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Coronavirus Drug: French Researcher Reports Successful Trial Using Malaria Medicine

COVID-19 Outpatients – Early Risk-Stratified Treatment with Zinc Plus Low Dose Hydroxychloroquine and Azithromycin: A Retrospect

Postby smix » Thu Jul 09, 2020 9:25 pm

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

URL: https://www.preprints.org/manuscript/202007.0025/v1
Category: healthNews
Published: July 3, 2020

Description: Abstract
Objective: To describe outcomes of patients with coronavirus disease 2019 (COVID-19) in the outpatient setting after early treatment with zinc, low dose hydroxychloroquine, and azithromycin (the triple therapy) dependent on risk stratification.
Design: Retrospective case series study.
Setting: General practice.
Participants: 141 COVID-19 patients with laboratory confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in the year 2020.
Main Outcome Measures: Risk-stratified treatment decision, rate of hospitalization and all-cause death.
Results: Of 335 positively PCR-tested COVID-19 patients, 127 were treated with the triple therapy. 104 of 127 met the defined risk stratification criteria and were included in the analysis. In addition, 37 treated and eligible patients who were confirmed by IgG tests were included in the treatment group (total N=141). 208 of the 335 patients did not meet the risk stratification criteria and were not treated. After 4 days (median, IQR 3-6, available for N=66/141) of onset of symptoms, 141 patients (median age 58 years, IQR 40-60; 73% male) got a prescription for the triple therapy for 5 days. Independent public reference data from 377 confirmed COVID-19 patients of the same community were used as untreated control. 4 of 141 treated patients (2.8%) were hospitalized, which was significantly less (p<0.001) compared with 58 of 377 untreated patients (15.4%) (odds ratio 0.16, 95% CI 0.06-0.5). 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.
Conclusions: Risk stratification-based treatment of COVID-19 outpatients as early as possible after symptom onset with the used triple therapy, including the combination of zinc with low dose hydroxychloroquine, was associated with significantly less hospitalizations and 5 times less all-cause deaths.
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PDF: COVID-19 Outpatients – Early Risk-Stratified Treatment with Zinc Plus Low Dose Hydroxychloroquine and Azithromycin: A Retrospective Case Series Study



Newly Published Outpatient Study Finds that Early Use of Zinc, Hydroxychloroquine and Azithromycin Is Associated with Less Hospitalizations and Death
PR Newswire

URL: https://www.prnewswire.com/news-release ... 94237.html
Category: PressRelease
Published: July 15, 2020

Description: The study reports a survival rate of over 99% in patients with confirmed positive cases of COVID-19
NEW YORK, July 15, 2020 /PRNewswire/ -- Dr. Vladimir Zelenko, a New York based primary care physician, announced that a retrospective analysis based on his patient data is available to read online at http://www.thezelenkoprotocol.com. The study, which has been submitted for peer review, found that early intervention and treatment of risk stratified COVID-19 patients in the outpatient setting resulted in five times less hospitalizations and deaths. The medications used in the treatment approach were zinc, low dose hydroxychloroquine, and azithromycin. Prior studies of COVID-19 treatments have been largely based on severely ill patients in the hospital. This study examines outcomes of patients treated after their first visit to the doctor's office. Using simple risk stratification criteria, Dr. Zelenko identified which patients required prescriptions for the triple drug therapy, and prescribed these medications for five days. To produce the study, Zelenko collaborated with Dr. Roland Derwand, a German medical doctor and life science industry expert, and Professor Martin Scholz, an independent consultant and adjunct professor for experimental medicine at Heinrich Heine University, Düsseldorf, Germany. Derwand and Scholz performed the data analysis while Zelenko handled all in-person treatments. The main results show that of 141 patients who were treated with the triple therapy, only 2.8% (4/141) were hospitalized compared to 15.4% of an untreated control group (58/377) (odds ratio 0.16, 95% CI 0.06-0.5; p<0.001). Only 0.71% (1/141) patients died in the treatment group, versus 3.5% (13/377) in the untreated group (odds ratio 0.2, 95% CI 0.03-1.5; p=0.16). "These three medications are affordable, available in pill form, and work in synergy against COVID-19," said Zelenko. "Hydroxychloroquine's main function within this treatment approach is to allow zinc to enter the cell. Zinc is the virus killer, and azithromycin prevents secondary bacterial infection in the lungs and reduces the risk of pulmonary complications." "The world seems to have forgotten common medical knowledge: that we want to treat any patient with an infectious disease as soon as possible," said Derwand. "What differentiates this study is that patients were prescribed these medications early, in the outpatient setting. Dr. Zelenko treated his risk stratified patients immediately and didn't wait for the disease to intensify." "The well-tolerated 5-day triple therapy resulted in a significantly lower hospitalization rate and less fatalities with no reported cardiac side effects compared with relevant public reference data of untreated patients," said Sholz. "The magnitude of the results can substantially elevate the relevance of early use, low dose hydroxychloroquine, especially in combination with zinc. This data can be used to inform ongoing pandemic response policies as well as future clinical trials." "It's unfortunate much of the news coverage surrounding hydroxychloroquine has been negative," Zelenko added. "This study suggests that when taken early and together with zinc and azithromycin, this cost-effective drug can be part of the solution to the pandemic."
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Hydroxychloroquine and fake news

Postby smix » Tue Jul 14, 2020 9:17 pm

Hydroxychloroquine and fake news
The Duran

URL: https://theduran.com/hydroxychloroquine-and-fake-news/
Category: Politics
Published: July 8, 2020

Description: Fake news is keeping us away from the treatment to end the coronavirus crisis

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The anti-hydroxychloroquine media has been full of the supposed dangers of hydroxychloroquine and its failure as a treatment for the virus. Does hydroxychloroquine work or does it not, is it safe or dangerous, and should we be using it as a treatment for the virus? Here we examine the evidence for and against it. A New York doctor Vladimir Zelenko looked at treatments being used in China and Korea and gave it to 405 patients over 60 or with high-risk problems such as diabetes, asthma, obesity, hypertension or shortness of breath. In this high risk group he claimed to have cut hospital admission and mortality rates compared to what could be expected without treatment by 80 to 90%. https://internetprotocol.co/hype-news/2 ... r-zelenko/ Dr Zelenko sent a letter to President Trump urging him to issue an executive order to roll out the treatment which the FDA was blocking. Trump announced that hydroxychloroquine looked like it could be a “game-changer”, and thus the politicization of hydroxychloroquine began. Dr Fauci the director of the National Institute of Allergy and Infectious Diseases who was supposed to be advising Trump disagreed with him and backed Gilead’s rival treatment Remdesivir. YouTube deleted a video of Dr. Zelenko talking about the treatment on his Rabbi’s channel and despite objections that there was nothing wrong with the video YouTube never reinstated it. In this YouTube video interview with Rudy Giulliani from July 1, which hopefully will not be deleted by the time you read this, Dr. Zelenko claims 99,3% survival rate for the high-risk patients he has treated. https://www.youtube.com/watch?v=TFwjY0qe7ro Professor Didier Raoult of Marseilles used a similar protocol to Dr. Zelenko without the zinc. His study with a small group using hydroxychloroquine and azithromycin showed a fifty-fold benefit. He then went on to get similar results with a much larger group of 1,061 patients. Contrary to the warnings the media had been running that hydroxychloroquine would cause heart problems, no cardiac toxicity was observed and he achieved a mortality rate of only 0.5%. http://covexit.com/professor-didier-rao ... -patients/ The media quickly found critics who claimed that the only valid proof any treatment worked was a “gold-standard” double-blind clinical trial and dismissed Dr. Zelenko’s and Raoult’s results. Dr. Zelenko and Prof. Raoult both refused on ethical grounds to give placebos to half the patients in clinical trials and they defended their data as sufficient to show the treatment did work. They both stressed that the urgency of the situation made it necessary to act on available evidence, not clinical trials which would take months to produce results and be verified. There have subsequently been over a dozen studies which confirm that Dr. Zelenko’s and Prof. Raoult’s protocols do work. A study from the New York University Grossman school of Medicine published in May found patients given hydroxychloroquine and azithromycin at an early stage had a lower need for hospitalization than those who were not. The addition of zinc improved the results even more. https://www.medrxiv.org/content/10.1101 ... 1.full.pdf “I’ll tell you what. If this is me, and I am me, and I end up getting this thing, I am going to want Zinc plus Hydroxychloroquine plus Azithromycin. I would want that treatment.” commented Chris Martenson, PhD, in his video series about COVID-19 where he talks about this study. http://covexit.com/i-am-going-to-want-z ... erson-phd/ Yale Professor Harvey Risch submitted a report of five trials and studies using hydroxychloroquine in the American Journal of Epistemology titled “Early Outpatient Treatment of Symptomatic, High-Risk Covid-19 Patients that Should be Ramped-Up Immediately as Key to the Pandemic Crisis. https://www.medrxiv.org/content/10.1101 ... 20080036v1. Prof. Risch agreed that, in an ideal world, randomized double-blinded controlled clinical trials would be preferable but in the meantime “for the great majority I conclude that hydroxychloroquine and azithromycin, preferably with zinc can be this outpatient treatment, at least until we find or add something better. It is our obligation not to stand by as the old and infirm are killed by this disease and our economy is destroyed by it and we have nothing to offer except high-mortality hospital treatment. Available evidence of efficacy of HCQ+AZ has been repeatedly described in the media as anecdotal, but most certainly is not” http://covexit.com/yale-epidemiology-pr ... -covid-19/ A Brazilian study found 4.6 times less hospitalization in patients who took hydroxychloroquine and azithromycin within seven days of infection. Professor Paolo Zanotto reported that there were “41% of deaths among those who did not choose therapy and were hospitalized against 0% among those who chose by therapy.” http://covexit.com/new-brazilian-study- ... alization/ A retrospective study of 2,541 Detroit cases showed up to 71% reduction in mortality in early treatment with hydroxychloroquine azithromycin. https://doi.org/10.1016/j.ijid.2020.06.099 A retrospective study of 3,737 cases in Marseille showed a reduction of 50% in mortality without any adverse effects in the Hydroxychloroquine and Azithromycin group. https://doi.org/10.1016/j.tmaid.2020.101791 A meta-analysis of 105,040 cases from 20 studies in 9 countries found a reduction in mortality by up to three times in groups treated early with Hydroxychloroquine and Azithromycin: https://doi.org/10.1016/j.nmni.2020.100709 A study of 6,493 patients with COVID-19 at Mount Sinai Hospital, New York, showed that hydroxychloroquine helped to reduce mortality in hospitalized patients. . https://doi.org/10.1007/s11606-020-05983-z On July 3 a study by a Michigan team at Henry Ford Health System found that 13 percent of patients who were given the drug early on died while 26 percent of patients who were not given the drug died. The study which included 2,541 patients was published in the International Journal of Infectious Diseases and determined that hydroxychloroquine and azithromycin provided a 71% hazard ratio reduction. “Our results do differ from some other studies. What we think was important in ours … is that patients were treated early. For hydroxychloroquine to have a benefit, it needs to begin before the patients begin to suffer some of the severe immune reactions that patients can have with COVID” said Dr. Marcus Zervos, head of infectious disease for Henry Ford Health System. https://www.ijidonline.com/article/S1201-9712(20)30534-8/fulltext A statement from the Trump campaign hailed the study as fantastic news. “Fortunately, the Trump Administration secured a massive supply of hydroxychloroquine for the national stockpile months ago, yet this is the same drug that the media and the Biden campaign spent weeks trying to discredit and spread fear and doubt around because President Trump dared to mention it as a potential treatment for coronavirus. The new study from the Henry Ford Health System should be a clear message to the media and the Democrats: stop the bizarre attempts to discredit hydroxychloroquine to satisfy your own anti-Trump agenda. It may be costing lives.” Also on July 3 results from another study by Dr. Takahisa Mikami and his team at Icahn School of Medicine at Mount Sinai in New York, was published in the Journal of General Internal Medicine. The study analyzed the outcomes of 6,493 patients who had laboratory-confirmed COVID-19 in the New York City metropolitan area and found that hydroxychloroquine decreased mortality hazard ratio by 47% percent. https://doi.org/10.1007/s11606-020-05983-z Many more studies in addition to those above also show that treating early with hydroxychloroquine and azithromycin and preferably also zinc is the key to ending hospitalization and death. https://c19study.com/ The trials that confirm Dr. Zelenko’s and Prof. Raoult’s finding have been mostly ignored or dismissed by the anti-hydroxychloroquine media. The trials that they have given attention to are those that supposedly show that hydroxychloroquine doesn’t help or even increases the death rate. Statistics from the US Veterans hospital study (Magagnoli, 2020) showed patients who were given hydroxychloroquine died more frequently than those who did not. https://www.medrxiv.org/content/10.1101 ... 20065920v2 In this study hydroxychloroquine was only given to patients who were already seriously ill and those who were getting better without any treatment were not given it. Predictably those given hydroxychloroquine did worse than the untreated group but those conducting the study claimed it as proof that hydroxychloroquine did not work. Professor Raoult commented “In the current period, it seems that passion dominates rigorous and balanced scientific analysis and may lead to scientific misconduct. The study by Magagnoli et al is an absolutely spectacular example of this,” http://covexit.com/the-definitive-guide ... 19-part-1/ One of the collaborators in the trial reportedly received a $260 million grant from Gilead Sciences Inc. which produces the rival treatment Remdesivir. The US Secretary of Veteran Affairs Robert Wilkie, acknowledged that the drug was given to veterans at their last stages of life and added “We know the drug has been working on middle-age and young veterans … it is working in stopping the progression of the disease.” Another study that supposedly showed that hydroxychloroquine was dangerous and didn’t work came from a group that claimed to have data on hydroxychloroquine use for Covid-19 from hospitals around the world The study was published on 22 May in the Lancet medical journal. The results were immediately disputed by one of the Australian hospitals from which Surgisphere, the company which supplied the data claimed to have obtained it. Following this a group of 140 scientists, researchers, and statisticians wrote an open letter to the Lancet and the authors of the study questioning the data used. A Guardian investigation revealed that Surgisphere was run by employees who lacked any scientific background. One was a science fiction author and fantasy artist and another was an “adult model and events hostess.” The Lancet conducted an independent investigation, retracted the study and in an interview with The New York Times, Dr. Richard Horton, the editor in chief admitted that the study should never have appeared in his journal. https://www.thelancet.com/journals/lanc ... 40-6736(20)31180-6/fulltext On the basis of the flawed Lancet study the WHO suspended the hydroxychloroquine trials it was sponsoring. When the study was retracted they resumed them briefly but soon after suspended them again on the results of another faulty study, the Oxford University’s “RECOVERY Trial”. The researchers in this trial gave patients massive doses of hydroxychloroquine without the necessary addition of azithromycin and they started treatment too late. That the RECOVERY Trial was never going to work was pointed out on the Covexit website two months before it started. http://covexit.com/uk-recovery-trial-in ... bly-fails/” Prof. Raoult compared the Oxford academics who carried out the hydroxychloroquine section of the RECOVERY trial to the Marx Brothers in a video interview titled “The Marx Brothers are Doing Science – the Example of RECOVERY” http://covexit.com/professor-raoult-com ... -brothers/ Prof. Raoult sarcastically commented that the good news that came out of the trial was that hydroxychloroquine is not toxic. The RECOVERY trial used a 2,400 mg dose on the first day compared to Dr.Raoult’s 600 mg. Even with such high dosage there were no cardiac side effects with any of the participants. Prof. Raoult recalled that “two weeks ago one was told everybody was dying because of cardiac issues. At least, this trial is good to assess the toxicity of hydroxychloroquine as they did not announce any toxicity, even at such high dosage”. Although by now it should have been abundantly clear that hydroxychloroquine and azithromycin only worked in combination and if given early, not to patients in hospital more than seven days after infection, in April the US National Heart, Lung, and Blood Institute (NHLBI) at the National Institutes of Health (NIH) started hydroxychloroquine trials on hospitalized patients too late, some already in emergency wards, and then abandoned the trials with the conclusion that “hydroxychloroquine does no harm but provides no benefit”. The FDA cancelled its emergency use authorization and the NIH halted their clinical trials of hydroxychloroquine The media hostile to hydroxychloroquine successfully whipped up hysteria about its supposed dangers although it has an excellent safety record and it is not even alongside aspirin on the WHO list of the 100 most dangerous drugs. Specialists and doctors prescribing hydroxychloroquine for Rheumatoid Arthritis and Lupus have confirmed that thousands of patients are being prescribed the same dose Dr. Zelenko is giving for five days for years on end without problems. Were the failed studies faulty because of ignorance or by design? Who gains from them? The drug companies can’t make much money on a generic drug, and they found in the media and the scientific community willing accomplices to stop its use. Gilead Sciences Inc. gives grants in addition to those mentioned above to Oxford University and the WHO. Is it possible that people in these prestigious institutions may have their integrity compromised by money, or is it mere coincidence that Gilead with their rival treatment is funding them? Some of the media will do anything to make Trump look like a fool and these faulty trials were the perfect opportunity. The media hostile to hydroxychloroquine downplayed or cast doubt on the many successful studies and trials with hydroxychloroquine and made the most of the faulty trials as proof that the drug Trump had touted didn’t work. For the media it seems to have been more about scoring political points and increasing their audience ratings rather than investigative reporting which uncovers the truth. For those who are dying and their families and friends as a result of this treatment not being used because of media misinformation it is lives tragically lost, and for the rest of us it is our economies sinking, businesses failing, and unemployment, poverty and suffering rising. Hundreds of thousands of lives could be saved, and loss ruin, suffering and devastation to our economies and societies avoided if we simply started using this safe, cheap and readily available treatment. It is a ludicrous and tragic farce that because of the massive misinformation on behalf of corporate greed and political point scoring that we are not.
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Scientists evaluated the perspectives of zinc intake for COVID-19 prevention

