Told you so

HCQ coctail works when used early and on outpatient basis

A peer reviewed study confirms that the HCQ cocktail used early on an outpatient basis reduced hospitalizations by 80%.

The failure in other studies was the result of testing it on patients already sick enough to need hospitalization when it was too late for antiviral intervention.

So, how many thousands have died needlessly because of the reflexive political rejection of the treatment because President Trump endorsed it.

33 thoughts on “Told you so

  1. Dr. Zelenko said as much in March. He and Dr. Simone Gold emerged as the real geniuses in American medicine for a bizarre reason, they actually tried to help patients. Zelenko explained in an early video that the Hippocratic Oath leaves doctors no choice, if they don’t have the perfect solution, they must try to find option B and option C and so on.

    Zelenko also emphasized that the Hippocratic Oath requires that doctors prescribe what they think is best for their patients. No bureaucrats allowed.

    It’s Fauci’s approach that has killed so many thousands of people. I think history will treat him badly. All that chatter about following the science is fatuous. He was following the vaccine billion; hurting Trump was another kind of payoff.

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    1. “He was following the vaccine billion; hurting Trump was another kind of payoff.”

      Delusional poppycock. Again. He is a public servant doing his job in the best way he knows how and to the best of his ability. You think you can do better, call the Trump WH. They are always looking for sycophants to fill important positions (See Scott Atlas, Radiologist)

      Dr. Fauci has no political axe to grind. To consider otherwise is just plain stupid. One of your more asinine statements recently.

      Liked by 2 people

  2. Epidemiologists and scientists around the world for the most part don’t give a hoot about Trump. Don’t blame the media for that.

    Here is a report on how the US helped contain the virus. Not at home, but in Asia.

    Since 2005 we have spent hundreds of millions to develop strategies to control a coronavirus pandemic. We worked hand in surgical glove with epidemiologists in Thailand and S. Korea for effective tests, research, controlling the spread through masks, distancing and contact tracing.

    And it worked beautifully.

    There, not here at home.

    We had the information, the money, the means but crap for leadership.

    Closing in on a quarter million dead (probably way undercounted), an economy in the loo and #LIBERATE.

    Liked by 2 people

  3. The CDC is not at liberty to cherry-pick studies to support a conclusion that they might like. They have to follow all the evidence and weigh the risks and benefits in their guidance.

    From September 4,2020 bulletin . . .

    “Earlier this year, [HCQ and CQ] were widely reported to be of potential benefit in the prevention and treatment of COVID-19; however, current data indicate that the potential benefits of these drugs do not outweigh their risks.”

    https://www.cdc.gov/mmwr/volumes/69/wr/mm6935a4.htm

    Now, if you want to claim that they are NOT following the science for some perverse reason then you need to remember that Trump has been in charge for four years. The buck stops with him.

    Liked by 2 people

    1. The FDA has a problem with risk. They only access the risk of saying yes, but ignore the risks of saying no.

      The FDA revoked its EUA based on a study on averse reactions that was retracted as invalid by the Lancet, yet the FDA has not restored the EUA.

      They are guided by hospital studies, in spite of the experience of doctors that it is too late by the time the patient is sick enough to need hospitalization.

      So, it is not a matter of cherry picking studies, it is elimination those that are irrelevant.

      The Ford Clinics found HCQ fairly effective when administered early in hospitalization, but this study is based on use BEFORE the patients get that sick and found it reduced hospitalizations from 15% to 3%.

      No one who doesn’t get sick enough to need hospitalization dies.

      This translates into thousands of needless deaths.

      State Depts of Health are enforcing the FDA guidelines that only allow HCQ prescriptions for traditional uses. Your PCP can lose his license for prescribing HCQ when appropriate for COVID, and the pharmacy can lose their license if they fill the prescription.

      Why is an abortion a decision between a patient and doctor but use of a drug that is safer than Tylenol dictated by guidelines by unelected bureaucrats in DC?

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        1. You keep alleging that but it is simply untrue.

          The FDA has, by law, a great deal of autonomy. Trump could fire the guy at the top, but 99% of the FDA is untouchable civil service employees.

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          1. Poor little Trump, powerless to manage the FDA. Buzz. Wrong.

            His appointed Commissioner can organize and manage the FDA as they see fit. If it is still – according to you – dysfunctional after four years then clearly Trump has appointed the wrong people to run it. If you go to the FDA organization charts you will find that many senior positions have been filled from outside of the FDA.

