Bolsonaro, the press, and hydroxychloroquine
Brazil’s Bolonaro lives to fight another day – having recovered from COVID.
And to make matters even more tragic for the left, the Brazilian president does a Trumpish thing:
Brazilian President Jair Bolsonaro announced on Saturday he has tested negative for the new coronavirus more than two weeks after being diagnosed on July 7, attributing his recovery to an unproven malaria drug.
“RT-PCR for Sars-Cov 2: negative. Good morning everyone,” the 65-year-old tweeted, along with a photo of himself smiling and holding a packet of hydroxychloroquine. Its effectiveness against Covid-19 has not been demonstrated in clinical trials.
There are only three sentences in that quote, but there are at least two lies (or errors, or misrepresentations). The first is “unproven malaria drug.” It certainly is an extremely proven malaria drug. From the CDC:
Hydroxychloroquine (also known as hydroxychloroquine sulfate) is an arthritis medicine that also can be used to prevent malaria…Hydroxychloroquine can be prescribed for either prevention or treatment of malaria…Hydroxychloroquine can be prescribed to adults and children of all ages. It can also be safely taken by pregnant women and nursing mother.
Both adults and children should take one dose of hydroxychloroquine per week starting at least 1 week before traveling to the area where malaria transmission occurs. They should take one dose per week while there, and for 4 consecutive weeks after leaving…
Hydroxychloroquine can only be used in places where chloroquine (a related medicine) is still effective. There are only a few places left in the world where hydroxychloroquine is still effective including parts of Central America and the Caribbean.
So, to recap: it’s a malaria drug, quite proven, but only good in certain areas. It is also used for arthritis (and, if memory serves me, for certain other auto-immune diseases like lupus).
Ah, but maybe they meant “unproven in treating COVID”? Maybe they did, but that’s not what they wrote. However, that is more or less what they wrote in the last sentence I quoted from the Bolsonaro article: “Its effectiveness against Covid-19 has not been demonstrated in clinical trials.”
Which is confusing and misleading to the average reader, who almost certainly doesn’t know what a “clinical trial” is and how it differs from other types of studies that might show a drug’s efficacy. Let’s just say that clinical trials are a particular type of research, that they take longer to perform, and that in the case of hydroxychloroquine and COVID, the results of the bogus Lancet study (that one that had to be withdrawn) caused the panicked stoppage of a host of clinical trials around the world. And so clinical trials for the use of the drug against COVID have been even slower to come out.
Here’s one that still seems to be in the early stages, and so far they’ve only tested for safety and found it to be safe in COVID patients. Here’s another which, by the headline, seems to have found the drug not to be helpful with COVID, but if you read the actual study you might wonder – as I did – why it was even done, because the researchers did not use zinc. The people I’ve seen advocating the drug as a treatment for early cases of COVID have all emphasized that zinc must be part of the protocol. But that is often ignored. As one of several commenters to that study wrote: “This study and all others left out daily Zinc supplements! And it was given too late, meaning many patients already had a fatal viral load. Study is designed to fail.”
I don’t know about “all others.” But I’ve found plenty of studies (I’m not sure if they were all clinical trials, though) that have those two flaws as well.
Actually, the efficacy of hydroxychloroquine has been demonstrated in a number of studies (not necessarily clinical trials), particularly ones that use it early in the course of the illness, in the right dose, and which include zinc.
In addition, here’s one example of good results with the drug even in sicker patients, and even when taken without zinc:
Treatment with hydroxychloroquine cut the death rate significantly in sick patients hospitalized with COVID-19 – and without heart-related side-effects, according to a new study published by Henry Ford Health System.
In a large-scale retrospective analysis of 2,541 patients hospitalized between March 10 and May 2, 2020 across the system’s six hospitals, the study found 13% of those treated with hydroxychloroquine alone died compared to 26.4% not treated with hydroxychloroquine. None of the patients had documented serious heart abnormalities; however, patients were monitored for a heart condition routinely pointed to as a reason to avoid the drug as a treatment for COVID-19.
The study was published today in the International Journal of Infectious Diseases, the peer-reviewed, open-access online publication of the International Society of Infectious Diseases (ISID.org)…
“The findings have been highly analyzed and peer-reviewed,” said Dr. Marcus Zervos, division head of Infectious Disease for Henry Ford Health System, who co-authored the study with Henry Ford epidemiologist Samia Arshad. “We attribute our findings that differ from other studies to early treatment, and part of a combination of interventions that were done in supportive care of patients, including careful cardiac monitoring. Our dosing also differed from other studies not showing a benefit of the drug. And other studies are either not peer reviewed, have limited numbers of patients, different patient populations or other differences from our patients.”
