Coronavirus

[SteveG3]

You KEEP falling into the same trap. You keep cherry-picking things that you believe support your wishes, and ignoring the preponderance of evidence as a whole. You also fail to point out that when I made those "the jury is out" comments, it was before the large RCT trials of HCQ that have since shown it to be . . . . worthless for COVID-19, and dangerous overall.

But hey, what does the guy here with an M.D. and a Ph.D. in molecular biology, that has real life experience with genetic manipulation of viruses (adenovirus in this case) know, right?

If you want a "cheap", simple, and effective single drug treatment, use dexamethasone (a 70 year old steroid drug). If you want to further improve your chances, add in Remdesivir. That is the CURRENT, STANDARD OF CARE.

You are wrong about the FDA adverse event reporting on HCQ. ALL of them used to support the removal of HCQ as a recommended treatment were ACUTE events after Jan 1, 2020 (i.e. during the pandemic). You have the American College of Physicians, the American Heart Association, and MANY other physician groups ALL recommending against HCQ.

I don't know you, and I could care less if you take HCQ (have fun with that btw).

I do not consider discerning between efficacy of dosing X of a medication and dosing 2X to be cherry picking data. if you can share a preponderance of data at the dosing Zelenko & HF used showing no efficacy, that would be disappointing, but useful information to know. please reply with data rather than ilstrong characterizations without the inclusion of data.

as to adverse event reporting, can you provide a link to data that contradicts the assertions from the Yale epidemiologist

finally, you’ve not addressed the Oxford University paper re adverse events being only 1/10,000 in a massive 320,000 patient sample size taking HCQ and Azith.

 

[bkp_duke]

I do not consider discerning between efficacy of dosing X of a medication and dosing 2X to be cherry picking data. if you can share a preponderance of data at the dosing Zelenko & HF used showing no efficacy, that would be disappointing, but useful information to know. please reply with data rather than ilstrong characterizations without the inclusion of data.

as to adverse event reporting, can you provide a link to data that contradicts the assertions from the Yale epidemiologist

finally, you’ve not addressed the Oxford University paper re adverse events being only 1/10,000 in a massive 320,000 patient sample size taking HCQ and Azith.

Link to paper, I cannot find anything with 320,000 patients that shows any benefit. All Oxford papers I find show NO benefit.

Also, Zelenko has been universally discredited by the scientific community, so much so that there is a criminal investigation by the feds going on (yes, the same gov that has a leader that keeps pimping HCQ) for falsifying data. You really should pick a better hero to hang your hat on.

 

[dfwatt]

https://www.washingtonpost.com/worl...b1e622-d25f-11ea-826b-cc394d824e35_story.html

View attachment 570597

I just want to know where you got that cute picture of Tweedle Dum and Tweedle Dumber

 

[SteveG3]

PLEASE stop quoting the Henry Ford study, every physician group I have seen has denounced that study as EXTREMELY flawed:
A flawed Covid study gets Trump's attention — and FDA may pay the price

At the core:
"The study that sparked the latest controversy was anything but randomized. Not only was it not randomized, outside experts noted, but patients who received hydroxychloroquine were also more likely to get steroids, which appear to help very sick patients with Covid-19. That is likely to have influenced the central finding of the Henry Ford study: that death rates were 50% lower among patients in hospitals treated with hydroxychloroquine."


We know, for FACT, that corticosteroids improve COVID-19. HCQ did not add anything additional to this.


I'm actually appalled that the Institutional Review Board for the hospital allowed this study at all. What they gave patients was basically a "cocktail of anything we can think might help". It was a colossal confounding of variables. The right-leaning media, of course, focused in on HCQ. What anyone unbiased should have done was to test serially each cocktail component, and then start grouping them in batches for testing that way. Not toss in the entire kitchen sink.

But hey, I did train at a better institution than this, so I guess I'm being too harsh on them, right?

see above reply to JRP. agree we need better studies. specifically better studies designed to control for those variable and including an HCQ arm with zinc.

if we have specific data on what percent of patients in each group received steroids, we can make a better assessment as to whether the steroids were a driving factor to the 50% reduction in fatalities or not. I’ve not seen that specific data, if you have, please share a link. at this point, absent that data, I don’t think any of us can say to what extent the steroids contributed to the results.

