3083 replies to this topic

[Gal220]

Vitamin D levels ng/mL :

 

"Among mild cases, it was, on average, 31.2; among ordinary cases, it was 27.4;

among severe cases, it was 21.2; among critical cases, it was 17.1."

 

So it is apparent that the higher the D levels the better the outcome.  Some doctors believe the

optimal D levels are between 50 to 70 ng/ml.  So would having even higher levels than the mild

cases average of 31.2 ng/ml provide even better outcomes.

 

The people you listed believe that too much vitamin D will increase the expression of ACE2 causing the

virus to infect more and cause a worse outcome. The study does not back up their theory.

 

Thanks for the additional numbers, its tricky for sure.  Not so worried about myself, but if you were advising an older family member, tough to know what to recommend.

 

Just as a reference point, some of the best multivitamins(Thorne, LEF, Pure) put 2000IU/50mcg in their formulas. 

 

Edit, maybe not so tricky, he states in his response to Rhonda Patrick that 30nm/ml is maintained by 1700iu, not far enough off from 2000iu for me worry about.  Other guy misquoted him I guess.

 

https://chrismasterj...-d-and-covid-19

 

 

Edited by Gal220, 30 April 2020 - 02:02 AM.

[bladedmind]

Chris Martenson has a fantastic review of all the remdesivir news here (starting at minute 4 of the show)

 

https://youtu.be/VscMiksyfW4?t=244

 

I must say I'm SHOCKED at the blatant preference / bias from Fauci towards this expensive alternative to HCQ.  NO difference in overall mortality is "quite good news"?  REALLY?  Read in another article 23% of patients on remdesivir in one trial showed signs of liver damage.  

 

We live in interesting times!  

 

Dorian Grey for some reason I thought of you when I read this news this morning.  There was no statistically significant difference in mortality between remdesivir arm and placebo arm.  That means NO difference.  It reduced time to recovery from 15 to 11 days.  Is that all!?!

 

I don't wanna be a fanboy for HCQ/Zinc, glad to update my views back and forth as evidence of various quality accumulates.  Remdisivir lowers recovery time by 4 days, Fauci:  "This will be the standard of care."  What about the small Chinese RCT that showed statistically significant improvement in recovering from fever, cough, and pneumonia?  Fauci:  "That was not a very robust study. It is still possible that there is a beneficial effect, but the study that was just quoted, on a scale of strength of evidence, that’s not overwhelmingly strong. It’s an indication, a hint of it."

 

Is Fauci consistent? Seriously, am I biased or confused in suspecting that the thumb is on the scale?

Edited by bladedmind, 30 April 2020 - 02:03 AM.

[Hebbeh]

Well at least one good thing that happen because of Fauci's weird fawning over that drug was

that some analyst believe it was his comments that caused the stock market to go up around

500 points.  They said it gave the market reassurance that there was some type of treatment.

 

You hit the nail on the head.  Playing politics to give hope to the economy.  There is no other explanation.

[Gal220]

Is Fauci consistent? Seriously, am I biased or confused in suspecting that the thumb is on the scale?

 

Hard to say what their motivations are exactly, I look at all the blow back Derek Lowe and others got for his HCQ write up(whether you agree with him or not), maybe Fauci thought it best not to be critical.

 

https://blogs.scienc...-as-of-april-11

https://blogs.scienc...roxychloroquine

[Dorian Grey]

Dorian Grey for some reason I thought of you when I read this news this morning.  There was no statistically significant difference in mortality between remdesivir arm and placebo arm.  That means NO difference.  It reduced time to recovery from 15 to 11 days.  Is that all!?!

 

I don't wanna be a fanboy for HCQ/Zinc, glad to update my views back and forth as evidence of various quality accumulates.  Remdisivir lowers recovery time by 4 days, Fauci:  "This will be the standard of care."  What about the small Chinese RCT that showed statistically significant improvement in recovering from fever, cough, and pneumonia?  Fauci:  "That was not a very robust study. It is still possible that there is a beneficial effect, but the study that was just quoted, on a scale of strength of evidence, that’s not overwhelmingly strong. It’s an indication, a hint of it."

 

Is Fauci consistent? Seriously, am I biased or confused in suspecting that the thumb is on the scale?

 

Everyone in Costa Rica with SARS-CoV-2, both confirmed and suspected, are getting HCQ. 

Now compare the CFR in Costa Rica (0.86%) to Brazil (6.83%) and the rest of the world (7.05%)

--------------------

The Association of American Physicians and Surgeons (AAPS) presented data on 2,333 patients treated with hydroxychloroquine across the globe that shows 91.6 percent of those who got the drug fared better after treatment.

[gamesguru]

Everyone in Costa Rica with SARS-CoV-2, both confirmed and suspected, are getting HCQ. 

Now compare the CFR in Costa Rica (0.86%) to Brazil (6.83%) and the rest of the world (7.05%)

--------------------

The Association of American Physicians and Surgeons (AAPS) presented data on 2,333 patients treated with hydroxychloroquine across the globe that shows 91.6 percent of those who got the drug fared better after treatment.

 

There are some truly funny examples of correlation and causation not being the same thing.  And research shows 20% of statistics are completely made up.

