers.

Hydroxychloroquine for the Treatment and Prevention of COVID-19

Were you also ignorant of the statement of these doctors?

For me, the key member of the Front Line Doctors group is Dr. James Todaro, who has been mentioned by other respondents to your post. Dr. Todaro has compiled perhaps the most complete summary of the value of HCQ in early treatment for Covid-19.

Do you have some well-founded reason for questioning Dr. Todaro’s competence?  Evidence, please, not slurs.  But you are apparently ignorant of his work, which is summarized here.

https://www.medicineuncensored.com/

OK, I could go on and on, but I need to get back to my day job.

And, in fact, Dr. Howard and I went on in considerable length about evidence for the safety, value and use of HCQ in a Medium post a couple of months ago. It also appears that you are ignorant of our humble contribution to this debate on the value of HCQ.

https://medium.com/@drbrucedale/hydroxychloroquine-can-prevent-many-covid-19-related-deaths-ae5de7a73570

I hope you will do your homework so that you will be less ignorant and careless the next time you discuss HCQ.

 

  • Thu, Jul 30, 2020 - 10:54am

    #17
    Island girl

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    Reply To: An HCQ post making the rounds

I interpreted denazilen’s comments as sharing a post circulating on FB and soliciting comment. I did not interpret it as advocating for the post, just citing it. Perhaps denazilen is simply interested in soliciting information for an evidence-based response. Dr. Dale has provided ample such evidence if needed to address the FB post claims.

The fact that all first hand information about these doctors and the references they cite is being censored does make it easy for others to try to discredit them with disingenuous statements. One must ask, what do these doctors have to gain by putting their reputation on the line? What do those promoting expensive and unproven therapies as “game-changers” stand to gain?

The doctors now have a new website and have posted the papers they cite in support of their claims under references

https://americasfrontlinedoctorsummit.com/

 

 

  • Thu, Jul 30, 2020 - 12:11pm

    #18
    drbrucedale

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    Wrongful death suits

I think we will see thousands and thousands of wrongful death suits filed against social media, political figures, etc. regarding the blatant censorship against HCQ.  It will be a target-rich environment for lawyers.

Bruce

  • Thu, Jul 30, 2020 - 06:34pm

    #19
    tatagiri

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    HCQ is not the silver bullet

i get it, HCQ works and there is a conspiracy ….  but all these long discussions are missing the point, that there are countries where HCQ is primary defense and recommended official medical board ( for eg, ICMR in India). Its cheap and available over the counter. A lot of people think -only if HCQ was approved and prescribed we will have a better outcome and covid will be cured.  Nothing can be farther than betting on HCQ.

look at India, most HCW take it as prophylaxis, available as OTC and cheap and prescribed as standard of care along zinc and az. People are still dying by thousands, case fatality rate is still 3-4% . Nothing has changed, covid will continue to take many lives .

what has really helped is

– treating it as vascular disease instead of ards

– vitamin d, c

– masks, contact tracing, lockdowns and the basics.

 

HCQ is very small tool in the bigger fight, the war is still going on and win is not in sight yet. dont get too worked up on HCQ.  Lives of people who have access to HCQ are not too different from who don’t have access to HCQ. There are bigger problems to solve ahead.

 

  • Thu, Jul 30, 2020 - 09:14pm

    #20

    davefairtex

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    PEP/PREP effectivenss

look at India, most HCW take it as prophylaxis, available as OTC and cheap and prescribed as standard of care along zinc and az. People are still dying by thousands, case fatality rate is still 3-4% . Nothing has changed, covid will continue to take many lives .

According to the numbers I have, India’s 10-day lagged CFR is 2.05%, not 3-4% (727 / 35512).   And deaths: as mentioned, last count: 727/day – not yet a thousand, although I do use a moving average to smooth out the bumps.  And they have more than a billion people.

So, what are the infection rates of those Indian HCWs?  How many HCW lives have been saved?  How many of our HCWs will become infected in the US because we don’t do this?

At a minimum, Boulware’s PEP study tells us that just HCQ alone, if taken within 1-2 days of close contact with an infected person – no zinc, just HCQ – will eliminate 30-40% of infections.  Do we think this is worthwhile?  If you were at risk, would you want this for yourself?  I sure would.

And if I were one of those frontline HCWs, I’d sure want it available to be used as a prophylaxis.

So India: great CFR, and their HCW’s get infected at much lower rates.  Seems like we should be emulating them.  If we put the vulnerable population on HCQ PREP, and gave away vitamin D to them too, where would we be right now?  CFR=0.5?

Pharma won’t allow it, though.  It might actually be really effective, and then where would that vaccine demand be?

  • Fri, Jul 31, 2020 - 06:20am

    #21
    tbp

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    HCQ use in India

i get it, HCQ works and there is a conspiracy …. but all these long discussions are missing the point, that there are countries where HCQ is primary defense and recommended official medical board ( for eg, ICMR in India). Its cheap and available over the counter. A lot of people think -only if HCQ was approved and prescribed we will have a better outcome and covid will be cured. Nothing can be farther than betting on HCQ.

You seem to be assuming everyone has access to HCQ (how many poor people are there in India?). It also won’t work if you have vitamin D deficiency. And other deficiencies will affect outcome as well, and poorer people tend to have lots of nutrient deficiencies, and also won’t be using HCQ (unless late and already in hospital).

How many are using it? Of those, how many are taking it with zinc? How many are deficient in saturated fats or fat-soluble vitamins (A, E, K) obtained from animal foods? What role might iodine or magnesium deficiency play in India?

Look at the charts:

If any other drug was this effective, they’d declare it a cure… unless the goal is to avoid any and all cures in order to favor vaccines…

 

  • Fri, Jul 31, 2020 - 02:47pm

    #22
    Island girl

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    An HCQ post making the rounds-sources

c19study.com – very interesting site – other graph shows the positive results early and the mixed results late.

Comprehensive list.

Do you know who is assembling the database and analyzing the cumulative data?

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