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The cult of hydroxychloroquine versus dangerous arrhythmias

A new study of #Hydroxychloroquine and #Chloroquine to treat #COVID19 was published this morning in The Lancet. The results? More deaths and arrhythmias in treated patients. [NOTE ADDENDUM: This study has been retracted. Here’s a link to my followup post.]

[NOTE FROM ORAC (June 4, 2020): This study was retracted today, due to issues of discrepancies in the data and a lack of transparency from Surgisphere, the company running the database used. Orac has written a long, detailed post about what happened. He’s not proud of the post below now, but won’t delete or edit it, other than to add this update, because, well, he’s more transparent than Surgisphere.]

So hydroxychloroquine is in the news again. It’s as though it can’t be escaped, probably because it can’t. When President Trump announced earlier this week that he had been taking hydroxychloroquine to protect himself against contracting COVID-19, I briefly debated over whether to write about it but ended up deciding not to, not so much from a sense of the uselessness of doing so but rather due to a profound ennui over the topic, an ennui that, I confess, has hampered my usual ridiculously prolific blog output of late. After all, no matter how much the evidence is trending (and has been for nearly two months now) in the direction that hydroxychloroquine is very likely ineffective against COVID-19 (or, at best, so mildly effective that only large double-blind, randomized, placebo-controlled clinical trials will be necessary to detect any effect) and causes harm through cardiac arrhythmias, the hydroxychloroquine con men, grifters, and cultists are unrelenting. But this morning I’ve been feeling signs of snapping out of it. Why? I don’t know, but one reason might be a study in The Lancet that’s hot off the presses, which I learned about thanks to Eric Topol, that demonstrates increased mortality and ventricular arrhythmias from hydroxychloroquine:

Here’s the study. Again, it’s not a randomized study (none has been published yet), but it is the largest retrospective study to date examining the use of hydroxychloroquine to treat COVID-19. The study is by Mandeep Mehra, a Harvard Medical School professor and physician at Brigham and Women’s Hospital, and colleagues at other institutions. It was a registry analysis that looked at over 96,000 patients with COVID-19 treated with hydroxychloroquine or chloroquine with or without a macrolide antibiotic (e.g., azithromycin) using de-identified data obtained by automated data extraction from from inpatient and outpatient electronic health records, supply chain databases, and financial records. The specific database used is the Surgical Outcomes Collaborative (Surgisphere Corporation, Chicago, IL, USA), which consists of de-identified data obtained by automated data extraction from inpatient and outpatient electronic health records, supply chain databases, and financial records, all taken from 671 hospitals located on six continents.

There are a couple of important things to note about the Surgical Outcomes Collaborative. First, it’s primarily designed to look at cardiovascular disease and outcomes, making it better suited than most databases to examine outcomes related to cardiac events. Second, as described in the study:

The registry uses a cloud-based health-care data analytics platform that includes specific modules for data acquisition, data warehousing, data analytics, and data reporting. A manual data entry process is used for quality assurance and validation to ensure that key missing values are kept to a minimum. The Surgical Outcomes Collaborative (hereafter referred to as the Collaborative) ensures compliance with the US Food and Drug Administration (FDA) guidance on real-world evidence. Real-world data are collected through automated data transfers that capture 100% of the data from each health-care entity at regular, predetermined intervals, thus reducing the impact of selection bias and missing values, and ensuring that the data are current, reliable, and relevant. Verifiable source documentation for the elements include electronic inpatient and outpatient medical records and, in accordance with the FDA guidance on relevance of real-world data, data acquisition is performed through use of a standardised Health Level Seven-compliant data dictionary, with data collected on a prospective ongoing basis. The validation procedure for the registry refers to the standard operating procedures in place for each of the four ISO 9001:2015 and ISO 27001:2013 certified features of the registry: data acquisition, data warehousing, data analytics, and data reporting.

