More evidence hydroxychloroquine works

In countries where most everyone takes the drug to ward off malaria Covid is virtually non existent. One of those things that make you go hmmmm.
Nigeria: 254 cases, 0 deaths (population 191 million)
Democratic Republic of Congo: 0 cases (population 81.3 million)



Uganda: 52 cases, 0 deaths (population 43 million)

Mozambique: 17 cases, 0 deaths (population 29.7 million)
Democratic Republic of Congo: 0 cases (population 81.3 million)

Uganda: 52 cases, 0 deaths (population 43 million)

Mozambique: 17 cases, 0 deaths (population 29.7 million)
Cote de’ Ivoire: 0 cases (population 24.3 million)

Ethiopia: 55 cases, 2 deaths (population 105 million)

Malawi: 8 cases, 1 death (population 18.6 million)
Niger: 278 cases, 11 deaths (population 21.5 million)

Pakistan: 4,194 cases, 60 deaths (population 197 million)

India: 5,480 cases, 164 deaths (population 1.3 billion)

https://www.foxnews.com/world/do-co...-of-malaria-have-fewer-coronavirus-deaths.amp

 

That's interesting. Thanks for posting that link.

 

What do you think is more likely: (1) a drug no legitimate organization has been able to show works to prevent or treat covid is somehow preventing the virus from spreading in the countries you mention, or (2) a bunch of third world countries have incorrectly or fraudulently misreported the instances of infections and deaths due to covid in their countries?

I'm going with #2.

 

What do they have to gain by misreporting infections and deaths?

 

Huh?

https://www.nature.com/articles/s41...d-id=61CF4C0767161E1D2B15C77665918141BC57D421

 

A few more unrelated facts that prove...

Those countries are majority PoC so PoC don't get Covid.
Most of those countries are Majority Muslim so Muslims don't get Covid.
Those countries are all between The Atlantic ocean and the Pacific ocean so people in those countries can't get covid.

What more "proof" do you need?

 

India has 1.5 million cases 50k today.
I didn't bother to look up the other countries

 

Still turning in comparatively low numbers though

 

Difference is nobody ever claimed being Muslim protects you whereas
Hydrox is alleged to do just that

 

I just alleged it.

With just as much actual scientific evidence as provided for HCQ.

 

Not really. And they came late to the party

seriously wtf?

 

Big difference between you alleging it and all the anecdotal and real world evidence it may be effective

 

For their population yes seriously

 

That is just the ones they know about

 

No, there's not.

 

Fauci pushes back against Trump's claims that he's misleading
the public about coronavirus and hydroxychloroquine

Warning: Anthony Fauci is a medical doctor and public health expert in consultation with leading healthcare authorities.
The opinions of reality-tv entertainers and casino operators may differ.

​

 

Huh, what??? India, 5,480 cases, 164 deaths?
Try this, instead: as of today, India 1,532,135 cases and 49,632 deaths.

Nigeria, 254 cases, 0 deaths?
Try this, instead: as of today, Nigeria 41,804 cases, 868 deaths (and a very low performing diagnostic and reporting system with only 1,297 tests per M of population, while here in the US we have 168,138 tests per million of the population. So likely Nigeria has A LOT more than what they have managed to diagnose.

Pakistan, 4,194 cases, 60 deaths?
Try this, instead: as of today, Pakistan 275,225 cases, 5,865 deaths, also very little testing (8,634 per M of the population)

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Since I'm likely to encounter the same absurd distortions in the data in reference to all the countries you've mentioned above, I'll stop.

Oh, and let's also look at Brazil, a country where malaria is also endemic and where chloroquine is very popular: despite so-so testing (59,251 per million of the population), 2,484,649 cases and 88,634 deaths. So, come again? Areas with malaria have fewer COVID-19 cases and deaths???

Africa did get a late start in the pandemic. So did India. Just wait and see what the numbers, already looking much worse, will be in a couple of months.

