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Here’s my conspiracy theory for the day - hydroxychloroquine


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3 minutes ago, GoodGrief1 said:

Likely it is more because you are politically inclined to dislike him than because of your and your husband's degrees 🙂 But, granted, he is obnoxious and clearly a narcissist, and not a scientist.

It’s probably both since I think most people are likely more sensitive in areas where they have devoted lots of time and effort to attaining expertise. And although you are right that I disagree with much of his politics, my biggest issues with him are his temperament, character, and psychological make-up and the fact that someone like him, regardless of party or politics, is our president. I think it’s shameful and dangerous.

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Our VA hospital is using it, so I don't think there's a conspiracy to keep it for the elite.  How about an alternative conspiracy theory in which a different "they" want Trump to be wrong more than th

Back in early April or whenever Donald Trump went on television to talk about hydroxychloroquine, the Israeli government immediately purchased an enormous amount of the stuff.  Doctors here had been e

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18 minutes ago, GoodGrief1 said:

Agreed. That is what is interesting to me in the whole backlash again HCQ. He really did not speak strongly in favor of using the drug or tout it as a miracle cure. He mentioned it as a possibility that was being researched, in what appeared to be an attempt to inject some optimism into the discussion. Which is really fine/appropriate for a non-physician to do. And people lost their minds over it.

I don't watch main stream news - no tv. Did they really lose their minds over it? My more right leaning friends have been saying it's a cure from the get go and can't understand why everyone isn't using it, this is from before I was able to see any trials other than the one in France. So I kind of wonder if they really lost their minds and didn't use it or could some of it be they were waiting for results or evidence?

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It seems weird to me that a drug without any proven or even kind of proven record of helping has become the target of so much hype. 

 

This is an example of an article on chloroquine for SARS1 — without extreme current political football.

 Iirc, Hydroxychloroquine was found to be as good or better with way lower risk (though not none! )

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1232869/

Please remember that early in SARS2, and still to a significant degree now, we were depending on what we knew from SARS1 (and MERS etc.) research since the SARS1 epidemics to make educated decisions.  

For example, There had not been studies on SARS2, so we looked to what was known about cleaners that could deactivate SARS1, for example.  That was also true for guessing about transmission (unfortunately turned out wrong as SARS2 is apparently more easily transmissible by breathing air with it than SARS1. That was also true for assumptions about time of infectiousness and likelihood of Asymptomatic carriers (also turned out wrong)

And afaik it is a right thing to do that at start of new virus epidemic (and we really are even now near start with more research probably happening on it faster than ever before in human history for dealing with an epidemic). 

Possibly more later.

Back after interruption 

 

Thus also for medications that already exist, and in many parts of world are inexpensive (I have seen reports that HCQ is only around $5for a month supply to use I think daily for malaria prophylaxis in many parts of world— USA medicines of course get price way jacked up), does make sense to be given a good chance of to see if it will work.  

(And just personally, irl real people I have heard enough good reports to personally consider it a good prospect if taken early enough (not magic bullet cure, I haven’t seen **any** magic bullet cure, and do not expect even a vaccine to do better than reduction, but maybe it is a help.  ) 

 

The hype, I cannot help. 

 

If it were kept quiet and turned out good and that had not been revealed that a relatively low cost medicine was beneficial, people would be hugely upset. That would be just as bad as making a mistake to reveal something that turns out maybe not to be as good as hoped — about which many people are upset about that now.

 

Many People are going to be upset regardless.

 

 

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4 minutes ago, Arctic Mama said:

I skim headlines of many sources and tickers, every few days.  Some of my favorite sources are also good aggregators, so that helps too 🙂

I guess I’m still confused about how this allows you to determine that some outlets have reported nothing positive at all about the drug, unless you read every article (not just skim headlines) and have a photographic memory (one of my coworkers does and it is amazing to behold). Or are you saying that some of your sources are saying this? Just out of curiosity, I did a search for the drug in one of my sources, the main newspaper in our state. I only recalled reading about half the articles in which it was mentioned. Then again, I know my memory is not what it used to be. 😜

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10 hours ago, happysmileylady said:

I think he was talking about the drug trials that were getting started.  HCQ wasn't the only trial that he talked about that I can recall, it was just the one he expressed the most hope about (seriously I might have to go back to rewatch it, it was quite a while ago)

Is it irresponsible for a president to express that he is very hopeful that a particular drug trial could work out very well?  I don't know if it is.  (but again, after a month or so, I can't promise my memory on his initial press briefing regarding it is all that great.)

 

9 hours ago, GoodGrief1 said:

Agreed. That is what is interesting to me in the whole backlash again HCQ. He really did not speak strongly in favor of using the drug or tout it as a miracle cure. He mentioned it as a possibility that was being researched, in what appeared to be an attempt to inject some optimism into the discussion. Which is really fine/appropriate for a non-physician to do. And people lost their minds over it.

Uh, no, he didn't just mention it casually once or twice as one possibility that was being researched, he repeatedly pushed it in multiple news conferences, speeches, and tweets, saying it was effective and very safe ("what do you have to lose?") and that the administration had bought 30 million doses (actually they were donated) and was distributing it around the country. He said it  was potentially "one of the biggest game-changers in the history of medicine." When Fauci suggested we really needed more clinical trials, he waved Fauci off saying "well, I like it better than he does." At one point he got visibly annoyed that reporters kept asking Fauci about it, and when a reporter tried to address the question to Fauci, he cut off the reporter and said Fauci didn't need to answer that.

The result of the president pushing it, amplified by Fox News and other right-wing outlets, was that so many people started hoarding it those who rely on it for other illnesses could not fill their prescriptions. Doctors were writing prescriptions for hundreds of pills for themselves, their families, and friends, and eBay sellers were selling mislabeled aquarium cleaner for hundreds of dollars. There are genuine concerns with prescribing a drug that can cause serious heart problems to treat a disease that can also cause serious heart problems, as well as lots of other unknowns. There's a reason so many drugs carry warnings of contraindications — and those were discovered through clinical trials, not people randomly experimenting on patients without genuinely informed consent. 

When the VA study was released by the FDA recently, showing negative results, Trump called it a fake study and a "Trump enemy statement." Because apparently if science doesn't agree with Trump, then the science is not only wrong, it was purposely falsified by his enemies to make him look bad. Most people can see that pretty clearly as the sign of a narcissist, but apparently some people buy it.

 

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The moral of The Boy Who Cried Wolf applies: when a person has repeatedly demonstrated a disregard for facts and a tendency to lie openly and loudly that person will have no credibility should they happen one day to tell the truth. Anything that comes out of such a person's mouth is going to be suspect.

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27 minutes ago, Corraleno said:

 

Uh, no, he didn't just mention it casually once or twice as one possibility that was being researched, he repeatedly pushed it in multiple news conferences, speeches, and tweets, saying it was effective and very safe ("what do you have to lose?") and that the administration had bought 30 million doses (actually they were donated) and was distributing it around the country. When Fauci suggested we really needed more clinical trials, he waved Fauci off saying "well, I like it better than he does." At one point he got visibly annoyed that reporters kept asking Fauci about it, and when a reporter tried to address the question to Fauci, he cut off the reporter and said Fauci didn't need to answer that.

I just pulled up his statements from April 6 and this is 100% accurate, including not allowing the press to ask Fauci his opinion. 

And even though I try to mostly read news from the center of the spectrum, and slightly more of my friends share from left of center, I have had as many good reports on the drug as bad ones come across my news feeds. If someone feels that the media has purposely buried any good news of this drug, their sampling of news may not be as broad as they think it is. 

