The video is very compelling but it falls short of making the case against the use of Hydroxychloroquine. The main reason is that all the tests referred to in it, tested the wrong protocol. The protocol that works is 200 mg twice day plus zinc.
Dr. Jeffrey Liva| Preventive Medicine
I having a little hard time believing the studies you cite. In 5 out of 6 studies, the prevalence of adverse events range from 22.6 % to 72 %. I have never encountered a drug Hydroxycloroquine (HC) that is so widely used ie Malaria prophylaxis, Lupus and Rheumatoid arthritis that has that high of a percentage of adverse events. I have to yet to read a study where they studied these groups that were on plaquenil for another reason prior to SARS-CoV-2. A study could be looking at individual on Plaquenil starting for example in January 2020 and comparing a randomizing of the three groups and do a standardized adjustments for variables such as age sex, adverse events and other and co-morbid events , antigen, antibody status and death rate. Then you could make a case for HC or not. With companies such as Express scripts you could get the pharmaceutical data, with a couple of large labs like Quest and LabCorp, with contact tracing that is a mandatory requirement for the reporting of COVID 19 results you could easily get an N of 100000. The data is already there, it just needs to be mined and especially since it COVID 19 related all the rules go out the window because you could use emergency authorization to bypass the usual bureaucratic process. Just a suggestion.
Dr. james whiting| Radiology
There seems to be no question that HCQ does not treat established covid. What is ongoing, last I saw, was whether it is beneficial as prophylaxis. I hear that there are three trials with health care workers likely to be exposed to covid, randomized and controlled. I have a nickel bet with my MD PhD son that they will show an effect. We’ll see.
The good news is that the prophylactic dose has no side effects.
Dr. Jill Koehler| Pediatrics, General
Try rewriting this after trump gets defeated , I will look at it then ,ANYTHING published in support of something that man suggests will not be looked at with anything but skepticism- he actually told people to inject bleach for gods sake – NONE of us will believe any study of anything he suggests until he’s gone
Dr. Vladimir Groysman| Anesthesiology
I’m offering most clean test-study on HCQ, There are thousands patients taking daily HCQ for different reasons : RA,SLE or else, why someone check morbidity with Covid 19 on this populations and I’m confident we learn something important.
Dr. John Raines| Family Medicine
I realize I am only a lowly FP but HCQ w/zpack greatly improved a couple of my patients…Bottom line: Worth-a shot before hospitalization…
Dr. Iraj Akhavan| Internal Medicine
Probably the most reliable study would be checking vast data of pharmacy based records, prescribers input and patients outcome of the patients treated with HCQ and of course honorable scientists, unlike the ones which their papers had to be pulled back due to fabricated data from Lancets and NEJM. And no grant from GILEAD please.
Dr. MARTA ZELWIANSKI CHERNER| Anesthesiology
I am not too sure about the comparative studies mentioned purpose . The doses of HCQ used were toxic. No wonder the adverse effects were higher in the HCQ groups. HCQ is an immune modulator and it should be used with that criteria in mind . It is not an antiviral and we shouldn’t expect a significant viral load decrease, but a lesser damage over the target organs affected by comparative similar viral loads. Characteristic of COVID 19 is the inflammatory response of the affected organs, as the first autopsy reports have shown. In RA and SLE patients, HCQ at therapeutic doses protect microvasculature and there is less damage in the glomerular messangium and a significant less development of CKF on those treated patients than the non Plaquenil treated patients. If you use the same criteria to ameliorate the immune response and decrease the severity of the cytokine storm elicited by COVID 19 you may save lives and/or the permanent scarring of lung or brain tissue. Sometimes,when there is so much we don’t know and there are so many human lives at stake, the purist in all of us needs to be pushed aside because letting patients die without using a drug that could save them because of ethical concerns is per se an unethical choice.
Dr. Robert Silvetz| Oncology, Medical<
The author is wrong. RCT’s are not all that he thinks they are.
Additionally, the antigen test is garbage and the antibody tests worse. Pathetic remdesivir never showed mortality benefit. It’s been an absurd, politicized show starting from Orange Man Bad And before anyone wants to argue PCR with me, let me remind y’all I met Kari Mullis. PCR was a manufacturing technique, and was never intended for diagnostic or viral load use.
In regards to evidence for HCQ, we have it in spades. So much so, the author should consider surrendering his academic credentials.
Academic medicine, and both the Lancet and NEJM, all got bloody noses deservedly in both retraction and status loss. I for one, no longer am interested in anything these journals or academics publish.