So although these patients were sick enough to be hospitalized, they were treated early, and attention was paid to giving the right dose. On the other hand, zinc doesn’t seem to have been part of the study, and yet the results were good.
The bottom line is that results are encouraging in quite a few studies, particularly ones that involve less sick patients, but there haven’t been sufficent clinical trials to say that the drug has been proven to help COVID. This type of situation is not unusual with drugs, but in the case of COVID the political aims of the press have overshadowed any ability to report fairly on the results of studies of this drug.
NOTE: Speaking of the press – later in the Bolsonaro article you can read this:
The pandemic has exploded in Brazil, the country with the most infections and deaths from Covid-19 anywhere in the world except the United States.
A relatively meaningless statistic, meant to sound worse than it is. Both the US and Brazil have large populations. The most meaningful number to look at is deaths per million of population. That metric puts the US and Brazil either even with or behind most of the countries of western Europe. Even Peru and Chile – if you’re going to look just at Latin America – have had more deaths per capita than Brazil.
One of the many things we’ve learned from this entire fiasco is people have no clue about sizes of countries and math. First saw this with the total lack of awareness that thousands of people die every day in the US. Then we get the raw numbers people who are either too stupid or willfully dishonest to realize that in very large countries with widespread testing you are going to see lots and lots of their beloved ‘cases’.
Then finally the survey that came out that said Americans thought that 9% of the population had died from COVID. That would be about 30 million people instead we have an extremely loose 150,000 deaths.
Griffin:
Do you have a link to that survey? Wow.
neo,
I saw Alex Berenson tweet about yesterday and Rush Limbaugh talked about on his show today.
Here is the Alex Berenson tweet
http://www.twitter.com/AlexBerenson/status/1288234943479414786
“Remdesivir was developed by Gilead with over $79 million in U.S. government funding.” From the Wikipedia on Gilead. Along with many other acquisitions, Gilead paid 12 billion for Kite Pharma in 2017. I always bristled when people complained about Big Pharma but I’ve been looking at things a little differently through this pandemic response. Is it any wonder that the world of extreme high-finance wants to see a certain drug used rather than the inexpensive, highly-available alternative?
I am beside myself over this blacklisting of hydroxychloroquine for COVID-19. It has a record worldwide of reducing the death toll from the virus. See this article, by a professor of epidemiology at Yale:
https://www.newsweek.com/key-defeating-covid-19-already-exists-we-need-start-using-it-opinion-1519535
He refers to the slum in Mumbai (Bombay), which I have seen. If there were ever a place for a massive death toll from an infectious disease, this is it, but they’ve controlled it well with HCQ, zinc, and vitamins.
I had my annual physical with my internist, and asked him if he’d prescribe HCQ if I got the virus. No, he said, there weren’t enough clinical studies to support it. So I have bailed out of working for the Board of Elections in November because I don’t feel I would get adequate treatment. This may be why we have still so many people dying in nursing homes around here. And the worst thing is that the drug is very safe and does no harm. Why not prescribe it outpatient, when it’s cheap and does no harm?
Sharon W, I think I agree with you. A new drug is a lot sexier and a lot more lucrative than a 60-year-old generic, plus cheap zinc tablets.
Laura Ingraham has been following HCQ very closely. She has two doctors who appear on her show regularly who have used it extensively during this pandemic. The key is to use it early – before pneumonia sets in, and to supplement it with Zinc. I don’t know if Azithromycin is actually required, but some doctors use it as a treatment for any secondary bacterial infections that might occur.
One thing that is unexplored is the fact that COVID-19 has not been very virulent in sub-Saharan Africa, where people take HCQ as a malaria preventative. More investigation of that would make sense, IMO.
I’m no doctor but it seems to me that it could do no harm to prescribe HCQ and Zinc to out patients who haven’t yet gotten to the pneumonia stage. My wife and i have taken HCQ on two occasions – when we traveled to Africa and Vietnam. Neither of us had any side effects. It’s a safe drug taken by millions of people every year.
That the media has politicized the drug is an crime against humanity. It might yet save lives.
One of the big problems we have is that those who either have no aptitude for math, even arithmetic, or who have no desire to learn any because its “hard”, seem to gravitate towards journalism because it really does not have any right or wrong answers. Math has right answers, and many wrong ones. These journalists start thinking they are smart with their degree from some journalism school and think they can write about anything. Not knowing what you don’t know is dangerous.