            Liked by 1 person

      1. Uh, the subject was CDC guidance. I know the FDA is your favorite whipping boy but it is the most recent CDC guidance that says : “. . . however, current data indicate that the potential benefits of these drugs do not outweigh their risks.” Are they lying? If so, why?

        By-the-way, Trump was presumably diagnosed very early and HE was not given HCQ. Does he know something he is not telling us? It would not be the first time.

        Liked by 1 person

        1. The CDC is not the problem.

          The FDA has, since the ACA was passed, assumed the role of dictating standards of practice, and those are enforced by State health departments.

          The CDC’s guidance is based on hospital based studies. It may change now that there is data from outside of hospital practice.

          Of course Trump didn’t use HCQ when he tested positive. HCQ is not a first line antiviral.

          My best guess ranking of antiviral treatments for COVID(remember that the 2nd phase requires a different approach) would be:

          Regeron’s and other monoclonal antibody cocktails ( a concentrated dose of 2 antibodies)

          Convalescent plasma(a diluted mix of dozens of antibodies)

          Recemdivir

          then the HCQ cocktail.

          There isn’t yet enough of the first three to use them for early treatment of out patient cases. If there were, I would start at the top of the list too. But HCQ is the one that is cheap and plentiful and USED EARLY is the most practical way to reduce the severity of the disease.

          Cutting the burden on hospitals by 80% would save a lot of lives.

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          1. We are discussing the efficacy of HCQ against Covid-19. You keep wanting to beat up the FDA. That is a different subject.

            The CDC is a scientific organization, not regulatory. You say HCQ is the best thing since sliced bread. The CDC says that the risk of using it outweighs the benefits.

            Believe it or not, I trust their scientific judgment far more than yours.

            Why so? you ask. Here is why. They are objective. You are not. You have an ax to grind – finding support for Dear Leader’s ravings (“I told you so.”). They do not. You have demonstrated a well-established pattern of cherry-picking scientific outliers to support your views while ignoring large bodies of other evidence. They do not. In this case you have picked the work of another outlier, V. Zelenko, and are treating it as holy writ. Others with even better medical training than you see him as a joke.

            https://www.physiciansweekly.com/the-skeptical-scalpel-awards/

            Then there is this . . .

            Liked by 1 person

          2. Couldn’t read your 2nd cite, paywalled.

            The first one was interesting, though not authoritative. Did you note that their “first place” award for bad science was the was the retracted paper claiming HCQ was dangerous, and the one that the FDA cited in withdrawing its EUA?

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          3. BTW, did you even read what I wrote?

            I didn’t claim HCQ was the best thing since sliced bread.

            I said it was the best option for widespread, very early treatment to avoid a serious outcome.

            It was 4th choice if you read what I wrote, but way better than waiting until you are seriously ill before doing anything.

            If there was enough convalescent plasma available, I’d say it should be given to every high risk person who wants it as a bridge to a vaccine.

            But within the limits of availability, HCQ is a useful treatment to reduce the seriousness of an infection.

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          4. I did read what you wrote. Of course, the expression “the best thing since sliced bread” was only a way of re-stating your belief that it would do wonders if administered as you say.

            As to why was Trump given totally unproven treatments when the “proven” efficacy of HCQ has been established, I think the answer is obvious – it hasn’t been “proven.” He touts it as a cure but did not take it himself. To me, that says quite a lot. Maybe not to you.

            The Zelenko et al retrospective paper that you link to is only a slight improvement on anecdotal evidence. It is far from the much larger scale double blind sort of trial that would be needed to confirm the claims he makes. So far, no such study has emerged.

            Liked by 1 person

          1. I suppose this My Body, My Choice is a rhetorical argument and that in reality you understand the role of the FDA to protect the public from the purveyors of not safe and/or not effective treatments? Why do they need to play this role? The answer is obvious. Without such oversight the “market” would rush to sell treatments that are neither safe nor effective.

            All treatments fall on a spectrum running from miracle cure at one end to deadly poison on the other. You think the market can sort this out. The consensus in our society is that science administered by professionals can do it with less overall damage to people. Sometimes, in exchange for enjoying the benefits of living in an organized and supportive society you can not get everything you want at the moment you want it. That’s life.

