Hydroxychloroquine is probably best known to the world these days as the magic drug that Donald Trump claimed to be the game changer in the fight against Covid-19. Soon after, the drug was discredited as dangerous, and prescribing the drug off label as a method to treat Covid-19 was eventually prohibited, if not demonised altogether, especially in the west.
I largely ignored the matter, thinking that the evidence simply was against the drug, and moved on. Until a few days ago.
America Frontline Doctors
A group of doctors that recently formed an association called America Frontline Doctors, went live on Facebook and other social media to declare to the US and the world that they had been treating patients with Hydroxychloroquine (+ Zinc + Azithromycin) and they had seen a great benefit. In fact, they essentially stated that the cure for Covid-19 exists and no one has or had to die so far. And went as far as saying that the protocol can be used as prophylaxis, too. The video has been banned repeatedly from all sorts of platforms. It’s currently available on this site (no direct link available, but it’s currently on the homepage, in rightmost column, entitled: “CENSORED: America’s Frontline Doctors Press Conference at the Supreme Court”).
Hardcore censorship and defamation
With the apparent reason of “false information about Covid-19”, the information shared by these doctors was forcefully censored (and still is) from all sorts of platforms. Not only that, very shortly after the fact, a number of blog and newspapers (mostly leftwing) have done their best to discredit the doctors involved. From claiming that these doctors never actually treated any Covid patient to using Dr Stella Immanuel’s peculiar religious beliefs (I haven’t fact-checked her beliefs, because for me it is beside the point), they have done their best to defame these doctors, although I have seen very little actual evidence against them.
I admit the whole thing seemed weird, but one fact actually haunted me: I was convinced these doctors had no advantage or benefit whatsoever from claiming what they claimed. So, why?
When I started digging, the first thing I realised is that I had been distracted during this pandemic. I mean, I have a lot going on. But. I should have paid more attention. I am referring to the Lancet study. The study, now formally retracted (which happened only 13 days after its publication), was based on fake data from a joke of a company. This is the same study that both the FDA and WHO have leveraged to carry out the decision to stop off-label use of hydroxychloroquine for Covid-19 treatment. As a result of that move, other bodies around the western world have done the same.
Some more digging
That just me made want to dig even more, specifically into some scientific literature.
The most striking paper I found after five minutes in my research is entitled Early Outpatient Treatment of Symptomatic, High-Risk Covid-19 Patients that Should be Ramped-Up Immediately as Key to the Pandemic Crisis. From the abstract:
Hydroxychloroquine+azithromycin has been used as standard-of-care in more than 300,000 older adults with multicomorbidities, with estimated proportion diagnosed with cardiac arrhythmias attributable to the medications 47/100,000 users, of which estimated mortality is <20%, 9/100,000 users, compared to the 10,000 Americans now dying each week. These medications need to be widely available and promoted immediately for physicians to prescribe.
You read that, and you go: mhm, ok. (The rest of the paper is available for free, by the way).
Then I found out that the person who wrote that paper is Harvey A. Risch, MD, PhD, professor of epidemiology, Yale School of Public Health. And he also wrote this op-ed entitled The Key to Defeating COVID-19 Already Exists. We Need to Start Using It.
So, this guy isn’t just a random nobody holding a sudden press conference saying they have been treating 350+ patients to date of all kind of ages and with comorbidities, with zero deaths (this is Dr Stella Immanuel, by the way). This is a respectable Yale professor publishing in reputable journals.
In this op-ed you’ll find that he says:
Since publication of my May 27 article, seven more studies have demonstrated similar benefit. 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.
Henry Ford Health System (HFHS)
Treatment with hydroxychloroquine cut the death rate significantly in sick patients hospitalized with COVID-19 – and without heart-related side-effects, according to a new study published by Henry Ford Health System.
Italian study agrees with HFHS
An Italian team published a study entitled Effectiveness of Hydroxychloroquine in COVID-19 disease: A done and dusted situation? In this paper, they say «Our results are remarkably similar to those shown by Arshad et al.» (i.e. HFHS study).
- Treatment with hydroxychloroquine, azithromycin, and combination in patients hospitalized with COVID-19 — Large retrospective study: 82% received HCQ w/in 24hrs of adm, HCQ reduced mortality by 66% (p=0.001) – HCQ+AZM reduced mortality by 71% (p=0.001)
- A Sound Approach: Hydroxychloroquine Reduces Mortality in Severe COVID-19 — HCQ was indep assoc w/decreased mortality, distinct benefit from steroid effect. Safe dosage & early utilization of HCQ reduced mortality in hosp COVID19 pts. Large cohort studies support our findings from NYC, (Italy) & France.
And even more studies
- Zelenko et al publishes study of outpatient HCQ use with 99.3% outpatient survival rate
- Raoult et al reports only 0.5% mortality rate in 3,737 COVID-19 patients treated with HCQ+AZ
- S. Korea prospective trial in long-term care hospitals on prophylaxis with HCQ was 100% protective in 211 patients…Over 2 months and 30,000 LTCH deaths later, the US struggles to publish its 1st HCQ prophylaxis study (SH Lee, et al)
- Risk Factors for Mortality in Patients with COVID-19 in New York City
More interesting links
Meanwhile, on the news
- India: Vadodara administration drive: HCQ helping in containing Covid-19 cases, say docs as analysis begins
Ok, let me have a look in Italy
At this point I stop and wonder: what about Italy? I usually trust the Italian doctors. They are excellent, they have a great training, they are very knowledgeable, and being Italian, they don’t just follow orders because they are orders. Which in cases like this, it’s probably good.
