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Coronavirus - What Are The Implications?

Discussion in 'Politics, Religion and Philosophy -(FORUM CLOSED)-' started by BangBoomPow, Feb 28, 2020.

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revgen - Lakers 6th Man -

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The Key to Defeating COVID-19 Already Exists. We Need to Start Using It

Harvey A. Risch, MD, PhD , Professor of Epidemiology, Yale School of Public Health

As professor of epidemiology at Yale School of Public Health, I have authored over 300 peer-reviewed publications and currently hold senior positions on the editorial boards of several leading journals. I am usually accustomed to advocating for positions within the mainstream of medicine, so have been flummoxed to find that, in the midst of a crisis, I am fighting for a treatment that the data fully support but which, for reasons having nothing to do with a correct understanding of the science, has been pushed to the sidelines. As a result, tens of thousands of patients with COVID-19 are dying unnecessarily. Fortunately, the situation can be reversed easily and quickly.

I am referring, of course, to the medication hydroxychloroquine. When this inexpensive oral medication is given very early in the course of illness, before the virus has had time to multiply beyond control, it has shown to be highly effective, especially when given in combination with the antibiotics azithromycin or doxycycline and the nutritional supplement zinc.

On May 27, I published an article in the American Journal of Epidemiology (AJE) entitled, "Early Outpatient Treatment of Symptomatic, High-Risk COVID-19 Patients that Should be Ramped-Up Immediately as Key to the Pandemic Crisis." That article, published in the world's leading epidemiology journal, analyzed five studies, demonstrating clear-cut and significant benefits to treated patients, plus other very large studies that showed the medication safety.

Physicians who have been using these medications in the face of widespread skepticism have been truly heroic. They have done what the science shows is best for their patients, often at great personal risk. I myself know of two doctors who have saved the lives of hundreds of patients with these medications, but are now fighting state medical boards to save their licenses and reputations. The cases against them are completely without scientific merit.

Since publication of my May 27 article, seven more studies have demonstrated similar benefit. In a lengthy follow-up letter, also published by AJE, I discuss these seven studies and renew my call for the immediate early use of hydroxychloroquine in high-risk patients. These seven studies include: an additional 400 high-risk patients treated by Dr. Vladimir Zelenko, with zero deaths; four studies totaling almost 500 high-risk patients treated in nursing homes and clinics across the U.S., with no deaths; a controlled trial of more than 700 high-risk patients in Brazil, with significantly reduced risk of hospitalization and two deaths among 334 patients treated with hydroxychloroquine; and another study of 398 matched patients in France, also with significantly reduced hospitalization risk. Since my letter was published, even more doctors have reported to me their completely successful use.

My original article in the AJE is available free online, and I encourage readers—especially physicians, nurses, physician assistants and associates, and respiratory therapists—to search the title and read it. My follow-up letter is linked there to the original paper.

Beyond these studies of individual patients, we have seen what happens in large populations when these drugs are used. These have been "natural experiments." In the northern Brazil state of Pará, COVID-19 deaths were increasing exponentially. On April 6, the public hospital network purchased 75,000 doses of azithromycin and 90,000 doses of hydroxychloroquine. Over the next few weeks, authorities began distributing these medications to infected individuals. Even though new cases continued to occur, on May 22 the death rate started to plummet and is now about one-eighth what it was at the peak.

A reverse natural experiment happened in Switzerland. On May 27, the Swiss national government banned outpatient use of hydroxychloroquine for COVID-19. Around June 10, COVID-19 deaths increased four-fold and remained elevated. On June 11, the Swiss government revoked the ban, and on June 23 the death rate reverted to what it had been beforehand. People who die from COVID-19 live about three to five weeks from the start of symptoms, which makes the evidence of a causal relation in these experiments strong. Both episodes suggest that a combination of hydroxychloroquine and its companion medications reduces mortality and should be immediately adopted as the new standard of care in high-risk patients.

Why has hydroxychloroquine been disregarded?

First, as all know, the medication has become highly politicized. For many, it is viewed as a marker of political identity, on both sides of the political spectrum. Nobody needs me to remind them that this is not how medicine should proceed. We must judge this medication strictly on the science. When doctors graduate from medical school, they formally promise to make the health and life of the patient their first consideration, without biases of race, religion, nationality, social standing—or political affiliation. Lives must come first.

Second, the drug has not been used properly in many studies. Hydroxychloroquine has shown major success when used early in high-risk people but, as one would expect for an antiviral, much less success when used late in the disease course. Even so, it has demonstrated significant benefit in large hospital studies in Michigan and New York City when started within the first 24 to 48 hours after admission.