You need to brush up in what is a correlation, and what is causality. If countries like India are still showing a relatively low number of cases per population, it's not because they use chloroquine or hydroxychloroquine to treat malaria. It's rather the dynamics of how the contagion is spreading there. Because, see, if your argument is that they are still relatively with low numbers and that's because of malaria treatment, then you'd have to look at other populous countries with relatively low numbers to their population, and see if malaria is rampant there, too.

Take Japan, for example. 126,445,338 people but only 998 COVID-19 deaths although they have one of the oldest populations in the entire world (unlike young African countries). Guess how many people have malaria in Japan and take hydroxychloroquine to fight off malaria? None. Japan has eradicated malaria since 1961. Hmmm... That does put a wrench in your theory, huh???

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Look, this issue is no longer being debated among anybody who actually understands it. It's been settled, already.

Especially in the case of a condition in which the best current estimate is that it kills only 0.65% of people who have it, therefore 99.35% of people eventually recover (although not without a significant proportion of them, which has been estimated as low as 5% and as high as 35%, coming out of it with some sort of nasty permanent health consequence), you can't gauge whether or not a given treatment helps just by saying "I heard that the cousin of my hair stylist's husband's landscaper got COVID-19, took hydroxychloroquine, and didn't die; yay, it works!!!" because odds are, at a rate of 99.35%, that the cousin of your hair stylist's husband's landscaper would have survived without hydroxychloroquine, too. That's why even the *opinion* of a bunch of naive doctors who swear it works, count for absolutely NOTHING in proving if it does or doesn't.

Especially for a condition with a low infection fatality rate like COVID-19, there is ONE and ONLY ONE way to prove if a given treatment works or doesn't. Absolutely NOTHING ELSE serves as proof, even large studies that observe what happened to people on it (what is called retrospective observational studies).

The ONLY way is to run what we call a prospective, randomized, double-blind, large placebo-controlled trial, abbreviated as RCT.

So, what do we do?

First, we get a LARGE cohort of patients. Then, BEFORE they are given the medication, they are paired in groups of 2 that are very similar (in age, gender, blood type, level of vitamin D, days since diagnosis, underlying conditions, severity of the illness, etc., or whatever else you can use to get as good a match as you can). Then, RANDOMLY you assign one of these patients to a group that will be given the medication (called active group) and the other one to a group that will be given a placebo or dummy pill (called control group). But neither you, the researcher, nor the patient, knows which is which (thus, "double-blind") as the randomization and the delivery of the active treatment or placebo are handled by other people in the research team, and who is taking what is kept in a sealed envelope until the end of the study. That's to avoid any sort of bias. Then you apply the active treatment or placebo, and you measure a number of outcomes (a.k.a. "end points") - for example, fatality rate, days to recovery, viral load (how much virus is in samples obtained from the patient), need for ICU, need for intubation, etc; preferably various end points, and preferably objective ones that can be objectively measured with standard instruments.

Then at the end of the study, AFTER collecting the "end point" scores, you open the envelopes and figure out who was who.

If the active treatment statistically significantly separates from placebo, that is, if it is statistically shown that any difference is large enough to be highly unlikely to be due to a fluke or to an intervening factor (which you have already weeded out by pairing the subjects before randomization) at a 95% certainty, which is expressed by a statistical index called "p" which needs to be less than 0.05 to be considered statistically significant, then the drug works.

If the active treatment doesn't separate from placebo, that is, is not shown to be any better than a dummy pill (in which case "p" is bigger than 0.05), then the drug doesn't work. Simple, right?

We want the number of subjects to be large enough to prevent flukes and spurious factors. By large enough, I'm talking in the thousands. Not some small study with 25 patients.

So, what happened with hydroxychloroquine? Mind you, it started with a small study with about 25 patients, in Marseille, France, by Didier Raoult. He did NOT randomize his patients. It was NOT double-blind... but he thought that his patients on HCQ had a smaller viral load by day 6, if I remember correctly (I did read the study in original French but it was a while ago). Mind you, he didn't find any better clinical outcome. As a matter of fact, patients in the group that took HCQ fared WORSE than the ones who didn't, with one death and 2 ICU cases versus zero in the group that didn't take it. But at least he thought they had a smaller viral load, so he published the study, saying that MAYBE this might help with contagion, and needed further confirmation with larger studies.