 

[bkp_duke]

see above reply to JRP. agree we need better studies. specifically better studies designed to control for those variable and including an HCQ arm with zinc.

if we have specific data on what percent of patients in each group received steroids, we can make a better assessment as to whether the steroids were a driving factor to the 50% reduction in fatalities or not. I’ve not seen that specific data, if you have, please share a link. at this point, absent that data, I don’t think any of us can say to what extent the steroids contributed to the results.

That's the problem, the HF researchers did NOT share their data showing which patients were on steroids. This set off all kinds of red flags in the scientific community.

 

[SteveG3]

It's unlikely any one's going to ante up the serious bucks it would take to study polyphenols in covid-19.

if that is the case in a global pandemic, I hope more people become aware of the skewing effect of the profit motive on our global health. that said, HCQ is a generic drug of nil cost, yet it’s been studied, perhaps quercetin, etc have a shot of being studied.

 

[bkp_duke]

see above reply to JRP. agree we need better studies. specifically better studies designed to control for those variable and including an HCQ arm with zinc.

Link please to study with 320,000 patients. I scrolled up looking at recent replies to JRP and didn't see it.

 

[bkp_duke]

if that is the case in a global pandemic, I hope more people become aware of the skewing effect of the profit motive on our global health. that said, HCQ is a generic drug of nil cost, yet it’s been studied, perhaps quercetin, etc have a shot of being studied.

HCQ costs a lot more than dexamethasone, and that drug has shown a much larger benefit than the (vapor) benefit of HCQ. This has nothing to do with profit motive.

 

[Papafox]

@SteveG3 ,
Thank you for jumping into the hornet's nest to add pertinent information about HCQ. Unfortunately, for quite some time this thread has not been a place where such topics can be discussed in a reasonable fashion. You will be ridiculed for proposing that HCQ has any merit.The gatekeepers of this thread have it locked up too tightly.for non-conforming ideas to be tolerated. At some point you will be hit with idiot spray. Offering positive evidence in the HCQ discussion in the coronavirus thread is about as rewarding as being a policeman in Portland, Oregon, right now. Thanks for trying, though. Your energies and quick intellect will be better served in other threads.

 

[EVNow]

Texas has ~four times the population of Washington. The whole state of Washington is barely the pop of a modern city.

Took a couple of months - but now TX fatalities / 1 Million is at 220. WA is 204.

Ofcourse, WA cases are increasing rapidly too.

There are no winners in a pandemic.

 

[HG Wells]

Let me Google that for you:
Gilead reports reduced mortality risk with remdesivir for Covid-19
"The data include findings from a comparative analysis of the Phase III SIMPLE-Severe clinical trial and a real-world retrospective cohort of patients with a severe form of the disease.

According to the analysis, the drug demonstrated an improvement in clinical recovery and a 62% reduction in the risk of mortality compared to standard of care."


As a physician, if I got sick with COVID-19 tomorrow, I would be screaming at the doc treating me to put me on Dexamethasone and Remdesivir.

Always ask politely, otherwise they may be sugar pills.

 

[linux-works]

With pier review, longer = not good. It usually means the pier review process found substantial problems and are giving the authors a chance to address those problems (if possible).

pier review?

sounds rather fishy to me....

 

[dfwatt]

see above reply to JRP. agree we need better studies. specifically better studies designed to control for those variable and including an HCQ arm with zinc.

if we have specific data on what percent of patients in each group received steroids, we can make a better assessment as to whether the steroids were a driving factor to the 50% reduction in fatalities or not. I’ve not seen that specific data, if you have, please share a link. at this point, absent that data, I don’t think any of us can say to what extent the steroids contributed to the results.

You're not a clinician so you can be forgiven for being naive about sepsis and the potentially massive collateral damage done by the immune system in infections that head into a fatal territory. It's well-established at this point the dexamethasone protects patients in that more severe trajectory from mortality. It may not be useful or even counterproductive in milder patients, but in patients with severe pneumonia and sepsis it can be, and has been proven to be in this case, life-saving.