            Liked by 1 person

          2. So, you’re going to assume that all PCP doctors are idiots who don’t share their experience?

            Note that I didn’t say it should be OTC, I said it should be between me and my doctor.

            Safety is one thing, though even there I would prefer to rely on the product liability insurers using a system like Underwriters Laboratory, over the FDA.

            But efficacy and appropriateness for use should be up to my doctor and I

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          3. “ But efficacy and appropriateness for use should be up to my doctor and I.”

            A decent point…up to a point.

            Big Pharma fudged, lied and marketed opioids to doctors with “studies” galore showing the safety and non-addictive qualities that were passed on to working men and women in Appalachia among other places.

            Doctors were assured that they were safe for cases of pain management in even minor cases like tooth extraction or temporary back pain. Fine, except doctors would prescribe 30 pills for the toothache or sprained muscles.

            Your doctor was probably among those marketed to, not saying he agreed.

            Left alone, corporations often do the right thing for increased profit. Consumer safety? Not so much.

            The Sacklers and Purdue Pharma were poster children for criminal behavior when money is being made and people got addicted. Justice would put them in prison. And that might still happen.

            Billions of pills were shipped to tiny, complicit pharmacies and doctors in the latter stages of the problem. But for 20 years, opioids were treated like Advil.

            Opioids have their usefulness, to be sure. Cancer pain, terminal cases, post surgery, severe chronic pain, etc. But the attraction of big bucks for addicting millions overrode safety.

            Liked by 2 people

          4. The Opiod Crisis is an artifact of the ACA.

            Payment to physicians has been tied to patient satisfaction surveys, and it only takes a few really bad reviews to tank a doctor’s “bonus payments” which have become a large part o their income.

            Drug seeking patients know how to threaten a doctor if he won’t prescribe what they want. A single disgruntled patient writing multiple complaints can wipe out those performance payments.

            I dealt with manipulative, drug seeking patients for 49 years and would not want to have to deal with the empowered drug seeker of today.

            https://www.forbes.com/sites/brucejapsen/2018/06/18/more-doctor-pay-tied-to-patient-satisfaction-and-outcomes/#1df3aa69504a

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          5. I disagree. There might have been some doctors worried about disgruntled patients.

            But shipping millions of pills to a pharmacy in a tiny town in West VA is not about doctor surveys.

            Telling doctors for decades that opioids are like candy is not in the ACA.

            You are blaming the wrong people.

            Plus, if you were a smart doctor and knew that opioids were addictive but still prescribe them to get good reviews then you are just as complicit as the gated community drug dealers like the Sacklers.

            Sorry, that boat won’t float.

            Liked by 2 people

          6. Of course there are unscrupulous doctors and pharmacies who serve addicts. And to the extent that Purdue continued to sell to pharmacies knowing they could not possibly have a legitimate need for that many pills, they are culpable.

            My first practice in Virginia was bought, unknowingly, from a Dr Feelgood. It almost bankrupted me when I told patients they couldn’t get a month long prescription for oxycontin after getting their teeth cleaned.

            But don’t kid yourself, no one told me or anyone else in practice that opiods were non-addictive. We all knew about the threshold for addiction, we also knew that patients often went to multiple doctors and would use trickery and intimidation to try to get prescriptions.

            I had a dental assistant who was writing opiod prescriptions on our computer and signing my name as a sideline. (Yes, I turned her in) She didn’t know about the audit trail in the computer system that reported deleted prescriptions.

            But no one in health care has ever believed opiods were not addictive in the last 100 years.

            But the ACA provided patients a great tool for intimidating a weak doctor.

            I fought that battle for 40 years and I am telling you the ACA made it much harder for physicians to say no.

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          7. Doctors were assured for decades that “new” research showed that opioids used for pain relief did not create addicts for the majority. Not everyone believed it, but still billions of pills were prescribed.

            Somebody screwed up.

            Again, if doctors did it to get good reviews, shame on them.

            If they were in a hurry, shame on them.

            If they believed the distributors, then the blame is eased a bit.

            But I stick to my point that it was not the ACA, but Big Pharma.

            Just like Big Tobacco and their BS line about cigarettes not causing cancer.

            Liked by 2 people

          8. Every doctor has known for 100 years that the only patients for whom opiod addiction was not a concern were the terminal ones.

            The only reason anyone tells you differently is that Purdue’s pockets are deeper than the doctors.