Postby smix » Wed Jul 15, 2020 2:57 am

Scientists evaluated the perspectives of zinc intake for COVID-19 prevention
EurekAlert

URL: https://www.eurekalert.org/pub_releases ... 071320.php
Category: healthNews
Published: July 13, 2020

Description: Researchers from Sechenov University in collaboration with colleagues from Germany, Greece and Russia reviewed scientific articles on the role of zinc in the prevention and treatment of viral infections and pneumonia, with projections on those caused by SARS-CoV-2. The results were published in the International Journal of Molecular Medicine. Zinc is necessary for normal metabolism and functioning of the reproductive, cardiovascular and nervous systems, but it is also important for the immune system, in particular for the proliferation and maturation of white blood cells (some of them are able to capture and digest microorganisms, and others - to produce antibodies). In addition, zinc is involved in the regulation of inflammation. Thus, normal levels of zinc support human resistance to inflammatory and infectious diseases. 'According to the current estimates, the risk of zinc deficiency is observed in more than 1.5 billion people in the world. In Russia, deficiency of this element occurs in 20-40% of the population; in some regions it reaches 60%. Given the crucial role of zinc in regulation of immunity, one can propose that its insufficiency may be considered as a risk factor for infectious diseases,' said the research leader, head of the Laboratory of Molecular Dietetics at Sechenov University, Professor Anatoly Skalny. The scientists reviewed the results of studies on the use of zinc-containing drugs for increasing immunity and preventing viral infections, including SARS-CoV-2 that caused COVID-19 outbreak this year. Previous studies showed that zinc and its binding substances can slow down the work of RNA polymerase (an enzyme that synthesises viral RNA molecules) of coronaviruses and suppress their spread in the body. One of the substances that stimulate the cellular zinc uptake, chloroquine, has already been tested on patients with SARS-CoV-2, but its strong side effects make it necessary to look for other compounds with a similar effect or use zinc separately. However, both options have not been sufficiently studied or tested yet. Observations of the development of other viruses, such as rhinoviruses (this family includes pathogens of acute respiratory diseases), show that an increase in the level of zinc in cells suppresses replication (reproduction) of the virus and stimulates production of interferon alpha, which has an antiviral activity. In addition, zinc deficiency is considered as one of the risk factors for the development of pneumonia: it increases the susceptibility to infectious agents and the disease duration. Several studies show the effectiveness of zinc-containing drugs in decreasing severity and duration of symptoms and reducing the prevalence of pneumonia. However, in general, data on the use of zinc as a therapy, rather than prevention, are contradictory. Another possible application of zinc is modulation of inflammation. Existing data show that zinc ions have an anti-inflammatory effect, reducing damage to lung tissue in pneumonia. Zinc also helps the body resist bacteria, and bacterial pneumonia frequently occurs in patients with secondary viral infections. 'A recent study conducted by scientists from the USA confirmed our assumptions, demonstrating the effect of zinc intake on the risk of a severe course and the need for artificial ventilation in patients with COVID-19,' said Alexey Tinkov, coauthor of the article, a leading researcher at the Laboratory of Molecular Dietetics at Sechenov University. Therefore, according to current research, adequate zinc status can bring down the likelihood of infectious respiratory diseases, pneumonia and its complications. There are also indirect indications that zinc intake may be effective in the fight against coronavirus disease (COVID-19), but there is still insufficient data for recommendations.
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Zinc and COVID-19 infection

Postby smix » Mon Jul 20, 2020 7:01 am

Zinc and COVID-19 infection
St, Luke's Clinic, Gdansk

URL: https://swietylukasz.pl/en/2020/03/20/z ... infection/
Category: healthNews
Published: March 20, 2020

Description: For some time, conflicting information has been circulating in the media: on the one hand, that zinc helps, on the other hand, that zinc supplementation during the infection period is pointless. A few days ago in Poland the drug – chloroquine has been registered. Effective mechanism of this drug is based on transporting the zinc ions inside the cell. The virus is a kind of cell parasite, it does not have its own metabolism, it is completely dependent on host cells. It penetrates inside the cells. In the case of coronavirus it attacks the cells of the respiratory system, e.g. lungs, where it begins to multiply. Coronavirus is an RNA virus. That means it replicates copies of its own genetic material – RNA, using a replicase enzyme (RNA-dependent replicase / RNA polymerase). The replicase begins to produce multiple copies of the virus. The more viruses will multiply, the more infected host cells will be. Massive immune response and cytokine influx will cause havoc in lung cells, which is associated with worse disease course and may result in the patient’s death. By stopping the virus replication process, it would be possible to alleviate the symptoms of the disease and reduce mortality. It turns out that zinc inhibits replicase’s activity. An obstacle to the action of zinc is the problem with the penetration of this element into the cell. What is needed here is a substance that causes the zinc to transfer from the external environment of the cell to its interior, where the virus potentially replicates. These substances are so-called ionophores, and their function is to transport ions through the cell membrane. Ionophores include hydroxychloroquine and chloroquine. Hydroxychloroquine (the commercial name is Plaquenil or Quensyl, successfully used in Korea) and chloroquine (the commercial name is Arechina, recently registered in Poland) belong to substances that potentially fight coronavirus. In Korea, hydroxychloroquine has always been given to the patients along with zinc – good treatment results and reduction in mortality have been reported. In Poland, chloroquine will be administered in hospitals, while Plaquenil (hydroxychloroquine) is available in pharmacies. Before you take this medicine, remember that it also has side effects. It can affect conduction in the heart (so-called QT interval), therefore the decision to take the drug should be made by the doctor taking into account all therapies and other medications taken, with ECG control. Hydroxychloroquine is less toxic than chloroquine, however, in the case of short-term use (several days) during an acute infection, the differences in toxicity are probably not very significant. In the case of zinc – it is not known what doses should be used and for whom or whether supplementation is needed at all. However, it is usually not known if the patient has sufficient levels of zinc in the body. According to research, zinc deficiencies occur quite often, therefore supplementation seems to be a rational approach. Signs of zinc deficiency:
– dry skin, bad condition of the hair and nails (in the absence of other problems, e.g. with thyroid gland or iron levels),
– worsened wound healing,
– weakened immunity, a history of hard infections,
– hormonal disorders, e.g. low testosterone,
The cause of zinc deficiency can also be an excessive load of heavy metals in the body. The greatest amount of zinc in the diet is found in animal source foods, therefore people who have been on a vegetarian or vegan diet for a long time should supplement zinc. Zinc supplementation during the infectious period is not a mistake. Zinc can be overdosed, but only by taking very high doses for a long time. Short-term zinc supplementation, even in people with normal zinc levels, does not have a negative impact on health, and may additionally support the immune system, which largely depends on the zinc level in the body to function properly. The aforementioned ionophores also include noteworthy natural substances, devoid of toxicity, such as:
– quercitin (plant flavonoid, found in many fruits and vegetables) – supports the immune system and increases the effectiveness of treatment of viral infections,
– phosphatidylcholine (a phospholipid that builds cell membranes, contained in lecithin) – necessary for the proper work of the nervous system, mitochondria, immune system and also helps to detoxify the body.
To sum up: zinc is an element that inhibits the multiplication of coronavirus, it is worth to consider its supplementation. Drugs used to fight coronavirus infection use the mechanism of zinc entering the cell. Also the use of natural substances, that act similarly to chlorocholine and hydroxychlorocholine, can be an additional weapon in the fight against infections.
Dr. Chris Majdyło
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Characteristics, Treatment Outcomes and Role of Hydroxychloroquine among 522 COVID-19 hospitalized patients in Jaipur City:

Postby smix » Mon Jul 20, 2020 7:18 am

Characteristics, Treatment Outcomes and Role of Hydroxychloroquine among 522 COVID-19 hospitalized patients in Jaipur City: An Epidemio-Clinical Study
Journal of The Association of Physicians of India

URL: https://www.japi.org/v2c474c4/character ... ical-study
Category: healthNews
Published: June 2020

Description: Abstract
Purpose: The present study was undertaken to investigate epidemiological distribution, clinical manifestation, co morbid status, treatment strategy and case fatality index of emerging COVID-19 infection at SMS Medical College Hospital, Jaipur, Rajasthan. It also evaluated efficacy of hydroxychloroquine (HCQ) in treatment of patients and risk of serious adverse outcomes in patients with COVID-19 in relation to their co morbid status.
Materials and methods: In an attempt to provide extensive information pertaining to epidemiological and clinical characteristics of COVID-19, the present study was undertaken on 522 patients. The patients were COVID-19 confirmed positive by genomic analysis through Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) at SMS Medical College and Attached Hospitals, Jaipur. The indoor admitted patient’s information inclusive of demographic profile (age, sex, nationality, residence), date of confirmation for positive COVID-19 case, travel/ exposure history, date of recovery/ death, clinical features, co morbidities and treatment plan was recorded. A serial follow-up of recovered patients to evaluate infective period of the disease was also part of the study.
Results: A total of 522 patients of laboratory confirmed COVID-19 test by RT-PCR at SMS Hospitals, Jaipur were assessed. Among the confirmed cases, most of patients were young adult in the age group with mean age of 35.42 years. 22.41% patients were below 20 years of age, majority of patients (58.80%) were in the age range of 21 to 50 years and only 18.79% patient population was in the age range of above 50 years. Females (39.08%) were affected less than males (60.91%) with an average sex ratio of female: male being 0.64. Out of the total analyzed patients, only 24.32% patients were symptomatic, among them fever (55.90%), cough (52.75%), sore throat (49.60%) and shortness of breath (46.45%) were the most common presenting clinical manifestations while a few patients also had symptoms of headache (26.77%), chest pain (6.29%) and other symptoms (7.87%) like pain abdomen, fatigue, joints pain, altered sensorium etc. Most of symptomatic patients belonging to older age group. An average of 40.40% patient population of above 50 years of age, were symptomatic while none of the patients below 10 years of age were symptomatic. 13.98% patients had some or the other underlying co morbid disease. The most prevalent co morbidity was hypertension (42.46%) followed by Diabetes mellitus (39.72%), Old k-chest (20.54%), COPD/ Bronchial Asthma (16.43%), Coronary artery disease (13.69%), Chronic kidney disease (13.69%) and Valvular heart disease (6.84%) distributed in co morbid patients of COVID-19. 60.27% of patient population with underlying co morbid conditions were more prone to develop symptomatology complex as compared to that observed in patients with no co morbidity (18.42%). 116 patients had recovered with effective treatment till the date of data analysis. Time of recovery was counted from the date of positive report to 1st negative report of oropharyngeal sample by RT-PCR for COVID-19 with an average recovery time of 8.15 days. 23.27% patients recovered within 5 days, while 52.58% patients took about 6-10 days, 23.27% patients took 11-15 days and remaining 0.86% took more than 16 days to recover. In the present study 15 patients had died till analysis of data, among the deceased, 73.33% were above 50 year of age with a male preponderance (66.6%). Interestingly, all deceased (100%) had presented with clinical manifestations of COVID-19 and all had underlying multiple co morbid conditions. Majority of patients had early mortality after admission to hospital with two third death account in initial three days. Asymptomatic patients (cases) treated with HCQ recovered early (average recovery time =5.4 days) compared to asymptomatic patients who did not receive any treatment (control group) and had longer recovery time (average recovery time =7.6 days).
Conclusion: The varied spectra of COVID-19 mostly affects young adult age group (third to fifth decades of life). Interestingly, early age group was also affected in significant proportion when compared with similar data from other countries. It was observed that male population seemed to be was more prone to getting infected. Majority of COVID-19 positive patients (nearly three-fourth) were asymptomatic (mostly in young age range) at the time of diagnosis, which poses a major challenge for health care workers. Fever, cough, sore throat and shortness of breath were major symptoms that could be detected in such COVID-19 patients. Symptomatic clinical manifestations were more common in old age population. Infectivity was higher in patients that had underlying co morbid disease, especially in patients with multiple co morbid conditions. Symptomatic presentation of COVID-19 was observed to be higher in patients with co morbid disease. Average recovery time from COVID-19 was 8 days with effective treatment. Mortality in COVID-19 was higher in old age population, male gender, symptomatic and co morbid patients as compared to other similarly matched group. Most of mortality was noted within first few days of admission, suggestive of early mortality due to the primary disease process. Treatment with HCQ had early recovery without effectively influencing the overall mortality.
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Gilead: Twenty-one billion reasons to discredit hydroxychloroquine (ORIGINAL ARTICLE)

Postby smix » Thu Jul 23, 2020 7:29 pm

Gilead: Twenty-one billion reasons to discredit hydroxychloroquine (ORIGINAL ARTICLE)
OmniJournal - James M. Todaro, MD

URL: https://omnij.org/Gilead:_Twenty-one_bi ... AL_ARTICLE)
Category: Politics
Published: July 23, 2020

Description: Now primarily a marketing machine to sell drugs of dubious benefit, this industry uses its wealth and power to co-opt every institution that might stand in its way, including the U.S. Congress, the Food and Drug Administration, academic medical centers, and the medical profession itself. - Marcia Angell, former editor-in-chief of the NEJM, The Truth About the Drug Companies

marcia-angell-quote.jpg

Introduction
In the history of medicine, no single drug has been so singularly attacked by the media, World Health Organization, government officials and institutional health experts as hydroxychloroquine. Approved as a “safe and cost-effective” essential medicine by the WHO, CDC and regulatory authorities across Europe, hydroxychloroquine has been prescribed to millions of patients over the past 65 years. Despite decades of known safety, hydroxychloroquine was labelled “dangerous” and a “poisonous substance” after showing promise as a therapeutic for COVID-19. Many attribute this negative publicity to anti-Trump sentiment from mainstream media outlets including CNN, MSNBC, Washington Post, New York Times and Huffington Post. This thesis does not entirely hold up to scrutiny though. President Trump named both hydroxychloroquine and Gilead’s remdesivir as a “game changer” in his breaking March 19th press conference.
There are promising therapies produced by Gilead, and that’s remdesivir. Remdesivir. And that’s a drug used for other purposes that’s been out and has had very good results for other purposes, but it seems to have a very good result, having to do with this virus...So you have remdesivir and you have chloroquine and hydro- — hydroxychloroquine. So those are two that are out now, essentially approved for prescribed use. And I think it’s going to be very exciting. I think it could be a game changer...Very powerful. They’re very powerful.
- President Donald J. Trump, March 19th, 2020. 11:31 AM EDT

At the time of the press conference, there was only in vitro evidence of remdesivir’s effectiveness against SARS-CoV-2. No clinical trial existed showing remdesivir to be effective. The preliminary results from the NIH clinical trial were not available until over a month later on April 29. The evidence of its efficacy primarily stemmed from a few in vitro studies that included an article published in the Nature-owned journal Cell Research. Interestingly, the Nature publication demonstrated that both remdesivir and chloroquine were effective against SARS-CoV-2, stating “remdesivir and chloroquine are highly effective in the control of 2019-nCoV infection in vitro.” While there was only in vitro evidence of successes with remdesivir, there was both in vitro and clinical evidence of hydroxychloroquine’s efficacy. Nevertheless, scientists, including Dr. Fauci, as well as the WHO and media outlets worldwide criticized Trump for providing false hope on the therapeutic effect of hydroxychloroquine while staying quiet about remdesivir. It’s possible that the effort to undermine hydroxychloroquine may have even begun months prior to Trump’s announcement. Chloroquine was first shown to have strong antiviral effects on SARS-CoV infection in primate cells back in the 2005 publication Chloroquine is a potent inhibitor of SARS coronavirus infection. Pharmaceutical companies were likely aware that if hydroxychloroquine was shown to be effective against SARS-CoV-2 it would diminish the value of patented therapeutics or vaccines. Through lobbying efforts, regulation may have been the first step to control the availability of hydroxychloroquine. This may have been what occurred in France. Hydroxychloroquine was available without prescription in France for years. This came to an end on January 13, 2020, when hydroxychloroquine was classified “in all its forms” as a “list II poisonous substance.” After decades of widespread use, hydroxychloroquine quickly became a restricted substance in France in the earliest days of the COVID-19 pandemic. Just several weeks later, Dr. Didier Raoult in the South of France would report his landmark clinical trial demonstrating hydroxychloroquine’s efficacy against COVID-19. Why was hydroxychloroquine—a drug safely used for over half a century—aggressively labelled dangerous while an HIV medication with an unknown safety profile got a pass? Herein I outline the evidence showing hydroxychloroquine to be a direct threat to Gilead’s success as well as the massive sphere of influence Gilead has over government taskforces, the World Health Organization, medical journals, academic institutions and research scientists. These organizations provided ammunition for the media’s war on doctors prescribing hydroxychloroquine.
Remdesivir vs hydroxychloroquine
Gilead’s stock rises and falls based on the successes and failures of both hydroxychloroquine and remdesivir. Immediately before Trump first announced hydroxychloroquine as a promising therapeutic for COVID-19, GILD traded at a local high of $85 per share, a price unattained since early 2018. Hours after Trump’s press conference, GILD dropped 8.7%, and then continued to plummet to $69 per share the following week—erasing $21 billion from its market cap in mere days. Immediately after Dr. Fauci announced the success of remdesivir in the NIH trial, GILD stock surged back to $85 per share. Compared to the largest pharmaceutical companies by revenue, Gilead has consistently outperformed in this pandemic with GILD gaining over 20% YTD while most of its competition struggled with losses or meager gains. This growth is almost certainly attributed to remdesivir’s promise as an effective treatment for COVID-19.