The standardised Health Level Seven-compliant data dictionary used by the Collaborative serves as the focal point for all data acquisition and warehousing. Once this data dictionary is harmonised with electronic health record data, data acquisition is completed using automated interfaces to expedite data transfer and improve data integrity. Collection of a 100% sample from each health-care entity is validated against financial records and external databases to minimise selection bias. To reduce the risk of inadvertent protected health information disclosures, all such information is stripped before storage in the cloud-based data warehouse. The Collaborative is intended to minimise the effects of information bias and selection bias by capturing all-comer data and consecutive patient enrolment by capturing 100% of the data within electronic systems, ensuring that the results remain generalisable to the larger population. The Collaborative is compliant with the US Agency for Healthcare Research and Quality guidelines for registries. With the onset of the COVID-19 crisis, this registry was used to collect data from hospitals in the USA (that are selected to match the epidemiological characteristics of the US population) and internationally, to achieve representation from diverse populations across six continents. Data have been collected from a variety of urban and rural hospitals, academic or community hospitals, and for-profit and non-profit hospitals.

The primary outcome examined was in-hospital mortality, and the study looked for an association between use of a treatment regimen containing chloroquine or hydroxychloroquine, with or without a second generation macrolide like azithromycin, when initiated early after COVID-19 diagnosis, and this endpoint. Secondary outcomes were the occurrence of clinically significant ventricular arrhythmias. or sustained ventricular tachycardia or fibrillation (both life-threatening arrhythmias often requiring cardioversion). Other outcomes examined were rates of progression to mechanical ventilation and total and intensive care unit lengths of stay for patients in each group. A large number of patient demographics and characteristics were also recorded, including age, body-mass index (BMI), sex, race or ethnicity, and continent of origin were obtained. Underlying comorbidities were also recorded, including cardiovascular disease , smoking history, hypertension, diabetes, hyperlipidemia, or chronic obstructive pulmonary disease (COPD), and presence of an immunosuppressed condition, as well as use of medications at baseline, including cardiac medications or use of antiviral therapy other than the drug regimens evaluated.

In addition:

The initiation of hydroxychloroquine or chloroquine during hospital admission was recorded, including the time of initiation. The use of second-generation macrolides, specifically azithromycin and clarithromycin, was similarly recorded. A quick sepsis-related organ failure assessment (qSOFA) was calculated for the start of therapy (including a scored calculation of the mental status, respiratory rate, and systolic blood pressure) and oxygen saturation (SPO2) on room air was recorded, as measures of disease severity.

Confounding factors were controlled for, including demographic characteristics, comorbidities, disease severity at presentation, and other medication use (cardiac medications and other antiviral therapies).

So what were the results? Not good. Actually, that’s an understatement. Of the 96,032 patients with COVID-19 (mean age 53.8 years, with 46.3% women), 14,888 patients were in the treatment groups, with 1,868 receiving chloroquine, 3,783 receiving chloroquine + macrolide, 3,016 receiving hydroxychloroquine, and 6,221 receiving hydroxychloroquine + macrolide. That left 81,144 patients in the control group. Overall 10,698 patients (11.1%) died in the hospital. Then there was this:

After controlling for multiple confounding factors (age, sex, race or ethnicity, body-mass index, underlying cardiovascular disease and its risk factors, diabetes, underlying lung disease, smoking, immunosuppressed condition, and baseline disease severity), when compared with mortality in the control group (9·3%), hydroxychloroquine (18·0%; hazard ratio 1·335, 95% CI 1·223–1·457), hydroxychloroquine with a macrolide (23·8%; 1·447, 1·368–1·531), chloroquine (16·4%; 1·365, 1·218–1·531), and chloroquine with a macrolide (22·2%; 1·368, 1·273–1·469) were each independently associated with an increased risk of in-hospital mortality. Compared with the control group (0·3%), hydroxychloroquine (6·1%; 2·369, 1·935–2·900), hydroxychloroquine with a macrolide (8·1%; 5·106, 4·106–5·983), chloroquine (4·3%; 3·561, 2·760–4·596), and chloroquine with a macrolide (6·5%; 4·011, 3·344–4·812) were independently associated with an increased risk of de-novo ventricular arrhythmia during hospitalisation.