In fact, as inexpensive, oral and widely available medications, and a nutritional supplement, the combination of hydroxychloroquine, azithromycin or doxycycline, and zinc are well-suited for early treatment in the outpatient setting. The combination should be prescribed in high-risk patients immediately upon clinical suspicion of COVID-19 disease, without waiting for results of testing. Delays in waiting before starting the medications can reduce their efficacy.

Third, concerns have been raised by the FDA and others about risks of cardiac arrhythmia, especially when hydroxychloroquine is given in combination with azithromycin. The FDA based its comments on data in its FDA Adverse Event Reporting System. This reporting system captured up to a thousand cases of arrhythmias attributed to hydroxychloroquine use. In fact, the number is likely higher than that, since the reporting system, which requires physicians or patients to initiate contact with the FDA, appreciably undercounts drug side effects.

But what the FDA did not announce is that these adverse events were generated from tens of millions of patient uses of hydroxychloroquine for long periods of time, often for the chronic treatment of lupus or rheumatoid arthritis. Even if the true rates of arrhythmia are ten-fold higher than those reported, the harms would be minuscule compared to the mortality occurring right now in inadequately treated high-risk COVID-19 patients. This fact is proven by an Oxford University study of more than 320,000 older patients taking both hydroxychloroquine and azithromycin, who had arrhythmia excess death rates of less than 9/100,000 users, as I discuss in my May 27 paper cited above. A new paper in the American Journal of Medicine by established cardiologists around the world fully agrees with this.

In the future, I believe this misbegotten episode regarding hydroxychloroquine will be studied by sociologists of medicine as a classic example of how extra-scientific factors overrode clear-cut medical evidence. But for now, reality demands a clear, scientific eye on the evidence and where it points. For the sake of high-risk patients, for the sake of our parents and grandparents, for the sake of the unemployed, for our economy and for our polity, especially those disproportionally affected, we must start treating immediately.

Harvey A. Risch, MD, PhD, is professor of epidemiology at Yale School of Public Health.
Click to expand...

https://www.newsweek.com/key-defeat...exists-we-need-start-using-it-opinion-1519535

revgen, Jul 28, 2020

#381

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I blame Trump for endorsing this drug early which made the retards from leftist media push against it big time killing a lot more people in the process.

KareemtheGreat33, Jul 28, 2020

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KareemtheGreat33 said: ↑

I blame Trump for endorsing this drug early which made the retards from leftist media push against it big time killing a lot more people in the process.
Click to expand...

Trump: we have a cure!

Media and liberals: boo! Hiss! Orange man bad. We don't want a cure! Put on mask!

KareemTheGreat33: I blame Trump.

John3:16, Jul 28, 2020

#383

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I blame money .This drug that even Dr.Fauci approved back 10-15 years ago cost like 10 $,and remdesevir cost more than 3000 $ ,but I don't care anymore .I just glad that sports are back

KuzmoBall17, Jul 28, 2020

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sirronstuff - Lakers Legend -

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I can confirm that sex with Demons is really bad. But you really see their claws come out after the divorce

sirronstuff, Jul 28, 2020

#385

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Nah, it’s all good, we’re fine, this is fine. The sun kills it, so does drinking or injecting bleach or Lysol, eating Tide pods, or rebuking it in the name of Jeesusah! or Gawahd!!

Weezy, Jul 28, 2020

#386

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sirronstuff said: ↑

I can confirm that sex with Demons is really bad. But you really see their claws come out after the divorce

Click to expand...

LTLakerFan, Jul 28, 2020

#387

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This is just sad

KareemtheGreat33, Jul 29, 2020

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Weezy said: ↑

Nah, it’s all good, we’re fine, this is fine. The sun kills it, so does drinking or injecting bleach or Lysol, eating Tide pods, or rebuking it in the name of Jeesusah! or Gawahd!!

Click to expand...

Hey Weezy since you're criticizing Church services, what is your opinion on thousands of "protesters" shoulder to shoulder in the streets? What's good for the goose is good for the gander, I always say...

KareemtheGreat33, Jul 29, 2020

#389

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revgen said: ↑

https://www.newsweek.com/key-defeat...exists-we-need-start-using-it-opinion-1519535
Click to expand...

https://respectfulinsolence.com/2020/07/24/harvey-risch-defends-hydroxychloroquine/

Helljumper, Jul 29, 2020

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Battle of the articles above. Don’t have the interest or time to read both thoroughly and form my own opinion. But saw just couple paragraphs and headlining of the latter to wonder where and why that person decides to mock the entire practice of and science behind acupuncture in making his / her case? Found that highly offensive and pompous. Never have myself but know many people getting great benefit and obviously it’s been around what .... thousands of years? Lost credibility right off the top for me, and on behalf of my wife and one daughter in law (Kaiser executive and Cross Fit member / physically capable person) .... it pissed me off.