gilead-kills.jpg

Gilead has a direct financial incentive for hydroxychloroquine to fail. Actually, based on its share price, Gilead has 21 billion reasons to discredit hydroxychloroquine. Perhaps no other company has more to gain in the immediate future from hydroxychloroquine’s failure than Gilead.
Medical journals
Medical journals have increasingly become marketing machines for big pharma. This has been openly stated by editors of even the highest impact medical journals. Back in 2003, Richard Horton, editor-in-chief of The Lancet wrote, "The business climate for most modern medical journals, whether in the for-profit or non-profit sector, is strongly pro-pharmaceutical industry…In this environment, I know that it can be difficult for editors to raise questions about the ethics and marketing tactics of pharmaceutical companies..." The following year Horton again bemoaned the influence of big pharma stating, “Journals have devolved into information laundering operations for the pharmaceutical industry.” Similarly, Marcia Angell, former editor of the New England Journal of Medicine, excoriated the industry in her book The Truth About the Drug Companies saying, "Now primarily a marketing machine to sell drugs of dubious benefit, this industry uses its wealth and power to co-opt every institution that might stand in its way, including the U.S. Congress, the Food and Drug Administration, academic medical centers, and the medical profession itself. (Most of its marketing efforts are focused on influencing doctors, since they must write the prescriptions.)" Although written in 2004, Marcia Angell’s comments are especially prescient in the current setting of the promotion of remdesivir over hydroxychloroquine. In marketing alone, the situation has only worsened over the past two decades. According to researchers at Dartmouth College, the US pharmaceutical industry increased total spending on marketing from $17.7 billion in 1997 to nearly $30 billion in 2016. The strategy was successful with US spending on prescription drugs ballooning from $117 billion to $329 billion during this time. Advertising and sponsorships are a substantial source of revenue for most medical journals comprising up to 80% of publishing revenue for some journals. Likely less publicly vocal today than over a decade ago due to growing control of big pharma, editors still secretly complain about the influence of big pharma. Just recently, Philippe Douste-Blazy, former French Minister of Health and Under-Secretary-General of the United Nations, reported a leaked conversation from a conference where editors-in-chief of both The Lancet and NEJM bemoaned big pharma’s control over publishing. The reality is that without advertising revenue, most medical journals would go bankrupt. The unfortunate downside is that the very survival of journals relies on keeping big pharma happy at the expense of scientific truths. The Lancet may have chosen satisfying Gilead over scientific truths when it published a fraudulent study showing that hydroxychloroquine increased mortality and lethal arrythmias in COVID-19 patients. On May 22, 2020, The Lancet published a peer-reviewed, observational study comparing hydroxychloroquine to standard therapy in 96,032 hospitalized COVID-19 patients. Almost immediately afterwards, the WHO suspended all clinical trials on hydroxychloroquine because of safety concerns. Dr. Fauci also commented on the dangers of hydroxychloroquine, telling CNN’s Jim Sciutto that it likely causes "adverse events with regard to cardiovascular." Independent researchers not beholden to big pharma quickly recognized the study to be predicated on a likely fraudulent dataset that included an impossible number of COVID-19 patients or deaths and an improbable number of partnerships with hospitals. Almost laughable if not for the gravity of the malfeasance, the dataset was provided by the unknown corporation Surgisphere with only five employees that included a science fiction writer and erotic model-for-hire posing as the Director of Sales. Facing overwhelming evidence that the study was fraudulent, the authors retracted the study in less than two weeks from the date of publication. One could argue that the publication of this study was a mere oversight by The Lancet. That is, a study that slipped through the peer-review process. Let’s speculate for a moment, however, on what the strategy would be to publish a fraudulent study discrediting hydroxychloroquine.
* Step 1. Establish plausible deniability by relying on an external corporation to provide the dataset. Surgisphere.
* Step 2. Delete any digital footprint that could jeopardize the integrity of the data source. Surgisphere’s website is not included in the Internet Archives.
* Step 3. Establish a track record of publications in high impact journals that would lend legitimacy to the Surgisphere dataset. The authors had just enough time to publish in NEJM the study Cardiovascular Disease, Drug Therapy, and Mortality in Covid-19 using the Surgisphere dataset. (This study was later retracted as well.)
* Step 4. Select a lead author with impeccable credentials. Dr. Mandeep Mehra is a professor of medicine at Harvard Medical School, the William Harvey Distinguished Chair in Advanced Cardiovascular Medicine and the medical director of the Brigham Heart and Vascular Center in Boston.
* Step 5. Obfuscate the dataset as much as possible so that its integrity would be difficult to definitively invalidate. Patient data in the Lancet study was categorized by continent such that even the countries supposedly participating in the dataset were hidden.
* Step 6. Publish the study in a prestigious medical journal with the comfort of knowing that it will immediately garner the support of the WHO, Dr. Fauci and influential scientists worldwide. The Lancet.
Despite all the above hypothetical steps, through the power of social media platforms such as Twitter, independent researchers were able to collaborate to quickly debunk the study. The motivation for the above actions is admittedly still unclear. The connection between Gilead and the study authors is tenuous. What is known is that both Dr. Mehra and Dr. Sapan Desai (founder of Surgisphere) have openly praised remdesivir in various interviews and tweets. Of note though, Dr. Mehra was one of just a few experts selected to speak at a Gilead sponsored COVID-19 conference live-streamed by thousands of experts worldwide in early April. Without a formal investigation into this affair, it is likely the motivation—be it attention seeking or the meddling of big pharma—will never be fully revealed. The authors and Lancet were not the only involved parties though. The WHO suspended worldwide clinical trials on hydroxychloroquine based on this study.
World Health Organization
Gilead helps fund the WHO. Gilead Sciences provided 0.12% of the WHO’s funding for the biennium of 2018-19—more than doubling its contribution from the prior biennium. This may seem like an insignificant percentage, but it’s important to note that China contributed just 0.21%, Italy 0.48% and Spain 0.06% of the WHO’s funding. With the exception of Sanofi, Gilead gave more to the WHO than any other pharmaceutical company. With remdesivir approved as a standard therapy for COVID-19, I suspect Gilead will further increase its contributions to become the largest pharmaceutical donor in the 2020-2021 biennium. While Gilead may appear philanthropic, one must wonder how ethical it is for organizations making global recommendations on therapeutics to receive substantial funding from big pharma. This conflict of interest is suspicious considering the WHO’s dogged criticism of hydroxychloroquine while praising remdesivir. In late February 2020, WHO assistant director-general Bruce Aylward said: “There is only one drug right now that we think may have real efficacy and that’s remdesivir.” This statement is peculiar because just two weeks prior on February 5, an article was published in Cell Research titled “Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV).” Despite only in vitro evidence of efficacy for both medications, remdesivir was touted as a potential therapeutic while hydroxychloroquine and chloroquine were completely disregarded. It was only after grassroots investigators James Todaro, MD and Gregory Rigano published an article on chloroquine/hydroxychloroquine as a treatment for COVID-19 that caught the attention Elon Musk and President Trump did the WHO begin clinical exploration of hydroxychloroquine. Through various actions and inactions, the WHO provided little support for clinical trials on hydroxychloroquine. The WHO did nothing to dispel the myth that hydroxychloroquine was dangerous throughout April and May. We now know that the WHO was collaborating with Oxford University researchers, who were giving patients doses of hydroxychloroquine exceeding four times that of treatment courses administered by Drs. Raoult and Zelenko. Surely if hydroxychloroquine was dangerous, these high doses would not have been administered with the WHO’s blessing. Nevertheless, the WHO remained quiet allowing the narrative of hydroxychloroquine’s harmful effects to grow resulting in diminishing enrollment in clinical trials. Inaction turned into action when the WHO aggressively suspended its clinical trials of hydroxychloroquine in May 2020, after The Lancet published its fraudulent observational study. This bombshell announcement was splashed across media headlines reaching millions of patients and healthcare providers alike and deterring not just enrollment in its own SOLIDARITY trial, but also clinical trials outside the purview of the WHO. The WHO made this decision without any independent assessment of the study’s veracity. Soumya Swaminathan, chief scientist for the WHO, openly admitted the WHO’s mistake by stating, “It is [very] difficult for us to check data quality of each published paper & we trust authors to adhere to basic [standards]. HCQ restarted today after data safety committee approval.” It’s very surprising that an organization such as the WHO employing over 7000 people and receiving over $2 billion annually to investigate potential therapeutics for COVID-19 issued guidance based on a study that unpaid independent researchers debunked just a few days later.
US Government
The pharmaceuticals and health products spent $295 million in lobbying efforts in the United States which places it in 1st place in money spent on lobbying. For comparison, the insurance industry and automotive industry only spent $155 million and $69 million in 2019, respectively. In 2019, Gilead spent nearly $6 million in political lobbying efforts. This number is on track to reach record highs in 2020 as Gilead has spent already nearly $2.5 million on lobbying in just Q1 of 2020. The money appears to be well spent. The exclusive NIH COVID-19 Treatment Guidelines Panel that informs US clinicians how to care for patients is occupied by 8-9 experts who have received financial support from Gilead.
Academic medical centers and scientists
To compile all of the thousands of scientists and research institutions who have received funding from Gilead would take weeks of effort. However, it is peculiar that some of the most vehement critics of hydroxychloroquine have conflicts of interest with Gilead. Just for example, in the New York Times feature He Was a Science Star. Then He Promoted a Questionable Cure for Covid-19, all three scientists (Karine Lacombe, Christine Rouzioux, and Jean-Michel Molina) criticizing Dr. Raoult and his study are either on Gilead's advisory board and/or received funding from Gilead. Notably, the New York Times article fails to mention these conflicts of interest. Some other notable examples include Stanford University, School of Medicine that conducted two clinical trials on remdesivir (one funded by the NIH and the other by Gilead); University of Alabama at Birmingham who received funding from the NIAID to develop remdesivir (of note, Dr. Richard Whitley, principal investigator of the $37.5 million dollar NIAID grant, is on the board of directors for Gilead); Eric Topol, editor-in-chief of Medscape and prominent critic of hydroxychloroquine was formerly on the Scientific Advisory Board for Gilead; George P. Shultz, Stanford University was formerly on the Board of Directors for Gilead (notably also a prominent figure in the scandal of the biotech firm Theranos, continuing to support it as a board member even in the face mounting evidence of fraud.)
Conclusion
Gilead’s influence over the process of clinical investigation and approval of therapeutics is undeniable. A direct threat to remdesivir, hydroxychloroquine has likely been in Gilead’s crosshairs for months.



An Effective Treatment for Coronavirus (COVID-19)
OmniJournal - James M. Todaro, MD

URL: https://omnij.org/An_Effective_Treatmen ... _(COVID-19)
Category: healthNews
Published: March 13, 2020

Description: A paper proposing chloroquine and its derivative hydroxychloroquine in prophylaxis or treatment of COVID-19 based on in-vitro evidence, mechanism of action and use in China and South Korea treatment guidelines. Published as a Google document on March 13, 2020, and tweeted by Elon Musk, this was the first widely disseminated paper looking at chloroquine as a treatment option for the rapidly spreading novel-coronavirus. After millions of views, the paper was taken down by Google for violation of terms and conditions on March 18, 2020, although details on the specific violation are unknown. A copy of the paper remains publicly available on the decentralized file storage platform, IPFS.

Google Drive URL: https://docs.google.com/document/d/e/2P ... -7deJ7/pub

An Effective Treatment for Coronavirus (COVID-19)

Presented by: James M. Todaro, MD (Columbia MD, jtodaro2@gmail.com) and
Gregory J. Rigano, Esq. (grigano1@jhu.edu)

In consultation with Stanford University School of Medicine, UAB School
of Medicine and National Academy of Sciences researchers.

March 13, 2020

SPANISH: https://docs.google.com/document/d/e/2P ... KCZVyV/pub
Translation by: Celia Martínez-Aceves (Yale B.S. Candidate
2021; celia.martinez-aceves@yale.edu), Martín Martínez (MIT B.S. 2017
; martin.martinez.mit@gmail.com)

ITALIAN: https://docs.google.com/document/d/e/2P ... ZNa7tb/pub
Translation by: Google Translate and edited by Ross Shulman,
Cornell University MS '20 ross.shulman@gmail.com

Summary

Recent guidelines from South Korea and China report that chloroquine is
an effective antiviral therapeutic treatment against Coronavirus
Disease 2019. Use of chloroquine (tablets) is showing favorable
outcomes in humans infected with Coronavirus including faster time to
recovery and shorter hospital stay. US CDC research shows that
chloroquine also has strong potential as a prophylactic (preventative)
measure against coronavirus in the lab, while we wait for a vaccine to
be developed. Chloroquine is an inexpensive, globally available drug
that has been in widespread human use since 1945 against malaria,
autoimmune and various other conditions.

chloroquine.png
chloroquine.png (2.87 KiB) Viewed 33 times

Chloroquine: C18H26ClN3

Background

The U.S. CDC and World Health Organization have not published treatment
measures against Coronavirus disease 2019 (“COVID-19”). Medical
centers are starting to have issues with traditional protocols.
Treatments, and ideally a preventative measure, are needed. South
Korea and China have had significantly more exposure and time to
analyze diagnostic, treatment and preventative options. The U.S.,
Europe and the rest of the world can learn from their experience.
According to former FDA commissioner, board member of Pfizer and
Illumina, Scott Gotlieb MD, the world can learn the most about COVID-19
by paying closest attention to the response of countries that have had
significant exposure to COVID-19 before the U.S. and Europe.^[1]

As per the U.S. CDC, “Chloroquine (also known as chloroquine phosphate)
is an antimalarial medicine… Chloroquine is available in the United
States by prescription only… Chloroquine can be prescribed for either
prevention or treatment of malaria. Chloroquine can be prescribed to
adults and children of all ages. It can also be safely taken by
pregnant women and nursing mothers.”^[2]

CDC research also shows that “chloroquine can affect virus infection in
many ways, and the antiviral effect depends in part on the extent to
which the virus utilizes endosomes for entry. Chloroquine has been
widely used to treat human diseases, such as malaria, amoebiosis, HIV,
and autoimmune diseases, without significant detrimental side
effects.”^[3]

The treatment guidelines of both South Korea and China against COVID-19
are generally consistent, outlining chloroquine as an effective
treatment.

Specifically, according to the Korea Biomedical Review, in February
2020 in South Korea, the COVID-19 Central Clinical Task Force, composed
of physicians and experts treating patients agreed upon treatment
principles for patients with COVID-19.^[4] In China, the General
Office of the National Health Commission, General Office of the State
Administration of Traditional Chinese Medicine as well as a
Multi-Center Collaborative Group of Guangdong Provincial Department of
Science and Technology and Guangdong Provincial Health Comp and the
China National Center for Biotechnology Development have established
effective treatment measures based on human studies.^[5]

According to their research (reported in Clinical Trials Arena),

“Data from the drug’s [chloroquine] studies showed ‘certain curative
effect’ with ‘fairly good efficacy’ … patients treated with chloroquine
demonstrated a better drop in fever, improvement of lung CT images, and
required a shorter time to recover compared to parallel groups. The
percentage of patients with negative viral nucleic acid tests was also
higher with the anti-malarial drug… Chloroquine has so far shown no
obvious serious adverse reactions in more than 100 participants in the
trials… Chloroquine was selected after several screening rounds of
thousands of existing drugs. Chloroquine is undergoing further trials
in more than ten hospitals in Beijing, Guangdong province and Hunnan
province.”^[6]

Treatment Guidelines from South Korea^[7]

According to the Korea Biomedical Review, the South Korean COVID-19
Central Clinical Task Force guidelines are as follows:

1. If patients are young, healthy, and have mild symptoms
without underlying conditions, doctors can observe them without
antiviral treatment;

2. If more than 10 days have passed since the onset of the
illness and the symptoms are mild, physicians do not have to start an
antiviral medication;

3. However, if patients are old or have underlying conditions
with serious symptoms, physicians should consider an antiviral
treatment. If they decide to use the antiviral therapy, they should
start the administration as soon as possible:

… chloroquine 500mg orally per day.

4. As chloroquine is not available in Korea, doctors could
consider hydroxychloroquine 400mg orally per day (Hydroxychloroquine is
an analog of chloroquine used against malaria, autoimmune disorders,
etc. It is widely available as well).