Or, to boil it down, after controlling for confounders, the investigators found that all four groups treated with anti-malaria drug ± macrolide were more likely to die in the hospital than the control groups receiving neither chloroquine nor hydroxychloroquine. Those receiving hydroxychloroquine were 34% more likely to die, hydroxychloroquine + macrolide 45% more likely, and chloroquine 37% more likely, chloroquine + macrolide 37% more likely. Depending upon the specific group, the treated patients were between 2.37 and 5.1 times more likely to suffer a new ventricular arrhythmia, with the highest risk being among patients receiving Didier Raoult’s combination of hydroxychloroquine plus azithromycin or other macrolide. The authors also did a tipping point analysis to estimate the effects of an unmeasured confounder on the findings of significance with hydroxychloroquine or chloroquine and found:

For chloroquine, hydroxychloroquine, and chloroquine with a macrolide, a hypothetical unobserved binary confounder with a prevalence of 50% in the exposed population would need to have an HR of 1·5 to tip this analysis to non-significance at the 5% level. For a comparison with the observed confounders in this study, if congestive heart failure (which has an HR of 1·756) were left out of the model, it would need to have a prevalence of approximately 30% in the population to lead to confounding in the analysis. Similarly, for hydroxychloroquine with a macrolide, a hypothetical unobserved binary confounder with a prevalence of 37% in the exposed population would need to have an HR of 2·0 to tip this analysis to non-significance at the 5% level. Again, congestive heart failure (which has an HR of 1·756) would need to have a prevalence of approximately 50% in the population to lead to confounding in the analysis, had it not been adjusted for in the Cox proportional hazards model.

In other words, the finding is robust, at least as robust as a retrospective analysis can be, leading the authors to conclude that they saw no benefit, but did see a signal suggestive of a higher risk of cardiac arrhythmias and death in the groups treated with chloroquine and hydroxychloroquine:

In summary, this multinational, observational, real-world study of patients with COVID-19 requiring hospitalisation found that the use of a regimen containing hydroxychloroquine or chloroquine (with or without a macrolide) was associated with no evidence of benefit, but instead was associated with an increase in the risk of ventricular arrhythmias and a greater hazard for in-hospital death with COVID-19. These findings suggest that these drug regimens should not be used outside of clinical trials and urgent confirmation from randomised clinical trials is needed.

Or, as Eric Topol put it:

It is actually interesting to note that, while the incidence of life-threatening cardiac arrhythmias was 2-5 time higher in the treatment groups, the increased mortality was only 34-45%. One possible explanation is that we’re very good at treating such arrhythmias in hospitalized patients on cardiac monitor, so that most of the arrhythmias are reversed before the patient dies. We can’t tell, though, from this study, because, as they authors conceded, they did not study the relationship between ventricular arrhythmias and deaths (i.e., death due to arrhythmia versus death due to other causes). Also, it’s important to note that this study only examined hospitalized patients; so its results can’t be extrapolated to prophylactic use. Of course, to determine the efficacy of prophylactic use of drugs like this would require thousands of patients in a randomized, double-blind, placebo-controlled clinical trial, at least if the primary outcome is death from COVID-19.

In a news story about the new study:

Cardiologist Steven Nissen of the Cleveland Clinic said the new data, combined with data from smaller previous studies, suggests that the drug “is maybe harmful and that no one should be taking it outside of a clinical trial.”

Jesse Goodman, a former FDA chief scientist who is now a Georgetown University professor, called the report “very concerning.” He noted, however, that it is an observational study, rather than a randomized controlled trial, so it shows correlation between the drugs and certain outcomes, rather than a clear cause and effect.

Peter Lurie, a former top FDA official who now heads the Center for Science in the Public Interest, called the report “another nail in the coffin for hydroxychloroquine — this time from the largest study ever.”

He said it was time to revoke the emergency use authorization issued by the FDA, which approved the drug for seriously ill patients who were hospitalized or for whom a clinical trial was not available.

I agree 100%. The EUA should never have been issued, but, given that President Trump apparently still believes in hydroxychloroquine, I highly doubt that the FDA will revoke the EUA any time soon. Dr. Topol brings up a more interesting question, though:

He’s right, too. There’s a principle known as clinical equipoise, meaning a genuine uncertainty over whether a treatment is effective and safe or not. For a clinical trial to be ethical, there must be clinical equipoise, because, if there isn’t clinical equipoise, then it is unethical to randomize patients because there will be patients whom investigators knowingly randomize to a group that will receive inferior care. It’s the reason why a randomized, double-blind, placebo controlled trial of the vaccination schedule is unethical; the control group would be randomized to be left unprotected against potentially deadly infectious diseases. In this case, we now know that in hospitalized patients treatment with hydroxychloroquine very likely results in more dangerous arrhythmias and more death, not just from this study but from others.