 

Even if it has some benefit—by reducing cytokines, or taming the cardiovascular system—I don't think HCQ is the silver bullet.  It also has studies showing increased mortality, so it could be more of a springboard than an endgame.

[Gal220]

There are some truly funny examples of correlation and causation not being the same thing.  And research shows 20% of statistics are completely made up.

 

Even if it has some benefit—by reducing cytokines, or taming the cardiovascular system—I don't think HCQ is the silver bullet.  It also has studies showing increased mortality, so it could be more of a springboard than an endgame.

 

It is only anecdotal, but one LA doctor said he saw no benefit till adding zinc to HCQ and the very ill patients he treated were better in 8-12 hours(see 3rd post on page 40) .   

 

Although I completely disagreed with Derek Lowes assessment,  I hate to see him crucified for giving his opinion.  Hard to feel too sorry for him given his criticism of Trump's early investigation of HCQ.

 

Whether it pans out or not, it was worth a look.  But everyone loves to play the gotcha game.

Edited by Gal220, 30 April 2020 - 03:07 AM.

[bladedmind]

Updates

 

https://www.medrxiv....4.24.20075838v1

Suggestive support for Vitamin D.  Retrospective, correlational.

Vitamin D insufficiency “is highly prevalent in severe COVID-19 patients.”

 

 

https://www.research...cle/rs-21211/v1

Correlational.

Discussion: Vitamin D levels are severely low in the aging population especially in Spain, Italy and Switzerland. This is also the most vulnerable group of population for COVID-19.

Conclusions: We believe, that we can advise Vitamin D supplementation to protect against SARS-CoV2 infection.

 

 

 

 

https://www.preprint.../202004.0457/v1

New kid on the block. Yay for K!

Reduced Vitamin K Status as A Potentially Modifiable Prognostic Risk Factor in COVID-19

Vitamin K status was reduced in patients with COVID-19 and related to poor prognosis. Also, low vitamin K status seems to be associated with accelerated elastin degradation. An intervention trial is now needed to assess whether vitamin K administration improves outcome in patients with COVID-19.

 

 

 

https://accpjournals....1002/phar.2395

Doxycycline again (tetracyclines)

Multiple hypothesized mechanisms of action against COVID-19

 

 

https://www.research...VID-19_pandemic

Melatonin bonus.  Only hypotheses, including:

Bats have higher levels of melatonin than humans!

Can melatonin reduce the severity of COVID-19 pandemic?

 

 

https://www.ahajourn...SAHA.120.317134

Among hospitalized COVID-19 patients with hypertension, inpatient use of ACEI/ARB was associated with lower risk of all-cause mortality compared with ACEI/ARB non-users. 

 

 

[Dorian Grey]

There are some truly funny examples of correlation and causation not being the same thing.  And research shows 20% of statistics are completely made up.

 

Even if it has some benefit—by reducing cytokines, or taming the cardiovascular system—I don't think HCQ is the silver bullet.  It also has studies showing increased mortality, so it could be more of a springboard than an endgame.

 

I worked in healthcare as a Surgical Technologist for 35 years, and after seeing healthcare from the inside looking out I have come to have a deep respect for the front line of doctors actually treating patients in the field over the pencil pushers of the bureaucracy.  

 

Early in April: A global sermo poll of over 6000 doctors actually treating COVID in the field indicated they felt chloroquine meds (CQ & HCQ) were working best for their patients. Now, the Association of American Physicians and Surgeons (AAPS) presented data on 2,333 patients treated with hydroxychloroquine across the globe that shows 91.6 percent of those who got the drug fared better after treatment.

 

These are the guys & gals witnessing the various trials & therapies with their own eyes. The scientific method certainly has its place, but the wheels of research grind along at a snails pace, and there's a pandemic going on.

 

I wonder if there has ever in the history of medicine been such a fanatical resistance to the off-label prescribing of a half century old cheap generic, sold over the counter in many countries for many years.  If the fullness of time eventually shows HCQ really was the "Best Medicine" for COVID we'll have in 2020, it will go down as the biggest blunder ever known in the history of medicine.

Edited by Dorian Grey, 30 April 2020 - 03:34 AM.

[lancebr]

Thanks for the additional numbers, its tricky for sure.  Not so worried about myself, but if you were advising an older family member, tough to know what to recommend.

 

Just as a reference point, some of the best multivitamins(Thorne, LEF, Pure) put 2000IU/50mcg in their formulas. 

 

Edit, maybe not so tricky, he states in his response to Rhonda Patrick that 30nm/ml is maintained by 1700iu, not far enough off from 2000iu for me worry about.  Other guy misquoted him I guess.

 

https://chrismasterj...-d-and-covid-19

 

For the past few years I take a daily dose of D at 5,000 iu.  I also have a family member over 80 who is also

taking 5,000 iu daily.  Every year in January our family gets a full blood work up that we purchase online since

that is so much easier then going to a doctors office to get the same thing.

 

My D levels this past January was 68 and my elderly family member was 56.  I have read that the elderly might

have a harder time absorbing vitamin D.  There is this study that talks about dosage for over and under 65 yrs old.