5. The treatment is suitable for 7 - 10 days, which can be
shortened or extended depending on clinical progress.

Notably, the guidelines mention other antivirals as further lines of
defense, including anti-HIV drugs.

Treatment Guidelines from China^[8]

According to China’s Novel Coronavirus Pneumonia Diagnosis and
Treatment Plan, 7th Edition, the treatment guidelines are as follows:

1. Treatment for mild cases includes bed rest, supportive treatments,
and maintenance of caloric intake. Pay attention to fluid and
electrolyte balance and maintain homeostasis. Closely monitor the
patient's vitals and oxygen saturation.

2. As indicated by clinical presentations, monitor the hematology
panel, routine urinalysis, CRP, biochemistry (liver enzymes, cardiac
enzymes, kidney function), coagulation, arterial blood gas analysis,
chest radiography, and so on. Cytokines can be tested, if possible.

3. Administer effective oxygenation measures promptly, including nasal
catheter, oxygen mask, and high flow nasal cannula. If conditions
allow, a hydrogen-oxygen gas mix (H2/O2: 66.6%/33.3%) may be used for
breathing.

4. Antiviral therapies:

... chloroquine phosphate (adult 18-65 years old weighing more than
50kg: 500mg twice daily for 7 days; bodyweight less than 50kg: 500mg
twice daily for day 1 and 2, 500mg once daily for day 3 through 7) …

Additionally, the Guangdong Provincial Department of Science and
Technology and the Guangdong Provincial Health and Health Commission
issued a report stating “Expert consensus on chloroquine phosphate for
new coronavirus pneumonia: … clinical research results show that
chloroquine improves the success rate of treatment and shortens the
length of patient’s hospital stay.”^[9] The report further goes on to
cite research from the US CDC from 2005 as well as research from the
University of Leuven University in Belgium regarding chloroquine’s
effectiveness against SARS coronavirus at the cellular level.^[10]

Like the South Korean guidelines, notably, other antivirals (e.g.
anti-HIV drugs) are listed as further lines of defense. The most
research thus far has been around chloroquine.

Chloroquine as a prophylactic (preventative) measure against
COVID-19^[11]

According to research by the US CDC, chloroquine has strong antiviral
effects on SARS coronavirus, both prophylactically and therapeutically.
SARS coronavirus has significant similarities to COVID-19.
Specifically, the CDC research was completed in primate cells using
chloroquine’s well known function of elevating endosomal pH. The
results show that “We have identified chloroquine as an effective
antiviral agent for SARS-CoV in cell culture conditions, as evidenced
by its inhibitory effect when the drug was added prior to infection or
after the initiation and establishment of infection. The fact that
chloroquine exerts an antiviral effect during pre- and post-infection
conditions suggest that it is likely to have both prophylactic and
therapeutic advantages.”

The study shows that chloroquine is effective in preventing SARS-CoV
infection in cell culture if the drug is added to the cells 24 h prior
to infection.

figure1.png

FIGURE 1
Prophylactic effect of chloroquine. Vero E6 cells pre-treated with
chloroquine for 20 hrs. Chloroquine-containing media were removed and
the cells were washed with phosphate buffered saline before they were
infected with SARS-CoV (0.5 multiplicity of infection) for 1 h in the
absence of chloroquine. Virus was then removed and the cells were
maintained in Opti-MEM (Invitrogen) for 16–18 h in the absence of
chloroquine. SARS-CoV antigens were stained with virus-specific HMAF,
followed by FITC-conjugated secondary antibodies. (A) The concentration
of chloroquine used is indicated on the top of each panel. (B) SARS-CoV
antigen-positive cells at three random locations were captured by using
a digital camera, the number of antigen-positive cells was determined,
and the average inhibition was calculated. Percent inhibition was
obtained by considering the untreated control as 0% inhibition. The
vertical bars represent the range of SEM.

In the case of chloroquine treatment prior to infection, the impairment
of terminal glycosylation of ACE2 may result in reduced binding
affinities between ACE2 and SARS-CoV spike protein and negatively
influence the initiation of SARS-CoV infection. The cell surface
expression of under-glycosylated ACE2 and its poor affinity to SARS-CoV
spike protein may be the primary mechanism by which infection is
prevented by drug pretreatment of cells prior to infection.

In addition, the study also shows that chloroquine was very effective
even when the drug was added 3–5 h after infection, suggesting an
antiviral effect even after the establishment of infection.

figure2.png

Figure 2
Post-infection chloroquine treatment reduces SARS-CoV infection and
spread. Vero E6 cells were seeded and infected as described for Fig. 1
except that chloroquine was added only after virus adsorption. Cells
were maintained in Opti-MEM (Invitrogen) containing chloroquine for
16–18 h, after which they were processed for immunofluorescence. (A)
The concentration of chloroquine is indicated on the top. (B) Percent
inhibition and SEM were calculated as in Fig. 1B. (C) The effective
dose (ED50) was calculated using commercially available software
(Grafit, version 4, Erithacus Software).

When chloroquine is added after infection, it can rapidly raise the pH
and subvert on-going fusion events between virus and endosomes, thus
inhibiting the infection. When added after the initiation of
infection, it likely affects the endosome-mediated fusion, subsequent
virus replication, or assembly and release. Specifically, rapid
elevation of endosomal pH and abrogation of virus-endosome fusion may
be the primary mechanism by which virus infection is prevented under
post-treatment conditions.

The US CDC study goes on to conclude that:
“The infectivity of coronaviruses other than SARS-CoV are also affected
by chloroquine, as exemplified by the human CoV-229E [15]. The
inhibitory effects observed on SARS-CoV infectivity and cell spread
occurred in the presence of 1–10 μM chloroquine, which are plasma
concentrations achievable during the prophylaxis and treatment of
malaria (varying from 1.6–12.5 μM) [26] and hence are well tolerated by
patients. Chloroquine, a relatively safe, effective and cheap drug
used for treating many human diseases including malaria, amoebiasis and
human immunodeficiency virus is effective in inhibiting the infection
and spread of SARS CoV in cell culture.”

COVID-19 and Chloroquine: Mechanisms of Action^[12]

COVID-19 in a single stranded, positive strain RNA virus with a protein
shell and membrane. The genome is of the same sense of the mRNA. It
goes through a lifecycle where incoming viral COVID genome has to
become double stranded RNA and the new strand becomes the new strand
for the new mRNA. There are significant similarities between COVID-19
and SARS coronavirus. Both COVID-19 and SARS-like coronaviruses have
machinery for regulating their own replication and production of their
proteins. Coronavirus depends on the breakdown of macromolecules such
as proteins. Specifically, the virus depends on turning over the host
proteins to trigger response for available building blocks to make
their own proteins or nucleic acids. They break down due to low PH
catalyzed by hydrolysis. Additionally, coronaviruses have
non-structural proteins that are not part of the capsid (protein shell
of the virus). These non-structural proteins are regulatory proteins
that take over the host cell and suppress the immune system of the host
(similar to HIV). Coronavirus can create growth factor like mechanisms
(e.g. cytokines) to optimize the growth environment in the cell to
favor it.

It is this part of the coronavirus’ replicative path that chloroquine
inhibits. Notably, because of its nitrogen structure, chloroquine has
the unique ability to get into cells and cross endosomal membranes.
Once inside, nitrogens in chloroquine (and quinines in general) prevent
acidification by absorbing a high amount of hydrogens that simply then
interact with nitrogen and then chloroquine becomes positively charged
- an ionic interaction which makes it harder for the endosome to become
acidified. The result is a buffer that holds it at the higher pH and
prevents it from becoming acidic enough to be functional. To
summarize, because chloroquine has a multitude of extra nitrogens, once
it crosses the membrane and enters an organelle, the organelle is
prevented from reaching a lower pH. The organelle’s enzymes cannot
work because the donor group will be a hydrogen ion, disabling the
hydrolysis required for coronavirus replication. This means that all
kinds of events in the cell are incapable of performing optimally,
including viral replication.

Chloroquine’s entrance into the organelle likely constipates the whole
system. An analogy is that the virus is like a garbage facility which
has to break down and burn up the garbage and if it cannot, the garbage
piles up and the city becomes paralyzed. This is likely the case for
any virus, cancer cells or any other condition that is dependent on
turning over the worn out or incorrectly synthesized proteins.

The UK has banned the export of Chloroquine^[13]

As of February 26, 2020, the UK government has added chloroquine to the
list of medicines that cannot be parallel exported from the UK.
Chloroquine was never on this list before. This likely happened
because of the growing body of evidence of chloroquine’s effectiveness
against coronavirus.

China prioritizes internal use of Active Pharmaceutical Ingredients
(APIs) including Chloroquine^[14]

In early February, Chongqing Kangle Pharmaceutical was requested by the
Ministry of Industry and Information Technology, Consumption Division
to promptly increase the manufacturing and production of the active
pharmaceutical ingredients chloroquine phosphate despite slowed
production during the Chinese New Year.

Key Risks and Tradeoffs

There has been massive de-stabilization of society due to COVID-19.

Mutations^[15]

RNA viruses are subject to fairly high mutation rates as RNA based
genomes do not copy themselves faithfully, thereby accumulating
mutations quickly which can lead to failure of the virus (analogy:
unaudited software code will often eventually fail due to a critical
error) or can lead to a stronger mutation - which is likely what has
happened in 2020 (when coronavirus “jumped” from animal to human; it is
doubtful that this has occurred because of the use of chloroquine) as
we have have two forms of COVID-19 (“more aggressive” and “less
aggressive”). If the replication quality of RNA virus like coronavirus
can be destabilized this will likely cause it to self destruct, but
there is always the risk that the virus mutates to become more
aggressive.

Treating COVID-19 with chloroquine, as is being done in South Korea and
China does have the potential to lead to a mutation. The mutation can
either be beneficial or harmful to humans. In this particular case,
chloroquine is likely being used to destabilize the replication quality
of COVID-19, providing significant potential for COVID-19 to
self-destruct, which would likely bide more time for health systems
worldwide to increase capacity and equipment as well as allow time for
the public release of a vaccine. All precaution must be taken into
account for the risk of escape where COVID-19 comes out stronger.

Manufacturing

Chloroquine and its analogs has been manufactured and distributed at
global scale since approximately 1945. While there has recently been a
shortage of N95 protective masks, medical systems can adjust and
dramatically increase the supply of chloroquine in the world.
Chloroquine tablets and intravenous formulations are generic and easy
to produce.

Safety^[16]

Chloroquine is a prescription drug. It can have side effects and has
contraindications. One often cited side effect is chloroquine
retinopathy, which can result in permanent vision loss after high
cumulative doses of chloroquine. However, retinal damage is extremely
rare in patients with a total dosage under 400g (dosage level only
reached after years of treatment). Medical professionals must be
consulted before use of chloroquine. Chloroquine tablets are readily
available in the U.S. and have never been removed from the market.
Intravenous chloroquine was taken off the market in the USA pre-2000
because of the absence of acute malarial infections in the USA - there
was no use for the intravenous form. It can easily be brought back to
the market.

Formulation Optimizations^[17]

Tablet vs. Intravenous

Currently chloroquine is most widely administered in tablet form
(chloroquine phosphate. While readily available, the issue is that
when the tablet is ingested, it must be processed through the stomach
and be taken up by the small intestine, for which then it enters the
blood and subsequently the respiratory system. Because of the
metabolism, this takes time and there is a loss of chloroquine delivery
to the respiratory system (where COVID-19 replicates).

When chloroquine is used intravenously against malaria (chloroquine
hydrochloride), it is being mainlined directly into the blood stream so
that it is distributing around the body within seconds, likely
encountering the virus faster and at a higher concentration in the
respiratory system. Intravenous formulations are readily available and
should be studied accordingly.

Further research should be carried out using chloroquine in
nanoparticles and various fast, slow and sustained released
formulations, as well as combinations of chloroquine and other
molecules.

Repurposing other FDA approved drugs

As per Steve Schow PhD, Professor of Chemical and Systems Biology at
Stanford University School of Medicine and Lead Advisor to Stanford’s
SPARK Translational Research Program:

“There are a number of related isoquinoline and quinoline drug family
members who might exhibit the same general acid neutralizing effects.
In addition certain antidepressants and antipsychotic drugs are known
to accumulate in lysosomes via this acid-base process and might be
effective here if the doses needed aren’t too high.”^[18]

New Molecular Entity: Chloroquine analogs with more nitrogens

The nitrogens in chloroquine and quinines in general prevent
acidification by absorbing a high amount of hydrogens that then
interact with nitrogen, and,in turn, transfer a positive charge to
chloroquine. This ionic interaction makes it harder and harder for the
endosome to become acidified, therefore disrupting viral replication.
If more nitrogens are added, either by making extra branches of
ionizable nitrogens or lengthening one of the chains by putting extra
carbons and other nitrogens around it, this may have even greater
effect. The key issue will be whether there is a heavy change in
bioavailability - will the new molecule be able to enter the cell and
reach the right place with similar efficiency.

Conclusion

Chloroquine can both prevent and treat malaria. Chloroquine can both
prevent and treat coronavirus in primate cells (Figure 1 and Figure 2).
According to South Korean and China human treatment guidelines,
chloroquine is effective in treating COVID-19. Given chloroquine’s
human safety profile and existence, it can be implemented today in the
U.S., Europe and the rest of the world. Medical doctors may be
reluctant to prescribe chloroquine to treat COVID-19 since it is not
FDA approved for this use. The United States of America and other
countries should immediately authorize and indemnify medical doctors
for prescribing chloroquine to treat COVID-19. We must explore whether
chloroquine can safely serve as a preventative measure prior to
infection of COVID-19 to stop further spread of this highly contagious
virus.

More Sources

Griffero-Diaz's F. , Hoschander SA , Brojatsch J .Endocytosis IS A
Critical entry in STEP B of subgroup Avian leukosis viruses[J].J
Virology,2003,76(24):12866-12876.The DOI: 10.1128 / jvi.76.24.
12866-12876.2002 .

Rodrigo D , Luiza H , Paula P , et al .Chloroquine, an Endocytosis
Blocking Agent, Inhibits Zika Virus Infection in Different Cell
Models[J].Viruses,2016,8(12):322-.DOI: 10.3390 / v8120322 .

Zhang S , Yi C , of Li C , et Al .Chloroquine inhibits the endosomal
Viral an RNA Release and autophagy in-dependent Viral Replication and
Effectively Prevents CARE OF to Fetal Transmission of Zika Virus. [J]
Antiviral Res.2019;169:104 547. The DOI: 10.1016
/j.antiviral.2019.104547

Kono M , Tatsumi K , Imai AM , et al .Inhibition of human coronavirus
229E infection in human epithelial lung cells (L132) by chloroquine:
involvement of p38 MAPK and ERK[J].Antiviral
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Didier Raoult, et. al. , Chloroquine and hydroxychloroquine as
available weapons to fight COVID-19 International Journal of
Antimicrobial Agents Available online 4 March 2020,
https://www.sciencedirect.com/science/a ... ia%3Dihub#!

Next Steps from the Community

1. Disseminate this publication amongst the medical community. Get
more feedback.
2. Send this publication to your scientific contacts in South Korea
and China - lets get more data, details, etc. Science never ends.
3. Translate this paper into all languages.
4. Explore all options for use of chloroquine against any medical
condition that depends on the turnover of worn out or incorrectly
synthesized proteins.

Acknowledgements

Special thanks to Stanford University School of Medicine, SPARK
Translational Research Program, Steve Schow, PhD, The Lab of Louise T.
Chow, PhD and Thomas R. Broker, PhD, Bruce Bloom DDS, JD of HealX and
Adrian Bye.

License

Due to urgency, certain parts of this publication are taken directly
from their attributed source. Cite them accordingly.

In all other circumstances, the GNU General Public License v3.0
applies.

Disclaimer

This white paper is for information purposes only. The authors and or
its affiliates does not guarantee the accuracy of or the conclusions
reached in this white paper, and this white paper is provided “as is”.
The authors and or its affiliates not make and expressly disclaims all
representations and warranties, express, implied, statutory or
otherwise, whatsoever, including, but not limited to: (i) warranties of
merchantability, fitness for a particular purpose, suitability, usage,
title or noninfringement; (ii) that the contents of this white paper
are free from error; and (iii) that such contents will not infringe
third-party rights. The authors and or its affiliates shall have no
liability for damages of any kind arising out of the use, reference to,
or reliance on this white paper or any of the content contained herein,
even if advised of the possibility of such damages. In no event will
the authors and or its affiliates be liable to any person or entity for
any damages, losses, liabilities, costs or expenses of any kind,
whether direct or indirect, consequential, compensatory, incidental,
actual, exemplary, punitive or special for the use of, reference to, or
reliance on this white paper or any of the content contained herein,
including, without limitation, any loss of business, revenues, profits,
data, use, goodwill or other intangible losses. All translations are
done voluntarily by third-parties for which the authors have no
affiliation - we do not attest to their accuracy.