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My main objection to the popularization of this drug is not that the president is promoting it, even though it's possible he's the first person I have actually hated in my life.  My objection is that because of the "popularization" of this medication, without evidence, people who NEED and RELY on this medication for other uses, uses that have been established, are unable to get it.  

I'm essentially agnostic on whether or not it's an effective treatment for covid, and I'd like to see studies done with it given earlier in the disease course.  But my number one fear is the people who need it not being able to get it because of political popularization.  

 

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41 minutes ago, maize said:

The moral of The Boy Who Cried Wolf applies: when a person has repeatedly demonstrated a disregard for facts and a tendency to lie openly and loudly that person will have no credibility should they happen one day to tell the truth. Anything that comes out of such a person's mouth is going to be suspect.

 

Especially in this case when that person has personal and financial ties with the people who produce that drug. I'm gonna be lazy and just link to The Mary Sue here: https://www.themarysue.com/trump-hydroxychloroquine-stocks-and-stakes/

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I think someone may have said this but; we know the drug works against malaria, we know Malaria is a huge killer.  Unless there is an essentially unlimited supply of the stuff without hiking the price up we should not be messing with the supply without proof. 

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22 hours ago, Ktgrok said:

Right, but there is no evidence that it DOES help either, right?  I mean, I dont' have any randomized controlled studies showing that drinking a margarita will make things worse, but I am not going to go on TV and say it is some miracle cure just because I don't have proof it isn't. You need proof it IS helpful, and all we have that I can see is evidence that it may make things worse, not better. 

The new study looks at exactly that, people given it before going on a ventilator, and within 48 hours of diagnosis. It didn't help, and patients were more likely to die with the medication. 

 Ktgrok,  I'm no doctor or researcher, but even I can see holes big enough to drive a Mack truck through in this study.  For crying out loud, they combined the data from HCQ and CQ.  How in the world is that an honest assessment?  Why, oh why, are some of the protocols using it without zinc?  Why are they using it with AZ, which by itself causes QT prolongation and cardiac events?  When you give the two together... 

Eeeeesh!

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19 hours ago, Corraleno said:

When the VA study was released by the FDA recently, showing negative results, Trump called it a fake study and a "Trump enemy statement." Because apparently if science doesn't agree with Trump, then the science is not only wrong, it was purposely falsified by his enemies to make him look bad. Most people can see that pretty clearly as the sign of a narcissist, but apparently some people buy it.

 

I've heard medical doctors who don't have a preference on drug choices and are presenting all the promising medical news regularly, talk about the unfortunate way the VA study was done.  From the clinical data (numerical values) presented for each cohort, it is obvious that the study was grossly flawed, giving the full cocktail only to the sickest patients, ones with bad. bad numbers.  Of course it is ineffective at that point.  

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23 minutes ago, Halftime Hope said:

 Ktgrok,  I'm no doctor or researcher, but even I can see holes big enough to drive a Mack truck through in this study.  For crying out loud, they combined the data from HCQ and CQ.  How in the world is that an honest assessment?  Why, oh why, are some of the protocols using it without zinc?  Why are they using it with AZ, which by itself causes QT prolongation and cardiac events?  When you give the two together... 

Eeeeesh!

I'm not sure which study is being discussed in which thread, but this study separates results into 4 categories: hydroxychloroquine with and without a macrolide (AZ) and chloroquine with and without a macrolide, and they only counted cases in which patients received treatment within 48 hours of diagnosis. The death rates for all four categories, including hydroxychloroquine alone, were higher than the control group. 

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4 hours ago, Pen said:

 

 

 

This is an example of an article on chloroquine for SARS1 — without extreme current political football.

 Iirc, Hydroxychloroquine was found to be as good or better with way lower risk (though not none! )

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1232869/

Please remember that early in SARS2, and still to a significant degree now, we were depending on what we knew from SARS1 (and MERS etc.) research since the SARS1 epidemics to make educated decisions.  

For example, There had not been studies on SARS2, so we looked to what was known about cleaners that could deactivate SARS1, for example.  That was also true for guessing about transmission (unfortunately turned out wrong as SARS2 is apparently more easily transmissible by breathing air with it than SARS1. That was also true for assumptions about time of infectiousness and likelihood of Asymptomatic carriers (also turned out wrong)

And afaik it is a right thing to do that at start of new virus epidemic (and we really are even now near start with more research probably happening on it faster than ever before in human history for dealing with an epidemic). 

Possibly more later.

Back after interruption 

 

Thus also for medications that already exist, and in many parts of world are inexpensive (I have seen reports that HCQ is only around $5for a month supply to use I think daily for malaria prophylaxis in many parts of world— USA medicines of course get price way jacked up), does make sense to be given a good chance of to see if it will work.  

(And just personally, irl real people I have heard enough good reports to personally consider it a good prospect if taken early enough (not magic bullet cure, I haven’t seen **any** magic bullet cure, and do not expect even a vaccine to do better than reduction, but maybe it is a help.  ) 

 

The hype, I cannot help. 

 

If it were kept quiet and turned out good and that had not been revealed that a relatively low cost medicine was beneficial, people would be hugely upset. That would be just as bad as making a mistake to reveal something that turns out maybe not to be as good as hoped — about which many people are upset about that now.

 

Many People are going to be upset regardless.

 

 

 

1 hour ago, Halftime Hope said:

 Ktgrok,  I'm no doctor or researcher, but even I can see holes big enough to drive a Mack truck through in this study.  For crying out loud, they combined the data from HCQ and CQ.  How in the world is that an honest assessment?  Why, oh why, are some of the protocols using it without zinc?  Why are they using it with AZ, which by itself causes QT prolongation and cardiac events?  When you give the two together... 

Eeeeesh!

See below

49 minutes ago, Corraleno said:

I'm not sure which study is being discussed in which thread, but this study separates results into 4 categories: hydroxychloroquine with and without a macrolide (AZ) and chloroquine with and without a macrolide, and they only counted cases in which patients received treatment within 48 hours of diagnosis. The death rates for all four categories, including hydroxychloroquine alone, were higher than the control group. 

Also, no one is saying this is definiteive that it is bad...but we have nothing definitive that it is good! We have a lot of evidence, not perfect, but evidence, pointing to it NOT being good, and NO evidence that I know of (not anectdotes) that say it is good. Yet when I  or others say "we need more research" that's somehow a conspiracy and politically motivated? I cannot for the life of me understand why people think that it DOES work so well, and everyone should take it, etc?? 

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2 hours ago, Halftime Hope said:

I've heard medical doctor who don't have a preference on drug choices and are presenting all the promising medical news regularly, talk about the unfortunate way the VA study was done.  From the clinical data (numerical values) presented for each cohort, it is obvious that the study was grossly flawed, giving the full cocktail only to the sickest patients, ones with bad. bad numbers.  Of course it is ineffective at that point.  

It’s one thing for people, especially experts, to criticize a study. That’s very common and expected and when done by scientists, it is how science advances. I don’t think that is at all the same as our president calling it a fake study and “Trump enemy study”. How is that helpful or productive?

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2 hours ago, Ktgrok said:

 

See below

Also, no one is saying this is definiteive that it is bad...but we have nothing definitive that it is good! We have a lot of evidence, not perfect, but evidence, pointing to it NOT being good, and NO evidence that I know of (not anectdotes) that say it is good. Yet when I  or others say "we need more research" that's somehow a conspiracy and politically motivated? I cannot for the life of me understand why people think that it DOES work so well, and everyone should take it, etc?? 

 

I don’t think everyone should take it.