 

https://www.ncbi.nlm...pubmed/20440693

 

This is some other interesting information about vitamin D and covid:

 

"Italy and Spain, perhaps surprisingly, have relatively high prevalences of vitamin D deficiency. Vitamin D deficiency has also

been shown to correlate with hypertension,5 diabetes,6 obesity7 and ethnicity8—all features associated with increased risk

of severe COVID‐19."

 

With this new study it shows lower levels of Vitamin D have to do with increasing odds of death.

 

https://papers.ssrn....&mirid=1&type=2

 

Just seems like more and more reports showing that low vitamin D levels are bad with this virus:

 

https://www.medrxiv....4.24.20075838v1

 

https://www.zmescien...ortality-rates/

 

Oregon State University Researchers are recommending 2,000 iu a day:

 

https://www.eurekale...u-dsa042320.php

 

Tyler Perry is telling black people to take Vitamin D for covid:

 

https://www.essence....min-d-covid-19/

 

 

Edited by lancebr, 30 April 2020 - 04:24 AM.

[bladedmind]

COVID-19 Science Aggregators

 

 

https://www.reddit.com/r/COVID19/

Only scientific or popular-scientifc articles and their discussion

 

https://flutrackers.com/forum/

Flu trackers, not Fuddruckers. Since 2006. Gargantuan organized links, especially good on international coverage.  

Huge number of entries in the Science Library on Covid-19.

 

https://www.springfieldcovid.org/links

Medical students attempt synthetic surveys of clinical literatures

 

 

 

https://threadreader...4398954497.html

Everythiing in the world on quercetin and zinc, in 98 tweets, pro tilt

 

https://docs.google....XARUomR9Ww/edit

HCQ and AZT, summary of evidence, Todara and Rigano, pro tilt

 

What else?

 

[Gal220]

For the past few years I take a daily dose of D at 5,000 iu.  I also have a family member over 80 who is also

taking 5,000 iu daily.  Every year in January our family gets a full blood work up that we purchase online since

that is so much easier then going to a doctors office to get the same thing.

 

Chris Kesser thinks you are just outside of the optimal range at 68 - https://chriskresser...-is-not-better/

 

Medscape claims most of the literature points to 35-40 for preventive health. - https://www.medscape...rticle/589256_7

 

Life extension and vitamin d council really push 5000 iu  a day.

 

Hard to know who to believe, I do think Kesser is right about this part though - I would make sure you are getting all the cofactors, and he should mention calcium and magnesium.

 

"Another factor that influences toxicity is nutritional status. The fat-soluble vitamins A, D, and K work synergistically, and adequate vitamin A and K may protect against toxic effects of excess vitamin D (33). Sufficient levels of potassium and magnesium have also been suggested to protect against vitamin D toxicity (34). Unfortunately, most people have nutrient deficiencies in these micronutrients in the developed world, making them more susceptible to vitamin D toxicity."

 

Sadly, doesnt appear there is even a consensus about what dose gives what result.  Medscape says 1000iu will get you to 40ng/ml(I feel he is mistaken).  Well, with a little research, at least this should be academic.

 

If someone thinks they have a definitive link on what D dosage gives what ng/ml , I would welcome it.

[Gal220]

https://docs.google....XARUomR9Ww/edit

HCQ and AZT, summary of evidence, Todara and Rigano, pro tilt

 

What else?

 

 

From the HCQ link

 

"In a review by the Italian Society for Rheumatology, 65,000 patients on long term treatment with hydroxychloroquine for rheumatoid arthritis and lupus showed only 20 patients infected with COVID-19. This is an infection rate of 0.03%. Of those 20 infected patients, there were no ICU admissions and no deaths. Compared to the testing confirmed infection rate in Italy of 0.33%, this study suggests that prophylactic use of hydroxychloroquine could reduce the rate of infection by 90%."

[lancebr]

Chris Kesser thinks you are just outside of the optimal range at 68 - https://chriskresser...-is-not-better/

 

Medscape claims most of the literature points to 35-40 for preventive health. - https://www.medscape...rticle/589256_7

 

Life extension and vitamin d council really push 5000 iu  a day.

 

Hard to know who to believe, I do think Kesser is right about this part though - I would make sure you are getting all the cofactors, and he should mention calcium and magnesium.

 

"Another factor that influences toxicity is nutritional status. The fat-soluble vitamins A, D, and K work synergistically, and adequate vitamin A and K may protect against toxic effects of excess vitamin D (33). Sufficient levels of potassium and magnesium have also been suggested to protect against vitamin D toxicity (34). Unfortunately, most people have nutrient deficiencies in these micronutrients in the developed world, making them more susceptible to vitamin D toxicity."

 

Sadly, doesnt appear there is even a consensus about what dose gives what result.  Medscape says 1000iu will get you to 40ng/ml(I feel he is mistaken).  Well, with a little research, at least this should be academic.

 

If someone thinks they have a definitive link on what D dosage gives what ng/ml , I would welcome it.

 

I think with the level I am at I will probably substitute two weekly 5,000 iu with 2,000 iu to try and maintain or lower

a tiny bit.