Here's a tip off: consider this question – how does Vitamin D moderate mortality in covid-19? If you look at its package of complex effects, they are mostly although not exclusively in an anti-inflammatory direction. It also has a still poorly understood role in activating classes of immune cells all of which have vitamin D receptors. But the evidence is vitamin D appears to restrain in some very complex and probably rather nuanced way cytokines and pro-inflammatory players, yet without compromising immune competence. Here's a link to the best single paper on this by a world-class expert on vitamin D. You'll see it has a section on covid-19.

When you consider this information, and the double-blinded and randomized trial evidence that dexamethasone moderates mortality in severe covid-19, you are forced to the conclusion that a significant fraction, perhaps even the majority of deaths in this illness are associated with the immune system kicking into a lethal gear (although there is also lethality from pathological clotting and kidney failure). One has to keep in mind that immune defense is an emergency action in a sense to save the organism, and in this context, it cannot be risk free - indeed, one of its conserved costs is that you are dysfunctional during severe illness due to what is called 'sickness behavior' which reflects a vertebrate-universal package of effects of high cytokine levels that clearly disrupt CNS network function and cause disinterest, fatigue, cognitive fog/inattention, and can even impair consciousness and create stupor and even coma. If you've ever spent time with septic patients (I used to do evals of them regularly), you know they are all pretty impaired, and many are confusional.

A perennial dilemma in this of course is how do you moderate the immune system while still supporting its antiviral activity which of course is organized by cytokines and other pro-inflammatory players? That's still an unanswered question and where we have fragments and bits of knowledge, and no clear technology without downsides. But the bottom line is the evidence favors the hypothesis that disinhibited innate immunity and perhaps failing recruitment of sufficient adaptive immunity may go together and determine a fatal outcome. Adaptive immunity is the antibody arm of the immune system that is organised by B and T lymphocytes, and is significantly more targeted and does significantly less collateral damage. It's possible that in patients with sluggish recruitment of adaptive immunity the innate immune system is more vulnerable to rev up and overdrive. This is just an hypothesis, but it is consistent with other data. As we age adaptive immunity declines and innate immunity is perhaps over activated in a compensatory fashion. This 'tilt' is known as 'inflammaging' and this may also be heightened in individuals with diabetes and vascular disease and other diseases of Aging that constitute comorbidities, where inflammation is for sure a factor.

 

[bkp_duke]

Always ask politely, otherwise they may be sugar pills.

Pretty please? What if I add cherries?

 

[bkp_duke]

pier review?

sounds rather fishy to me....

Touche. I don't always go back and edit my speech to text posts for grammar and spelling.

 

[SteveG3]

Link to paper, I cannot find anything with 320,000 patients that shows any benefit. All Oxford papers I find show NO benefit.

Also, Zelenko has been universally discredited by the scientific community, so much so that there is a criminal investigation by the feds going on (yes, the same gov that has a leader that keeps pimping HCQ) for falsifying data. You really should pick a better hero to hang your hat on.

why are you turning to false ad hominems rather than data? I’ve always used “claims” re Zelenko as I specifically began my mentioning of his claims with the note that his paper has not been peer reviewed to date. where do you find even a hint of my framing Zelenko as a hero?

why are you trying to frame this discussion as if it is all based on Zelenko’s credibility? it’s an unknown, but it is not the core of what I’ve written.

you repeatedly use the “everybody says” ruse in lieu of data, why is that?

while I don’t consider Zelenko “my hero” I believe you’ve grossly the facts. I think he’s being investigated because when he first spoke publicly he made a broad careless statement about something that has nothing to do with his claims re HCQ efficacy. He said something like the very closed community he serves was on its way to rampant corona infection. that pissed off the elected officials in the community, understandably. an inflammatory exaggeration re the context of his deciding to try HCQ+, not data he presented as results in a study.