 I have autoimmunity and could have taken it for that for years, but chose not to.  Maybe that was a mistake? As I read stories of people who cannot get their usual HCQ and are explaining in glowing terms how much better they feel with it, I wonder if I made an error in my life to reject it.  (Btw, If anyone is upset with potus for taking “their” HCQ, consider it my HCQ that I chose not to take for years and am not taking now.)

 I have nothing against the current potus taking it if he thinks it can help, nor people with  CV19 symptoms who want to try it to see if it can help them doing so (without that being difficult).  

I probably will tend to go with nutraceuticals rather than pharmaceuticals, as I have done for years. 

 But I would certainly consider HCQ if I had CV19 symptoms and could get the hcq.   As with vitamin D3, I have no proof that either will work, but sufficient evidence for my own satisfaction that both used at right time and in right way and along with correct cofactors are likely to help, likely to improve outcomes for someone like me, and with potential benefits outweighing risks. 

 

HCQ is not supposed to be something that should be hard or expensive to make enough of. So that it should not be a choice between people who need it for Lupus etc versus people who want to try it for CV19.

Probably there is a problem with sources being overseas, not domestic, and presumably India, China, South Korea etc would be holding on to their own supplies. 

unfortunately making it hard to get may add to runs on it and hoarding  by people who can do so, sort of like a toilet paper situation 

TP seems to be getting available again. I hope HCQ shortages will be fixed soon too. 

 

 

 

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38 minutes ago, Pen said:

I have nothing against the current potus taking it if he thinks it can help, nor people with  CV19 symptoms who want to try it to see if it can help them doing so (without that being difficult).  

I probably will tend to go with nutraceuticals rather than pharmaceuticals, as I have done for years. 

 But I would certainly consider HCQ if I had CV19 symptoms and could get the hcq.   As with vitamin D3, I have no proof that either will work, but sufficient evidence for my own satisfaction that both used at right time and in right way and along with correct cofactors are likely to help, likely to improve outcomes for someone like me, and with potential benefits outweighing risks. 

There's actually more scientific evidence in favor of D3, and unlike HCQ, there's zero evidence that taking D3 can increase your chances of dying from Covid-19. Did you read the Lancet study I linked above (which is also summarized here)?

In 15,000 patients who had received either HCQ or CQ within 48 hours of diagnosis, HCQ alone led to a 34% increase in deaths and 137% increase in serious heart arrhythmias. When combined with AZ there was a 45% increase in deaths and 411% increase in serious heart arrhythmias. Chloroquine + AZ actually had lower rates of death and arrhythmias than HCQ + AZ, and only slightly higher than HCQ alone. 

This is exactly why the FDA has been insisting that HCQ should only be used within clinical trials!  Maybe it can help under certain conditions in certain populations, but clearly it can also be very detrimental in some conditions and in some populations — and we simply don't know what's what without more research.

For the president and various news outlets to not only promote the indiscriminate use of this drug outside of clinical trials, but to repeatedly frame fact-based FDA warnings about the drug as left-wing propaganda and fake news designed to keep a safe and effective treatment away from the public just to make Trump look bad is beyond irresponsible, it's really reprehensible. 

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1 hour ago, Pen said:

 

I don’t think everyone should take it.

 I have autoimmunity and could have taken it for that for years, but chose not to.  Maybe that was a mistake? As I read stories of people who cannot get their usual HCQ and are explaining in glowing terms how much better they feel with it, I wonder if I made an error in my life to reject it.  (Btw, If anyone is upset with potus for taking “their” HCQ, consider it my HCQ that I chose not to take for years and am not taking now.)

 I have nothing against the current potus taking it if he thinks it can help, nor people with  CV19 symptoms who want to try it to see if it can help them doing so (without that being difficult).  

I probably will tend to go with nutraceuticals rather than pharmaceuticals, as I have done for years. 

 But I would certainly consider HCQ if I had CV19 symptoms and could get the hcq.   As with vitamin D3, I have no proof that either will work, but sufficient evidence for my own satisfaction that both used at right time and in right way and along with correct cofactors are likely to help, likely to improve outcomes for someone like me, and with potential benefits outweighing risks. 

 

HCQ is not supposed to be something that should be hard or expensive to make enough of. So that it should not be a choice between people who need it for Lupus etc versus people who want to try it for CV19.

Probably there is a problem with sources being overseas, not domestic, and presumably India, China, South Korea etc would be holding on to their own supplies. 

unfortunately making it hard to get may add to runs on it and hoarding  by people who can do so, sort of like a toilet paper situation 

TP seems to be getting available again. I hope HCQ shortages will be fixed soon too. 

 

 

 

There have been prepper types hoarding it since February.  (Partly why although I don’t like the president I don’t think he’s solely responsible for any shortages or for anyone taking it inappropriately - people were doing those things before.  He may have made it worse but it was always going to be a problem)

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5 hours ago, Terabith said:

My main objection to the popularization of this drug is not that the president is promoting it, even though it's possible he's the first person I have actually hated in my life.  My objection is that because of the "popularization" of this medication, without evidence, people who NEED and RELY on this medication for other uses, uses that have been established, are unable to get it.

 

This happened immediately after I first saw favorable mention of the use of this drug to mitigate CV, before the Trump quotes.  Kaiser started to just stockpile it, and informed all patients who were already using it that they would not be allowed to get any more, and that even if their doctors prescribed it the prescriptions would not be filled or allowed.  That’s pretty abrupt and heavy handed.  Ugh.

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3 hours ago, Frances said:

It’s one thing for people, especially experts, to criticize a study. That’s very common and expected and when done by scientists, it is how science advances. I don’t think that is at all the same as our president calling it a fake study and “Trump enemy study”. How is that helpful or productive?

 

I'm not addressing anything regarding the President's views or the media's.  I'm trying to stick to medical professionals whose expertise I've grown to trust over time.

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1 hour ago, Ausmumof3 said:

There have been prepper types hoarding it since February.  (Partly why although I don’t like the president I don’t think he’s solely responsible for any shortages or for anyone taking it inappropriately - people were doing those things before.  He may have made it worse but it was always going to be a problem)

 

Sure.

Nearly Anyone who had a smartphone and is capable of using google could have found plenty of articles and studies that showed that Hydroxychloroquine had shown promise for SARS1 as soon as they became aware that this budding pandemic or world health crisis or whatever it was being called back in January was probably a coronavirus thought to be similar to SARS1. 

(Not to mention that China as a large country, and probably other countries as well would have tried to gather supplies of it as soon as they could do so.) 

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This recent poll by Reuters/Ipsos reminded me of some of the things being discussed here regarding the politicizing of things that aren't inherently political (like medications).

Question: How would the following developments impact your interest in taking a coronavirus/COVID19 vaccine, if at all?...President Trump says the vaccine is safe:

More interested: Republicans 26%

No more or no less interested: Democrats 26%; Republicans 51%

Less interested: Democrats 55% 

https://www.ipsos.com/sites/default/files/ct/news/documents/2020-05/writeup_reuters_2020_coronavirus_vaccine_05_21_2020.pdf

There are several other equally interesting responses in this survey. I think it's a regrettable development in our culture that seemingly everything has to be politicized these days.

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17 hours ago, Corraleno said:

There's actually more scientific evidence in favor of D3, and unlike HCQ, there's zero evidence that taking D3 can increase your chances of dying from Covid-19. Did you read the Lancet study I linked above (which is also summarized here)?

In 15,000 patients who had received either HCQ or CQ within 48 hours of diagnosis, HCQ alone led to a 34% increase in deaths and 137% increase in serious heart arrhythmias. When combined with AZ there was a 45% increase in deaths and 411% increase in serious heart arrhythmias. Chloroquine + AZ actually had lower rates of death and arrhythmias than HCQ + AZ, and only slightly higher than HCQ alone. 