 

The issue with vitamin D is that it is so hard to know exactly what amount to take to hit a certain level since

it can be different for different people.  For example, post-menopausal women need to take more to get

their levels up...elderly usually need to take more to get their levels up...and dark-skinned people need to

usually take more to get their levels up. Overweight or obese individuals may also need higher

amounts of vitamin D (26Trusted Source, 27Trusted Source).

 

"A study of healthy adults showed that a daily intake of 3800 IU was needed to maintain sufficient blood

levels of vitamin D (23Trusted Source). The study also showed that individuals who were vitamin D deficient

needed 5000 IU to reach blood levels above 30 ng/ml."

 

 

 

 

[Dorian Grey]

From the HCQ link

 

"In a review by the Italian Society for Rheumatology, 65,000 patients on long term treatment with hydroxychloroquine for rheumatoid arthritis and lupus showed only 20 patients infected with COVID-19. This is an infection rate of 0.03%. Of those 20 infected patients, there were no ICU admissions and no deaths. Compared to the testing confirmed infection rate in Italy of 0.33%, this study suggests that prophylactic use of hydroxychloroquine could reduce the rate of infection by 90%."

 

HCQ is still being utilized around the world outside the US, & many are realizing the value of early treatment & augmentation with zinc & Z-Pack.  Not everyone can afford a $1000 per patient trial of remdesivir, which so far hasn't reduced case fatality rate.  At 5-14 days incubation and 14-30 days acute illness before viral elimination (after incubation), a 50 day lockdown should theoretically have reduced new cases to zilch.  Deaths are falling as doctors learn how NOT to treat this disease, but new cases are plateauing, not falling all that much.  

 

What I'm wondering is how much anecdotal evidence it will take before the dam breaks and the world capitulates to acceptance this (HCQ) may be the "Best Medicine" for COVID we're going to see in 2020.  Everyone is believing the China model.  Just lock down hard enough and it will go away.  Reports coming out of China are indicating multiple new outbreaks occurring since they've attempted to re-open.  China can afford to lose a chunk of their citizens the size of the entire population of the US and still have a billion folks left, so no worries there.  They’ve actually been trying to control population growth for almost half a century.  

 

I'm confident I'll be OK with the neutraceuticals we've discovered in this thread.  Astonishing to watch the greatest nation ever seen on planet earth throwing away a promising therapy while a pandemic is killing tens of thousands in only 40 days, with a million new cases only plateauing after 40 days hard lockdown.  

 

It's going to be a fine mess.  

Edited by Dorian Grey, 30 April 2020 - 06:31 AM.

[joelcairo]

 

This is NOT about COVID-19. It's about SARS and about canine coronavirus (SARS-CCoV). However it looks interesting for obvious reasons. Indomethacin is a less well-known NSAID which has some remarkable anticancer properties.

 

 

Indomethacin has a potent antiviral activity against SARS coronavirus

 

https://www.intmedpr...ad-e35f99be9211

 

"Indomethacin's potent antiviral activity (> 1000-fold reduction in virus yield was confirmed in CCoV-infected dogs."

 

 

 

I mentioned Indomethacin a few pages back. I did another search and found this recent article on how it affects SARS CoV-2 (COVID-19), in vitro and in vivo. Looking at the full text I can see there are some clear effects but it's hard for me to interpret how impressive the results are.

 

 

Indomethacin has a potent antiviral activity against SARS CoV-2 in vitro and canine coronavirus in vivo

https://www.biorxiv....7624v1.abstract

[Iporuru]

Link identified between dietary selenium and outcome of COVID-19 disease

"Examining data from provinces and municipalities with more than 200 cases and cities with more than 40 cases, researchers found that areas with high levels of selenium were more likely to recover from the virus. For example, in the city of Enshi in Hubei Province, which has the highest selenium intake in China, the cure rate (percentage of COVID-19 patients declared 'cured') was almost three-times higher than the average for all the other cities in Hubei Province. By contrast, in Heilongjiang Province, where selenium intake is among the lowest in the world, the death rate from COVID-19 was almost five-times as high as the average of all the other provinces outside of Hubei."

[kurdishfella]

been feeling nauseous after i developed a rash!

[gamesguru]

I wonder if there has ever in the history of medicine been such a fanatical resistance to the off-label prescribing of a half century old cheap generic, sold over the counter in many countries for many years.  If the fullness of time eventually shows HCQ really was the "Best Medicine" for COVID we'll have in 2020, it will go down as the biggest blunder ever known in the history of medicine.

 

Just because it helps COVID doesn't make its side effects equally as bad.  Ideally you want the disease to be much worse than the cure.

 

If you have a history of cardiovascular disease, it could very much amount to throwing the dice.

 

Even if it is shown perfectly safe, it's not clear if it works as a preventative, or a treatment, how much is taken for how long.  The medicine isn't actually that popular or well-understood, HCQ is really being cast into the limelight lately.

 

At least one study has found increased risk of death with HCQ, not surprising given its known cardiotoxic profile and the accruement of damage as treatment drags on.

 

I don't think this will be viewed as a blunder, even if the risks of cardiac complication can be shown minimal.  This will just go down as proper scientific skepticism in the face of an unscientific, cretinous president pushing his fans to lick toilet seats and guzzle bleach.  Is the skepticism justified in the face of a man of such outrageous stupidity and broscience?  I think so.  Is it costing people their lives in a way which is hard to delineate from the start, possibly, and that's just science.

