[Chi-Town]

Hydroxychloroquine is so yesterday. Lysol and sunlight is the new buzz.

[vilger]

Originally Posted by ithos

This is what he said.

"And then I see the disinfectant where it knocks it out in a minute. One minute," he said. "And is there a way we can do something like that, by injection inside or almost a cleaning?(question)
"Because you see it gets in the lungs and does a tremendous number on them, so it'd be interesting to check that," he said.

Shakespeare he is not. But it was his inarticulate way of expressing optimism that future cures lie on the horizon.

No rational thinking person would conclude that this is a recommendation to go take a swig of lysol based on that statement.

But thanks for the replies which confirms that TDS is a widespread concern even in The Villages.

100 people in Maryland called the health department to inquire about this. Some dim wits will believe anything; like the guy who showed up in D.C. with an automatic weapon because he heard that Hillary Clinton was running a pedophile ring out of a pizza parlor.

[Bucco]

Originally Posted by anothersteve

Some here take things way out of context, and keep saying the same things over and over and over until they believe what they type is fact.
Steve

I recall the dreaded "brown suit" incident. Of course, that had much more import than this. Thankfully, both n video so everyone can see first hand the "CONTEXT"

[Byte1]

It's interesting that NOW there is a problem with the same medication that they gave EVERY military member in Vietnam. Never heard of any problem with it then, and I bet they do not want to publicize any of the side effects now, other than by using it as a political weapon against one side or the other. If this is so dangerous, with side effects, then why has it taken almost 50 years to come to this conclusion?
A dying person is not going to worry about side effects if that is the only lifeline offered.
Kudos to those in our gov that are working hard to find some form of hope to offer all those that are currently suffering from the CHINA virus.

Originally Posted by GoodLife

Perhaps you've heard about the recent VA study on hydroxychloroquine. The MSM jumped on it with blaring headlines proclaiming failure and more deaths. It's no secret why they did.

There's also another big player in the war against hydroxychloroquine, Big Pharma.
HCQ has no patent, is made all over the world, and is dirt cheap compared to the designer drugs they make billions from. Gilead's remdesivir is one of the covid 19 drugs being touted, and they might price it at $1000 per day like they did with Solvadi for Hep C

So politics and billions of dollars are at play.

You might think that after that VA study proclaiming death and failure that Doctors all over the world would stop using it. Actually no, in fact they are still using it at the VA

Responding to the results during an appearance on MSNBC, Secretary of Veterans Affairs Wilkie said, “That’s an observational study. It’s not a clinical study. It was done on a small number of veterans; sadly, those of whom were in the last stages of life, and the drug was given to them.”

The drug “has been working on middle-age and younger veterans,” Wilkie added. By that, he meant that it was “stopping the progression of” COVID-19"

Dr Didier Raoult of France, who has treated over 1000 coronavirus patients, responded to the VA study with this letter.

In the current period, it seems that passion dominates rigorous and balanced scientific analysis and may lead to scientific misconduct. The article by Magagnoli et al. (Magagnoli, 2020) is an absolutely spectacular example of this. Indeed, in this work, it is concluded, in the end, that hydroxychloroquine (HCQ) would double the mortality in patients with COVID with a fatality rate of 28% (versus 11% in the NoHCQ group), which is extraordinarily hard to believe. The analysis of the data shows two major biases, which show a welling to be convinced before starting the work :

The first is that lymphopenia is twice as common in the HCQ groups (25% in the HCQ, 31% in the HCQ+AZ group versus 14% in the no HCQ group, p =.02) and there is an absolute correlation between lymphopenia (<0.5G/L) and fatality rate, which is well known (Tan, 2020) and confirmed here : 28% deaths, 22% and 11% in the HCQ, HCQ+AZ and No HCQ group, respectively. Lymphopenia is the most obvious criterion of patient severity (in our cohort, lymphocytes in dead individuals (n=22, mean ± standard deviation, 0.94 ± 0.45), versus in the living (n=2405, 1.79 ± 0.84, p < .0001)). As the authors acknowledge, the severity of the patients in the different groups was very different, and their analysis can only make sense if there is a selection of patients with the same degree of severity, i.e. the same percentage of lymphopenia.

