Dr. Harvey Risch, professor of epidemiology at Yale University School of Medicine, and Dr. George Fareed, former professor of medicine at Harvard and UCLA, have been saying for months that the evidence to use hydroxychloroquine/azithromycin/zinc early, well before potential hospitalization is necessary, is overwhelming in that it prevents a vast majority of hospitalizations and deaths that would have occurred without such treatments.
Dr. Anthony Fauci, citing randomized controlled trials of hospitalized patients, made the blanket assertion hydroxychloroquine doesn't work at all, period, no matter when given.
Thanks to Baron, we now know the AMA acknowledges this was a mistake. In addition, there are numerous studies prior to Covid that showed cloth and surgical masks to be completely useless in preventing viral transmission. Dr. Fauci, surgeon general Dr. Jerome Adams, the CDC and the WHO all acknowledged this fact earlier in the year when they all advised against wearing masks. However, they recognized N95 masks were effective in protecting the user, but said no one should wear them because medical professionals needed them.
By not recommending to the president that N95 masks should have been manufactured so everyone could have them, and by not acknowledging the obvious truth the "three-drug cocktail" was a way out of this mess, as Drs. Risch and Fareed have tried to point out for months, I submit Dr. Anthony Fauci is guilty of the greatest case of medical malpractice in this country's history.
But still shocking. They have officially surrendered their right to bitch about what a duplicitous liar Trump has been. For all their blather of honor and integrity they have clearly demonstrated they posses neither.
Stunning. Absolutely stunning.
Forgive typos. Sent from iPhone.
This time I guess Fauci and the rest of the medical establishment conspired to suppress medicines that worked against COVID in order to screw Trump. Never mind the fact that HCQ was studied relentlessly.
This board, as a reflection of this country, is so depressing.
Always, always with the conspiracies.
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I'm not sure what you're not getting here. There were three scenarios studied:
1) RCTs of the three-drug cocktail in hospitalized patients. Shown to be ineffective.
2) RCTs of hydroxychloroquine only in early-onset patients. Shown to be ineffective.
3) Observational trials of the three-drug cocktail given early well before potential hospitalization was necessary. Shown to be extraordinarily effective.
But because Fauci only considered 1 and 2 and dismissed 3, the mantra became, "It didn't work."
He's been proven wrong. Had Dr. Risch or Dr. Fareed been the head of the NIH instead of the incompetent Fauci, we wouldn't have 300,000 dead.
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Ivory Tower at the GOP HS dropouts about this. You sir, are a huge hypocrite.
Plus, I don't think I have to review that there was indeed collusion. It would be pointless.
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search this morning (see link) for all things "Hydroxychloroquine" doesn't show a change in the medical community's opinion on it. The latest paper listed (12/10/2020) had the following phrase in it's Findings..."but the combination use of hyroxychloroquine and azithromycin was associated with increased odds of mortality". I am aware that there are physicians in favor of the treatment, so if there's documentation to that effect elsewhere, then please present it.
Anecdotally, 'Hydroxy' was not part of President Trump's treatment at Walter Reed.
With regard to Dr. Fauci...his CV speaks for him...we're lucky to have such professionals who practice "Evidence-based medicine".
Link: https://jamanetwork.com/searchresults?q=hydroxychloroquine&&SearchSourceType=24&allSites=1
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It would seem to me that the linked study is another of the studies that the AMA noted are researching the drug for Phase 2 and 3 of COVID-19, whereas the treatment is being touted for use during Phase 1, prior to any type of hospital admission being necessary.
I do worry about the findings though because at the end there was this entry "A randomized, double-masked, placebo-controlled trail across the United States and parts of Canada also concluded that hydroxychloroquine did not help prevent illness when used as postexposure prophylaxis for COVID-19.
If you go to the trial that they cited, it says the following "According to a protocol-based treatment algorithm, among hospitalized patients, use of hydroxychloroquine alone and in combination with azithromycin was associated with a significant reduction in-hospital mortality compared to not receiving hydroxychloroquine."
I find it odd that you would cite a trial that disagrees with your own findings and characterize it in a one line summary that supports your findings. Is this common practice in the medical research field?
Here's an excerpt from the 12/10/2020 report...
"Patients with both azithromycin and hydroxychloroquine use had increased odds of mortality after adjusting for confounders. These findings are not only consistent with what was observed in other observational studies conducted in the earlier stage of the COVID-19 pandemic18-23 but also similar to results of recently published clinical trials in the United States and other countries.24,25 The multicenter, randomized, open-label trial of 504 patients with confirmed COVID-19 in Brazil by Cavalcanti et al24 found that neither hydroxychloroquine nor a combination of hydroxychloroquine and azithromycin showed any benefit compared with controls on clinical outcomes at 15 days.24 A randomized, controlled, open-label trial of more than 4500 patients hospitalized with COVID-19 in the United Kingdom (Horby et al25) indicated that 28-day mortality was slightly higher among patients treated with hydroxychloroquine than among those in the control group (OR, 1.09; 95% CI, 0.97-1.23).25 A randomized, double-masked, placebo-controlled trail (sic) across the United States and parts of Canada26 also concluded that hydroxychloroquine did not help prevent illness when used as postexposure prophylaxis for COVID-19."