This is exactly why the FDA has been insisting that HCQ should only be used within clinical trials!  Maybe it can help under certain conditions in certain populations, but clearly it can also be very detrimental in some conditions and in some populations — and we simply don't know what's what without more research.

For the president and various news outlets to not only promote the indiscriminate use of this drug outside of clinical trials, but to repeatedly frame fact-based FDA warnings about the drug as left-wing propaganda and fake news designed to keep a safe and effective treatment away from the public just to make Trump look bad is beyond irresponsible, it's really reprehensible. 

The Lancet analysis, IMO, has a lot of problems.

First.....it wasn't a drug trial.....it was just analysis of a bunch of data.  Which, can certainly be useful, but ultimately isn't really much evidence.  The data came from countries all over the world, and we all know that the accuracy of the data across the world is highly variable.  It also goes all the way back to December 20th......and that's like the most brand newest time we have for this thing.  (though I am going to be honest, it did surprise me that HCQ was being used as far back as 12/20/19.)

Second.....it was only for hospitalized patients.  I think our primary goal in treatment of this....treatment vs cure vs vaccine....is to find a treatment that keeps people out of hospitals.  I mean, ultimately, a cure or vaccine would be great, but since those are pretty much NOT going to happen any time soon (if at all) then the best hope we have is a treatment that keeps people out of the hospital in the first place.  Studying hospitalized people doesn't really advance us toward that goal.

Third....as I said before, within 48 hours of diagnosis simply IS NOT the same as within 48 hours of symptoms.  So again, the analysis really isn't addressing the goals.  It has nothing to do with preventative treatment or early intervention.  Especially when you consider that in many places, it took SO LONG to get test results back, especially in early days.  

 

There is no drug that is without potentially dangerous side effects.  And, the stronger the drug, the more dangerous it can be.  Chemo can be a lifesaver....and is in a lot of places.  It can also kill people.  Anyone with any condition could try a new med and end up with a life threatening allergic reaction.  

 

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8 minutes ago, happysmileylady said:

The Lancet analysis, IMO, has a lot of problems.

First.....it wasn't a drug trial.....it was just analysis of a bunch of data.  Which, can certainly be useful, but ultimately isn't really much evidence.  The data came from countries all over the world, and we all know that the accuracy of the data across the world is highly variable.  It also goes all the way back to December 20th......and that's like the most brand newest time we have for this thing.  (though I am going to be honest, it did surprise me that HCQ was being used as far back as 12/20/19.)

Second.....it was only for hospitalized patients.  I think our primary goal in treatment of this....treatment vs cure vs vaccine....is to find a treatment that keeps people out of hospitals.  I mean, ultimately, a cure or vaccine would be great, but since those are pretty much NOT going to happen any time soon (if at all) then the best hope we have is a treatment that keeps people out of the hospital in the first place.  Studying hospitalized people doesn't really advance us toward that goal.

Third....as I said before, within 48 hours of diagnosis simply IS NOT the same as within 48 hours of symptoms.  So again, the analysis really isn't addressing the goals.  It has nothing to do with preventative treatment or early intervention.  Especially when you consider that in many places, it took SO LONG to get test results back, especially in early days.  

 

There is no drug that is without potentially dangerous side effects.  And, the stronger the drug, the more dangerous it can be.  Chemo can be a lifesaver....and is in a lot of places.  It can also kill people.  Anyone with any condition could try a new med and end up with a life threatening allergic reaction.  

 

I get what you are saying but I’m sure you’ll agree that if HCQ proves to be unsuccessful the sooner we know the better, and I also hope that all this attention on HCQ doesn’t interfere with the search for other successful therapies. I don’t think all us armchair researchers speculating are interfering with the search of course, but I hope the whole political furor doesn’t interfere with it either. 

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12 minutes ago, TCB said:

I get what you are saying but I’m sure you’ll agree that if HCQ proves to be unsuccessful the sooner we know the better, and I also hope that all this attention on HCQ doesn’t interfere with the search for other successful therapies. I don’t think all us armchair researchers speculating are interfering with the search of course, but I hope the whole political furor doesn’t interfere with it either. 

I agree that we do need to know and I also agree with the hope that it doesn't interfere with the search for other successful therapies.  Unfortunately I think it already has, in that the rush to discredit one treatment, ends up potentially rushing to credit another.  Media popularization does influence the back side of the power and politics and funding of treatments, so it wouldn't surprise me in the least to find that other treatments have been subject to questionable trials.  He (/she/they/) who hold the money, make the rules 🙂 

 

ETA: I want to be clear about my meaning.  I am NOT "pro-HCQ"  I am also NOT "anti remdesivir"  I am NOT "anti plasma transfer"  I am NOT  "anti Ivermectin"  

I am VERY MUCH pro.......treatments that work.  And very much pro.....do the trails.  

I am VERY MUCH anti.....making medicine political. 

Unfortunately, science and medicine has always been political, all throughout history.  Which is really why double blind clinical trials exist.  It's really the closest we can get to an unbiased result.  And even then.....far from perfect.  Human nature is, and will always be......human nature.  

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20 hours ago, Pen said:

 

  As with vitamin D3, I have no proof that either will work, but sufficient evidence for my own satisfaction that both used at right time and in right way and along with correct cofactors are likely to help, likely to improve outcomes for someone like me, and with potential benefits outweighing risks. 

 

What is this evidence? Seriously asking. 

55 minutes ago, happysmileylady said:

The Lancet analysis, IMO, has a lot of problems.

First.....it wasn't a drug trial.....it was just analysis of a bunch of data.  Which, can certainly be useful, but ultimately isn't really much evidence. 

 

Right...but it is the most evidence we have. I mean, does anyone have better evidence to the contrary? If that level of evidence isn't enough, than what are they basing their idea that taking helps on? Because I'm not seeing BETTER evidence that it helps. So you can't say, "well, I think it helps" based on even less evidence, then say this study isn't enough evidence to say it might be dangerous. If that makes any sense, lol. 

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9 minutes ago, Ktgrok said:

What is this evidence? Seriously asking. 

Right...but it is the most evidence we have. I mean, does anyone have better evidence to the contrary? If that level of evidence isn't enough, than what are they basing their idea that taking helps on? Because I'm not seeing BETTER evidence that it helps. So you can't say, "well, I think it helps" based on even less evidence, then say this study isn't enough evidence to say it might be dangerous. If that makes any sense, lol. 

As I said in an earlier post it was my understanding that there was testing done in culture dishes/test tubes/similar.  The term I understood was "in vitro" but as a mom who has used IVF....I am struggling to really get the application of the term differently.  

Generally speaking, it's my understanding that in order to at least start trials, there has to be at least more info/evidence for starting a trial than a wing and a prayer and a million dollars.  I mean, maybe not.  A million dollars can probably buy a lot of clout, so maybe that's enough to start a trial.  Another poster in the thread has more experience with drug trails than I do, so maybe she can speak to what level of evidence might be required to get an actual trail started.  And since there ARE trials going on right now, I would assume at least some evidence.  

 

 

ETA: I suppose that what I am really saying is that for me, an analysis of data from countries all over the world, over the course of the newest 4 months of this very new disease.....really just doesn't hold much more weight for me than anecdotes.  Actual, real, blind/double blind clinical trails....I will give those lots of weight.  I hope the University of Minnesota trail yields some results that are useful.  