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          9. Purdue’s pockets aren’t so deep anymore. And if the Sackler family is charged, which might still happen, even billions more gets back to the hardest hit states.

            And, if there is any justice, the Sacklers will finish out their lives as guests of the state.

            Liked by 1 person

          10. Let me see if I have your arguments straight.

            No matter the misleading “studies” and promotions from Big Pharma telling doctors that their new pain killers were not addictive, “Every doctor” has known for 100 years that pain killer addiction was a serious danger except for the terminally ill. But, you say, even though knowing how dangerous these pain killers are, countless doctors have over prescribed them – causing the opioid crisis – because they feared bad reviews from their patients. And golly, that might in theory reduce their takings. So the opioid crisis is Obama’s fault for allowing healthcare consumers to share information about their experience. Is that about right? And now you demand that FDA leave doctors to prescribe whatever a demanding patient demands? These same doctors who have killed hundreds of thousands out of penny ante greed?

            I am not making this up to make you look silly. This is what you have said. Just today.

            Liked by 1 person

          11. There was an opiod problem prior to the ACA. It goes back to when Laudanum was the state of the art.

            And there have been Dr Feelgoods for a long time too.

            There have been manipulative drug seeking patients just as long.

            But the ACA brought a lot of pressure on hospital based doctors, for whom their pay is not fee for service but salary plus performance bonuses. For many, those bonuses are a large part of their pay, and those are directly tied to their patient ratings. If you have been to a hospital lately, you will have been given a rating form before you left, and one of the questions will have been whether you were given enough medicine to control your pain. If you answer no, it counts against your doctor. And that hospitalist has no relationship with you. It is unlikely you will ever see him again. He will never know if he started you on a destructive addiction or not, he only knows how you rated him.

            That added a crisis on top of the preexisting problem.

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          12. “The Opioid Crisis is an artifact of the ACA.”

            So, what was that statement – hyperbole? Or just another example of you displaying your penchant to blame every malady on President Obama?

            We had a “problem” but only became a “crisis” because of the ACA. And what was the mechanism – fear of getting bad reviews from patients.

            There is no evidence of that mechanism beyond anecdotal. To change an existing “problem” into a “crisis” would require massive malfeasance with most hospital doctors willing to addict patients to get an attaboy and a few extra bucks. Really? You think hospital doctors are that venal?

            No, the reality is that opioid addiction has been growing steadily for decades. You yourself provide evidence of that – I assume you inherited your practice before Obama became President. And, “conservative” and family values hero, Rush Limbaugh, was busted for abusing Oxycontin abuse five years before Obama became President. Hey, maybe THAT is what turned a “problem” into a “crisis?”

            But, let’s say your blaming the ACA is accurate. If it did happen, then why should the FDA follow your advice and just trust your doctor to prescribe in your best interests? According to this theory of the opioid crisis, they will do just about anything for money.

            Liked by 1 person

          13. Some doctors will do anything for money.

            Addiction has been a problem a long time. There have always been doctors willing to exploit that. But the ACA provided a means for addicts to pressure an otherwise careful doctor into providing what they want. That is what I believe elevated the ongoing problem into a crisis, the involvement of doctors who would otherwise say no and refer the patient for treatment for addiction.

            A hospital based doctor who refuses to prescribe opiods can face a complaint that will not just lose that patient’s business but will reduce his pay for all of his patient’s treatment.

            That is stupid policy.

            Of course, you wouldn’t like my solution. I’d make all opiods OTC, eliminating the profit motive for doctors, and let evolution run its course.

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          14. “That is what I believe elevated the ongoing problem”

            When there is no evidence you can believe anything that you want. But your belief does require that a vast number of doctors are criminally negligent money grubbing assholes. That MAY be true but there is no systematic evidence that it is. More likely is that a great many doctors were fooled by the lies told by the purveyors of the new pain killers. You know, the criminal lies that are now being prosecuted.

            As for your solution of making opioids over-the-counter I actually do no disagree. Making things illegal that people are going to do any way is generally counter-productive. In the UK where hard drugs are provided to addicts by the NHS those people getting their “meds” function economically far better than addicts do here.

            Rather than selling them over-the-counter, I would have them sold like liquor is in Virginia and other states. Easier to keep out of the hands of children and to be sure that the users are fully informed about the risks. Maybe require a license to purchase based on attending some educational presentations.

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