If you are referring to another report, please link it in your reply....bottom line...I can't find a statement or report that recommends hydroxychloroquine as the treatment of choice...it certainly wasn't in President Trump's case at Walter Reed Hospital...plus, as a 'prophylactic' it didn't keep him from getting the disease.
It's important to all of us that our medical professionals rely on 'Evidence-based Medicine', and in the case of hydroxychloroquine, there appears to be no conclusive benefit...still.
The 10 December link you provided is titled "Risk Factors Associated With In-Hospital Mortality in a US National Sample of Patients With COVID-19"
In that report, which is the part you quote, "A randomized, double-masked, placebo-controlled trail (sic) across the United States and parts of Canada26 also concluded that hydroxychloroquine did not help prevent illness when used as postexposure prophylaxis for COVID-19" The 26 represents the citation that I noted, of a report titled "Treatment with hydroxychloroquine, azithromycin, and combination in patients hospitalized with COVID-19" dated 1 July 2020.
26 Arshad S, Kilgore P, Chaudhry ZS, et al; Henry Ford COVID-19 Task Force. Treatment with hydroxychloroquine, azithromycin, and combination in patients hospitalized with COVID-19. Int J Infect Dis. 2020;97:396-403. https://www.ijidonline.com/article/S1201-9712(20)30534-8/fulltext
That cited report, linked as requested, has as the second bullet "According to a protocol-based treatment algorithm, among hospitalized patients, use of hydroxychloroquine alone and in combination with azithromycin was associated with a significant reduction in-hospital mortality compared to not receiving hydroxychloroquine." Which is the opposite of what happened in the JAMA report you posted.
I did not read that entire report, I had to get some work done :) but doing a search for prophylaxis in the "Treatment" article came up with 2 matches, "Currently, randomized trials of hydroxychloroquine for treatment and chemoprophylaxis are underway (NIH, 2020a, NIH, 2020b, NIH, 2020c, Pagliano et al., 2020). Based on these early reports, hydroxychloroquine alone and in combination with azithromycin was incorporated into our institutional clinical guidelines for the treatment of hospitalized patients with COVID-19." and a citation :
Pagliano P., Piazza O., Caro F.D., Ascione T., Filippelli A. Is Hydroxychloroquine a possible post exposure prophylaxis drug to limit the transmission to healthcare workers exposed to coronavirus disease 2019?. Clin Infect Dis. 2020; https://academic.oup.com/cid/article/71/15/887/5811417
This is from 24 March 2020, and this study is actually about using it as a pre and post exposure prophylaxis for health care workers, so this is the report that the article you posted really should have referenced, and it has the following:
"On the basis of these investigations, we believe that hydroxychloroquine can be effective in preventing respiratory tract invasion in HCWs exposed to SARS-CoV-2 and that hydroxychloroquine administration as a prophylactic agent could be particularly useful for HCWs attending to high-risk procedures on the respiratory tract in COVID-19 patients. Hydroxychloroquine’s effectiveness profile, its ability to inhibit lung viral replication for a 10-day period after only a 5-day cycle of therapy, and the large amounts of knowledge in term of safety deriving from its use for malaria prophylaxis and rheumatologic diseases lead us to recommend its preexposure or postexposure use for those performing procedures at high risk of viral diffusion in patients with COVID-19 pneumonia."
Again, I'm not a doctor, but how do you cite a report saying it says one thing when it does not say that at all? The report that they cite is not about using it as a prophylaxis, and the report cited in that report says that it recommends it as a prophylaxis.
I did not get into the actual raw data, so we do not know for the 10 December report that you link when treatment was given or who it was given to. The AMA change is specifically about Phase 1 of the infection, and from what I read in the linked 10 December report it would appear from the verbiage that these were essentially all people who were admitted into the hospital, so most likely Phase 2 and 3 patients, which the AMA also notes in their resolution is where most of the study has been done, and not enough in Phase 1.
More to Baron's point, the cited report from Pagliano et al was available in March and recommends using the cocktail for what would have been Phase 1. This was what many doctors like Baron were advocating for, for their patients, but their ability to use it at their discretion was taken away, for what seems like pure politics. I'm not one of those who believe that everything was nefarious, but when you read through the resolution, it looks like the AMA and the groups they worked with went against everything they stood for when they backed not allowing off label use of these drugs for COVID-19. I do find that disturbing. As an IT professional, that is like me rescinding best practices at my boundary because I found out they don't help against insider threats. I don't know if that makes sense to anyone here, but it's the way I read all of this.