 

Something new comes on the market, it has to be tested against a variety of genetic conditions, it has to be verified for effectiveness.  You don't just rush something to mass production at the first sign of promise.  This HCQ parade could quickly turn into an AZT nightmare like so many of the early "treatments" of HIV/AIDS turned out to be dismal relics of the past.  No, sorry that's harsh, they were springboards to safer and more effective drugs.  That's all.

 

Chloroquine diphosphate in two different dosages as adjunctive therapy of hospitalized patients with severe respiratory syndrome in the context of coronavirus (SARS-CoV-2) infection: Preliminary safety results of a randomized, double-blinded, phase IIb clinical trial (CloroCovid-19 Study)

Mayla Gabriela Silva Borba, Fernando de Almeida Val, Vanderson Sousa Sampaio, Marcia Almeida Ara&uacutejo Alexandre, Gisely Cardoso Melo, Marcelo Brito, Maria Paula Gomes Mour&atildeo, Jos&eacute Diego Brito Sousa, Djane Clarys Baia-da-Silva, Marcus Vinitius Farias Guerra, Ludhmila Abrahāo Hajjar, Rosemary Costa Pinto, Antonio Alcirley Silva Balieiro, Felipe Gomes Naveca, Mariana Simāo Xavier, Alexandre Salomão, André Machado Siqueira, Alexandre Schwarzbolt, Júlio Henrique Rosa Croda, Maurício Lacerda Nogueira, Gustavo Adolfo Sierra Romero, Quique Bassat, Cor Jesus Fontes, Bernardino Cláudio Albuquerque, Cláudio Tadeu Daniel-Ribeiro, Wuelton Marcelo Monteiro, Marcus Vinícus Guimarães Lacerda, CloroCovid-19 Team

doi: https://doi.org/10.1....04.07.20056424

This article is a preprint and has not been peer-reviewed [what does this mean?]. It reports new medical research that has yet to be evaluated and so should not be used to guide clinical practice.

Abstract

Background

There is no specific antiviral therapy recommended for the disease caused by SARS-CoV-2 (COVID-19). Recent publications have drawn attention to the possible benefit of chloroquine (CQ). Our study aimed to comprehensively evaluate the safety and efficacy of two different CQ dosages in patients with established severe COVID-19.

Methods

We performed a parallel, double-blinded, randomized, phase IIb clinical trial, aiming to assess safety and efficacy of two different CQ dosages as adjunctive therapy of hospitalized patients with SARS in Manaus, Brazilian Amazon. Eligible participants were allocated to receive orally or via nasogastric tube high dose CQ (600mg CQ twice daily for 10 days or total dose 12g); or low dose CQ (450mg for 5 days, twice daily only on the first day, or total dose 2.7g). In addition, all patients received ceftriaxone and azithromycin. This study was registered with ClinicalTrials.gov, number NCT04323527.

Findings

Out of a pre-defined 440 patients sample size, 81 patients were enrolled. The high dose CQ arm presented more QTc>500ms (25%), and a trend toward higher lethality (17%) than the lower dosage. Fatality rate was 13.5% (95%CI=6.9-23.0%), overlapping with the CI of historical data from similar patients not using CQ (95%CI=14.5-19.2%). In 14 patients with paired samples, respiratory secretion at day 4 was negative in only one patient.

Interpretation

Preliminary findings suggest that the higher CQ dosage (10-day regimen) should not be recommended for COVID-19 treatment because of its potential safety hazards. Such results forced us to prematurely halt patient recruitment to this arm. Given the enormous global push for the use of CQ for COVID-19, results such as the ones found in this trial can provide robust evidence for updated COVID-19 patient management recommendations.

Competing Interest Statement

The authors have declared no competing interest.

Clinical Trial

NCT04323527.

 

 

From the HCQ link

 

"In a review by the Italian Society for Rheumatology, 65,000 patients on long term treatment with hydroxychloroquine for rheumatoid arthritis and lupus showed only 20 patients infected with COVID-19. This is an infection rate of 0.03%. Of those 20 infected patients, there were no ICU admissions and no deaths. Compared to the testing confirmed infection rate in Italy of 0.33%, this study suggests that prophylactic use of hydroxychloroquine could reduce the rate of infection by 90%."

It's a retrospective study so is prone to error.  Nothing is surprising to me about the 0.33% (I think these antibody studies are overestimating incidence by an order of magnitude sometimes).

 

People with pre-existing conditions generally avoid others in the pandemic, out of self-concern and malaise, so it is not surprising they are much less infected, and totally not fair to compare with average infection rates of more carefree people.

 

Additionally, nothing is surprising about seeing no deaths out of 20 positives.  Unless they had advanced age, or preexisting heart condition.

Edited by gamesguru, 30 April 2020 - 12:59 PM.

[Gal220]

I don't think this will be viewed as a blunder, even if the risks of cardiac complication can be shown minimal.  This will just go down as proper scientific skepticism in the face of an unscientific, cretinous president pushing his fans to lick toilet seats and guzzle bleach.  Is the skepticism justified in the face of a man of such outrageous stupidity and broscience?  I think so.  Is it costing people their lives in a way which is hard to delineate from the start, possibly, and that's just science.