I watch the absurdity on masks, with medical schools falling over each other endorsing the idiocy. No 2 to 4 micron pore surgical mask has EVER stopped a 0.125 micron viral particle. Droplets you say? What the hell do you think happens to viral particles when a droplet dries?
Thankfully, the HCQ restrictions are being lifted. Next we need to forbid governments from ever interfering in the Practice of Medicine ever again. And the FDA for making it appear that we needed their permission to prescribe (we didn’t). for COVID. And NEVER AGAIN should a pharmacy interfere with prescription writing. It is NOT their say to be between us and patients, only to put the meds correctly in the patient’s hand.
I leave you with the thoughts of the Belgian doctors: https://docs4opendebate.be/en/
Dr. Thomas Leytham| Family Medicine
Isn’t it getting a little tiring to hear from people declaring themselves to be on the “right” side of an issue to pontificate on an issue about which there is little debate and little controversy? I’m just asking. The question has never been should we have an RCT or not and never will be that. So, a condescending diatribe on why RCTs are so important to board certified providers who have already been relying on them for decades is preaching to the choir at best and self aggrandizing at worst. The question is and always has been: are these studies well designed enough to deal with the clinical dilemmas we now face. A few are maybes and a lot are straight up, no. I don’t understand why people who claim moral high ground treat all RCTs similarly even when some are obviously flawed study designs (or impractical). It reminds me of a famous guidebook (in case management) that declared boldly that children with bacterial meningitis needed no more than 3-4 days of inpatient care even though three weeks of IV antibiotics were needed because antibiotics can be given IV on an outpatient basis. Yet none of the antibiotic combinations recommended in the same set of guidelines were available as once daily treatments. Have you ever tried to order multiple daily doses of outpatient IV antibiotics? It’s not easy to do (impossible to do at the time this report was written). So what does that mean ? It means sometimes the researchers who are pontificating conclusions are not fully familiar with actually making these decisions in the real world (or at least have suboptimal empathy and respect for those who do have to make these decisions on a daily basis).
Dr. carl hubbell| Plastic Surgery and Aesthetic Medicine
It seems that the deep state extends to clinical medicine in the university setting. Testing (outside of the parameters of how HCTZ has been used with zinc supplementation at the EARLY stages of the disease) seems quite easy to show that the drug does not help in the more ADVANCED stages of the disease. HCTZs side effects which are certainly not as severe as those of hurriedly rushed into use drugs by the FDA such as Remdesivir (which does have important side effects which so many seem to forget) are blown way of proportion. How many people are succumbing to those HCTZ side effects in the malaria ridden nations where COVID 19 infection rates and deaths are very low? Drugs like Remdesivir will also make Big Pharma and their investors huge money and are promoted instead with those in control of medical research saying that those meds are the ETHICAL choice! Get your heads, please, out the sand and come up for air (even if you cannot breathe it very well with your masks on). Medicine is becoming hopelessly politicized by the folks in the white castles who wish to run as fast as they can to stay in the same place.
Dr. jeffrey kunkes| Otolaryngology
I have been in practice for 45 years and have done over 16000 surgeries. I have been seeing office ENT patients throughout the COVID crisis. I have been taking HCT for four months on the days I see patients. I have hypertension issues and a former T2D which was cured with an aggressive diet. I have recommended this to family and friends. I have not had one cardiac issue and I take as part of my health routine an ECG twice a week. I am appalled and disturbed how the health community has divided on political issues and how Democrats have politicized medicine. Democrat Bllue state have no right to tell doctors what drugs they can use based only political leanings. The same insanity is now being turned on the amazing progress being made on COVID vaccines. Cuomo has already been complicit in abetting thousands of deaths in nursing homes. Now he is saying he will not release the vaccine in New York until his health experts????approves it. Please unleash all the trial lawyers. Democrats say listen to science whatever that means but we have a chance to put this epidemic behind us and if it means Trump will win, so be it. He deserves it. He fought a phony impeachment and while Congress was preening berfore cameras Trump banned China travel, Europe travel, mobilized manufacturing for ventilators and produced protective gear for all when our cupboards were bare. Remember that when you see the upcoming debates.
Dr. William Irby
This is not my first comment in support of HCQ and was called a maverick for supporting it the first time. Thus far I have seen nothing to negate the pathophysiological effects of HCQ. No, it has no antiviral activity it is an immune modulator. Know what else is an immune modulator? Corticosteroids which won worldwide praise following its study with very advanced near death studies of Covid patients.