"Hydroxychloroquine is totally debunked. Not helpful and is literally a joke in the ID community"...so there's that.
wife says "one more?" and I say "why not, we're not going anywhere tomorrow"...plus an extra three hours for being on the 'Left Coast' ;-).
Nonetheless, thanks for hanging in there on this issue...we're both getting educated in areas we never would have explored before. As to the 'Hydroxy' issue, it seems as though the crux of the matter has to do with "Off Label Drug Usage" (OLDU)...not something I was familiar with...and I've linked a paper that endeavors to explain what it means in the medical profession.
As mentioned in an earlier post, some doctors are Ok with prescribing 'Hydroxy', while others are not. It would appear that the prevailing opinion is that a) there is insufficient data that shows a clear benefit to the population, and b) there are situations where fatalities could result from its use (e.g. abnormal heart rhythms). To me, it boils down to a "judgement call" by physicians (very common OLDU activity) and most choose not to prescribe it...case in point...the doctors at Walter Reed treating President Trump. Clearly, 'Hydroxy' is not the "Gold Standard" for treatment and it is not unreasonable for the AMA to express caution about its use...but again, some physicians see value in their cases and are free to do what they feel is best.
I've also got a call into our family ICU Doc to get 'another opinion'...I'll let you know if I hear back (they're really busy and don't like to take time out for politically based chatter).
Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3538391/
I don't personally have a dog in this fight, really this is the first time that I've read up on this.
I think you boil it down properly in your A and B. The AMA notes that not enough research has been done for the cocktail during phase 1, so we have a lack of data to show the benefit (A). There is an abundance of research for Phase 2 and 3 patients, mostly based on data from hospitals and not clinical trials, which do bring about some warning signs for use in Phase 2 and 3 (B). We have to remember that those reports can differ as shown in two of the articles we read, and that there was no clearly defined rhyme or reason to the usage; as such, the data can be flawed in ways that we don't know since we aren't looking at raw data.
I'm not sure that Trump's doctors at Walter Reed would have been able to use it as a treatment because at the time OLDU approval had been rescinded, so I'm not sure how much weight to lend that.
If I could, I would ask the ID doctor which studies debunk it in Phase 1, since the AMA seems to think that there has not been enough research into the efficacy of the treatment. Obviously the only one that I read was the previously linked study that was actually for using it as a treatment. I would hope as an ID that he has read far more than me. 😁 I would also defer to his medical opinion if I were his patient. I trust in my doctors, because I know they usually want to keep me alive.
My biggest issue with this is that the waters have been made murky because some people are advocating for Phase 1 use, and other people are railing against that because of failures noted in Phase 2 and 3 studies, no one seems to be able to logically separate this out when they discuss it. Jimbasil linked to a drugs.com article in the other thread that had been "updated" on 14 December but still referenced a rescinded study from the NEJM. This is bad information that people are taking to heart. That is part of the problem. The other part of the problem is that people take this information to heart and then believe that they are more informed than doctors, who I hope are reading more than one study like me, and not listening to drugs.com to make their decisions. This discussion should never have become political, with people taking sides, the only thought someone who is not a doctor like me should have is, I hope my doctor is reading up on this and makes the best decision possible for me if I get COVID.
I don't mind having a discussion with someone about it, but bring information to the table like you did, and have an open mind about it. Too often this board devolves into closed minded yelling matches where no one posts anything but opinion pieces from their favorite partisan sites. And that goes for both sides, so I appreciate your attempts to suck people into real conversations on topics. I'm normally a lurker who reads a lot and posts not as often because I'm usually to busy to continue a conversation.
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BTW, not one board lib chimed in
a "full throated" endorsement of hydroxychloroquine mentioned...just that some physicians (e.g. Baron) are comfortable with it, while others are not...i.e. there is no consensus, nor official recommendation for its use. For Baron to equate a "stalemate" to a "victory" seems specious to me.
Now, couple this with the published reports in JAMA that I linked which show increased mortality with the use of 'Hydroxy', then you can appreciate my post...I hope.
Let me know your thoughts on the JAMA articles...especially the most recent one.
I did not say that HZQ was the best Tx. It should have always been an option depending on the situation. But our medical bodies have been completely taken over by politics. The NEJM published false data. JAMA would not have had time to respond to the AMA's about face.
politics has muddied the waters more than a little. I'm concerned about any departure from "Evidence-based medicine" as we struggle to save lives and get our economy back on track. As long as our physicians are endeavoring to use 'best practices' - and continuing to learn - along the way, I feel more comfortable. COVID-19 is a new challenge...e.g. who knew at the outset that "Proning" was an important technique?...so everyone needs to keep an open mind for options...but act and adjust based on "evidence"...
previous position on hydroClor. That's how I read it.