LTLakerFan, Jul 29, 2020

#391
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LTLakerFan said: ↑

Battle of the articles above. Don’t have the interest or time to read both thoroughly and form my own opinion. But saw just couple paragraphs and headlining of the latter to wonder where and why that person decides to mock the entire practice of and science behind acupuncture in making his / her case? Found that highly offensive and pompous. Never have myself but know many people getting great benefit and obviously it’s been around what .... thousands of years? Lost credibility right off the top for me, and on behalf of my wife and one daughter in law (Kaiser executive and Cross Fit member / physically capable person) .... it pissed me off.
Click to expand...

Well if you’re going to eliminate credibility right off the bat, also consider how the same people here pushing the success of hydroxychloriquine were also just trying to peddle you crap from a quack whose medical opinions involve sex demons and alien sperm.

Whenever people keep up bringing hydroxychloriquine, it never seems to be inspired by a nuanced desire to discuss the pharmaceutical merits of the drug. It’s always a jumping off point to “This is a confirmed 100% miracle cure that is being suppressed by the liberal elite who are purposely exaggerating the virus and killing Americans to hurt Trump, we need to open everything back up ASAP and no need to wear masks”. I.e, ridiculous conspiracy nonsense that requires immense leaps in logic and is not supported by the consensus within the global scientific community.

Helljumper, Jul 29, 2020

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No quarrel with you dude. Did not understand or like that they mocked something entirely off topic. Easy. #notatrumpfan

LTLakerFan, Jul 29, 2020

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LTLakerFan said: ↑

No quarrel with you dude. Did not understand or like that they mocked something entirely off topic. Easy. #notatrumpfan
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Yeah I got you, I think I have a sense of where you stand on these issues and overall I think I probably see eye-to-eye with you more than I do with most others on this board. Yeah calling out acupuncture specifically like that was probably not a good move from that writer, but I think it doesn’t take away from the point that HCQ has NOT been demonstrated to be the success some here are touting.

Helljumper, Jul 29, 2020

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KareemtheGreat33 said: ↑

Hey Weezy since you're criticizing Church services, what is your opinion on thousands of "protesters" shoulder to shoulder in the streets? What's good for the goose is good for the gander, I always say...
Click to expand...

You can worship god at home, you can also wear a mask to church. The article points out masks were not required for that church event, which is stupid, so those people deserve what they get. Protest to try to force change for the better is not equatable to going to church to me, and from what I’ve seen most people are wearing masks at protests. You can stay home and read the Bible, or do Zoom church meetings. You can’t really stay home and try to get police to stop murdering unarmed people, of color or otherwise. I don’t think protesting in this climate is wise either, but I do understand it, and again, most seem to be wearing masks. But sure, I was “criticizing church services” because I found it dumb those people held a week long church event with no masks required. I’d say the same thing if people held a music festival, a film festival, a major sporting event, and didn’t require masks, it’s dumb. Some people genuinely believe they’re protected from COVID by god at church, I’ve read the quotes, and I’m sorry, but I’m gonna make fun of you if you’re that stupid.

Weezy, Jul 29, 2020

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most of these people are there for spiritual comfort, stupid or not, that's their belief, I'm not a church goer, and I'm just curious if there is some cognitive dissonance in being up in arms over people peacefully worshipping, then you think it is important to protest in time of a pandemic for some inequality that technically is there ever since.

KareemtheGreat33, Jul 29, 2020

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It’s not stupid to go to church, never said that. It’s stupid to go to a week long church event and not wear a mask. Masks should be required at such events, to think you are special and protected because you’re going to church and doing a good thing is ignorant and sad, but common from what I read a lot online. I don’t think I was up in arms over anything either, and while I do think it’s a crucial and important time to try to force change with systemic racism in policing, again, I also said people should be wearing masks. I grew up religious, and now am not, so I’ll admit I do have my biases, but my stance remains what it is. It’s dumb to attend any large gathering and not wear a mask.

Weezy, Jul 29, 2020

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It would be nice to have a leader who could bring the country together. I don’t see that happening anytime soon unfortunately.

sirronstuff, Jul 30, 2020

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John3:16, Jul 31, 2020

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Last edited: Jul 31, 2020

Helljumper, Jul 31, 2020

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