The second major bias is that in an attempt to provide meaningful data, by eliminating the initial severity at the time of treatment, two tables are shown: one table where drugs are prescribed before intubation, and which shows no significant difference in the 3 different groups (9/90 (10%) in the HCQ group, 11/101 (10. 9%) HCQ+AZ, and 15/177 (8.5%) in the group without HCQ, chi-square = 0.47, ddl = 2, p = 0.79), and one table, where it is not clear when the drugs were prescribed, where there are significant differences. These differences are most likely related to the fact that the patients had been intubated for some before receiving hydroxychloroquine in desperation. It is notable that this is unreasonable at the time of the cytokine storm, as it is unlikely that hydrochloroquine alone would be able to control patients at this stage of the disease.

Moreover, incomprehensibly, the “untreated” group actually received azithromycin in 30% of cases, without this group being analyzed in any distinct way. Azithromycin is also a proposed treatment for COVID (Gautret, 2020) with in vitro efficacy (Andreani, 2020), and to mix it with patients who are supposedly untreated is something that is closer to scientific fraud than reasonable analysis.

Altogether these 3 voluntary biases are all pushing to the idea of dangerosity of hydroxychloroquine safest drug as reported on nearly 1 million people (Lane, 2020).
All in all, this is a work that shows that, in this period, it is possible to propose things that do not stand up to any methodological analysis to try to demonstrate that one is right.

End of letter

The cohort for this "study" was elderly black males with a variety of health issues and most of them were already intubated on ventillators, or about to be. And the HCQ group was biased towards the most critical patients as Dr Raoult says above. The death rate in NYC for coronavirus patients on ventillators has been reported at 88%. Most Doctors reporting success are using HCQ plus Zithromycin plus zinc and report the best results when the cocktail is used within a few days of symptoms start.

A couple of personal anecdotes:

An American friend who lives in Chapala, Mexico called me after he and his younger Mexican wife had both tested positive. She had light symptoms, and recovered easily without medications. He got very sick, high fever, cough, headaches etc and then his Doctor prescribed the HCQ + Zith + Zinc cocktail and after a few days recovered and is fine today.

Yesterday I had a video appt with my cardiologist, we reviewed my heart health (I had heart ablation surgery recently) and then I asked him if I were to catch coronavirus would I be able to use the HCQ cocktail for treatment. He took a look at my most recent EKG and said yes you'd be a good candidate for that, we've had success with several patients, I would just have you stop taking one of the medications you're on.

"What about that VA study" I asked.

"It looks like it was designed to fail"

[JayDo]

Which ever drug is the cheapest is the drug the va will use , even if it kills us vets

[Stu from NYC]

Sad when there are no repercussions for reporters putting out false or biased stories

[airstreamingypsy]

As soon as I see MSM I know the rest of the post was written by a cult member. No thanks.

[blueash]

Originally Posted by GoodLife

I think I'll stick with what the doctors are reporting

Lead author of the VA study, Joseph Magagnoli, has an MS in statistics. I wonder if he knows how to cook the books.

What a terrible idea to have an expert in statistics be part of the team that is doing a statistical evaluation. Should I conclude from your belief that statisticians are there to create false conclusions that any paper that does not have a qualified statistician is better? I am sure had this paper not had one you would opine "Where is the statistics expert? The data is not reliable unless proper statistical analysis was done"

If you are here to accuse Joseph Magagnoli of fudging the data, please at least have the guts to directly accuse him and not just suggest it with no evidence.