Informational Purposes Only
__________________________________________________________________

[1] https://www.cnbc.com/video/2020/03/02/c ... k-box.html

[2] https://www.cdc.gov/malaria/resources/p ... oquine.pdf

[3] Vincent, Martin J et al. “Chloroquine is a potent inhibitor of SARS
coronavirus infection and spread.” Virology journal vol. 2 69. 22 Aug.
2005, doi:10.1186/1743-422X-2-69 ,
https://www.ncbi.nlm.nih.gov/pmc/articl ... 32869/#B15. Savarino A,
Boelaert JR, Cassone A, Majori G, Cauda R. Effects of chloroquine on
viral infections: an old drug against today's diseases? Lancet Infect
Dis. 2003;3:722–727. doi: 10.1016/S1473-3099(03)00806-5.

[4] http://www.koreabiomed.com/news/article ... idxno=7428

[5] https://www.ncbi.nlm.nih.gov/pubmed/32075365/ ;
http://www.nhc.gov.cn/yzygj/s7653p/2020 ... 3730.shtml
translated as https://www.chinalawtranslate.com/en/ch ... phosphate/ ;
Novel Coronavirus Pneumonia Diagnosis and Treatment Plan
(Provisional 7th Edition) translated as
https://www.chinalawtranslate.com/en/co ... nt-plan-7/ ;
https://www.clinicaltrialsarena.com/new ... uine-data/ .

[6] https://www.clinicaltrialsarena.com/new ... uine-data/ .
This research must be confirmed and furthermore ruled
out that the subjects that had negative viral nucleic acid tests might
not have been infected with C-19.

[7] http://www.koreabiomed.com/news/article ... idxno=7428

[8] Novel Coronavirus Pneumonia Diagnosis and Treatment Plan
(Provisional 7th Edition) translated as
https://www.chinalawtranslate.com/en/co ... nt-plan-7/

[9] https://www.ncbi.nlm.nih.gov/pubmed/32075365/ Guangdong Provincial
Science and Technology Department and Guangdong Provincial Health and
Health Commission's Multicenter Collaboration Group on Chloroquine
Phosphate for New Coronavirus Pneumonia. Expert Consensus on
Chloroquine Phosphate for New Coronavirus Pneumonia [J / OL]. Chinese
Journal of Tuberculosis and Respiratory Medicine, 2020,43 (2020-02-20)
http://rs.yiigle.com/yufabiao/1182323.htm.

[10] US CDC, Vincent MJ , Bergeron E , Benjannet S , et Al .Chloroquine
IS A potent inhibitor of SARS coronavirus Infection and Spread
of[J].Virology Journal,2005,2(. 1):69.The DOI: 10.1186 /
1743-422X-2-69 . Keyaerts E , Vijgen L , Maes P , et Al .The In Journal
Severe acute Inhibition of Respiratory syndrome coronavirus by
chloroquine[J].Biochem Biophys Res Communications,2004,323(.
1):0-268.The DOI: 10.1016 / j.bbrc .2004.08.085 .

[11] All research from this section is from: US CDC, Vincent MJ ,
Bergeron E , Benjannet S , et Al .Chloroquine IS A potent inhibitor of
SARS coronavirus Infection and Spread of[J].Virology Journal,2005,2(.
1):69.The DOI: 10.1186 / 1743-422X-2-69

[12] All research from this section is from:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4147684/ ,
https://virologyj.biomedcentral.com/art ... 2-0#citeas ,
https://www.ncbi.nlm.nih.gov/pmc/articl ... 32869/#B15 ,
https://www.nature.com/articles/s41422-020-0282-0 ,
Thomas R. Broker, PhD, Stanford University School of Medicine,
Telephone discussion March 12, 2020 ,
https://www.sciencealert.com/genetic-an ... ar-to-sars .

[13] https://assets.publishing.service.gov.u ... sv/preview

[14] http://doc.irasia.com/listco/hk/tfkf/announcement/a224851-e_01312ann_20200203(20200203_1952).pdf

[15] All information in this section is from:
https://www.sciencealert.com/genetic-an ... ar-to-sars ,
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4147684/ ,
https://virologyj.biomedcentral.com/art ... 2-0#citeas ,
Thomas R. Broker, PhD, Stanford University School of Medicine,
Telephone discussion March 12, 2020.

[16] https://www.accessdata.fda.gov/drugsatf ... 044lbl.pdf ,
https://www.accessdata.fda.gov/scripts/ ... lNo=006002 ,
https://www.cdc.gov/malaria/resources/p ... oquine.pdf

[17] See Safety citations.

[18] Steve Schow PhD,
https://sparkmed.stanford.edu/about-spark/who-we-are/ .
Email correspondence March 2020.
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The Key to Defeating COVID-19 Already Exists. We Need to Start Using It

Postby smix » Tue Jul 28, 2020 5:31 pm

The Key to Defeating COVID-19 Already Exists. We Need to Start Using It
Newsweek - Harvey A. Risch, MD, PhD

URL: https://www.newsweek.com/key-defeating- ... on-1519535
Category: healthNews
Published: July 23, 2020

Description: As professor of epidemiology at Yale School of Public Health, I have authored over 300 peer-reviewed publications and currently hold senior positions on the editorial boards of several leading journals. I am usually accustomed to advocating for positions within the mainstream of medicine, so have been flummoxed to find that, in the midst of a crisis, I am fighting for a treatment that the data fully support but which, for reasons having nothing to do with a correct understanding of the science, has been pushed to the sidelines. As a result, tens of thousands of patients with COVID-19 are dying unnecessarily. Fortunately, the situation can be reversed easily and quickly. I am referring, of course, to the medication hydroxychloroquine. When this inexpensive oral medication is given very early in the course of illness, before the virus has had time to multiply beyond control, it has shown to be highly effective, especially when given in combination with the antibiotics azithromycin or doxycycline and the nutritional supplement zinc. On May 27, I published an article in the American Journal of Epidemiology (AJE) entitled, "Early Outpatient Treatment of Symptomatic, High-Risk COVID-19 Patients that Should be Ramped-Up Immediately as Key to the Pandemic Crisis." That article, published in the world's leading epidemiology journal, analyzed five studies, demonstrating clear-cut and significant benefits to treated patients, plus other very large studies that showed the medication safety. Physicians who have been using these medications in the face of widespread skepticism have been truly heroic. They have done what the science shows is best for their patients, often at great personal risk. I myself know of two doctors who have saved the lives of hundreds of patients with these medications, but are now fighting state medical boards to save their licenses and reputations. The cases against them are completely without scientific merit. Since publication of my May 27 article, seven more studies have demonstrated similar benefit. In a lengthy follow-up letter, also published by AJE, I discuss these seven studies and renew my call for the immediate early use of hydroxychloroquine in high-risk patients. These seven studies include: an additional 400 high-risk patients treated by Dr. Vladimir Zelenko, with zero deaths; four studies totaling almost 500 high-risk patients treated in nursing homes and clinics across the U.S., with no deaths; a controlled trial of more than 700 high-risk patients in Brazil, with significantly reduced risk of hospitalization and two deaths among 334 patients treated with hydroxychloroquine; and another study of 398 matched patients in France, also with significantly reduced hospitalization risk. Since my letter was published, even more doctors have reported to me their completely successful use. My original article in the AJE is available free online, and I encourage readers—especially physicians, nurses, physician assistants and associates, and respiratory therapists—to search the title and read it. My follow-up letter is linked there to the original paper. Beyond these studies of individual patients, we have seen what happens in large populations when these drugs are used. These have been "natural experiments." In the northern Brazil state of Pará, COVID-19 deaths were increasing exponentially. On April 6, the public hospital network purchased 75,000 doses of azithromycin and 90,000 doses of hydroxychloroquine. Over the next few weeks, authorities began distributing these medications to infected individuals. Even though new cases continued to occur, on May 22 the death rate started to plummet and is now about one-eighth what it was at the peak. A reverse natural experiment happened in Switzerland. On May 27, the Swiss national government banned outpatient use of hydroxychloroquine for COVID-19. Around June 10, COVID-19 deaths increased four-fold and remained elevated. On June 11, the Swiss government revoked the ban, and on June 23 the death rate reverted to what it had been beforehand. People who die from COVID-19 live about three to five weeks from the start of symptoms, which makes the evidence of a causal relation in these experiments strong. Both episodes suggest that a combination of hydroxychloroquine and its companion medications reduces mortality and should be immediately adopted as the new standard of care in high-risk patients.
Why has hydroxychloroquine been disregarded?
First, as all know, the medication has become highly politicized. For many, it is viewed as a marker of political identity, on both sides of the political spectrum. Nobody needs me to remind them that this is not how medicine should proceed. We must judge this medication strictly on the science. When doctors graduate from medical school, they formally promise to make the health and life of the patient their first consideration, without biases of race, religion, nationality, social standing—or political affiliation. Lives must come first. Second, the drug has not been used properly in many studies. Hydroxychloroquine has shown major success when used early in high-risk people but, as one would expect for an antiviral, much less success when used late in the disease course. Even so, it has demonstrated significant benefit in large hospital studies in Michigan and New York City when started within the first 24 to 48 hours after admission. In fact, as inexpensive, oral and widely available medications, and a nutritional supplement, the combination of hydroxychloroquine, azithromycin or doxycycline, and zinc are well-suited for early treatment in the outpatient setting. The combination should be prescribed in high-risk patients immediately upon clinical suspicion of COVID-19 disease, without waiting for results of testing. Delays in waiting before starting the medications can reduce their efficacy. Third, concerns have been raised by the FDA and others about risks of cardiac arrhythmia, especially when hydroxychloroquine is given in combination with azithromycin. The FDA based its comments on data in its FDA Adverse Event Reporting System. This reporting system captured up to a thousand cases of arrhythmias attributed to hydroxychloroquine use. In fact, the number is likely higher than that, since the reporting system, which requires physicians or patients to initiate contact with the FDA, appreciably undercounts drug side effects. But what the FDA did not announce is that these adverse events were generated from tens of millions of patient uses of hydroxychloroquine for long periods of time, often for the chronic treatment of lupus or rheumatoid arthritis. Even if the true rates of arrhythmia are ten-fold higher than those reported, the harms would be minuscule compared to the mortality occurring right now in inadequately treated high-risk COVID-19 patients. This fact is proven by an Oxford University study of more than 320,000 older patients taking both hydroxychloroquine and azithromycin, who had arrhythmia excess death rates of less than 9/100,000 users, as I discuss in my May 27 paper cited above. A new paper in the American Journal of Medicine by established cardiologists around the world fully agrees with this. In the future, I believe this misbegotten episode regarding hydroxychloroquine will be studied by sociologists of medicine as a classic example of how extra-scientific factors overrode clear-cut medical evidence. But for now, reality demands a clear, scientific eye on the evidence and where it points. For the sake of high-risk patients, for the sake of our parents and grandparents, for the sake of the unemployed, for our economy and for our polity, especially those disproportionally affected, we must start treating immediately.
--
Harvey A. Risch, MD, PhD, is professor of epidemiology at Yale School of Public Health.
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America’s Frontline Doctors SCOTUS Press Conference Transcript

Postby smix » Tue Jul 28, 2020 5:52 pm

America’s Frontline Doctors SCOTUS Press Conference Transcript
Rev

URL: https://www.rev.com/blog/transcripts/am ... transcript
Category: Politics
Published: July 27, 2020

Description: A group of American doctors calling themselves “America’s Frontline Doctors” held a press conference on COVID-19, hydroxychloroquine, and more outside the Supreme Court of the United States. Read the transcript of their press conference here.

Americas-Frontline-Doctors-Press-Conference.jpg

Congressman Norman: (00:00)
… I’ll turn it over.

Simone Gold: (00:01)
Thank you. Thank you so much congressmen. So we’re here because we feel as though the American people have not heard from all the expertise that’s out there all across our country. We do have some experts speaking, but there’s lots and lots of experts across the country. So some of us decided to get together. We’re America’s Frontline Doctors. We’re here only to help American patients and the American nation heal. We have a lot of information to share. Americans are riveted and captured by fear at the moment. We are not held down by the virus as much as we’re being held down by the spider web of fear. That spiderweb is all around us and it’s constricting us and it’s draining the lifeblood of the American people, American society, and American economy.

Simone Gold: (00:53)
This does not make sense. COVID-19 is a virus that exists in essentially two phases. There’s the early phase disease, and there’s the late phase disease. In the early phase either before you get the virus or early, when you’ve gotten the virus, if you’ve gotten the virus, there’s treatment. That’s what we’re here to tell you. We’re going to talk about that this afternoon. You can find it on America’s Frontline Doctors, there’s many other sites that are streaming it live on Facebook. But we implore you to hear this because this message has been silenced. There are many thousands of physicians who have been silenced for telling the American people the good news about the situation, that we can manage the virus carefully and intelligently, but we cannot live with this spider web of fear that’s constricting our country.

Simone Gold: (01:45)
So we’re going to hear now from various positions. Some are going to talk to you about what the lockdown has done to young, to older, to businesses, to the economy, and how we can get ourselves out of the cycle of fear. Dr. Hamilton.

Dr. Bob Hamilton: (02:03)
Thank you, Simone. And thank you all for being here today. I’m Dr. Bob Hamilton. I’m a pediatrician from Santa Monica, California. I’ve been in private practice there for 36 years. And today I have good news for you. The good news is the children as a general rule are taking this virus very, very well. Few are getting infected. Those who are getting infected are being hospitalized in low numbers. And fortunately the mortality rate of children is about one fifth of 1%. So kids are tolerating the infection very frequently, but are actually asymptomatic.

Dr. Bob Hamilton: (02:38)
I also want to say that children are not the drivers of this pandemic. People were worried about, initially, if children were going to actually be the ones to push the infection along. The very opposite is happening. Kids are tolerating it very well, they’re not passing it on to their parents, they’re not passing it onto their teachers. Dr. Mark Woolhouse from Scotland, who is a pediatric infectious disease specialist and epidemiologist said the following. He said, “There has not been one documented case of COVID being transferred from a student to a teacher in the world.” In the world.

Dr. Bob Hamilton: (03:19)
I think that is important that all of us who are here today realize that our kids are not really the ones who are driving the infection. It is being driven by older individuals. And yes, we can send the kids back to school I think without fear. And this is the big issue right now, as Congressman Norman alluded to, this is the really important thing we need to do. We need to normalize the lives of our children. How do we do that? We do that by getting them back in the classroom. And the good news is they’re not driving this infection at all. Yes, we can use security measures. Yes, we can be careful. I’m all for that. We all are. But I think the important thing is we need to not act out of fear. We need to act out of science. We need to do it. We need to get it done.

Dr. Bob Hamilton: (04:07)
Finally, the barrier, and I hate to say this, but the barrier to getting our kids back in school is not going to be the science, it’s going to be the national unions, the teachers union, the National Education Association, other groups who are going to demand money. And listen, I think that it’s fine to give people money for PPE and different things in the classroom. But some of their demands are really ridiculous. They’re talking about, where I’m from in California, the UTLA, which is United Teachers Union of Los Angeles, is demanding that we defund the police. What does that have to do with education? They’re demanding that they stop or they shut all private charter schools, privately funded charter schools. These are the schools that are actually getting the kids educated.

Dr. Bob Hamilton: (04:59)
So clearly there are going to be barriers. The barriers will not be science. There will not be barriers for the sake of the children. That’s going to be for the sake of the adults, the teachers, and everybody else, and for the union. So that’s where we need to focus our efforts and fight back. So thank you all for being here and let’s get our kids back in school.

Dr. Stella Immanuel: (05:27)
Hello, I’m Dr. Stella Immanuel. I’m a primary care physician in Houston, Texas. I actually went to medical school in West Africa, Nigeria, where I took care of malaria patients, treated them with hydroxychloroquine and stuff like that. So I’m actually used to these medications. I’m here because I have personally treated over 350 patients with COVID. Patients that have diabetes, patients that have high blood pressure, patients that have asthma, old people … I think my oldest patient is 92 … 87 year olds. And the result has been the same. I put them on hydroxychloroquine, I put them on zinc, I put them on Zithromax, and they’re all well.

Dr. Stella Immanuel: (06:12)
For the past few months, after taking care of over 350 patients, we’ve not lost one. Not a diabetic, not a somebody with high blood pressure, not somebody who asthma, not an old person. We’ve not lost one patient. And on top of that, I’ve put myself, my staff, and many doctors that I know on hydroxychloroquine for prevention, because by the very mechanism of action, it works early and as a prophylaxis. We see patients, 10 to 15 COVID patients, everyday. We give them breathing treatments. We only wear surgical mask. None of us has gotten sick. It works.

Dr. Stella Immanuel: (06:46)
So right now, I came here to Washington DC to say, America, nobody needs to die. The study that made me start using hydroxychloroquine was a study that they did under the NIH in 2005 that say it works. Recently, I was doing some research about a patient that had hiccups and I found out that they even did a recent study in the NIH, which is our National Institute … that is the National … NIH, what? National Institute of Health. They actually had a study and go look it up. Type hiccups and COVID, you will see it. They treated a patient that had hiccups with hydroxychloroquine and it proved that hiccups is a symptom of COVID. So if the NIH knows that treating the patient would hydroxychloroquine proves that hiccup is a symptom of COVID, then they definitely know the hydroxychloroquine works.