 

It was an approved drug and been used for decades with minimal side effects. I just dont understand the reasoning that it wasnt worth a look, especially given the fact people are dying or in critical condition.  If it turns out complications of the virus + drug make it unsuitable, so be it.

 

Ive seen people criticize the travel bans and hand washing as well, these were never guarantees of prevention.  

[Daniel Cooper]

 

 

I don't think this will be viewed as a blunder, even if the risks of cardiac complication can be shown minimal.  This will just go down as proper scientific skepticism in the face of an unscientific, cretinous president pushing his fans to lick toilet seats and guzzle bleach.  Is the skepticism justified in the face of a man of such outrageous stupidity and broscience?  I think so.  Is it costing people their lives in a way which is hard to delineate from the start, possibly, and that's just science.

 

 

 

I hate to see the thread get so overtly political.  Seems so unproductive.

[Dorian Grey]

Just because it helps COVID doesn't make its side effects equally as bad.  Ideally you want the disease to be much worse than the cure.

 

If you have a history of cardiovascular disease, it could very much amount to throwing the dice.

 

Even if it is shown perfectly safe, it's not clear if it works as a preventative, or a treatment, how much is taken for how long.  The medicine isn't actually that popular or well-understood, HCQ is really being cast into the limelight lately.

 

At least one study has found increased risk of death with HCQ, not surprising given its known cardiotoxic profile and the accruement of damage as treatment drags on.

 

I don't think this will be viewed as a blunder, even if the risks of cardiac complication can be shown minimal.  This will just go down as proper scientific skepticism in the face of an unscientific, cretinous president pushing his fans to lick toilet seats and guzzle bleach.  Is the skepticism justified in the face of a man of such outrageous stupidity and broscience?  I think so.  Is it costing people their lives in a way which is hard to delineate from the start, possibly, and that's just science.

 

Something new comes on the market, it has to be tested against a variety of genetic conditions, it has to be verified for effectiveness.  You don't just rush something to mass production at the first sign of promise.  This HCQ parade could quickly turn into an AZT nightmare like so many of the early "treatments" of HIV/AIDS turned out to be dismal relics of the past.  No, sorry that's harsh, they were springboards to safer and more effective drugs.  That's all.

 

 

 

It's a retrospective study so is prone to error.  Nothing is surprising to me about the 0.33% (I think these antibody studies are overestimating incidence by an order of magnitude sometimes).

 

People with pre-existing conditions generally avoid others in the pandemic, out of self-concern and malaise, so it is not surprising they are much less infected, and totally not fair to compare with average infection rates of more carefree people.

 

Additionally, nothing is surprising about seeing no deaths out of 20 positives.  Unless they had advanced age, or preexisting heart condition.

 

Every prescription medicine has contraindications, risks and side effects.  Yes, doctors shouldn't prescribe penicillin to those who are allergic to it or chloroquine meds to those with contraindications, but that doesn't mean it must be banned for everyone, particularly during a pandemic like this one.  

 

Regarding those dreadful cardiac risks...The World Health Organization's own 2017 monograph "the cardiotoxicity of antimalarials" opines on the safety: “Despite hundreds of millions of doses administered in the treatment of malaria, there have been no reports of sudden unexplained death associated with quinine, chloroquine or amodiaquine, although each drug causes QT/QTc interval prolongation.”

 

https://www.who.int/...rt-session2.pdf

 

That's right, not a single case of sudden unexplained cardiac death associated with chloroquine in over half a century of use, even when sold over the counter. Remdesivir on the other hand is showing signs of liver damage during clinical trials. 

 

https://www.japantim...g/#.XqrZayjYrrc

 

"23 percent showed signs of liver damage on laboratory tests"  

Edited by Dorian Grey, 30 April 2020 - 01:37 PM.

[gamesguru]

I just dont understand the reasoning that it wasnt worth a look

 

If it turns out complications of the virus + drug make it unsuitable, so be it.

 

It's being looked at.  AFAIK, it was found to increase mortality in the study I quoted above.  Which is the only one I know of.

 

I'm sure other studies will emerge shortly.  There will be more, and then meta-analysis.

 

We still have to go through the scientific method to get things approved.  And the reality is, this medicine had some set backs and is probably not a magic cure and is probably not going to be approved tomorrow.

 

It is difficult to dig up pre-corona literature on HCQ.  But it was known to cause retinopathy (blindness), cardiotoxic buildup, and was generally not the first choice in treating malaria.

 

Mayo Clinic cardiologist: 'Inexcusable' to ignore hydroxychloroquine side effects

While safe for most, the drug carries serious side effects for some, including sudden cardiac arrest.

President Donald Trump stops a reporter from asking Dr. Anthony Fauci a question about use of the drug hydroxychloroquine to treat the disease caused by the new coronavirus near the end of the daily coronavirus task force briefing at the White House on April 5, 2020.Joshua Roberts / Reuters

April 7, 2020, 7:11 PM EDT / Updated April 7, 2020, 7:34 PM EDT

 

WASHINGTON — As the U.S. scales up purchase and use of the drug hydroxychloroquine to treat coronavirus patients, a leading Mayo Clinic cardiologist is sounding a warning: Anyone promoting the drug also needs to flag its rare but serious — and potentially fatal — side effects.