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23 hours ago, Halftime Hope said:

 Ktgrok,  I'm no doctor or researcher, but even I can see holes big enough to drive a Mack truck through in this study.  For crying out loud, they combined the data from HCQ and CQ.  How in the world is that an honest assessment?  Why, oh why, are some of the protocols using it without zinc?  Why are they using it with AZ, which by itself causes QT prolongation and cardiac events?  When you give the two together... 

Eeeeesh!

I think it's because you can have a quick study or a good study; not both. 

I think that the evidence is still out on this medication. Some people who have used it (as in prescribing physicians) think it works. Others have said they don't really see a difference or that it does more harm than good. We don't know and I think we should continue studying it along with all the other possibly promising drugs, but that we shouldn't just give it to everyone. 

I took it as an antimalarial (almost 20yrs ago) and it was safe but there were definitely a lot of warnings around it. My doctor said that he only approves it if the risk for malaria is high. I decided not to travel somewhere with a malaria risk with small kids specifically because the risks of the drug. 

 

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6 minutes ago, Ktgrok said:

What is this evidence? Seriously asking. 

Right...but it is the most evidence we have. I mean, does anyone have better evidence to the contrary? If that level of evidence isn't enough, than what are they basing their idea that taking helps on? Because I'm not seeing BETTER evidence that it helps. So you can't say, "well, I think it helps" based on even less evidence, then say this study isn't enough evidence to say it might be dangerous. If that makes any sense, lol. 

 

You mean HCQ, not D, right?

 I don’t have it available.  The only thing I felt strongly enough about to try to convince others of at least initially was the D.

I am not taking HCQ and hope I wont feel I am sick enough to want to ask for it. But it is on my list of things that I would ask for if I had a confirmed case and felt like I was not doing well. 

 

However, I would personally start with Quercitin which I think has potentially similar positive effects to HCQ without the dangers. Along with zinc.  

 

On Quercitin:  I don’t have it now (am only on short break dealing with electric, fridge, freezer, and mouse troubles) but there was an interesting preliminary study that came from possibly Turkey on reasons potentially promising for Quercitin and other more natural food (mostly fruit and vegetable) components .   I might have that or others more related to HVQ saved somewhere and if so I’ll post later (after mice etc.)  Or maybe pm you.  I’m willing to try to answer serious question seriously, but don’t want an unpleasant bunch of human interaction on top of the electric etc troubles. 😊

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4 hours ago, Skippy said:

This recent poll by Reuters/Ipsos reminded me of some of the things being discussed here regarding the politicizing of things that aren't inherently political (like medications).

Question: How would the following developments impact your interest in taking a coronavirus/COVID19 vaccine, if at all?...President Trump says the vaccine is safe:

More interested: Republicans 26%

No more or no less interested: Democrats 26%; Republicans 51%

Less interested: Democrats 55% 

https://www.ipsos.com/sites/default/files/ct/news/documents/2020-05/writeup_reuters_2020_coronavirus_vaccine_05_21_2020.pdf

There are several other equally interesting responses in this survey. I think it's a regrettable development in our culture that seemingly everything has to be politicized these days.

I think that question found what it was designed to find. I mean who looks to any president, R or D, generally mature, honest, and trustworthy or not, for healthcare advice? We generally don’t elect people to that office who have science or healthcare backgrounds. The results across party were much more similar when asked about FDA, personal doctor, and scientific studies. Rather than asking about the president, it seems like the Surgeon General or Dr. Fauci would make more sense in this case.

Edited to add that it also asked, if President Trump says it is safe rather than something like, if President Trump says the CDC or FDA believes the vaccine is safe. Why would anyone care about any president’s personal opinion on the vaccine? It’s like his comments about HCQ. Many were personal and off the cuff rather than referring specifically to experts or studies or federal agencies in charge of regulating such things.

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@Ktgrok  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5461643/

a place to start.  

And from its links you could find some more that is related to potential direct virus replication inhibition aspects of chloroquine type drugs.

(That is, this a reason that HCQ itself may help early on completely separate from zinc ionophore aspects.) 

 

(then in addition there are potential benefits in reducing cytokines storm...     perhaps more on this tomorrow, but I suspect lack of help from HCQ late in game suggests either that damage is too far gone, or that there is more direct blood cell and circulatory system damage going on. Because if it mostly cytokines storm alone I think HCQ would be doing better than it is later into illness.) 

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@Ktgrok though in a different grouping of viruses dengue is also a single RNA  strand encapsulated virus:

https://www.nature.com/articles/s41598-017-07023-z

and the same mechanism of endocytosis could likely apply to both

as well, hcq might be able to interfere with the spike proteins in coronavirus from being able to attach to the ACE2 receptors on cells (as very probably does vitamin D interfere with spike protein attachment). 

 

so possibly HcQ would be a help to block attachment

and then possibly be a help to slow replication inside the cell ...

 

However, nb, use for both those potential benefits would have to be quite early, or even

prophylactic 

It would not be especially helpful once lots of virus has already attached and already replicated itself numerous times 

is what my reading (largely having to do with other viruses) indicates. 

 

But, contrary to this, HCQ, probably has not helped with HIV, maybe even makes AIDS  worse for some reason.

so if there are actually meaningful bits of HIV in the SARS2 genome / RNA, that might make SARS2 able to resist HCQ like HIV seems to do, rather than to be more like SARS1 and Dengue where Hcq seems to be likely to be able to help decrease attachment and replication .  

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6 hours ago, happysmileylady said:

The Lancet analysis, IMO, has a lot of problems.

First.....it wasn't a drug trial.....it was just analysis of a bunch of data.  Which, can certainly be useful, but ultimately isn't really much evidence.  The data came from countries all over the world, and we all know that the accuracy of the data across the world is highly variable.  It also goes all the way back to December 20th......and that's like the most brand newest time we have for this thing.  (though I am going to be honest, it did surprise me that HCQ was being used as far back as 12/20/19.)

Second.....it was only for hospitalized patients.  I think our primary goal in treatment of this....treatment vs cure vs vaccine....is to find a treatment that keeps people out of hospitals.  I mean, ultimately, a cure or vaccine would be great, but since those are pretty much NOT going to happen any time soon (if at all) then the best hope we have is a treatment that keeps people out of the hospital in the first place.  Studying hospitalized people doesn't really advance us toward that goal.

Third....as I said before, within 48 hours of diagnosis simply IS NOT the same as within 48 hours of symptoms.  So again, the analysis really isn't addressing the goals.  It has nothing to do with preventative treatment or early intervention.  Especially when you consider that in many places, it took SO LONG to get test results back, especially in early days.  

 

The Lancet paper is an analysis of 15,000 cases, all of whom received HCQ or CQ within 48 hours of diagnosis, and many scientists find that data more reliable and trustworthy than the data from the small and very flawed French study that started all the HCQ hype. That study (Gaudret et al) (1) was not randomized or blind, the "control group" consisted of patients who had preexisting conditions that contraindicated use of HCQ as well as those who refused HCQ treatment, (2) they were only tested for a period of 6 days, (3) it included only 26 patients, and (4) 6 of those 26 were excluded from the results because 3 were transferred to ICU, 1 died, 1 stopped treatment due to side effects, and 1 left the hospital for undisclosed reasons. So ALL of the patients who had underlying conditions that would have made HCQ treatment dangerous were put in the control group, and then they excluded ALL of the patients in the treatment group who did not get better, and claimed that HCQ treatment reduced viral load in all patients who completed the very brief treatment. And if those issues weren't damaging enough, there were other anomalies with testing dates reported, serious questions about the control group (who were at 4 different hospitals, while the treatment group were all at the Marseille hospital, and some of the control patients were missing test data because of differences in data collection at different hospitals), and various other issues that raised red flags after the study was mysteriously rushed through "peer review" in only 24 hours.