Recent retrograde study of the Covid statistics revealed very eye opening numbers including proof that only 6% of Covid deaths were DUE to Covid rather than died WITH Covid. The other 93-94%? They died due to complications of Comorbid conditions! Huh! Interesting how that works! And there are stories popping up all over the place where local politicians were caught trying to keep a lid on the numbers of new cases that arose out of restaurants, bars and other public meeting places. Turns out those numbers were waaay under 1%.
And now people all over the country are being arrested for not wearing masks in public even though masks have been proven ineffective in preventing passage of communicable diseases. We are slowly, but surely, approaching another civil war in this country and this one will not end well.
In reviewing my 30+ years in medicine the statistics indicate I have been in contact with Covid virus strains on at least 6, if not 7 prior outbreaks. Seems it has a habit of turning up as “the bug of the week” in small localized outbreaks every 6 years or so. Most people recover without sequelae but THEY DO RECOVER. Based on ice core studies Coronavirus has been around for over 10,000 years. This hasn’t been our first first exposure to it and won’t be the last. And whether people like to admit it or not, blunting the immune response early in the course to keep serous and inflammatory fluids out of crucial spaces (eg. alveoli) seems to be more important and potentially life saving than anyone “riding the politics of the infection” will ever be willing to admit.
Dr. David Henderson| Psychiatry/Mental Health
Love how you report that you have no financial relationships to disclose and then follow that statement immediately with the mention of your government grants you apply for to fund your research! This is the hypocrisy: the idea that somehow because you’re on the government dime makes you unbiased in your analysis.
Dr. lf s| Dermatology, General
Therapeutics, on or innovative, off-label use, should remain within the confines and purview of the physician-patient relationship.<
Not sure what your loved ones have to do with this conversation!?
Dr. Jeffrey Goodman| General Practice
We have little to offer patients who are ill and at home. Right now all we can suggest is hope and prayer. Giving medications like HCQ + Zn and ivermectin is perhaps beneficial with very few side effects. The decision should be between the patient and their physician. If these medications do prove to be efficacious when RCT’s are completed, you might regret your purely scientific approach.
Dr. Mario Beer| Oncology, Hematology/Oncology
Far as I can see, what we are still waiting for is a well-designed, risk-stratified, randomized controlled trial that addresses the critical issue that was still open in… March, viz. one that examines disease control and viral titres when the drug (or combination) is administered very early following the apparition of the first symptoms.
That was the claim based on the observations, and many very serious colleagues in different countries, who know at least as well as others what RCTs are, still have the impression that early administration is working better than controls and they are often saying that they have not been shown an answer.
It looks as if most reported studies were designed to avoid responding to the specific question of early administration. Including this paper, which does not even mention the day of first administration in the different study populations. If the specific question has already been answered, it would be nice to know. Wasting the subject population of hundreds of studies for no clear result doesn’t sound like a good idea.
The popular rumor has accused the US medical establishment of suppressing HCQ (+) because it is infinitely cheaper than its favorites like remdesivir, that seem to be underwhelming. A satisfactory answer would be RCTs that respond to the early administration requirement.
Dr. Tony Ham| Family Medicine
@Dr. Mario Beer Thank you Dr. Beer. You hit it on the nail. There is a fanatical effort at willful disinterest in investigating what was postulated in the first place. I have only read and heard the following. It works if you start it in the first five days (my limit) and I do it just the opposite. The older the sicker with more symptoms for sure, young doing okay, not so much.
RCTs fail miserable at this kind of evidence. It is why Tamiflu comes out equivocal. When the dust settles. let us remember these articles and revisit them.
Meanwhile in my area of the country they are doing what I do.
Adeleye Erinle| Pharmacist
Hi, Is there anyway you can explain the Sweedish story please? They had no political COVID-19 gerrymandering and were using the good old drug HCQ but when they tried the political COVID-19 stunt, death went up until they pick their brains where they left it (resume HCQ use), death went down to pre-political COVID-19 stunt.<
Check recommended doses of HCQ also and one more thing, was the side effect report with high doses continued after they finish doses, or what happened to it.<
I like other will ask for a study where digoxin toxic doses are administered to AF patient compared to normal doses and look at the side effect profile.
Dr. alex wonner| Surgery, General
Crazy to do studies with HCQ THREE TO FOUR TIMES the recommended dosage and then finding a high percentage of AE. Let’s do a study of AMIODARONE at THREE times the recommanded dosage, then I think AMIODARONE will be banned for life. It just shows that there is an extreme bias. It feels as if those studies have been designed SPECIFICALLY to show the negative impact of HCQ most probably for financial interest.