 

President Donald Trump has repeatedly touted the potential benefits of hydroxychloroquine, which has been approved by the Food and Drug Administration to treat malaria, lupus and other autoimmune ailments but hasn't yet been proven effective and safe in treating the coronavirus.

 

"What do you have to lose?" Trump asked Saturday at the White House when pressed by reporters about hydroxychloroquine's effectiveness. And while he's suggested that patients consult with their physicians about the treatment, he's also said the drug can "help them, but it's not going to hurt them."

 

On Tuesday, when asked about the drug’s potential side effects, he downplayed them. “The side effects are the least of it,” said Trump. “You’re not gonna die from this pill,” he said. “I say ‘try it’” he said, noting “I’m not a doctor” and to get a physician’s approval.

 

But the president's reassurance is raising concerns among experts about the dangers the drug poses to some.

 

After observing the debate over hydroxychloroquine on TV news and in social media, Dr. Michael Ackerman, a genetic cardiologist who is director of the Mayo Clinic's Windland Smith Rice Genetic Heart Rhythm Clinic, took the unusual step in late March of issuing guidance for physicians.

 

"What disturbed me the most was when I was seeing not political officials say these medications are safe but seeing on the news cardiologists and infectious disease specialists say" hydroxychloroquine "is completely safe without even mentioning this rare side effect," Ackerman said in an interview.

 

"That's inexcusable," he added.

[gamesguru]

https://www.who.int/...rt-session2.pdf

 

That's right, not a single case of sudden unexplained cardiac death associated with chloroquine in over half a century of use, even when sold over the counter. Remdesivir on the other hand is showing signs of liver damage during clinical trials.

 

It's Africa, they don't exactly always have technology on hand to "confirm" cause of death.  There have been a lot of cardiac arrest calls in New York, and it's not clear if this is due to the virus itself or from people buying up chloroquine at their local pet shops.

 

Chloroquine hypotension from peripheral vasodilation and negative inotropy was the probable cause of sudden death reported following the rapid parenteral administration of chloroquine for the treatment of malaria in children. PK/PD assessments found that toxicity resulted from transiently very high plasma concentrations following parenteral administration. This effect was circumvented by using as low,continuous,rate-controlled infusion or smaller,more frequent intramuscular or subcutaneous doses to administer the drug (14).

 

And I found other studies corroborating the effect,

Drug Saf. 2018 Oct;41(10):919-931. doi: 10.1007/s40264-018-0689-4.

Cardiac Complications Attributed to Chloroquine and Hydroxychloroquine: A Systematic Review of the Literature.

Chatre C¹, Roubille F^2,3, Vernhet H⁴, Jorgensen C^1,5, Pers YM^6,7.

INTRODUCTION:

Chloroquine and hydroxychloroquine are widely used in the long-term treatment of connective tissue disease and usually considered safe. However, chloroquine- or hydroxychloroquine-related cardiac disorder is a rare but severe adverse event, which can lead to death. This systematic review investigates cardiac complications attributed to chloroquine and hydroxychloroquine.

METHODS:

PubMED, EMBASE, and Cochrane database searches were conducted using keywords derived from MeSH terms. Reports published prior to 31 July, 2017 were eligible for inclusion, without restriction to study design. Searches were also conducted on reference lists of included studies.

RESULTS:

Eighty-six articles were identified, reporting individual cases or short series, providing information on 127 patients (65.4% female). A majority of patients were treated with chloroquine (58.3%), with the remaining treated with hydroxychloroquine (39.4%), or both in succession. Most patients had been treated for a long time (median 7 years, minimum 3 days; maximum 35 years) and with a high cumulative dose (median 1235 g for hydroxychloroquine and 803 g for chloroquine). Conduction disorders were the main side effect reported, affecting 85% of patients. Other non-specific adverse cardiac events included ventricular hypertrophy (22%), hypokinesia (9.4%), heart failure (26.8%), pulmonary arterial hypertension (3.9%), and valvular dysfunction (7.1%). For 78 patients reported to have been withdrawn from treatment, some recovered normal heart function (44.9%), while for others progression was unfavorable, resulting in irreversible damage (12.9%) or death (30.8%).

LIMITATIONS:

The risk of cardiac complications attributed to chloroquine/hydroxychloroquine was not quantified because of the lack of randomized controlled trials and observational studies investigating the association.

CONCLUSIONS:

Clinicians should be warned that chloroquine- or hydroxychloroquine-related cardiac manifestations, even conduction disorders without repercussion, may be initial manifestations of toxicity, and are potentially irreversible. Therefore, treatment withdrawal is required when cardiac manifestations are present.

[Daniel Cooper]

It's being looked at.  AFAIK, it was found to increase mortality in the study I quoted above.  Which is the only one I know of.

 

I'm sure other studies will emerge shortly.  There will be more, and then meta-analysis.

 

We still have to go through the scientific method to get things approved.  And the reality is, this medicine had some set backs and is probably not a magic cure and is probably not going to be approved tomorrow.