So the "best" evidence we have so far that HCQ is effective against CV19 is one very small study that put all the patients with underlying conditions in the "control group" AND excluded from the treatment results all the patients who did worse. And that is the study that prompted Trump to call HCQ + AZ "one of the biggest game changers in the history of medicine."

So a meta-analysis of 15,000 patients doesn't count because it's not a double-blind study, but a tiny French study (neither blind, nor legitimately controlled) does? The VA study showing worse outcomes with HCQ doesn't count, because only severely ill patients received the treatment; and studies showing negative results for HCQ + AZ don't count because AZ is the dangerous part (except that combination actually got better results in the French study than HCQ alone), and studies showing negative results for CQ + AZ don't count, because everyone knows CQ is more dangerous than HCQ (except the Lancet analysis showed that CQ + AZ was actually less dangerous than HCQ + AZ), and studies showing negative results when HCQ is given more than 48 hours after diagnosis don't count, but the Lancet analysis of 15,000 patients who did get HCQ or CQ within 48 hours of diagnosis also doesn't count because they actually should have gotten the drug within 48 hours of the first symptoms.

So none of the results from multiple studies showing negative results for HCQ treatment count, because the only acceptable evidence would have to come from a large, randomized, double-blind study where healthy patients with no underlying conditions were given HCQ + zinc within 48 hours of their very first symptom, before they ever tested positive. But the vast majority of people with "Covid-like symptoms" turn out to be negative, and you really can't just indiscriminately give a drug with potentially dangerous side effects to anyone with a sniffle or cough on the off chance they actually do have Covid, so you kind of need to wait for a confirmed test (i.e. a diagnosis). And until a study that meets all of these criteria is published that shows negative results for HCQ, people will continue to believe that HCQ is an effective treatment and the only reason so many studies show seriously negative results, and the FDA is warning against its use outside of clinical trials, is because scientists all over the world care more about making Donald Trump look stupid than actually saving lives.

 

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7 hours ago, Corraleno said:

 

The Lancet paper is an analysis of 15,000 cases, all of whom received HCQ or CQ within 48 hours of diagnosis, and many scientists find that data more reliable and trustworthy than the data from the small and very flawed French study that started all the HCQ hype. That study (Gaudret et al) (1) was not randomized or blind, the "control group" consisted of patients who had preexisting conditions that contraindicated use of HCQ as well as those who refused HCQ treatment, (2) they were only tested for a period of 6 days, (3) it included only 26 patients, and (4) 6 of those 26 were excluded from the results because 3 were transferred to ICU, 1 died, 1 stopped treatment due to side effects, and 1 left the hospital for undisclosed reasons. So ALL of the patients who had underlying conditions that would have made HCQ treatment dangerous were put in the control group, and then they excluded ALL of the patients in the treatment group who did not get better, and claimed that HCQ treatment reduced viral load in all patients who completed the very brief treatment. And if those issues weren't damaging enough, there were other anomalies with testing dates reported, serious questions about the control group (who were at 4 different hospitals, while the treatment group were all at the Marseille hospital, and some of the control patients were missing test data because of differences in data collection at different hospitals), and various other issues that raised red flags after the study was mysteriously rushed through "peer review" in only 24 hours.

So the "best" evidence we have so far that HCQ is effective against CV19 is one very small study that put all the patients with underlying conditions in the "control group" AND excluded from the treatment results all the patients who did worse. And that is the study that prompted Trump to call HCQ + AZ "one of the biggest game changers in the history of medicine."

So a meta-analysis of 15,000 patients doesn't count because it's not a double-blind study, but a tiny French study (neither blind, nor legitimately controlled) does? The VA study showing worse outcomes with HCQ doesn't count, because only severely ill patients received the treatment; and studies showing negative results for HCQ + AZ don't count because AZ is the dangerous part (except that combination actually got better results in the French study than HCQ alone), and studies showing negative results for CQ + AZ don't count, because everyone knows CQ is more dangerous than HCQ (except the Lancet analysis showed that CQ + AZ was actually less dangerous than HCQ + AZ), and studies showing negative results when HCQ is given more than 48 hours after diagnosis don't count, but the Lancet analysis of 15,000 patients who did get HCQ or CQ within 48 hours of diagnosis also doesn't count because they actually should have gotten the drug within 48 hours of the first symptoms.

So none of the results from multiple studies showing negative results for HCQ treatment count, because the only acceptable evidence would have to come from a large, randomized, double-blind study where healthy patients with no underlying conditions were given HCQ + zinc within 48 hours of their very first symptom, before they ever tested positive. But the vast majority of people with "Covid-like symptoms" turn out to be negative, and you really can't just indiscriminately give a drug with potentially dangerous side effects to anyone with a sniffle or cough on the off chance they actually do have Covid, so you kind of need to wait for a confirmed test (i.e. a diagnosis). And until a study that meets all of these criteria is published that shows negative results for HCQ, people will continue to believe that HCQ is an effective treatment and the only reason so many studies show seriously negative results, and the FDA is warning against its use outside of clinical trials, is because scientists all over the world care more about making Donald Trump look stupid than actually saving lives.

 

 

I do not think the studies are good, no. 

None are very good.

the French one for reasons you give

others I have been able to read had HcQ given to

1)sicker people 

and/or

2) too late in disease for HcQ ‘s most likely mode of possible action to work (aside from zinc ionophore aspect) 

eta: 

(actually, 48 hours after might even also often  be too late for zinc ionophore aspect too ...  if there’s already substantial tissue damage, or movement into tissues that are hard for drugs to reach)

HCQ alone may (based on SARS1 and Dengue  experimenting) be helpful to stop / decrease spike protein bonding to ACE2 receptors

and might be helpful to slow down or decrease replication inside cells. 

But by 48 hours after diagnosis there pretty much has to have been enough virus already bonded, entered into cells, replicated, and being shed to get a positive test result.which probably means the illness is at a stage already past when many people would be helped by HCQ alone. 

Thus even 50,000 cases would not be  especially meaningful if they are all set up in a way that won’t work well for the probable mode of action of the drug.  

(It seems kind of like concluding seatbelts don’t work if they are only fastened after the crash has already happened.  

Like saying, “You see, we fastened seatbelts on all these car crash victims within 48 minutes after the crash,  and  yet they died at the same rate or more than car crash victims with no seatbelts.”

...and even more useless if the small print reveals that seatbelts were applied too late on the more seriously injured  )

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12 hours ago, Pen said:

@Ktgrok  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5461643/

a place to start.  

And from its links you could find some more that is related to potential direct virus replication inhibition aspects of chloroquine type drugs.

(That is, this a reason that HCQ itself may help early on completely separate from zinc ionophore aspects.) 

 

(then in addition there are potential benefits in reducing cytokines storm...     perhaps more on this tomorrow, but I suspect lack of help from HCQ late in game suggests either that damage is too far gone, or that there is more direct blood cell and circulatory system damage going on. Because if it mostly cytokines storm alone I think HCQ would be doing better than it is later into illness.) 

yeah...that's not particuarly impressive, especially given how small most of the sample sets were. The larger ones and the RCT ones look like they show it wasn't very effective. This is the link to the chart with results of the various studies mentioned in the article if people want to look.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5461643/table/prp2293-tbl-0001/?report=objectonly

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Another problem with HCQ in terms of timing would be its effects on interferon production.

 If it were given too late to stop bonding of spike protein to ACE2 receptors and too late to help halt intracellular replication, but instead just at the time to inhibit the Toll-like receptors, so that interferon production were not signaled at the time when it was needed to fight massive intracellular viral production, then it might well make CV19 worse. 