Dr. Stella Immanuel: (07:42)
I’m upset. Why I’m upset is that I see people that cannot breathe. I see parents walk in, I see diabetic sit in my office knowing that this is a death sentence and they can’t breathe. And I hug them and I tell them, “It’s going to be okay. You’re going to live.” And we treat them and they leave. None has died. So if some fake science, some person sponsored by all these fake pharma companies comes out say, “We’ve done studies and they found out that it doesn’t work.” I can tell you categorically it’s fixed science. I want to know who is sponsoring that study. I want to know who is behind it because there is no way I can treat 350 patients and counting and nobody is dead and they all did better.

Dr. Stella Immanuel: (08:21)
I know you’re going to tell me that you treated 20 people, 40 people, and it didn’t work. I’m a true testimony. So I came here to Washington DC to tell America nobody needs to get sick. This virus has a cure. It is called hydroxychloroquine, zinc, and Zithromax. I know you people want to talk about a mask. Hello? You don’t need mask. There is a cure. I know they don’t want to open schools. No, you don’t need people to be locked down. There is prevention and there is a cure.

Dr. Stella Immanuel: (08:48)
And let me tell you something, all you fake doctors out there that tell me, “Yeah. I want a double blinded study.” I just tell you, quit sounding like a computer, double blinded, double blinded. I don’t know whether your chips are malfunctioning, but I’m a real doctor. I have radiologists, we have plastic surgeons, we have neurosurgeons, like Sanjay Gupta saying, “Yeah, it doesn’t work and it causes heart disease.” Let me ask you Dr. Sanjay Gupta. Hear me. Have you ever seen a COVID patient? Have you ever treated anybody with hydroxychloroquine and they died from heart disease? When you do, come and talk to me because I sit down in my clinic every day and I see these patients walk in everyday scared to death. I see people driving two, three hours to my clinic because some ER doctor is scared of the Texas board or they’re scared of something, and they will not prescribe medication to these people.

Dr. Stella Immanuel: (09:35)
I tell all of you doctors that are sitting down and watching Americans die. You’re like the good Nazi … the good one, the good Germans that watched Jews get killed and you did not speak up. If they come after me, they threaten me. They’ve threatened to … I mean, I’ve gotten all kinds of threats. Or they’re going to report me to the bots. I say, you know what? I don’t care. I’m not going to let Americans die. And if this is the hill where I get nailed on, I will get nailed on it. I don’t care. You can report me to the bots, you can kill me, you can do whatever, but I’m not going to let Americans die.

Dr. Stella Immanuel: (10:09)
And today I’m here to say it, that America, there is a cure for COVID. All this foolishness does not need to happen. There is a cure for COVID. There is a cure for COVID is called hydroxychloroquine. It’s called zinc. It’s called Zithromax. And it is time for the grassroots to wake up and say, “No, we’re not going to take this any longer. We’re not going to die.” Because let me tell you something, when somebody is dead, they are dead. They’re not coming back tomorrow to have an argument. They are not come back tomorrow to discuss the double blinded study and the data. All of you doctors that are waiting for data, if six months down the line you actually found out that this data shows that this medication works, how about your patients that have died? You want a double blinded study where people are dying? It’s unethical. So guys, we don’t need to die. There is a cure for COVID.

Simone Gold: (11:02)
My gosh. Dr. Immanuelle also known as warrior. Before I introduce the next guest, I just want to say that I wish all doctors that are listening to this bring that kind of passion to their patients. And the study that Dr. Immanuel was referring to is in Virology, which talks about a SARS viral epidemic that affects the lungs that came from China. And they didn’t know what would work. The study showed that chloroquine would work. It sounds exactly like it could have been written three months ago, but in fact, that’s study in Virology, which was published by the NIH, the National Institute of Health when Dr. Anthony Fauci was the director. Again, the official publication of the NIH, Virology, 15 years ago showed that chloroquine … we use hydroxychloroquine, it’s the same … little safer … works. They proved this 15 years ago when we got this novel coronavirus, which is not that novel, it’s 78% similar to the prior-

Simone Gold: (12:03)
… coronavirus, which is not that novel. It’s 78% similar to the prior version. The COV-1, not surprisingly. It works. I’m now going to introduce our next speaker. Sorry. I forgot to say your name. Sorry.

Dr. Dan Erickson: (12:12)
That’s all right. Dr. Dan Erickson, Dr. Gold asked me to talk about the lockdown, how effective they were and do that cause anything nonfinancial? They always talk about the financial, but you have to realize that lockdown, we haven’t taken a $21 trillion economy and locked it down. So when you lock it down, it causes public health issues. Our suicide hotlines are up 600%, our spousal abuse. Different areas of alcoholism are all on the rise. These are public health problems from a financial lockdown. So we have to be clear on that fact that there is, it’s not like you just lock it down and have consequences to people’s jobs. They also have consequences, health consequences at home. So we’re talking about having a little more of a measured approach, a consistent approach. If we have another spike coming in cold and flu season, let’s do something that’s sustainable.

Dr. Dan Erickson: (13:13)
What’s sustainable. Well we can socially distance and wear some masks, but we can also open the schools and open businesses. So this measured approach I’m talking about, isn’t made up, it’s going on in Sweden and their deaths are about 564 per million. UK, full lockdown, 600 deaths per million. So we’re seeing that the lockdown aren’t decreasing significantly, the amount of deaths per million. Some of their Nordic neighbors have less deaths for a variety of reasons, I don’t have time to go into today. So what, my quick message here in a minute or two is just that we need to take an approach that’s sustainable. A sustainable approach is slowing things down, opening up schools, opening up businesses. And then we can allow the people to have their independence and their personal responsibility to choose to wear masks and socially distance, as opposed to putting edicts on them, kind of controlling them. Let’s empower them with data and let them study what other countries have done and make their own decision. That’s what I’d like to share. Thank you.

Speaker 1: (14:28)
Are there any questions?

Simone Gold: (14:29)
Are there any questions?

Speaker 2: (14:32)
You guys, we’re so excited I’m from South Dakota? You might have heard.

Simone Gold: (14:36)
Yes.

Speaker 2: (14:38)
I’m so glad you guys are preaching this message.

Simone Gold: (14:39)
You know, South Dakota did something interesting. It’s interesting that you’re from there. So the governor did not restrict access to hydroxychloroquine.

Speaker 2: (14:46)
We know. [crosstalk 00:02:48].

Simone Gold: (14:49)
Right. And you were, I believe you were the only state in the union that did that. And there’s been studies out there that attempt to show that it doesn’t work. They’re inaccurate because they’re given at the time, the wrong dose, the wrong patient either too much or a long time. So South Dakota did better because it had access to hydroxychloroquine. Thank you so much.

Speaker 3: (15:06)
Okay. So if someone we love does get sick with COVID and you said the word hydro, or however you say it, it’s restricted. How do we get access to that?

Simone Gold: (15:16)
Yeah. That’s the number one question we’re all asked every day. I want you to know that you’re not alone. I’ve had many congressmen ask me, how can I get it? So the congressmen can’t get it, it’s tough luck for the average American Joe getting it. It’s very difficult. You have to overcome a few hurdles. Your doctor has to have read the science with a critical eye and have eliminated the junk science. Many studies have been retracted as you know, and number two, the pharmacist has to not restrict it. Many states have empowered their pharmacists to not honor physician prescription. That’s never happened before. That interferes with the doctor patient relationship where the patient talks to the doctor, honestly, and the doctor answers the patient honestly has been violated.

Simone Gold: (15:55)
So you have a very difficult time as the average American. Some of the information we’ll share later this afternoon is to show the mortality rates in countries where it’s not restricted and the mortality rates where it is restricted. So I have friends all over the world now because of this. And in Indonesia, you can just buy it over the counter. It’s in the vitamin section. And I’m here to tell the American people that you could buy it over the counter in Iran. Because the leaders in Iran, the mullahs in Iran, think that they should have more freedom than Americans. I have a problem with that. My colleagues have problems with that. We don’t like to watch patients die.

Julie: (16:26)
So when people have problems, they should be picking up the phone, they should be calling their state and their federal representatives and senators and say, we are the American people.

Speaker 1: (16:42)
Let me say one thing [crosstalk 00:16:46].

Julie: (16:45)
You guys, we need the public to be.

Speaker 1: (16:49)
Thank you. Thank you, Julie. That is exactly right. If you hear what you’re, when you hear this, if you’re concerned and wondering why you may not be able to get access to it, we need to make four calls, call your governor, call both of your senators and call your Congressman and tell them that you want to know why you’re not able to get access to a drug that doctors are telling you will help end this and help us reduce the number of hospitalizations and reduce the number of deaths. Urge them to read Dr. Harvey Rich’s study from Yale. He’s a Yale professor of epidemiology. And from there you’ll find other studies.

Speaker 4: (17:31)
Yes. I wanted to ask how do people trust the data that they are looking at every day? The numbers are so variable when you go to Johns Hopkins, CDC, which divides COVID deaths in different categories related to pneumonia, other things where we get the right information to make sense?

Simone Gold: (17:52)
So the only number that I think is worth paying any attention to, and even that number is not so helpful is mortality because that’s a hard and fast number. So the case number is almost irrelevant. And that’s because there’s a lot of inaccuracies with the testing. And also even if the test is accurate, most people are asymptomatic or mildly symptomatic. So it’s not that important to know. So the case number, which you see rising all the time in the news is basically irrelevant. And if you had told us a few months ago, that that was the number that the media was going to go crazy over, we all would have just laughed at that. I mean, that’s essentially herd immunity. There’s lots of people out there who have tested positive without symptoms or with very mild symptoms. So the only number that’s worth paying attention to is mortality.

Simone Gold: (18:33)
When you look at the mortality, this is a disease that takes, that unfortunately kills our most frail members of society. People with multiple comorbid conditions, specifically diabetes, obesity is a big one. We don’t talk about that, but it is. It’s a fact. Coronary artery disease, severe coronary artery disease, people like that. And also if you’re older, it’s a risk factor. But the biggest risk factor is if you have comorbid conditions. If you’re young and healthy, this is not … You’re going to recover. If you’re under 60 with no comorbid conditions, it’s less deadly than influenza. This seems to come as great news to Americans because this is not what you’re being told. I would say the answer is it’s very difficult to get accurate numbers.

Speaker 5: (19:13)
This is [inaudible 00:19:13] of Breitbart News, if you had a message to Dr. Anthony Fauci, what would you say to him?

Speaker 1: (19:18)
Listen to the doctors. [inaudible 00:19:21] the frontline doctors. Have a meeting with the frontline doctors, and maybe I need to say that into the microphone. My message to Dr. Anthony Fauci is to have a meeting with these frontline doctors who are seeing real patients. They’re touching human skin. They’re looking people in the eye, they’re diagnosing them and they’re helping them beat the virus. They’re the ones who are talking to the patients, have meetings with them and do it every single day and find out what they are learning about the virus firsthand. And this is, and it’s important to understand, we have doctors here who are not emergency room doctors. They’re preventing patients from even hitting the emergency room. So if they’re only listening to emergency room or ICU at the very tragic end of a person’s life they’re not getting the full story. They need to come back in here the earlier portion. And they also need to understand what the lockdown and the fears are doing to patients around this country, because there are a lot of unintended consequences, which the doctors can speak about.

Dr. Stella Immanuel: (20:30)
Can I say something. My message to Dr. Anthony Fauci is when is the last time you put a stethoscope on a patient? That when you start seeing patients like we see on a daily basis, you will understand the frustration that we feel. You need to start feeling for American people like we, the frontline doctors, feel. I need to start realizing that. They are listening to you. And if they are going to you, you got to give them a message of hope. Got to give them a message that goes with what you already know that hydroxychloroquine works.

Speaker 6: (21:06)
I have a question for Dr. Warrior.

Simone Gold: (21:09)
Dr. Immanuel.

Speaker 6: (21:10)
Dr. Immanuel, okay. You mentioned before some remarkable results that you’ve had treating your own patients. She said, I believe she said 300 patients.

Dr. Stella Immanuel: (21:17)
Yes. Yes.

Speaker 6: (21:19)
Have you been able to publish your findings and results [inaudible 00:00:21:22].

Dr. Stella Immanuel: (21:22)
We’re working on publishing it right now. We’re working on that, but this is what I’ll say. People like Dr. Samuel [inaudible 00:21:29] published the data. And my question is, and? That will make you see patients. There’s no data around the world. Yes. My data will come out. When that comes out. That’s great. But right now people are dying. So my data is not important for you to see patients. I’m saying that to my colleagues out there that talk about data, data, data.

Speaker 6: (21:44)
If I can ask just one more question.

Simone Gold: (21:46)
May I just interject. There is a lot of [crosstalk 00:21:49] data on this. Not every clinician needs to publish their data to be taken seriously. The media has not covered it. There is a ton. I’ve got a compendium on americasfrontlinedoctors.com, there is a compendium of all the studies that work with hydroxychloroquine. The mortality rate was published in Detroit, less than a … It was July 4th weekend. They published it. Mortality by half in the critically ill patients, the patients who are get it early, it’s been estimated that one half to three quarters of those patients, wouldn’t be dead. We’re talking 70,000 to 105 … 70 to 100,000 patients would still be alive if we followed this policy. There’s plenty of published data. [crosstalk 00:22:27].

Dr. Stella Immanuel: (22:26)
Even with Dr. Rich. Dr. Rich published data recently. So there’s a lot of data out there. They don’t need mine to make those decisions.

Speaker 6: (22:34)
If I can ask one more question. There was a little girl who just a few days ago [inaudible 00:22:37] otherwise healthy and it was concluded that she died of COVID-19 so I was curious from your perspective, you feel that this little girl possibly died from some other condition and it was attributed to COVID-19 or is there some other reason why she [crosstalk 00:00:22:52].

Dr. Stella Immanuel: (22:52)
I will not. I will not be able to say that till I look at the little girl’s history and whatever happened. I know I’ve taken care of a lot of family members and I see a lot of children and they usually get mild symptoms, but I cannot talk about kids that I have not looked at.

Dr. Bob Hamilton: (23:07)
What was the age of the child again?

Speaker 6: (23:10)
She was nine years old.

Dr. Bob Hamilton: (23:10)
Okay. So listen, there are children who are dying of this infection. And the reality is that when they do die, they seem to have comorbidities. Really, you have to kind of look at each individual case. Uniquely there have been a little over 30 patients in the entire country, in the age category of 15 and below who have died of COVID. Frequently they do have comorbidities like heart disease. They have asthma, they have other pulmonary issues. So I don’t know, we don’t know the answer to this nine year old girl, tragically. She passed, and she’s no longer with us, but there’s probably, if you dig into it, there’s probably a story behind it.

Speaker 1: (23:48)
Dr. Hamilton, have you seen any patients who are having adverse side effects because schools have been closed, who have depression or suicide?

Dr. Bob Hamilton: (23:54)
I mean, I think that it is common knowledge that with the schools not being open, when you think about what your experience in junior high and high school-

Dr. Bob Hamilton: (24:03)
… not being open. When you think about your experience in junior high and high school, what do you think about? You think about parties and you think about football games, socializing. Those are the things we think about. Those are all being shut down, folks. Nobody is having fun anymore. And I will tell you that these are critical years of life to be out mixing with other kids, other people, and that has been shut down. So yes, there are lots of comorbidities that go along with shutting down. We’re talking about anxiety, we’re talking about depression, loneliness, abuse is happening, and kids who have particular… Children who have special needs, kids are not doing well either. So, there is a long list of complications that occur when you quarantine and lockdown people.

Speaker 7: (24:48)
So an extension to what you were just talking about, we hear all these studies and all this polling that moms are afraid to go back to work because of letting their children go to school, they shouldn’t go to school because then they’re exposed, and if the moms go back to school, then the elderly grandparents, they’re [crosstalk 00:25:04].

Dr. Bob Hamilton: (25:04)
Right, well, this is the big [crosstalk 00:25:05].

Speaker 7: (25:06)
Can you speak to that please?

Dr. Bob Hamilton: (25:07)
Sure. Yeah, this is a big issue because people are afraid not that their children are going to get particularly ill, because I think they’re learning the truth is that this infection is being tolerated well by children. But certainly, they look at their environment, their particular unique family, and I think in some situations that may be an appropriate fear. However, I do think that as a general comment, a general rule through the country, kids can go back to school. Maybe a few kids here and there, their living situation, who they’re being cared for, that can be a potential problem. But again, for younger children in particular, they’re not the ones passing on the disease to the adults.

Speaker 7: (25:52)
Wouldn’t the hydroxychloroquine be…

Dr. Stella Immanuel: (25:52)
I’ll talk about that.

Speaker 7: (25:52)
Maybe Dr. Immanuel can speak to that, or somebody else.

Dr. Bob Hamilton: (25:53)
Well hydroxychloroquine, yeah. [crosstalk 00:25:56].

Speaker 7: (25:53)
In terms of as a prophylaxis.

Dr. Bob Hamilton: (25:53)
That can be done. Yes, that can be used. [crosstalk 00:26:06]

Dr. Stella Immanuel: (26:06)
We’re talking about, we can’t open our businesses. We can’t go to school and parents are scared to get treated. And I personally, have put over a hundred people on hydroxychloroquine prophylaxis. Doctors, teachers, people who are health care workers, my staff, me, I see over 15 to 20, sometimes 20, 15, 10 patients a day. I use a surgical mask. I’ve not been infected. Nobody I know has been infected that’s around me. So this is the answer to this question. You want to open schools, everybody get on hydroxychloroquine. That is the prevention for COVID. One tablet every other week is good enough. And that is what we need to get across to the American people. There’s prevention and there is cure. We don’t have to lock down schools. We don’t have to lockdown our businesses. There’s prevention, and there is cure. So instead of talking about a mask, instead of talking about lockdowns, instead of talking about all these things, put our teachers on hydroxychloroquine.