Well, some politicians got hold of this, in the French Ministry of Health. Next a bunch of journalists and politicians touted that this was a cure and a game changer and it spread like hay fire to other politicians in other countries. The HCQ craze started. A bunch of small RETROSPECTIVE and OBSERVATIONAL studies seemed to show that maybe it helped. The whole world went berserk.

What needed to happen did happen: reputable health organizations started LARGE randomized controlled trials, or RCTs. They took a good while to conclude (because they are long and difficult to run). Meanwhile, since the pandemic was raging and for lack of option people couldn't wait, FDAs in different countries granted emergency authorization for HCQ in the treatment of COVID-19.

So, now, the RCTs have concluded.

What did they show?

The large RECOVERY trial out of Oxford University with 16,000 patients showed NO BENEFIT for hospitalized patients with more severe cases. No separation from placebo. It did show a larger incidence of cardiac toxicity in the active group (that is, it caused some harm, rather than some good).

People said, "well, maybe it's because we used it too late, after the replication phase of the virus."

Then, a decently-sized RCT, multi-centered, by a group of various Canadian universities looked at HCQ for early and mild cases (a few thousand patients). Found NO BENEFIT. No separation from placebo. People taking it or not taking it didn't fare any better, didn't get well any sooner, didn't progress to severe illness any less frequently, when used for mild and initial cases.

People said, "oh well, it doesn't help severe cases, it doesn't help mild cases, maybe it helps in prophylactics. Maybe if we give it to people before they get the disease they won't get sick."

Then, another RCT out of a university in Minnesota looked at prophylactic use and rate of infection after exposure. Oh well. Sad. They found NO BENEFIT either. People who took it, got sick just as often as people who didn't take it.

That was the last nail in the coffin. Regardless of what observational studies seemed to initially *suggest*, the real proof, the real RCTs, failed EVERY TIME to show any benefit whatsoever, in all phases of the illness - before people get it, after people get it but it is still mild and initial, and after people get very sick.

IT. DOESN'T. WORK.

Period, full stop.

The FDAs here and elsewhere (Italy, Belgium, France, etc.) then cancelled the emergency authorizations and issued statements saying that the drug doesn't work, the risks outweigh the benefits, and it shouldn't be used for COVID-19 (especially because in COVID-19 patients that already have inflamed hearts, it tends to prolong a heart interval called QTc and thus tends to cause a type of irregular beat called Torsades de Pointes, which is often fatal - a problem that doesn't happen to the same degree in patients with malaria, lupus, and RA, so HCQ is NOT indicated for COVID-19 but remains valid for the other three indications).

Interestingly enough, a paper by the American Society of Rheumatology then showed that people with Lupus and Rheumatoid Arthritis, the two conditions other than malaria for which people get HCQ (we don't have malaria here), showed that people being treated for years for these conditions with HCQ, caught COVID-19 and got sick just as often as people being treated for Lupus and AR with other medications (defeating the whole premise of your original post, once more).

Am I saying this because I'm some sort of anti-Trump person with an agenda? No. I couldn't care less for that part of it. Trump also touted remdesivir, and then secured pretty much the whole stock of remdesivir in the world for use to treat Americans, and I applauded him and thanked him for it. Why? Because remdesivir does work! Two large RCTs showed separation from placebo. I also don't stop praising the Trump Administration for the apparent and promising success of the Warp Speed vaccine initiative (I say apparent and promising because it hasn't concluded yet and maybe will still fail, but things are looking pretty good, now).

So, it's not any anti-Trump bias. It's just saying it the way it is.

Remdesivir works. There is a good chance that the members of the Warp Speed vaccine initiative, Moderna/NIH, Oxford/AstraZeneca, Inovio, Pfizer/BioNTech, and a few others, will produce vaccines that will work, in record time. So kudos to the the Trump Adminstration for their part in fostering that.