Dr. Stephen Vampola| Internal Medicine
I thought this was going to upset me, but I actually really liked it. I hate it when scientific issues become political or ideological footballs, like this drug has. Good job reviewing the key evidence and presenting it concisely. I wish this were shown instead of any random 11 minutes and 37 seconds of any prime-time news network’s regular programming!
Dr. Jade Lazaro| Cardiology, Nuclear
The issue here is choices denied because of absentee corporate approvals, aka “ significant “data.<
Politicians secure gainful employment from corporations, not experienced practitioners.<
The virus is Weaponized to chip away civil liberties and profesional choices.
Dr. K. Holden| Internal Medicine
“The virus is Weaponized to chip away civil liberties and professional choices.” Your last sentence concisely and clearly sums up your belief about COVID 19, regardless of the science.
Dr. Nathan Stein| Psychiatry/Mental Health
Your involvement with NIH and DOD makes you far from objective. Toxic doses used to boost adverse events, dose of zinc not stated, stage of the illness not always stated are amongst some of the flaws, other wruters have highlighted other potential flaws. Countries using HCQ due to Malaria getting much flatter curves despite lack of social distancing.<
HCQ plus zinc for prevention and/or treatment (early) plus a com ination of 1, 2 or more of: quercetin, vit D adequacy, interferon beta, vit C 2+ grams a day (for prevention. More for active cases), hydrogen peroxide ( 3% or less) nasal drops and gargle for prevention, nebulized for lung treatment, lysine, fenofibrate, elderberry extract (sambucol).<
You can perhaps afford to ethically dismiss strong empirical evidence by committed colleagues ONLY after bias from any cause incl. corporate or political corruption, are ruled out in the RCT studies AND lifestyle changes that boost immunity are promoted AND something better is on offer. Some (safe) hope is better than none. Hope in itself is therapeutic. How ethical would it be to have witheld treatment for lack of corporate evidence, or because RCTs weren’t yet completed or reliable, only to find out later that the empirical treatment would have worked?<
Dr Zelenski in Monsey had fantastic results and ONLY treated the 600 out of 2000 C19 patients whom he considered at risk. He emphasized the need to treat very early on, in the 1st 5 days of symptoms, and the centrality of zinc.
Ronald McRaney| Other Healthcare Provider
Use under Doctor’s advice, early stages, don’t wait till their dead
Dr. James Ransom| Allergy & Clinical Immunology
I’m pretty well convinced that HCQ is ineffective, but I’m throwing out all the studies in which high doses were given and patients were hospitalized. I also question the high incidence of “side effects” in the HCQ patients; seems contrary to the previous record of this drug in other disorders, and I would like to know what “side-effects” were seen and how often they resulted in discontinuation of treatment. I hate to say it, but I even wonder how “blinded” some of these studies actually were? I think we really need to have a blinded study with low doses of HCQ (2 arms-one with ZN and one without; and this study should only include people between 20–50, with positive test AND some symptoms, but not hospitalized. I believe this would answer some of the outstanding questions.
Dr. Lewis Cox| Internal Medicine
When you are faced with something like covid-19, I feel you must do whatever you can, even HCQ. We’ve got a long way to go. Latest I read on subject before your article, HCQ was effective in some populations, but efficacy was determined by when in the disease process that HCQ initiated. I was a premie on Dec 26, 1949, 3lb, 2 oz or just over 1400 grams. There were no neonatologist or NICUs then. Standard of care then was 100% 02 in incubater. Later providers learned 100% 02 was toxic to optic nerves. Lot’s of children lost the sight. I was spared. Thank God there was someone there in Tallahassee who tried.<
It’s why we call it “the Practice of Medicine”. We are always learning. Thank you for being there to help. I’m retired and physically unable to practice due to a drunk driver.
Dr. Tony Ham| Family Medicine
@Dr. Lori Arney From the CDC Medicines for the Prevention of Malaria While Traveling Hydroxychloroquine (Plaquenil™)<
Who can take hydroxychloroquine?<
Hydroxychloroquine can be prescribed to adults and children of all ages. It can also be safely taken by pregnant women and nursing mothers<
Who should not take hydroxychloroquine?<
People with psoriasis should not take hydroxychloroquine.<
WHO monograph on the cardiotoxicity of antimalarials (2017): “Despite hundreds of millions of doses administered in the treatment of malaria, there have been no reports of sudden unexplained death associated with quinine, chloroquine or amodiaquine, although each drug causes QT/QTc interval prolongation.”
Dr. Andrew Buscemi| Family Medicine
HCQ w/ Zinc Quercetin Vita C