HCQ appears to have some application to Covid-19 when the virus is identified early. In more advanced cases, maybe not so much. Maybe it is too complicated for people to see the difference.
A far greater number of people recover from CV19 without hydroxychloroquine. So saying that hydroxychloroquine cures them when they aren’t deathly ill and using it as a last resort is a stretch. It is an unproven drug in the sense that if people get CV19 they can’t expect hydroxychloroquine to magically cure them any sooner than the normal two to three weeks. Might was well take a placebo. And actually a placebo wouldn’t have the side effects. The only cure is not invented yet. But a vaccine is hopefully on the way.
Montage:
Do yourself a favor – don’t quit your day job in order to design scientific studies. You don’t seem to understand how they work.
Montage,
The vaccine dream is probably a pipe dream and even if there is one how effective will it be since the flu vaccine isn’t exactly a sure thing and are you going to force people to get the vaccine? How about kids? Will the teachers union insist on it?
The rational response (haha I know) would be to continue to protect the at risk and work on treatments whether it’s HCQ or whatever and let everybody else live their damn lives without masks (unless you want to then go for it) or insane government rules.
In case you haven’t seen these items…. First is the MedCram YouTube site. The doctor explains the disease and treatments. And, he works with C19 patients. Video #34 includes an explanation of the science of how HCQ and zinc work to disrupt the virus.
https://www.youtube.com/watch?v=9vMXSkKLg2I&list=PLQ_IRFkDInv_zLVFTgXA8tW0Mf1iiuuM_
Second item is a paper to take to your doctor in case you get C19. The paper is the work of frontline doctors, so they know what they are talking about. On page three, there is a list of vitamins and drugs to take now – before you get sick. And, if you wonder why you should take them, go back to the MedCram videos.
https://www.evms.edu/media/evms_public/departments/internal_medicine/EVMS_Critical_Care_COVID-19_Protocol.pdf
I trust these doctors over Fauci – primarily since they are practicing medicine and not just pushing papers.
It is my understanding that HCQ is an ionophore which affects the cell wall and lets the zinc get into the cell to disrupt the virus reproduction. On that list of things to take is quercetin, which is also an ionophore. You can take quercetin and zinc as pills or just check out what foods contain them.
https://justthenews.com/politics-policy/coronavirus/yale-epidemiologist-accuses-fauci-running-disinformation-campaign
“We don’t need to use this medication in the hospital because the whole point is to keep patients out of the hospital.”
Exactly, AesopFan.
“Its effectiveness against Covid-19 has not been demonstrated in clinical trials.”
Maybe the next time that Dr. Fauci, as head of the NIH, contracts with China to bio-engineer a virus he’ll stipulate that they must complete a 3-year 100,000 patient double blind Clinical Trial before they release their “novel virus” to the World.
So Rush Limbaugh is on the radio right now going on about Twitter’s censorship of the video of doctors vouching for HCQ as a treatment for COVID-19. How is it, he asks, that Twitter can presume to suppress doctors offering professional experiences with medical treatment?
New insights on the antiviral effects of chloroquine against coronavirus: what to expect for COVID-19?
The multiple molecular mechanisms by which chloroquine can achieve such results remain to be further explored. … preliminary data indicate that chloroquine interferes with SARS-CoV-2 attempts to acidify the lysosomes and presumably inhibits cathepsins, which require a low pH for optimal cleavage of SARS-CoV-2 spike protein
Zn2+ Inhibits Coronavirus and Arterivirus RNA Polymerase Activity In Vitro and Zinc Ionophores Block the Replication of These Viruses in Cell Culture
The risk profiles are well-established. The only question that remains for clinical review is efficacy, but anecdotal and retrospective studies both support their use to reduce viral load and function, mitigate disease progression, and improve patient viability.
I have never heard whether or not such a study has been done with remdesivir.
I am awestruck by the power and reach of Big Pharma. So many “unprecedented” actions taken in an effort to discourage use of a drug regimen that has been in use for well over half a century, one that has a proven track record of success, all in an effort to cash in on a potential “vaccine” that, if it’s anything like a common cold vaccine, will either never work or never appear. To me, steering people away from a proven remedy, for whatever reason, is tantamount to killing them.
Joe Van Steenbergen:
A COVID vaccine is unlikely to bear any resemblance to the problems with a common cold vaccine. I see people make that analogy all the time, and it is incorrect.
I wrote this comment on the matter.
if it’s anything like a common cold vaccine,
Last I heard, what we call ‘colds’ can be caused by one of over 100 viruses, and there isn’t a common surface antigen for our immune system to identify. This is a single virus.