But HCQ? Nope, unfortunately it doesn't work. I'd be delighted if it did, but it doesn't.

I'd say, if between HCQ, remdesivir, and the mRNA vaccines that received the most support from the Trump Administration, we get two out of tree to pay off (remdesivir, vaccine) that's an OUTSTANDING result for a novel disease, in record time.

But HCQ? That one didn't pay off. And there is no shame in it. It shouldn't have been so politicized. In the History of Medicine there are literally hundreds of thousands of treatments that seemed promising in small 25-people pilot studies and even in larger observational studies, that failed to fulfill their promises in large RCTs and therefore never earned regulatory approval.

As a matter of fact, HCQ's situation for COVID-19 (not working after promising initial observations) is the rule rather than the exception: 9 out of 10 of these promising drugs, ultimately don't work.

 

Continued from above.

We need to stop beating this dead horse and move on to things that do work, like the heads of Oxford's RECOVERY Trial said. RECOVERY stands for "Randomized Evaluation of COVID-19 Therapy" and is the most authoritative examination of the efficacy of proposed treatments, or lack thereof. You know, Oxford. Simply the HIGHEST RANKED university in the entire freaking world, and the same people who are about to deliver a vaccine that might solve this problem once and for all. Here:

https://www.recoverytrial.net/files/hcq-recovery-statement-050620-final-002.pdf

So, don't give me an infamous survey with the *opinions* of 6,000 doctors saying they thought it worked (that survey, by the way, was ordered and paid for by a group that distributes HCQ; who knows if it's even accurate?). Don't give me the observational study from Detroit that suggested that it works, but compared it with a group of patients with a different age average and different severity, and was run by two Joe Nobodies with links to pharmaceutical companies. These sources are laughable as compared to Oxford University and the huge and authoritative RECOVERY trial.

In Medicine, there are are 7 categories of evidence, from the strongest to the weakest. Do you know what's the category of strength of evidence for large RCTs like the three that I mentioned above? Category #1, the highest. Do you know what's the strength for a retrospective observation like the one in Detroit? #6 or second weakest. Do you know what's the strength for expert opinion like that infamous survey? #7 or weakest.

So, don't even try to disprove a category 1 study with a category 6 study (or even worse, a category 7 survey). The latter delivers no proof. The former does. And the proof is that HCQ doesn't work.

Pardon the long rant. It's becoming a pet peeve of mine. I get irritated with how this dead horse is still being looked at.

 

You seem knowledgeable so what are your qualifications ?

Having said that I think you dismiss correlation too easily. It is relevant in this situation.

 

Thank you. Sorry, I do have sizable and relevant qualifications, but specifically claiming them in an anonymous Internet forum is a fool's errand. Given that there is no way to prove my qualifications without disclosing personal identifying information, the knee-jerk reaction of most people when someone claims them, is to doubt them and call the person a poseur and a pretender. I'll leave it up to you to look at the bulk of my posting if you are so interested and inclined, and if you feel like it is indicative of relevant qualifications and you have a guess as to what those might be, unfortunately I regret to say that I won't confirm nor deny your guess.

Besides, what I'm saying should better stand on its own merit without the need to appeal to the higher authority of someone who is qualified. Sound data should prevail each time, regardless of who is diffusing the information. If sound data won't prevail unless the person issuing it is able to prove qualifications, then the data are not that sound, right? My data stand on their own without the need to disclose my qualifications.

As for these correlations being relevant, well, there are several problems with your statement. First, you are issuing wrong data. If you input the wrong information, you won't get the correct interpretation. Like I've demonstrated, the numbers you've quoted for at least the three countries I've looked at (I'm prepared to bet that it is the same for all the countries you've mentioned; I just don't feel like going through the trouble of looking them up one by one), are HUGELY off. So, what correlation??? These countries are NOT failing to have expressive numbers of cases and deaths. Maybe you would have had a point if your numbers were correct, but they are not, and not by a little. They are off by a whole lot!!! I mean, you say 5,480 cases when the truth is 1,532,135 cases (280 times more) and you say 164 deaths when the truth is 49,632 (303 times more) and you expect us to draw some valid correlation from your HUGELY flawed data??? Where the hell are you getting these numbers???