[GoodLife]

Originally Posted by blueash

What a terrible idea to have an expert in statistics be part of the team that is doing a statistical evaluation. Should I conclude from your belief that statisticians are there to create false conclusions that any paper that does not have a qualified statistician is better? I am sure had this paper not had one you would opine "Where is the statistics expert? The data is not reliable unless proper statistical analysis was done"

If you are here to accuse Joseph Magagnoli of fudging the data, please at least have the guts to directly accuse him and not just suggest it with no evidence.

I don't think he fudged the data, the study was designed to produce a negative result by looking at data from diseased old men on intubators, more of which were included in the HCQ group.

[blueash]

Originally Posted by Byte1

It's interesting that NOW there is a problem with the same medication that they gave EVERY military member in Vietnam. Never heard of any problem with it then, and I bet they do not want to publicize any of the side effects now, other than by using it as a political weapon against one side or the other. If this is so dangerous, with side effects, then why has it taken almost 50 years to come to this conclusion?
A dying person is not going to worry about side effects if that is the only lifeline offered.
Kudos to those in our gov that are working hard to find some form of hope to offer all those that are currently suffering from the CHINA virus.

You are misunderstanding the discussion. No one has ever claimed that HCZ is not a good anti-malarial or a good lupus/RA drug. This discussion is ONLY about whether it is beneficial for COVID, period. After a couple small reports of dramatic benefit the use of HCZ skyrocketed because frankly there was nothing else to offer. Since those initial positive results almost every subsequent study has shown no benefit from using HCZ in COVID.
Now, none of the reports yet presented has been a randomized study, those are coming. Most of them have been from doctors looking back on their patients, some of whom got HCZ, some didn't and using established statistical methods to see if the ones who got the drug did better. And the studies do balance for the age, gender, severity of illness at presentation, and many other factors when they can. All have weaknesses.
The initial positive studies had more weaknesses than most others, and the fewest patients, and claimed the most benefit from very short courses of medicine.
No one has been able to replicate Dr. Raoult's findings and it was his study that got the use of HCZ going.
I agree a dying person is not going to worry about side effects. The finding of the VA study was that in their population there was no benefit of HCZ, and the most important side effect was that you were more likely to die than if you were not given HCZ.
I find that conclusion bizarre and it is likely a statistical fluke, like flipping tails six times in a row. No other study has shown the drug kills you. But it is well known that HCZ can kill you if heart side effects are not monitored. The authors of this study, who were not bedside clinicians, did not extract or report on whether EKG's were being followed or not. If the conclusion is not a fluke, then HCZ is not a lifeline, it is a deathline for the patient population studied, older males ill enough to be hospitalized with COVID.

[blueash]

Originally Posted by GoodLife

I don't think he fudged the data, the study was designed to produce a negative result by looking at data from diseased old men on intubators, more of which were included in the HCQ group.

Most of the time you make some sense when you look at data. Not this time. How do you think the study was "designed to produce a negative result?" I don't believe that authors had any outcome they desired when they designed the study; they wanted to examine the outcome of giving HCZ in " all United States Veterans Health Administration medical centers "

The authors are very clear about who they studied, men admitted all of whom were over 64. That was who they had because that is who got admitted. They didn't manipulate by throwing out younger men, none got admitted to the VA system. They did have a few women but too few to study independently. Their outcomes were not studied or reported.

The question is : Does HCZ help our patients? How to answer it - Look at all the patients we have treated. How to do that? Use the electronic records across several hospitals and extract the data. What data? There are specific codes entered into the record that show if a patient did or did not get HCZ at some point in the hospitalization. One group did, one group did not. The people who got HCZ were then subdivided into whether they got it before they went on a vent or after. Now look at how they did with outcome data. The outcomes checked were Died, and needed a ventilator.

Goodlife said: diseased old men on intubators, more of which were included in the HCQ group

Yes, these were sick older men, the exact population that is highest risk, exactly the patients who need an effective therapy. And you completely wrongly then state they were on "intubators" I think you meant ventilators. There were 368 patients in the study. Only 44 ended up on vents. This is NOT a study of old men on vents. You are wrong, you are misstating easily checked facts.