Dr. Stella Immanuel: (26:59)
Put those that are high risk on hydroxychloroquine. Those that want it. If you want to catch COVID, that’s cool, but you should be given the right to take it and be prevented. So that’s the message. All this stuff that we’re putting together, it’s not necessary because hydroxychloroquine has a prevention. Hydroxychloroquine is a prevention for COVID.

Speaker 8: (27:17)
Earlier I heard you say that…

Dr. Stella Immanuel: (27:18)
Hydroxychloroquine.

Speaker 8: (27:21)
… hydroxychloroquine, that that drug was the cure.

Dr. Stella Immanuel: (27:22)
Cure, mm-hm (affirmative).

Speaker 8: (27:25)
But you also said measured with zinc and other things.

Dr. Stella Immanuel: (27:27)
Yes.

Speaker 8: (27:27)
And you guys also said that previous doctors have used it, but they’ve used it in the wrong dosage. So I keep hearing the drug, but then what is the right dosage. What is the right mixture?

Dr. Stella Immanuel: (27:39)
That you’re going to discuss with your doctor, but let [inaudible 00:03:43] take that.

Speaker 9: (27:45)
Yeah, that’s a great question. Because the whole political situation has driven the fear towards this drug. So let’s address that. This drug is super safe. It’s safer than aspirin, Motrin, Tylenol. It’s super safe. All right. So what the problem is in a lot of those studies, they did very, very high doses, massive doses all through the country. They did the remaps study, the solidarity trial. That was the world health organization trial, and also the recovery trial. They use 2,400 milligrams in the first day. All you need is 200 twice a week for prophylaxis. They used massive toxic doses. And guess what they found out? When you use massive toxic doses, you get toxic results. The drug doesn’t work when you give toxic doses. It’s a very safe drug. It concentrates in the lungs, 200 to 700 times higher in the lungs.

Speaker 9: (28:38)
It’s an amazing drug because in the bloodstream, you’re not going to get high levels, but you get massive levels in the lungs. So you’re going to find yourself, if you prophylax, that as soon as the virus gets there, it’s going to have a hard time getting through because the hydroxychloroquine blocks it from getting in. And then once it gets in, it won’t let the virus actually replicate. Bring in zinc and zinc will mess up the copy machine called the RDRP. So with the combination of drugs, it’s incredibly effective in the early disease. By itself, it’s incredibly effective as a prophylaxis. Does that answer to the question?

Simone Gold: (29:15)
Yeah. I want to emphasize on something that Dr. [inaudible 00:29:20] just said, because I love the question. This is a treatment regimen that’s very simple, and it should be in the hands of the American people. The difficult aspect of this is that at the moment, because of politics, it’s being blocked from doctors prescribing it, and it’s being blocked from pharmacists releasing it. They’ve been empowered to overrule the doctor’s opinion. Why is this not over the counter? As you can get it in much of the world and almost all of Latin America, in Iran, in Indonesia, in Subsaharan Africa, you can just go and buy it yourself. And the dose, my friends is 200 milligrams twice in a week and zinc daily. That’s the dose. I’m in favor of it being over the counter. Give it to the people. Give it to the people.

Moderator: (30:06)
We have two more, who can answer this question and they know this information.

Dr. James Todaro: (30:12)
Hi, Dr. James Todaro [inaudible 00:30:13]. I just want to add a couple of comments to what Dr. Gold was saying. If it seems like there is an orchestrated attack that’s going on against hydroxychloroquine it’s because there is. When have you ever heard of a medication generating this degree of controversy? A 65 year old medication that has been on the World Health Organization’s safe, essential list of medications for years. It’s over the counter in many countries. And what we’re seeing is a lot of misinformation. So I coauthored the first document on hydroxychloroquine as a potential treatment for coronavirus. This is back in March and that kind of kicked off a whole series of a storm on it. And since then, there’s been a tremendous amount of censorship on doctors like us and what we’re saying. And a number of us have already been censored. That Google document that I coauthored was actually pulled down by Google. And this is after now, many studies have shown that it is effective and it is safe. You still can’t read that article. And there’s also this misinformation out there. And unfortunately, this has reached the highest orders of medicine. In May there was an article published in The Lancet. This is one of the world’s most prestigious medical journals in the world. The World Health Organization stopped all their clinical trials on hydroxychloroquine because of this study. And it was independent researchers like us who care about patients, who care about the truth that dug into this study and determined that it was actually fabricated data. The data was not real. And we did this so convincingly that this study was retracted by The Lancet less than two weeks after it was published. This is almost unheard of, especially for study of this magnitude.

Dr. James Todaro: (31:44)
So I apologize to everyone for the fact that there is so much misinformation out there, and it’s so hard to find the truth. And unfortunately, it’s going to take looking at other places for the truth. That’s why we formed frontline doctors here to try to help get the real information out there.

Speaker 10: (32:00)
What did you say your name was?

Dr. James Todaro: (32:01)
I’m James Todaro.

Moderator: (32:02)
Give your website.

Dr. James Todaro: (32:05)
Most of my thoughts, I actually publish on Twitter. Twitter has been great lately. So, James Todaro, M D. T-O-D-A-R-O M-D but I also have a website medicineuncensored.com, which contains kind of a lot of the information about hydroxychloroquine I think is much more objective than what’s going on in other media channels.

Speaker 10: (32:28)
One point, in terms of Twitter. That’s important because as I understand not only from doctors, but from other people in the media, that YouTube has blocked information specifically about hydroxychloroquine.

Dr. James Todaro: (32:42)
I’ll go ahead and address that real quickly. I would say Facebook and YouTube have taken the most draconian measures to silence and censorship people. And this is coming from the CEO of YouTube, as well as Mark Zuckerberg saying anything that goes against what the World Health Organization has said is subject to censorship. And we all know the World Health Organization has made a number of mistakes during this pandemic. They have not been perfect by any means. Twitter, although they have some flaws and faults and flag certain content and stuff, they really still remain one of the freest platforms to share dialogue, intelligent discussion regarding this information. And many of us here today actually connected on social platform mediums like that.

Speaker 11: (33:21)
Could you talk about what you mentioned earlier about the medication and how long it’s been around?

Dr. Joe Ladapo: (33:27)
Sure thing. I’m Dr. Joe. Ladapo. I’m a physician at UCLA and I’m a clinical researcher also. And I’m speaking for myself and not on behalf of UCLA. So I want to say that I’m thinking of the people who are behind the screens that are watching what you guys were broadcasting. And I want to share with you because there’s so much controversy and the atmosphere is so full of conflict right now that what this group of doctors is trying to do fundamentally, is really to bring more light to this conversation about how we manage COVID-19 and the huge challenge. And that’s what this is ultimately about. And bringing light to something means thinking more about trade offs, about one of my colleagues said on unintended consequences. And I actually think that’s not even the right word, the right word is unanticipated consequences. Really thinking about the implications of the decisions we’re making in this really, really extraordinary time that we’re in.

Dr. Joe Ladapo: (34:45)
So, I’m sure people are listening to some of the discussion about hydroxychloroquine and wondering, what are these doctors talking about? And, these are doctors that take care of patients, board certified, med school, great med schools, all of that. How could they possibly be saying this? I watch CNN and NBC, and they don’t say anything about this. And that’s actually, that’s the point. There are issues that are moral issues, that really there should be a singular voice. So for me, issues related to whether people are treated differently based on their sex or race, or their sexual orientation. I personally think those are moral issues and there’s only one position on those. But COVID-19 is not a moral issue. COVID-19 is a challenging, complex issue that we benefit from having multiple perspectives on. So it’s not good for the American people when everyone is hearing one perspective on the main stations. There’s no way that’s going to service. So, the perspective most people have been hearing is that hydroxychloroquine doesn’t work. That’s the perspective that most people have been hearing on the mainstream television.

Dr. Joe Ladapo: (36:03)
That’s the perspective that most people have been hearing on the mainstream television, and I believe that perspective too, until I started talking to doctors who would look more closely than some of the physicians behind me here, who would look more closely at the data and at the studies.

Dr. Joe Ladapo: (36:17)
So it is a fact that several randomized trials have come out so far, that’s our highest level of evidence, and have shown that hydroxychloroquine… Their findings have generally been that there’s no significant effect on health benefit. So, that’s a fact, that the randomized control trials have come out… So far that have come out. In fact, there were two or three big ones that came out over the last two weeks, [inaudible 00:36:44] Internal Medicine, New England Journal of Medicine, and I think one other journal.

Dr. Joe Ladapo: (36:49)
It is also a fact that there have been several observational studies. These are just not randomized controlled trials, but patients who are getting treated with this medication that have found that hydroxychloroquine improves outcomes. So both of those things are true. There’s evidence against it and there’s evidence for it. It is also a fact that we are in an extraordinarily challenging time. Given those considerations, how can the right answer be to limit physician’s use of the medication? That can’t possibly be the right answer. And when you consider that this medication before COVID-19 had been used for decades, by patients with rheumatoid arthritis, by patients with lupus, by patients with other conditions, by patients who were traveling to West Africa and needed malaria prophylaxis, we’ve been using it for a long time, but all of a sudden it’s elevated to this area of looking like some poisonous drug. That just doesn’t make sense.

Dr. Joe Ladapo: (37:59)
Then when you add onto that the fact that we’ve had two of the biggest journals in the world, New England Journal of Medicine, and Lancet, as my colleagues say, retract studies that found, interestingly, that hydroxychloroquine harmed patients. Both of these studies. They had to retract these studies, which really is unheard of. That should raise everyone’s concern about what is going on. At the very least, we can live in a world where there are differences of opinion about the effectiveness of hydroxychloroquine, but still allow more data to come, still allow physicians who feel like they have expertise with it use that medication, and still talk, and learn, and get better at helping people with COVID-19.

Dr. Joe Ladapo: (38:50)
So why we’re not there is not good. It doesn’t make sense, and we need to get out of there.

Dr. Stella Immanuel: (38:58)
Listen, let me just put a little bit of that. I have seen 350 patients and counting. Put them on hydroxychloroquine. They all got better. This is what I would say to all those studies, they had high doses, they were given to wrong patients. I will call them fake science. Any study that says hydroxychloroquine doesn’t work, is fake science and I want them to show me how it doesn’t work. How is it going to work for 350 patients for me and they’re all alive, and then somebody say it doesn’t work? Guys, all them studies, fake science.

Simone Gold: (39:30)
What was your question? Thank you.

Speaker 14: (39:31)
Last question.

Simone Gold: (39:31)
Yeah, last question.

Speaker 13: (39:35)
I’ve heard there’s an increase in anxiety, suicidal ideation, substance abuse, and various mental health issues as a result of school closures and shutdowns. Is it your recommendation that [inaudible 00:39:48] federal funding for programs will help deal with those issues?

Simone Gold: (39:54)
Yeah, I don’t understand how you would go to that conclusion. If the problem was that the schools are shut down, and it’s causing it, then we need to open up the schools.

Speaker 14: (40:03)
[inaudible 00:40:03] mental healthcare [crosstalk 00:40:05].

Simone Gold: (40:06)
Yeah. I would go to the school. I would open up the schools, because the most important thing for children is to socialize, and to be with other kids, and to learn. Yeah. [crosstalk 00:40:14] Yeah. Let’s get kids back in school.

Speaker 14: (40:17)
You don’t believe that?

Simone Gold: (40:20)
Kids back in school. We’re in favor of kids back in school.

Speaker 15: (40:22)
Thank you everyone. [crosstalk 00:04:24]. Thank you very much. And we are going to be going back live continuing our summit, so you can continue watching. Once we get back, we may be running.

Speaker 16: (40:35)
Thank you so much. [inaudible 00:40:45].

Dr. Stella Immanuel: (40:38)
It’s fake science. [crosstalk 00:04:50]. It’s fake science.

Simone Gold: (40:50)
That’s right. I believe you. I believe you. [crosstalk 00:40:52].

Doctor 1: (40:54)
It’s more specialized, so I have to defer.

Speaker 18: (40:55)
You said that depression-

Doctor 1: (40:56)
That depression is caused by low zinc levels. When you go into a hospital nowadays, they don’t test for those zinc levels. Low zinc levels are manifested by loss of sense of smell, loss of taste. Why are these also symptoms of COVID, right? COVID, loss of sense of smell, loss of taste, right? And the reason is because zinc is the natural thing that used to fight the COVID. What happens is the zinc stops RNA polymerase, and the hydroxy chloroquine allows the zinc to go into the cells.

Speaker 18: (41:33)
I’m wondering-

Doctor 1: (41:33)
To stop the RNA polymerase-

Speaker 18: (41:35)
Because there was a-

Doctor 1: (41:36)
Hang on, hang on.

Speaker 18: (41:36)
It was implied that-

Doctor 1: (41:37)
Let me give you the science behind it. So if your lab is [crosstalk 00:41:41]… I understand.

Speaker 18: (41:43)
Yeah.

Doctor 1: (41:43)
Let me explain it a little bit better. The zinc stops RNA polymerase, and it’s used up by your cells in the normal fighting of COVID. So if you never took hydroxychloroquine, you’d still be zinc depleted. We’re in a natural state of zinc depletion in the United States, but the COVID decreases your zinc even more, and you need it to fight off any virus. That’s why your mom always said, “Take your zinc,” right?

Speaker 18: (42:04)
Is the problem with children on psych units that they have low zinc levels?

Doctor 1: (42:11)
No, no, no. We’re talking about the COVID and how that… [inaudible 00:06:13].

Speaker 18: (42:15)
Okay. My question was about if federal funds should be diverted to helping therapists, social workers and other frontline workers to deal with the psychological issues that were mentioned by your colleague, that shut downs in the government and school closures cause an increase in suicidal ideation, and substance abuse, and anxiety. So those environmental factors are what caused those mental health issues. Doesn’t it stand to reason that then funds to help those institutions deal with the problem should be receiving more funding?

Doctor 1: (42:47)
I’m going to defer to my psychiatrist colleague.

Speaker 18: (42:50)
He didn’t hear me ask the question. [crosstalk 00:42:51].

Doctor 1: (42:51)
First, we need to take care of the biological basis, which is the zinc, which is the vitamin D, lack of vitamin D. We’re dumping our milk.

Speaker 18: (43:03)
Yeah, I don’t know about that.

Doctor 1: (43:04)
We’re dumping our milk [crosstalk 00:07:05]. We’re dumping our milk in the manure pits right now. If we would get together-

Doctor 2: (43:09)
Yeah, that’s hard to believe.

Doctor 1: (43:10)
If we would get that to the kids out of school, that will be very helpful.

Speaker 18: (43:14)
Okay.

Doctor 1: (43:14)
So I’ll defer to my colleague.

Speaker 18: (43:17)
So my question, I still haven’t gotten a clear answer on it-

Doctor 2: (43:19)
I’ll try to answer. Public policy is not my expertise, but I can try.

Speaker 18: (43:23)
Oh no, it’s not really about… It’s not my expertise either, actually. But I was wondering since your colleague said that as a result of school closures and government shutdowns, which caused an increase in suicidal ideation, anxiety, substance abuse, and a variety of other issues, I’m wondering if federal funding should be diverted to frontline workers, social workers, mental health therapists?

Doctor 2: (43:45)
The answer your question is this, I see it this way, harm has already come is what we’re saying. So the answer to the question is, harm has already come. What should we do about that harm? I don’t know the inner workings of the government, but to say that harm has already come, and to say that we’re going to do something about it, it makes sense. To me as a doctor, I think if we know harm is coming, if you and I know we already got run over by a car, I think it makes sense to let me go ahead and go to the hospital to get my-

Speaker 18: (44:10)
There’s a real lack of funding for people in my profession to be able to help those kids and those adults.

Doctor 2: (44:12)
Yeah, I think it makes a lot of sense. So I’m going to just say, to me, it makes sense, and I think it’s fair.