Then, if your correlation were relevant, it should hold for another country that also has malaria, Brazil, right? Huh, no. Brazil has the second biggest number of cases in the world and the second biggest total deaths in the world, so where is the correlation you seem to be noticing, that countries with malaria equal fewer cases???

And again, if your correlation were relevant, other countries with low numbers should also be the ones with malaria and HCQ use, right? Huh, no. Japan has eradicated malaria 59 freaking years ago but still has a very low number of deaths... much lower proportionally than in those countries you *think* you are seeing a correlation.

Not to forget, you are quoting countries that are very poor and have a ridiculously low number of tests per million of the population, so the much more likely correlation, rather than saying "countries with malaria are seeing fewer cases than countries without malaria" (disproved by Brazil and Japan, and I could find you several others that would disprove it too, like South Korea, Singapore, Australia, Germany etc like Japan, and Ecuador, Bolivia, Peru, etc. like Brazil) is that "countries that don't have any money to do testing are reporting fewer confirmed cases and deaths."

And then, as I've abundantly showed, the very premise that HCQ is the differential factor in this *apparent* correlation (which isn't one because your data are flawed) is contradicted by the fact that... it can't do any of this because it's been proved that it doesn't work. So it can't be the relevant factor even if the correlation existed. Not even the people treated with it for lupus and RA have been shown to have fewer or less severe COVID-19... why in the hell would it be the determinant factor for this (non-existing) correlation???

Sorry, it gives me no pleasure to go after your opinion like this; like I said, I wish you were right and this cheap and widely available drug worked... but it simply doesn't, unfortunately.

Let's do what the Oxford experts say: focus our energy on stuff that does work, and waste no more time with stuff that doesn't.

You have mentioned "anecdotal and real-life evidence." I mean, what is anecdotal is by definition NOT evidence. And what you call "real-life" is just a non-controlled apparent correlation that isn't even one...

It's interesting that people seem to try to dismiss the large randomized clinical trials as if they were not "real life." Look, we're not talking about lab rats and Petri dishes here. In the Oxford RECOVERY trial, we are talking about 11,000 (sorry, I incorrectly said 16,000 before, but it's 11,000) patients in 175 hospitals in the United Kingdom. These are real people who were given various treatments in real hospitals, who presented real recoveries and real complications and real deaths. It doesn't get any more "real life" than this. It's just that unlike the misguided (and often absurd) anecdotal claims and flawed observations, their "real life" experiences were looked at by competent doctors and scientists who know how to tell apart a mere intervening factor (a.k.a. a fluke resulting in an apparent correlation) from the golden standard proof delivered by randomized clinical trials.

Clinical trials are not laboratory experiments. The point of clinical trials is exactly to put a lab hypothesis to test, in "real life."

Do you know how Dr. Didier Raoult first had the idea of HCQ? Because HCQ shows activity against the SARS-CoV-2 in-vitro. That is, in a test tube. That's not "real life." So he gave it to real life people. Killed one, landed two others in the ICU, and the others who didn't die didn't fare any better, but he thought they had some LAB TESTS improved (lower viral loads and faster PCR negativation). The funny thing is that this whole thing started with non-real life data... In-vitro activity... lab results... while the real life patients actually didn't fare any better. Actually they fared worse.

Then, we get the huge RCTs with thousands of real life patients, and they don't fare any better either... but fare worse, with more cardiac toxicity...

And you all think you are right about this because your anecdotes and flawed "correlations" are supposed to be "real life" and RCTs aren't???

Science should be left to scientists and not journalists, TV pundits, or politicians, because the latter have NO CLUE about science, and are filled to the brink with spurious agendas.

You can place your faith on a large RCT run by reputable organizations like Oxford University and the National Health Service of the United Kingdom any day over the anecdotes and opinions of journalists and politicians (by the way, the American counterparts of these organizations, as well as the ones in Italy, France, Belgium, etc., all reached the same conclusion).