In the group who never needed a vent, which is 344 patients, there is no difference in outcome whether treated or not treated with HCZ. It did them no good at all. It did them no harm either. The drug was useless.
In the group that progressed to needing a vent, those who had received HCZ at any time were more likely to die. The finding of increased death rate for the group as a whole is because of the increased deaths in ventilated drug recipients. This is why I have consistently written that the increased death rate may be a less reliable finding as it is a small sample size.

Bu the overall finding that the drug was useless is the kindest interpretation possible. It clearly did not help at all in the population studied which was overwhelmingly COVID positive men who were not sick enough to need a ventilator.

[ithos]

Originally Posted by blueash

What a terrible idea to have an expert in statistics be part of the team that is doing a statistical evaluation. Should I conclude from your belief that statisticians are there to create false conclusions that any paper that does not have a qualified statistician is better? I am sure had this paper not had one you would opine "Where is the statistics expert? The data is not reliable unless proper statistical analysis was done"

If you are here to accuse Joseph Magagnoli of fudging the data, please at least have the guts to directly accuse him and not just suggest it with no evidence.

From the VA

A spokeswoman for the Department of Veterans Affairs said that the research findings should not be seen as definitive. "This was not a clinical trial. It is simply an analysis of retrospective data regarding hospitalized patients," she told Fox News, via email. "The findings should not be viewed as definitive because the analysis doesn’t adjust for patients’ clinical status and showed that hydroxychloroquine alone was provided to VA’s sickest COVID-19 patients, many times as a last resort."



From the report itself

BACKGROUND:
Despite limited and conflicting data on the use of hydroxychloroquine in patients with Covid-19, the U.S. Food and Drug Administration has authorized the emergency use of this drug when clinical trials are unavailable or infeasible. Hydroxychloroquine, alone or in combination with azithromycin, is being widely used in Covid-19 therapy based on anecdotal and limited observational evidence.


This sounds like it was written by CNN. Credible reports are started off with more neutral language and then provide conclusions with just the facts.

Other issues that have been raised is that it was based on patients who had already been intubated and the study was not peer reviewed as of April 21. Proponents all say that it has limited benefits in late stages.

It also neglected to mention the use of another drug on those who did not receive HCQ.

There are several reasons to suspect this report was not credible enough to justify its bombastic coverage.

[GoodLife]

Originally Posted by blueash

Most of the time you make some sense when you look at data. Not this time. How do you think the study was "designed to produce a negative result?" I don't believe that authors had any outcome they desired when they designed the study; they wanted to examine the outcome of giving HCZ in " all United States Veterans Health Administration medical centers "

The authors are very clear about who they studied, men admitted all of whom were over 64. That was who they had because that is who got admitted. They didn't manipulate by throwing out younger men, none got admitted to the VA system. They did have a few women but too few to study independently. Their outcomes were not studied or reported.

The question is : Does HCZ help our patients? How to answer it - Look at all the patients we have treated. How to do that? Use the electronic records across several hospitals and extract the data. What data? There are specific codes entered into the record that show if a patient did or did not get HCZ at some point in the hospitalization. One group did, one group did not. The people who got HCZ were then subdivided into whether they got it before they went on a vent or after. Now look at how they did with outcome data. The outcomes checked were Died, and needed a ventilator.



Yes, these were sick older men, the exact population that is highest risk, exactly the patients who need an effective therapy. And you completely wrongly then state they were on "intubators" I think you meant ventilators. There were 368 patients in the study. Only 44 ended up on vents. This is NOT a study of old men on vents. You are wrong, you are misstating easily checked facts.

In the group who never needed a vent, which is 344 patients, there is no difference in outcome whether treated or not treated with HCZ. It did them no good at all. It did them no harm either. The drug was useless.
In the group that progressed to needing a vent, those who had received HCZ at any time were more likely to die. The finding of increased death rate for the group as a whole is because of the increased deaths in ventilated drug recipients. This is why I have consistently written that the increased death rate may be a less reliable finding as it is a small sample size.