 

This might even mean its potential best use might be on an as needed prophylactic basis, 1) for high risk CV19 situations similar to prophylactic use going into malarial areas,, or 2) if people were known to be exposed, as part of contact tracing to offer them HCQ if they did not have contraindications and with clear disclosure of very real severe risks with the medicine (ideally to be taken then also with zinc) as close to an exposure as possible when it might help prevent spike protein bonding to ACE2 receptors in the first place.  

Before there were symptoms.  Even before a positive test result. 

 

(Or, speculating, and this could relate to some people where it does seem by word of mouth to help later, if timing is **after** the Toll-like receptor s have already signaled for interferon such that the body’s own interferon is busy fighting virus and the the HCL is helping to stop spike protein attachments to yet more cells’s ACE2 receptors and helping to slow or stop yet more virus being manufactured in cells already infected so that the interferon has a chance to cope.)

 

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13 hours ago, Frances said:

I mean who looks to any president, R or D, generally mature, honest, and trustworthy or not, for healthcare advice?

 

13 hours ago, Frances said:

Why would anyone care about any president’s personal opinion on the vaccine?

Exactly! It's so obvious to us, but (taking out the D and R and looking at all respondents to the question), only 37% are able to think rationally about this question.

Question: How would the following developments impact your interest in taking a coronavirus/COVID19 vaccine, if at all?...President Trump says the vaccine is safe:

All respondents:

More interested 14%

Less interested 36%

No more or no less interested 37% 

Not sure 13%

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36 minutes ago, Skippy said:

 

Exactly! It's so obvious to us, but (taking out the D and R and looking at all respondents to the question), only 37% are able to think rationally about this question.

Question: How would the following developments impact your interest in taking a coronavirus/COVID19 vaccine, if at all?...President Trump says the vaccine is safe:

All respondents:

More interested 14%

Less interested 36%

No more or no less interested 37% 

Not sure 13%

I guess I just don’t find it surprising that when you take a controversial topic like vaccines and a controversial leader and combine them that rationality goes out the window for some. And if you combine not sure and no more or less, you do get to 50%, so in some respects that’s not too bad for such a long survey.

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Quote

(then in addition there are potential benefits in reducing cytokines storm...     perhaps more on this tomorrow,

 

So here’s the some more “tomorrow “

 

I think in re “cytokine storm” stage of CV19, HCQ has low level likely help in that because it would help at the Toll-cell receptor stage of signaling for interferon.  But Interferon is needed to fight virus.

Thus a “cytokine storm” like event can be stopped for autoimmunity this way, and when there is not actually a virus present that would help. However,  if there were an actual virus infection, especially a severe one, then stopping the interferon production would be a problem.  Instead for CV19 type cytokine storm, it seems like it would be the interleukine production stage that would need to be stopped, and afaik that isn’t when/where in the whole cytokine process the HCQ acts. 

It also seems increasingly likely that the huge damage being seen may not be cytokine storm, but rather primary viral attachment to ACE2 receptors in numerous tissues not just lungs and damage to those tissues.

Particularly attachment to and damage in circulatory system and blood, so that low O2 at the blood level is actually causing much of the damage to body in numerous ways. Hypoxia. Or also now clots and results of clots. 

And in that case, things that can likely reduce coronavirus spike protein (that’s the crown ends that stick out and fit like keys into the ACE2 receptors) from bonding in first place are likely to be hugely important.  

So D is in that category. And I am taking D3 at upper safe level amount because I think its benefits hugely outweigh risks to me.  

And So too probably from the studies on other viruses is HCQ a substance that reduces spike protein bonding to ACE2 receptors, but I am not taking it because I think it has some serious risks greater than my current immediate risk of infection.  Though with underlying conditions for which HCQ is often prescribed, yes, it is something I would try for if timing were right...  for the CV19 itself very likely, and also in my case to possibly prevent an AI flare up which I tend to get when I get sick with anything. 

 

Edited by Pen
Clarity maybe? Still seems unclear...
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5 hours ago, Pen said:

 

I do not think the studies are good, no. 

None are very good.

the French one for reasons you give

others I have been able to read had HcQ given to

1)sicker people 

and/or

2) too late in disease for HcQ ‘s most likely mode of possible action to work (aside from zinc ionophore aspect) 

eta: 

(actually, 48 hours after might even also often  be too late for zinc ionophore aspect too ...  if there’s already substantial tissue damage, or movement into tissues that are hard for drugs to reach)

HCQ alone may (based on SARS1 and Dengue  experimenting) be helpful to stop / decrease spike protein bonding to ACE2 receptors

and might be helpful to slow down or decrease replication inside cells. 

But by 48 hours after diagnosis there pretty much has to have been enough virus already bonded, entered into cells, replicated, and being shed to get a positive test result.which probably means the illness is at a stage already past when many people would be helped by HCQ alone. 

Thus even 50,000 cases would not be  especially meaningful if they are all set up in a way that won’t work well for the probable mode of action of the drug.  

(It seems kind of like concluding seatbelts don’t work if they are only fastened after the crash has already happened.  

Like saying, “You see, we fastened seatbelts on all these car crash victims within 48 minutes after the crash,  and  yet they died at the same rate or more than car crash victims with no seatbelts.”

...and even more useless if the small print reveals that seatbelts were applied too late on the more seriously injured  )

But these limitations may be exactly the reason why it is NOT an effective and safe treatment.    You don't give potentially dangerous medications to people who you aren't even sure are sick.    That's part of the safety/efficacy assessment.   

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1 hour ago, Ktgrok said:

yeah...that's not particuarly impressive, especially given how small most of the sample sets were. The larger ones and the RCT ones look like they show it wasn't very effective. This is the link to the chart with results of the various studies mentioned in the article if people want to look.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5461643/table/prp2293-tbl-0001/?report=objectonly

 

I wasn’t looking for large numbers. I was looking for likely understanding of the metabolic pathways and other immunological aspects that would be relevant to me. 

Large numbers are really helpful if there’s a well done prospective study with well matched control cohorts.

 I don’t find large numbers especially relevant to trying to understand potential biochemical mechanisms.

If the study I linked was not one about the likely ways that the HCQ works then, in my dealings with mice and electric issues being more my focus yesterday (and is about to be again today), I may have linked a wrong one.  It was in my saved file, but I didn’t reread before linking here.  I’ll look later if I can. 

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15 minutes ago, Pen said:

 

 

 

It also seems increasingly likely that the huge damage being seen may not be cytokine storm, but rather primary viral attachment to ACE2 receptors in numerous tissues not just lungs and damage to those tissues.

 

 

That does seem to be what we are seeing. 

2 minutes ago, Pen said:

 

I wasn’t looking for large numbers. I was looking for likely understanding of the metabolic pathways and other immunological aspects that would be relevant to me. 

later if I can. 

Right, but those theoretical metabolic pathways are not important if in actual use it doesn't work. Which, in the larger random control trial in that link, as well as other smaller ones, it didn't. 

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On 5/25/2020 at 7:06 AM, Where's Toto? said:

But these limitations may be exactly the reason why it is NOT an effective and safe treatment.    You don't give potentially dangerous medications to people who you aren't even sure are sick.    That's part of the safety/efficacy assessment.   

 

Otoh, Lots of people have taken HCQ prophylactically for malaria over the years without knowing which person would develop malaria .   Sometimes even chloroquine which had more risks was taken for months by missionaries and others in malarial areas (before malaria developed resistance), and many did  just fine with it. 