Speaker 18: (44:20)
I appreciate the well-rounded concern. It just kind of stops with concern and it doesn’t continue into action. Congress might not, I’m not sure who he was, maybe you could actually give [crosstalk 00:08:31].
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Treatment with hydroxychloroquine, azithromycin, and combination in patients hospitalized with COVID-19

Postby smix » Fri Jul 31, 2020 7:31 pm

Treatment with hydroxychloroquine, azithromycin, and combination in patients hospitalized with COVID-19
International Journal of Infectious Diseases

URL: https://www.ijidonline.com/article/S1201-9712(20)30534-8/abstract
Category: healthNews
Published: July 1, 2020

Description: Highlights
* As of May 27, 2020 there are over 1,678,843 confirmed cases of COVID-19 claiming more than 100,000 lives in the Unites States. Currently there is no known effective therapy or vaccine.
* According to a protocol-based treatment algorithm, among hospitalized patients, use of hydroxychloroquine alone and in combination with azithromycin was associated with a significant reduction in-hospital mortality compared to not receiving hydroxychloroquine.
* Findings of this observational study provide crucial data on experience with hydroxychloroquine therapy, providing necessary interim guidance for COVID-19 therapeutic practice.
Abstract
Significance
The United States is in an acceleration phase of the COVID-19 pandemic. Currently there is no known effective therapy or vaccine for treatment of SARS-CoV-2, highlighting urgency around identifying effective therapies.
Objective
The purpose of this study was to evaluate the role of hydroxychloroquine therapy alone and in combination with azithromycin in hospitalized patients positive for COVID-19.
Design
Multi-center retrospective observational study.
Setting
The Henry Ford Health System (HFHS) in Southeast Michigan: large six hospital integrated health system; the largest of hospitals is an 802-bed quaternary academic teaching hospital in urban Detroit, Michigan.
Participants
Consecutive patients hospitalized with a COVID-related admission in the health system from March 10, 2020 to May 2, 2020 were included. Only the first admission was included for patients with multiple admissions. All patients evaluated were 18 years of age and older and were treated as inpatients for at least 48 h unless expired within 24 h.
Exposure
Receipt of hydroxychloroquine alone, hydroxychloroquine in combination with azithromycin, azithromycin alone, or neither.
Main outcome
The primary outcome was in-hospital mortality.
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). Overall in-hospital mortality was 18.1% (95% CI:16.6%–19.7%); by treatment: hydroxychloroquine + azithromycin, 157/783 (20.1% [95% CI: 17.3%–23.0%]), hydroxychloroquine alone, 162/1202 (13.5% [95% CI: 11.6%–15.5%]), azithromycin alone, 33/147 (22.4% [95% CI: 16.0%–30.1%]), and neither drug, 108/409 (26.4% [95% CI: 22.2%–31.0%]). Primary cause of mortality was respiratory failure (88%); no patient had documented torsades de pointes. From Cox regression modeling, predictors of mortality were age >65 years (HR:2.6 [95% CI:1.9–3.3]), white race (HR:1.7 [95% CI:1.4–2.1]), CKD (HR:1.7 [95%CI:1.4–2.1]), reduced O2 saturation level on admission (HR:1.5 [95%CI:1.1–2.1]), and ventilator use during admission (HR: 2.2 [95%CI:1.4–3.3]). Hydroxychloroquine provided a 66% hazard ratio reduction, and hydroxychloroquine + azithromycin 71% compared to neither treatment (p < 0.001).
Conclusions and relevance
In this multi-hospital assessment, when controlling for COVID-19 risk factors, treatment with hydroxychloroquine alone and in combination with azithromycin was associated with reduction in COVID-19 associated mortality. Prospective trials are needed to examine this impact.
--
PDF: Treatment with hydroxychloroquine, azithromycin, and combination in patients hospitalized with COVID-19
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An Effective COVID Treatment the Media Continues to Besmirch

Postby smix » Wed Aug 05, 2020 11:55 pm

An Effective COVID Treatment the Media Continues to Besmirch
RealClear Politics

URL: https://www.realclearpolitics.com/artic ... 43875.html
Category: Politics
Published: August 4, 2020

Description: On Friday, July 31, in a column ostensibly dealing with health care “misinformation,” Washington Post media critic Margaret Sullivan opened by lambasting “fringe doctors spouting dangerous falsehoods about hydroxychloroquine as a COVID-19 wonder cure.” Actually, it was Sullivan who was spouting dangerous falsehoods about this drug, something the Washington Post and much of the rest of the media have been doing for months. On May 15, the Post offered a stark warning to any Americans who may have taken hope in a possible therapy for COVID-19. In the newspaper’s telling, there was nothing unambiguous about the science -- or the politics -- of hydroxychloroquine: “Drug promoted by Trump as coronavirus game-changer increasingly linked to deaths,” blared the headline. Written by three Post staff writers, the story asserted that the effectiveness of hydroxychloroquine in treating COVID-19 is scant and that the drug is inherently unsafe. This claim is nonsense. Biased against the use of hydroxychloroquine for COVID-19 -- and the Washington Post is hardly alone -- the paper described an April 21, 2020, drug study on U.S. Veterans Affairs patients hospitalized with the illness. It found a high death rate in patients taking the drug hydroxychloroquine. But this was a flawed study with a small sample, the main flaw being that the drug was given to the sickest patients who were already dying because of their age and severe pre-existing conditions. This study was quickly debunked. It had been posted on a non-peer-reviewed medical archive that specifically warns that studies posted on its website should not be reported in the media as established information. Yet, the Post and countless other news outlets did just the opposite, making repeated claims that hydroxychloroquine was ineffective and caused serious cardiac problems. Nowhere was there any mention of the fact that COVID-19 damages the heart during infection, sometimes causing irregular and sometimes fatal heart rhythms in patients not taking the drug. To a media unrelentingly hostile to Donald Trump, this meant that the president could be portrayed as recklessly promoting the use of a “dangerous” drug. Ignoring the refutation of the VA study in its May 15 article, the Washington Post cited a Brazil study published on April 24 in which a COVID trial using chloroquine (a related but different drug than hydroxychloroquine) was stopped because 11 patients treated with it died. The reporters never mentioned another problem with that study: The Brazilian doctors were giving their patients lethal cumulative doses of the drug. On and on it has gone since then, in a circle of self-reinforcing commentary. Following the news that Trump was taking the drug himself, opinion hosts on cable news channels launched continual attacks on both hydroxychloroquine and the president. “This will kill you!” Fox News Channel’s Neil Cavuto exclaimed. “The president of the United States just acknowledge that he is taking hydroxychloroquine, a drug that [was] meant really to treat malaria and lupus.” Washington Post reporters Ariana Cha and Laurie McGinley were back again on May 22, with a new article shouting out the new supposed news: “Antimalarial drug touted by President Trump is linked to increased risk of death in coronavirus patients, study says.” The media uproar this time was based on a large study just published in the Lancet. There was just one problem. The Lancet paper was fraudulent and it was quickly retracted. However, the damage from the biased media storm was done and it was long-lasting. Continuing patient enrollment needed for early-use clinical trials of hydroxychloroquine dried up within a week. Patients were afraid to take the drug, doctors became afraid to prescribe it, pharmacies refused to fill prescriptions, and in a rush of incompetent analysis and non-existent senior leadership, the FDA revoked its Emergency Use Authorization for the drug.
So what is the real story on hydroxychloroquine? Here, briefly, is what we know:
When the COVID-19 pandemic began, a search was made for suitable antiviral therapies to use as treatment until a vaccine could be produced. One drug, hydroxychloroquine, was found to be the most effective and safe for use against the virus. Federal funds were used for clinical trials of it, but there was no guidance from Dr. Anthony Fauci or the NIH Treatment Guidelines Panel on what role the drug would play in the national pandemic response. Fauci seemed to be unaware that there actually was a national pandemic plan for respiratory viruses. Following a careful regimen developed by doctors in France, some knowledgeable practicing U.S. physicians began prescribing hydroxychloroquine to patients still in the early phase of COVID infection. Its effects seemed dramatic. Patients still became sick, but for the most part they avoided hospitalization. In contrast --- and in error -- the NIH-funded studies somehow became focused on giving hydroxychloroquine to late-presenting hospitalized patients. This was in spite of the fact that unlike the drug’s early use in ambulatory patients, there was no real data to support the drug’s use in more severe hospitalized patients. By April, it was clear that roughly seven days from the time of the first onset of symptoms, a COVID-19 infection could sometimes progress into a more radical late phase of severe disease with inflammation of the blood vessels in the body and immune system over-reactions. Many patients developed blood clots in their lungs and needed mechanical ventilation. Some needed kidney dialysis. In light of this pathological carnage, no antiviral drug could be expected to show much of an effect during this severe second stage of COVID. On April 6, 2020, an international team of medical experts published an extensive study of hydroxychloroquine in more than 130,000 patients with connective tissue disorders. They reaffirmed that hydroxychloroquine was a safe drug with no serious side effects. The drug could safely be given to pregnant women and breast-feeding mothers. Consequently, countries such as China, Turkey, South Korea, India, Morocco, Algeria, and others began to use hydroxychloroquine widely and early in their national pandemic response. Doctors overseas were safely prescribing the drug based on clinical signs and symptoms because widespread testing was not available. However, the NIH promoted a much different strategy for the United States. The “Fauci Strategy” was to keep early infected patients quarantined at home without treatment until they developed a shortness of breath and had to be admitted to a hospital. Then they would they be given hydroxychloroquine. The Food and Drug Administration cluelessly agreed to this doctrine and it stated in its hydroxychloroquine Emergency Use Authorization (EUA) that “hospitalized patients were likely to have a greater prospect of benefit (compared to ambulatory patients with mild illness).” In reality just the opposite was true. This was a tragic mistake by Fauci and FDA Commissioner Dr. Stephen Hahn and it was a mistake that would cost the lives of thousands of Americans in the days to come. At the same time, accumulating data showed remarkable results if hydroxychloroquine were given to patients early, during a seven-day window from the time of first symptom onset. If given during this window, most infections did not progress into the severe, lethal second stage of the disease. Patients still got sick, but they avoided hospitalization or the later transfer to an intensive care unit. In mid-April a high-level memo was sent to the FDA alerting them to the fact that the best use for hydroxychloroquine was for its early use in still ambulatory COVID patients. These patients were quarantined at home but were not short of breath and did not yet require supplemental oxygen and hospitalization. Failing to understand that COVID-19 could be a two-stage disease process, the FDA ignored the memo and, as previously mentioned, it withdrew its EUA for hydroxychloroquine based on flawed studies and clinical trials that were applicable only to late-stage COVID patients. By now, however, some countries had already implemented early, aggressive, outpatient community treatment with hydroxychloroquine and within weeks were able to minimize their COVID deaths and bring their national pandemic under some degree of control. In countries such as Great Britain and the United States, where the “Fauci-Hahn Strategy” was followed, there was a much higher death rate and an ever-increasing number of cases. COVID patients in the U.S. would continue to be quarantined at home and left untreated until they developed shortness of breath. Then they would be admitted to the hospital and given hydroxychloroquine outside the narrow window for the drug’s maximum effectiveness. In further contrast, countries that started out with the “Fauci-Hahn Doctrine” and then later shifted their policy towards aggressive outpatient hydroxychloroquine use, after a brief lag period also saw a stunning rapid reduction in COVID mortality and hospital admissions. Finally, several nations that had started using an aggressive early-use outpatient policy for hydroxychloroquine, including France and Switzerland, stopped this practice when the WHO temporarily withdrew its support for the drug. Five days after the publication of the fake Lancet study and the resulting media onslaught, Swiss politicians banned hydroxychloroquine use in the country from May 27 until June 11, when it was quickly reinstated. The consequences of suddenly stopping hydroxychloroquine can be seen by examining a graph of the Case Fatality Ratio Index (nrCFR) for Switzerland. This is derived by dividing the number of daily new COVID fatalities by the new cases resolved over a period with a seven-day moving average. Looking at the evolution curve of the CFR it can be seen that during the weeks preceding the ban on hydroxychloroquine, the nrCFR index fluctuated between 3% and 5%. Following a lag of 13 days after stopping outpatient hydroxychloroquine use, the country’s COVID-19 deaths increased four-fold and the nrCFR index stayed elevated at the highest level it had been since early in the COVID pandemic, oscillating at over 10%-15%. Early outpatient hydroxychloroquine was restarted June 11 but the four-fold “wave of excess lethality” lasted until June 22, after which the nrCFR rapidly returned to its background value. Here in our country, Fauci continued to ignore the ever accumulating and remarkable early-use data on hydroxychloroquine and he became focused on a new antiviral compound named remdesivir. This was an experimental drug that had to be given intravenously every day for five days. It was never suitable for major widespread outpatient or at-home use as part of a national pandemic plan. We now know now that remdesivir has no effect on overall COVID patient mortality and it costs thousands of dollars per patient. Hydroxychloroquine, by contrast, costs 60 cents a tablet, it can be taken at home, it fits in with the national pandemic plan for respiratory viruses, and a course of therapy simply requires swallowing three tablets in the first 24 hours followed by one tablet every 12 hours for five days. There are now 53 studies that show positive results of hydroxychloroquine in COVID infections. There are 14 global studies that show neutral or negative results -- and 10 of them were of patients in very late stages of COVID-19, where no antiviral drug can be expected to have much effect. Of the remaining four studies, two come from the same University of Minnesota author. The other two are from the faulty Brazil paper, which should be retracted, and the fake Lancet paper, which was. Millions of people are taking or have taken hydroxychloroquine in nations that have managed to get their national pandemic under some degree of control. Two recent, large, early-use clinical trials have been conducted by the Henry Ford Health System and at Mount Sinai showing a 51% and 47% lower mortality, respectively, in hospitalized patients given hydroxychloroquine. A recent study from Spain published on July 29, two days before Margaret Sullivan’s strafing of “fringe doctors,” shows a 66% reduction in COVID mortality in patients taking hydroxychloroquine. No serious side effects were reported in these studies and no epidemic of heartbeat abnormalities. This is ground-shaking news. Why is it not being widely reported? Why is the American media trying to run the U.S. pandemic response with its own misinformation?



MN Governor Quietly Reverses Course on Hydroxychloroquine
RealClear Politics

URL: https://www.realclearpolitics.com/artic ... 43978.html
Category: Politics
Published: August 17, 2020

Description: This past week Minnesota became the second state to reject regulations that effectively ban the controversial drug hydroxychloroquine for use by COVID-19 patients. The decision, which comes two weeks after the Ohio Board of Pharmacy reversed an effective ban of its own, was rightfully praised by local health care advocates. “We are pleased that Governor [Tim] Walz lifted his March 27 Executive Order 20-23 restrictions on chloroquine and hydroxychloroquine,” said Twila Brase, president of Citizens’ Council for Health Freedom. The reversal by Walz, a first-term Democrat, clears the way for doctors to prescribe hydroxychloroquine, a drug commonly used to treat malaria and other conditions but one the FDA has declined to recommend for COVID-19 treatment. The decision is the latest development in the weird saga of arguably the most divisive drug in modern history. The acrimony began in March after President Trump tweeted that hydroxychloroquine had the potential to be “one of the biggest game changers in the history of medicine” as a treatment for the coronavirus. The tweet and similar statements provoked an avalanche of media criticism, with many claiming that the president was going to get people killed. Critics pointed out that medical evidence suggests the medication is linked to a fatal arrhythmia and some trials show no benefits in coronavirus treatments. Though his critics are likely loath to admit it, there’s reason to believe the president may have been on to something. In recent weeks a chorus of voices in the medical community has emerged to challenge the view that hydroxychloroquine is ineffective as a COVID treatment. Dr. Harvey A. Risch, a professor of epidemiology at the Yale School of Public Health, said a full analysis of the literature suggests hydroxychloroquine may be the key to defeating the coronavirus. “Physicians who have been using these medications in the face of widespread skepticism have been truly heroic,” Risch wrote in Newsweek, adding that a full review of the COVID literature on the drug shows “clear-cut and significant benefits.” Prescribing hydroxychloroquine in the early stages of the virus is key, Risch said, and others agree. Steven Hatfill, a veteran virologist and adjunct assistant professor at the George Washington University Medical Center, says the literature supporting hydroxychloroquine is overwhelming. “There are now 53 studies that show positive results of hydroxychloroquine in COVID infections,” Hatfill wrote in RealClearPolitics. “There are 14 global studies that show neutral or negative results -- and 10 of them were of patients in very late stages of COVID-19, where no antiviral drug can be expected to have much effect.” One of the positive studies, published by Henry Ford Health System, was a large-scale retrospective of six hospitals. Analyzing 2,541 patients, it found that those treated with hydroxychloroquine alone died at about half the rate of patients not treated with it. It’s unclear if it was this research that prompted Walz to reverse his March ruling, which ordered the Board of Pharmacists to instruct pharmacists to not issue hydroxychloroquine prescriptions unless the diagnosis was “appropriate” -- which halted any off-label prescription requests. The reason it’s unclear is that Walz has been mum on why he rescinded his order. There’s been no announcement or new stories. Local lawmakers told me they had no idea Walz had reversed course. “There’s been absolutely no transparency here,” said Dr. Scott Jensen, a Republican state senator who criticized Walz’s approach. Jensen, who has practiced medicine for more than 30 years in Minnesota, told me pharmacists he’s worked with for years told him they could not fill a hydroxychloroquine prescription for COVID because of the March executive order. He agrees that hydroxychloroquine is terribly misunderstood by the public and said politicians need to take a step back. “Hydroxychloroquine is one of the most studied drugs in the history of mankind,” Jensen said. “My wife was on hydroxychloroquine for 15 years. It’s been on the World Health Organization’s list of essential medicines for decades. It’s been in play since 1955, the year after I was born.” Hydroxychloroquine might be politically controversial, but that hasn’t stopped some of its critics from taking advantage of the drug. In a May interview, former presidential hopeful Sen. Amy Klobuchar admitted her husband was successfully treated with hydroxychloroquine, a medication she had mocked on Twitter. The politics of hydroxychloroquine are unlikely to cool before November’s presidential election. Yet, if Walz’s decision is any indication, at least some leaders are starting to recognize the ethical dilemma of using the long arm of government to stand between suffering patients and a drug that may have the potential to save them.
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