Do you know why we're even still talking about it? Because politics.

I'll make up a fictitious situation. Suppose that there is a drug called, say, Rotasud, which is approved for say, Irritable Bowel Syndrome, is shown in test tubes to inhibit the multiplication of Borrelia Burgdorferi, the agent of Lyme disease. Say a doctor gets 25 patients with Lyme disease and runs a small, non-randomized trial and finds that while the patients didn't clinically fare any better, certain lab tests improved. Say, the FDA is dealing with an outbreak of Lyme disease and issues an emergency authorization to try Rotasud for Lyme disease patients. NO POLITICIAN and NO JOURNALIST pays any attention to it; the issue only makes the pages of the Journal of Infectious Diseases but no lay press publication. Then, Harvard University decides to run a large randomized clinical trial to verify if Rotasud is effective for Lyme disease. They recruit two thousand patients, give the drug to 1,000 and placebo to the other 1,000. Nobody taking Rotasud in that trial gets any better, but a number of those get a bad reaction, say, liver toxicity. The disease remains unchanged. Rotasud doesn't show any advantages over the dummy pills and actually shows harm. So Harvard publishes the results in the Journal of Infectious Diseases saying "Rotasud does not work for Lyme Disease and causes liver toxicity in this population." The FDA then cancels the emergency authorization, and issues a memo saying "do not use Rotasud for Lyme disease; its risks which are significant outweigh its hypothetical benefits which are non-existing for this population; it remains approved for Irritable Bowel Syndrome." End of the story, everybody moves on, and researchers go look at other potential treatments for Lyme Disease.

Nobody on Political Forum discusses Rotasud. Nobody talks about it on Fox News. No politician touts it. Nobody pays any attention to the matter, except the relevant people regarding this issue, that is, the medical doctors involved in the treatment of Lyme Disease.

Well, substitute Rotasud for Hydroxychloroquine, Lyme Disease for COVID-19, Irritable Bowel Syndrome for Malaria, liver toxicity for heart toxicity, Harvard University for Oxford University... and that's exactly what happened to hydroxychloroquine.

So why in the hell are we talking about it here? Because politics...

Certainly not because Medicine, and not because Science.

Real life situations like the one I just made up have happened literally hundreds of thousands of times in the History of Medicine. Small pilot studies, action in-vitro, small observational studies, are looked at ALL THE TIME for thousands of different diseases and hundreds of thousands of different proposed treatments, and then they go to RCTs for confirmation, and only 1 out of 10 pays off. But people like you never hear about it, because there is nothing to say to the lay public about it. It's just another step in medical and pharmacological research, and a negative trial (one that shows that a drug doesn't work) isn't that exciting; isn't news. When things DO pay off, then you hear about it... you get an ad on TV saying "if you have Lyme disease, ask your doctor if Rotasud is right for you." That's AFTER the RCTs, and AFTER the FDA has granted approval to the indication otherwise the FDA won't allow the ad to run.

HCQ never got to that point, because it failed the RCTs, and its emergency provisional authorization was correctly yanked out by the FDA. That is, a settled issue, for good. We're only still talking about it because politics.

Get it now?

 

Tldr

 

Still tldr

 

Your loss. It's quantity AND quality.

 

Much better!

 

Remdesivir doesn't work. It doesn't kill the virus. Nothing kills the virus. And the virus isn't killing people either, it's the body's reaction to the virus. You wanna live? Treat the side effects that kill you.....which is swelling of and secretions in the lungs. HCQ would help, Dexamethasone is better, and Budesonide is best. Corticosteroids and a Z pack is the best bet.

The virus is mutating daily. Even IF a vaccine is created, there is no surety it will kill all versions of the virus. Just like flu shots.

Why does HCQ help? It suppresses the body's overreaction which reduces the inflammation in the lungs.

You folks can do what you want to do.....get this crap and lay on your death bed (depending on your immune system's reaction) and poopoo corticosteroids......and wait until the magic silver bullet vaccine arrives.

I'll take the **** that big pharma can't make any money on and live to talk about it.