Yet I didn’t hear much about hydroxychloroquine in Italy. Or perhaps, once again, I hadn’t paid much attention. Of course, above, I linked a study by an Italian team that agrees with Henry Ford Health System. But that’s recent in my research trail.
Early in my research, I found out that Dr Moreno Ferrarese of Alessandria (Piedmont) had been using hydroxychloroquine with success. Hundred more doctors were apparently doing the same. We are talking about GPs, family doctors, treating patients at home. And we talk about May time, before The Lancet came out with its fraudulent study.
The latest public comment by Dr Ferrarese I could find goes back to 25 May, and states that he had by then treated 169 patients, no deaths, and only 7% was hospitalised, although none of them ever developed severe complications.
When the AIFA forbade the use of hydroxychloroquine for Covid-19, the Italian doctors denounced that without alternatives, home-based treatment of patients was now at risk.
Also, as far as I can tell, the “Alessandria protocol” (such was labelled the approach used by Ferrarese using hydroxychloroquine) was never big news on TV or elsewhere. In fact, living in the UK, the thing I had heard more about coming from Italy was the Ascierto protocol, using Tocilizumab, which now a randomised study says had no statistically relevant benefits.
That said, it remains that in Italy, too, we have doctors that disagreed with the global advice of not using hydroxychloroquine for Covid-19.
As you dig, you find many doctors in the West have chosen, for the sake of their patients, to follow the science instead of the politics. Some names are:
After the storm
Interestingly enough, after the storm that the American Frontline Doctors unleashed, suddenly more and more people came out as both patients willing to testify and more doctors willing to put their neck on the line.
Within days from that presse conference, Food and Drug Administration Commissioner Stephen Hahn said there are some medical observational studies that “suggest a benefit” in using the drug hydroxychloroquine for treating COVID-19 and that doctors can still prescribe the drug off-label for coronavirus patients.
The FDA official guidance hasn’t however changed, and Hahn added that clinical, randomised trials do not show a benefit (which based on the literature I reviewed, I don’t think it’s an accurate claim).
In the light of all the data I presented here, which is only a fraction of what’s available, it bewilders me to read Fauci, as of three days ago, still say that hydroxychloroquine is ineffective.
Mind you, this is the same man who can’t guarantee in-person voting at the US elections in November, but apparently has no advice to give regarding the hoards of rioters amassing in the streets of the USA.
You should really be starting to think hard at this point, because if you don’t feel something is wrong, I am not sure what could ever make you budge.
Again, from prof. Risch:
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.
Not new and not unsafe
It was 2005 when Chloroquine is a potent inhibitor of SARS coronavirus infection and spread was published. Now, the study speaks of chloroquine, not hydroxychloroquine, but the latter is essentially a less toxic form of the former. So, the efficacy of such a drug against this kind of viruses has been known for a while, and the SARS-related study mentioned above suggests “both prophylactic and therapeutic advantage”, which is essentially the same thing many doctors are now claiming of hydroxychloroquine for SARS-CoV-2.
It is also false that these drugs are not safe. Fears of heart problems seem overblown. Prof. Risch also deems the drug safe. And many have suggested that it takes extremely long period of exposure to the drug or toxic doses to see the problems HCQ has been accused of causing. In essence, the so much feared side-effects seem to be extremely rare.
Why has hydroxychloroquine been disregarded?
Prof. Risch says it best:
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.
The reason is not scientific. In fact, Risch continues:
- The medication has become highly politicised
- The drug has not been used properly in many studies
- Concerns have been raised by the FDA and others about risks of cardiac arrhythmia, 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.
To close, some common misconceptions about the virus
It’s a completely new virus. No, it isn’t. It’s 79% similar to SARS-CoV and 50% similar to MERS-CoV. And there are plenty more coronaviruses around.
There is (was) no immunity at all in the population. False. Because the virus belongs to a family of viruses we as human have already encountered, and because the virus is naturally similar to those other coronaviruses, claiming total lack of immunity to the virus is a lie. See recent research from Oxford scientists. And also interview with Dr Gupta, who says “The pre-existing antibodies & T-cell responses against coronaviruses seem to protect against SARS-CoV-2 infection, not just the outcome of infection”.
The pandemic will become endemic. Actually, research suggests that the four coronaviruses responsible for the cold once caused pandemics. This also may suggest that this new coronavirus will end up the same. This is also the opinion of Sadler, former director of the Institute for Immunology at the University of Bern, a biologist and professor emeritus.
Children have a central role in spreading the virus. Early in the pandemic had become clear this wasn’t the case. A recent study confirms that “Almost 6 months into the pandemic, accumulating evidence and collective experience argue that children, particularly school-aged children, are far less important drivers of SARS-CoV-2 transmission than adults.”