"Patients with both azithromycin and hydroxychloroquine use had increased odds of mortality after adjusting for confounders. These findings are not only consistent with what was observed in other observational studies conducted in the earlier stage of the COVID-19 pandemic18-23 but also similar to results of recently published clinical trials in the United States and other countries.24,25 The multicenter, randomized, open-label trial of 504 patients with confirmed COVID-19 in Brazil by Cavalcanti et al24 found that neither hydroxychloroquine nor a combination of hydroxychloroquine and azithromycin showed any benefit compared with controls on clinical outcomes at 15 days.24 A randomized, controlled, open-label trial of more than 4500 patients hospitalized with COVID-19 in the United Kingdom (Horby et al25) indicated that 28-day mortality was slightly higher among patients treated with hydroxychloroquine than among those in the control group (OR, 1.09; 95% CI, 0.97-1.23).25 A randomized, double-masked, placebo-controlled trail across the United States and parts of Canada26 also concluded that hydroxychloroquine did not help prevent illness when used as postexposure prophylaxis for COVID-19."
Does this strike you as a repudiation of the AMA's established counsel on not using hyroxychloroquine for COVID-19?
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he was deleted, thank God
Most Americans have always been suspicious of the media. Can count on them to do their job by not doing their job.
Medical professionals NOT perusing a treatment to harm a political candidate?!? That is beyond shocking!
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Because they were lazy, not even doing 10% of the Covid research I, a mere layman, have done. No, instead they just automatically trusted what the Great Fauchino and other medical "leaders" said.
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right... even if it was Trump and not Fauci.
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So I am trying to understand. The AMA has now acknowledged this works. At least early on. What exactly is untrue here.,,
Link: Here you go
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"A vaccine will not be possible by December".
He did this to contradict Trump in the height of the campaign when Trump was right. Fauci did not say that he didn't think it was possible....he said that it wouldn't happen. He lied. Even if he believed what he said, he didn't really know for sure, but said it with defninitve authority...he lied.
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separating the two
I won't even touch the Dr. Fauci stuff. He has more integrity in his pinkie nail then anyone in Trump's cabinet. As for the mask debate Fauci provided a mea culpa on the mask early on in March. In April that changed and CDC guidelines pushed mask use heavily. They were short on supplied and look who was tasked to stock back up. Good ol Jared Kushner!
This spring, as the United States faced a critical shortage of masks, gloves and other protective equipment to battle the coronavirus pandemic, a South Carolina physician reached out to the Federal Emergency Management Agency with an offer of help.
Dr. Jeffrey Hendricks had longtime manufacturing contacts in China and a line on millions of masks from established suppliers. Instead of encountering seasoned FEMA procurement officials, his information was diverted to a team of roughly a dozen young volunteers, recruited by the president’s son-in-law, Jared Kushner, and overseen by a former assistant to Mr. Kushner’s wife, Ivanka Trump.
The volunteers, foot soldiers in the Trump administration’s new supply-chain task force, had little to no experience with government procurement procedures or medical equipment. But as part of Mr. Kushner’s governmentwide push to secure protective gear for the nation’s doctors and nurses, the volunteers were put in charge of sifting through more than a thousand incoming leads, and told to pass only the best ones on for further review by FEMA officials.
As the federal government’s warehouses were running bare and medical workers improvised their own safety gear, Dr. Hendricks found his offer stalled. Many of the volunteers were told to prioritize tips from political allies and associates of President Trump, tracked on a spreadsheet called “V.I.P. Update,” according to documents and emails obtained by The New York Times. Among them were leads from Republican members of Congress, the Trump youth activist Charlie Kirk and a former “Apprentice” contestant who serves as the campaign chair of Women for Trump.
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Link: Link
Tell us why the antibody cocktail and Regeneron medicine that worked so well for Trump, Giuliani and Christie is not available for regular folks??
Link: Trump's legacy ...
Although we disagree on a lot, I think you two are probably the straightest shooters on board. To not even concede that this seems to work and it was not promoted because of Trump is pretty bad form my friend. Bad indeed.
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Link: Link
No apology either....too bad. I expected more here.
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He has also reiterated the need for masks hundred of times since to dumbos like Orange and you.
Especially among the Trump Cult.
Normals are going to trust him, and the science he represents.
Clearly, and it always was. The AMA NOW ADMITS IT AT THE VERY SOONEST TIME AFTER THE ELECTION THAT THEY COULD.
Your definition of normals obviously means 1) people without the intelligence and education to interpret data and know better, and 2) liberal zealots more concerned with the political ramifications to their cause than with actual medicine and outcome to commoners.
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And it extends to the political hacks who knowingly withheld a treatment option to many thousands of patients In order to achieve their political ends.
I realize that you would give them a medal, but then again, you are you.