 

[bkp_duke]

why are you turning to false ad hominems rather than data? I’ve always used “claims” re Zelenko as I specifically began my mentioning of his claims with the note that his paper has not been peer reviewed to date. where do you find even a hint of my framing Zelenko as a hero?

why are you trying to frame this discussion as if it is all based on Zelenko’s credibility? it’s an unknown, but it is not the core of what I’ve written.

you repeatedly use the “everybody says” ruse in lieu of data, why is that?

while I don’t consider Zelenko “my hero” I believe you’ve grossly the facts. I think he’s being investigated because when he first spoke publicly he made a broad careless statement about something that has nothing to do with his claims re HCQ efficacy. He said something like the very closed community he serves was on its way to rampant corona infection. that pissed off the elected officials in the community, understandably. an inflammatory exaggeration re the context of his deciding to try HCQ+, not data he presented as results in a study.

Third and LAST time I will ask:
Link to the paper with 320,000 people studying HCQ and COVID-19.

Pretty please.


EDIT - you appear to be quoting this article, but (conveniently?) it is leaving out any links to the source material (i.e. the ACTUAL studies):
'The key to defeating COVID-19 already exists. We need to start using it,' Yale Epidemic Professor says | Tech News | Startups News

 

[linux-works]

question for those that have been following possible indications or side-effects.

a few people I have been talking to have noticed a vertigo kind of effect; tilt your head and the world spins. happened to me (never before in my life, either) and has been slowly fading, but still there a week later.

any info about this?

 

[bkp_duke]

question for those that have been following possible indications or side-effects.

a few people I have been talking to have noticed a vertigo kind of effect; tilt your head and the world spins. happened to me (never before in my life, either) and has been slowly fading, but still there a week later.

any info about this?

Vertigo is a very non-specific finding, and very age dependent.

In most people 50 and over, it is due to "Benign Paroxysmal Positional Vertigo":
Benign paroxysmal positional vertigo (BPPV) - Symptoms and causes
Classically you will see specific horizontal eye movements.

The semicircular (SC) canals of the inner ear control balance and in BPPV individuals have crystal deposits that move around and touch the cilia of the SC canals, which are literally nerve endings, and cause problems.

There is a series of movements that one can undertake to move the crystals back to Utricle and Saccule to stop this:

Now, vertigo and COVID-19, I am not aware of reports. However, there are acetylcholinesterase 2 receptors in most cells of the body, so in theory the virus could infect the inner ear as well and cause vertigo.

 

[SteveG3]

@SteveG3 ,
Thank you for jumping into the hornet's nest to add pertinent information about HCQ. Unfortunately, for quite some time this thread has not been a place where such topics can be discussed in a reasonable fashion. You will be ridiculed for proposing that HCQ has any merit.The gatekeepers of this thread have it locked up too tightly.for non-conforming ideas to be tolerated. At some point you will be hit with idiot spray. Offering positive evidence in the HCQ discussion in the coronavirus thread is about as rewarding as being a policeman in Portland, Oregon, right now. Thanks for trying, though. Your energies and quick intellect will be better served in other threads.

thanks Papafox

that’s becoming more and more apparent. the intellectually dishonest tactics of “people say,” ad hominems, and gross mischaracterization of my statements in lieu of considering the data I share and sharing data in turn in response to collaborate on refining our understanding have been more than a small set of clues.

all that said, I don’t say any of this with animosity. forgive the sharing of my personal view of life, but I don’t see being human as easy for any of us, and we share a developmental susceptibility to grab at an illusory ‘ego certain safe haven’ that is strong and can be intertwined with all kinds of things... like whether drug X is “allowed to be thought of as potentially helpful.” note, I wrote “intellectually dishonest” above. I think everybody here is being emotionally honest so to speak. They really, really, feel like they want HCQ in covid to be quackery because of very intense human tensions we all experience that have us all susceptible to that kind of illusory ego chase. I’ll probably be mocked for writing all this... that’s okay, privately, even those mocking may realize I’m trying to be empathetic and non-judgemental.

I’m going to take a break for the moment then return to finish replying to posts made prior to this one as people took the time to write them. after that I’ll move on to more helpful uses of my time as you’ve suggested.