Bu the overall finding that the drug was useless is the kindest interpretation possible. It clearly did not help at all in the population studied which was overwhelmingly COVID positive men who were not sick enough to need a ventilator.

Again, most of the Doctors reporting good results advocate using the HCQ cocktail early and are emphatic about using zinc sulfate as well. Don't see that in the study.

The death rates once you get admitted to a hospital are really bad for older patients. 11.5% for 65 to 74 and 25.5% for 75 plus




lymphopenia is twice as common in the HCQ groups (25% in the HCQ, 31% in the HCQ+AZ group versus 14% in the no HCQ group, p =.02) and there is an absolute correlation between lymphopenia (<0.5G/L) and fatality rate, which is well known

Looks like a stacked deck to me.

If you want to see a drug fail, study hospitalized old black men with a host of pre existing maladies plus coronavirus. Stick more of the guys with lymphopenia in the drug group.

I love to see a drug that cures people who are really sick, but even better would be one that cures people before they have to go to the hospital.

Hopefully there will be a study using the correct cocktail, at the correct time. Until then there are a lot of Doctors reporting success who don't have time for full on clinical trials.

[Marty94]

There have been some comments in this tread about Secretary Wilkie and I’d like to offer a different perspective.

Robert was one of my students at the Joint Forces Staff College. He was a Reserve Officer in the Navy then and an advisor to Condoleezza Rice. We had many discussions and remained friends for many years and as is typical in the military we drifted apart due to orders and moves. I was extremely pleased though when I heard he was assigned to head the VA. I couldn’t think of a better candidate. Robert has the highest integrity of any officer I have ever had the honor of serving with, and while he has a law degree, he is first and foremost a veteran. He represents and fights for all veterans. He is incredibly intelligent and has served his country with honor and tremendous professionalism for many, many selfless years of personal sacrifice. Robert is the kind of fellow that would leave Washington and drive 3 hours to have lunch with me, just to “catch up” and I was really no one, not a dignitary and not a flag officer. I was just his teacher. So, I hope before anyone passes judgement on a “political appointee” that you’ll stop and consider that there are those few men and women who rise above politics. I trust Robert. He is one person I’d gladly have next to me in the worst situation, working through challenges and finding solutions. As this thread has mentioned, he most recently went on camera to clear up the misunderstanding of a report that was released from the VA. Some of you are questioning if you can believe a lawyer and a political appointee. That’s up for you to decide, but for me, I know him and I know that he would resign before he would let anyone force him to make a false statement.

[Heyitsrick]

Originally Posted by Marty94

There have been some comments in this tread about Secretary Wilkie and I’d like to offer a different perspective.

Robert was one of my students at the Joint Forces Staff College. He was a Reserve Officer in the Navy then and an advisor to Condoleezza Rice. We had many discussions and remained friends for many years and as is typical in the military we drifted apart due to orders and moves. I was extremely pleased though when I heard he was assigned to head the VA. I couldn’t think of a better candidate. Robert has the highest integrity of any officer I have ever had the honor of serving with, and while he has a law degree, he is first and foremost a veteran. He represents and fights for all veterans. He is incredibly intelligent and has served his country with honor and tremendous professionalism for many, many selfless years of personal sacrifice. Robert is the kind of fellow that would leave Washington and drive 3 hours to have lunch with me, just to “catch up” and I was really no one, not a dignitary and not a flag officer. I was just his teacher. So, I hope before anyone passes judgement on a “political appointee” that you’ll stop and consider that there are those few men and women who rise above politics. I trust Robert. He is one person I’d gladly have next to me in the worst situation, working through challenges and finding solutions. As this thread has mentioned, he most recently went on camera to clear up the misunderstanding of a report that was released from the VA. Some of you are questioning if you can believe a lawyer and a political appointee. That’s up for you to decide, but for me, I know him and I know that he would resign before he would let anyone force him to make a false statement.

Great post, Marty. Thanks for providing that background.