(Or also similar with Amodiaquine, which I think has more risks yet, but seems also to have antiviral effects such as for Ebola )

Edited by Pen
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8 hours ago, Corraleno said:

 

The Lancet paper is an analysis of 15,000 cases, all of whom received HCQ or CQ within 48 hours of diagnosis, and many scientists find that data more reliable and trustworthy than the data from the small and very flawed French study that started all the HCQ hype. That study (Gaudret et al) (1) was not randomized or blind, the "control group" consisted of patients who had preexisting conditions that contraindicated use of HCQ as well as those who refused HCQ treatment, (2) they were only tested for a period of 6 days, (3) it included only 26 patients, and (4) 6 of those 26 were excluded from the results because 3 were transferred to ICU, 1 died, 1 stopped treatment due to side effects, and 1 left the hospital for undisclosed reasons. So ALL of the patients who had underlying conditions that would have made HCQ treatment dangerous were put in the control group, and then they excluded ALL of the patients in the treatment group who did not get better, and claimed that HCQ treatment reduced viral load in all patients who completed the very brief treatment. And if those issues weren't damaging enough, there were other anomalies with testing dates reported, serious questions about the control group (who were at 4 different hospitals, while the treatment group were all at the Marseille hospital, and some of the control patients were missing test data because of differences in data collection at different hospitals), and various other issues that raised red flags after the study was mysteriously rushed through "peer review" in only 24 hours.

So the "best" evidence we have so far that HCQ is effective against CV19 is one very small study that put all the patients with underlying conditions in the "control group" AND excluded from the treatment results all the patients who did worse. And that is the study that prompted Trump to call HCQ + AZ "one of the biggest game changers in the history of medicine."

So a meta-analysis of 15,000 patients doesn't count because it's not a double-blind study, but a tiny French study (neither blind, nor legitimately controlled) does? The VA study showing worse outcomes with HCQ doesn't count, because only severely ill patients received the treatment; and studies showing negative results for HCQ + AZ don't count because AZ is the dangerous part (except that combination actually got better results in the French study than HCQ alone), and studies showing negative results for CQ + AZ don't count, because everyone knows CQ is more dangerous than HCQ (except the Lancet analysis showed that CQ + AZ was actually less dangerous than HCQ + AZ), and studies showing negative results when HCQ is given more than 48 hours after diagnosis don't count, but the Lancet analysis of 15,000 patients who did get HCQ or CQ within 48 hours of diagnosis also doesn't count because they actually should have gotten the drug within 48 hours of the first symptoms.

So none of the results from multiple studies showing negative results for HCQ treatment count, because the only acceptable evidence would have to come from a large, randomized, double-blind study where healthy patients with no underlying conditions were given HCQ + zinc within 48 hours of their very first symptom, before they ever tested positive. But the vast majority of people with "Covid-like symptoms" turn out to be negative, and you really can't just indiscriminately give a drug with potentially dangerous side effects to anyone with a sniffle or cough on the off chance they actually do have Covid, so you kind of need to wait for a confirmed test (i.e. a diagnosis). And until a study that meets all of these criteria is published that shows negative results for HCQ, people will continue to believe that HCQ is an effective treatment and the only reason so many studies show seriously negative results, and the FDA is warning against its use outside of clinical trials, is because scientists all over the world care more about making Donald Trump look stupid than actually saving lives.

 

I am not sure why you are referencing the French study.  I didn't, and in fact, IMO, it should be totally ignored.  I don't know why they bothered to even do it.

I also never said the Lancet analysis "doesn't count."   What I did say was 

Quote

Which, can certainly be useful, but ultimately isn't really much evidence.

Which means.....I find it to be useful information.  But the real evidence for me will come from the actual trials.  (and no, that study out of France isn't an actual trial IMO.)

Quote

you really can't just indiscriminately give a drug with potentially dangerous side effects to anyone with a sniffle or cough on the off chance they actually do have Covid, so you kind of need to wait for a confirmed test (i.e. a diagnosis).

 

I am not sure where you got the idea that anyone is suggesting that we just indiscriminately hand HCQ out to anyone with a sniffle.  

As I have stated before, one of the greatest hopes we have, is a medication that keeps people OUT of the hospital.  THAT is the sort of trial we need (at it appears there's at least one, or even a few, trials underway looking at that.)  This analysis only looked at people that were already in the hospital.  So, it gives us information that can certainly be useful.......but it's not really giving us information about whether or not HCQ can keep people out of the hospital.  

 

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33 minutes ago, Ktgrok said:

That does seem to be what we are seeing. 

Right, but those theoretical metabolic pathways are not important if in actual use it doesn't work.

I agree.  If it doesn’t work then it doesn’t.

 

 But I do not agree that any trials that I have read about have thus far proved it does not work.  When I have read the studies that I have been able to read thus far, they have all been seriously flawed as to patients given HCQ being sicker or timing being too late, or both. 

 

 

 

 

 

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1 minute ago, Pen said:

I agree.  If it doesn’t work then it doesn’t.

 

 But I do not agree that any trials that I have read about have thus far proved it does not work.  When I have read the studies that I have been able to read thus far, they have all been seriously flawed as to patients given HCQ being sicker or timing being too late, or both. 

 

 

 

 

 

Right..but there are no studies showing it does work. 

I have no well done double blind studies showing vanilla ice cream doesn't cure COVID 19. But that doesn't mean that it should be promoted as something that DOES cure COVID 19. Which is sort of where we are with HCQ. And those studies you linked using it on other viruses don't give any impression it generally works for that. Sort of like I don't have any showing ice cream works. 

And given how varied the responses to this illness are, we really can't trust much anecdotal evidence. Someone taking it and getting better isn't really saying anything, given how many people take nothing and get better. You'd need a really large sample size to see a statistical difference, so anecdotes really don't help. 

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10 minutes ago, Ktgrok said:

Right..but there are no studies showing it does work. 

I have no well done double blind studies showing vanilla ice cream doesn't cure COVID 19. But that doesn't mean that it should be promoted as something that DOES cure COVID 19. Which is sort of where we are with HCQ. And those studies you linked using it on other viruses don't give any impression it generally works for that. Sort of like I don't have any showing ice cream works. 

And given how varied the responses to this illness are, we really can't trust much anecdotal evidence. Someone taking it and getting better isn't really saying anything, given how many people take nothing and get better. You'd need a really large sample size to see a statistical difference, so anecdotes really don't help. 

 

Do you have anything even in vitro suggesting that ice cream might work?

 

I am not wanting you or anyone else to have HCQ, especially not against your will or sense of what would be right for you personally.

But I would like to be able to have it myself if I had an exposure.   Even for a significant likelihood of exposure, but not certain . Well before a need for hospital stage.  At the right timing, I don’t think it would take the sort of extended use that results in retinal damage etc. Not even close.  I realize heart issues can be sooner, but are pretty rare.  

 

Edited by Pen
Fixing error... are there actually any studies whatsoever in cell cultures, in mice, anything that actually puts ice cream on same footing of possibility as HCQ?
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Does anyone have any experience with how a drug moves from research into clinical trials?  I don't, but another poster mentioned having experience with clinical trials, maybe she has some more info on that transition?  

My assumption is that in order for a drug to enter a clinical trial, there has to be some research on it first.....there has to be enough data to make starting a clinical trial worth it, right?  Clearly, HCQ and remdesivir and some other drugs have shown enough positive data in that research to get trials started, right?  Or is there usually very little data before the trials are started?  

 

ETA:  Should have googled first, I found this

https://www.fda.gov/patients/drug-development-process/step-2-preclinical-research

Presumably, because HCQ is not something brand new from scratch, but something we already had, I would presume that step 1 was skipped, but I would presume that they would have had to do the preclinical research before the trials were actually started.  

Edited by happysmileylady
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