 

It is difficult to dig up pre-corona literature on HCQ.  But it was known to cause retinopathy (blindness), cardiotoxic buildup, and was generally not the first choice in treating malaria.

 

 

There was research showing an anti-SARS effect from hydroxychloroquine going back to the immediate post SARS era in 2003 done by the Chinese, so Trump didn't make this out of whole cloth.  It has been considered to be safe enough to treat many less deadly diseases for decades.  It was not silly to promote this drug based on the evidence available at the time, particularly when the experts were forecasting 2.2 million deaths in the US alone.  With those sorts of numbers you do have to consider taking some risks that you might not otherwise and not doing everything with a controlled double blind experiment that might take a year or two.

 

Look, I get it.  Trump is an ass.  But the fact is, they're all asses on both sides of the aisle.  Some are just more obvious than others.  Let's not let our political biases and hatreds get in the way of investigating reasonable routes to mitigating this disease.

[gamesguru]

There was research showing an anti-SARS effect from hydroxychloroquine going back to the immediate post SARS era in 2003 done by the Chinese, so Trump didn't make this out of whole cloth.  It has been considered to be safe enough to treat many less deadly diseases for decades.  It was not silly to promote this drug based on the evidence available at the time, particularly when the experts were forecasting 2.2 million deaths in the US alone.  With those sorts of numbers you do have to consider taking some risks that you might not otherwise and not doing everything with a controlled double blind experiment that might take a year or two.

 

Look, I get it.  Trump is an ass.  But the fact is, they're all asses on both sides of the aisle.  Some are just more obvious than others.  Let's not let our political biases and hatreds get in the way of investigating reasonable routes to mitigating this disease.

 

 

It has been considered a last resort in treating a select handful of few diseases, and then only with constant patient monitoring.

 

It was especially silly to promote it then, at a time when fear was so high and reason so low.  In my opinion the president and his Fox News puppets shouldn't be promoting anything.  They're not an authority on medical consensus.  It was revealed Trump had financial connections to HCQ as well, which just makes the whole situation 300% more frightening and inappropriate.

 

There are ways to accelerate controlled studies, but the way to do that is not by having the spokesperson of the country encourage every hayseed yobbo run down to the fish supply store and start snorting non-medical grade powder.  Do you not see how a line has been crossed in going from accelerating medical research, to this?

[DanCG]

 

There are ways to accelerate controlled studies, but the way to do that is not by having the spokesperson of the country encourage every hayseed yobbo run down to the fish supply store and start snorting non-medical grade powder. 

If you read the time line of this very thread you will see that self-experimenters were buying fish store chloroquine long before Trump ever mentioned it.

Just sayin....

[Gal220]

It has been considered a last resort in treating a select handful of few diseases, and then only with constant patient monitoring.

 

It was especially silly to promote it then, at a time when fear was so high and reason so low.  In my opinion the president and his Fox News puppets shouldn't be promoting anything.  They're not an authority on medical consensus.  It was revealed Trump had financial connections to HCQ as well, which just makes the whole situation 300% more frightening and inappropriate.

 

Do you not see how a line has been crossed in going from accelerating medical research, to this?

 

No doubt our country has an issue electing officials, we put a few governors in jail in my state.  But it is the presidents job to listen to his advisors and make the call, even if I disagreed with him, it is his call.  And sometimes they might be wrong.

 

No I dont see how a line was crossed given the current situation.

 

 

Edit : I dont want to drag it on, we probably arent going to come to any common ground. But IMO this is exactly why we dont already know if things like Quercetin are effective or not, even though most integrative groups are recommending it.

Edited by Gal220, 30 April 2020 - 02:47 PM.

[gamesguru]

If you read the time line of this very thread you will see that self-experimenters were buying fish store chloroquine long before Trump ever mentioned it.

Just sayin....

 

People were buying bleach too.  But the day after he recommends it, suddenly the shelves are completely empty.  It would be wrong to assume he did not make the situation worse.

 

The problem is his advisors are all corrupt too, and willing to do whatever he likes most.  The line was crossed because he's not a medical authority and is recommending trash.  No self-respecting president would urge people at large to taken an unproven drug.

 

Trump Has ‘Financial Interest’ in Hydroxychloroquine Manufacturer: NYT

THERE IT IS

Justin Baragona

President Donald Trump has a “small financial interest” in the maker of an anti-malarial drug that he has been touting as a “game changer” in treating coronavirus, according to The New York Times. Over the past two weeks, Trump and his Fox News allies have aggressively promoted hydroxychloroquine as a potential cure, despite top infectious-disease expert Dr. Anthony Fauci and others urging caution and noting that there was not enough evidence of the drug’s efficacy.

[joelcairo]

I'm an agnostic on chloroquine, but it was indeed strange that so many serious side effects were found when the drug has been used so widely for so long.

 

I wonder if the doctors could have been seeing cardiac/clotting problems and damage to organs and mistakenly attributing it to the chloroquine? Early on those risks were not anticipated, but we now know they are common in serious cases. Normally the risk of this should be minimized when doing a randomized trial, but I imagine misinterpretations can happen when the disease isn't yet well understood.