Of course, as is always the case with treatments like these, be they vitamin C or whatever, the treatment can never fail; doctors and patients can only fail the treatment. What then happens is, inevitably, the claim that the drug or intervention has to be started “early”:

I’m definitely getting a vitamin C vibe now from the hydroxychloroquine cultists, or, as Mark Hoofnagle points out:

Hydroxychloroquine acolytes are definitely well down this progression, at least to #5 and #6. Because I’m dedicated to evidence and science when it comes to medical decision making, I always concede that it is still possible that hydroxychloroquine might still be found to have some anti-COVID-19 activity, although it’s becoming increasingly clear that, if there is any activity it will be modest and require large clinical trials to detect and might be outweighed by potential complications from the drugs, most prominently cardiac arrhythmias. However, my gut feeling, for what it’s worth, is that the drug does not work and has likely killed patients who might otherwise have survived.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

148 replies on “The cult of hydroxychloroquine versus dangerous arrhythmias”

For believers

Today I am identifying(?) houses of worship such as churches, synagogue, and mosques as essential places that provide essential services… I call upon governors to allow churches and places of worship to open right now. If, there is any question they’re gonna have to call me but they are not gonna be successful in that call…

— Trump Church Decree, Friday, May 22, 2020

Of note is that many of them are all ready open and without the full guidelines of the original CDC church section such as masks, no singing, no passing the collection plate, no common food items and the like.

But what of some other governors, such as Newsom of California? They are just not gonna be successful?

President Trump’s grasp of federalism is not as good as it should be. He does not have the authority to dictate to governors on this. And they have ignored his statements on other things.

He does have a big mike, and I think the reactions of states run by Republican governors where this is not already done may provide interesting indications on how they see his chances.

It’s all grandstanding to appeal to his base. He needs to feed them some Lib Ownage, because FSM knows he’s got nothing of substance.

It’s all grandstanding to appeal to his base.

Well. He may have just royally fucked up, then. Because his disinfo babe, Kayleigh McEnany, had this to say at the presser:

…we can all hope that, this Sunday, people are allowed to pray to their gods across this country — that’s a good thing.

Though she was wearing a little crucifix prominently so as to mark the spot to put the tracheostomy when she wigs on some shellfish, I wonder if her true faith is that she must hold her clipboard of talking points against her chest at the time of death in order to enter Valhalla.

I predict that Trump will find some church that will let his unmasked face in this Sunday. He is superman. He has superior genes. And he will bask in a flood of adoratiion as his ‘base’ emulates him.

And yet, he was always a germophobe about everything else every when before.

I note that, at the Ford plant yesterday, when asked if he had the test to check for antibodies, he said no.

No. And might that be because it might leak that he is loaded with them? Only, they are not his but those of many other people. That would explain alot. And his gig would be up.

“we can all hope that, this Sunday, people are allowed to pray to their gods across this country”
a true blow for religious freedom – at last, polytheism has been acknowledged by the White House. Personally, I’m never sure if I should worship Cernobog, Libulan, or both.

Yes, Jays. It does.

It is not so much the praying, but the spraying. Now, If I saw people walking around walmart hand in hand five isles wide belting out How Firm A Foundation then what you said might hold.

Also, a physical church comprising The Body Of Christ was not really a thing back in Jesus’ time. In fact (and I’m not going to quote the whole verse or give a citation — that is left as an exersise for the reader) it is written that ‘wherever two or three be gathered* together…’

That is ‘safer at home’ compliant.

Basically, “mass church gatherings are not an essential service” — literally Jesus

*I hear the Zoom app has become the most popular goto for such gatherings in this day and age.

I am a churchgoer. I think church is probably one of the least safe places to be right now, long exposure time, enclosed space, singing with leaking and / or useless cloth masks.

This study says nothing about the use of HCQ as a prophylactic or medication to prevent progression of disease. COVID-19 is actually 2 diseases: a viral syndrome on presentation with progression to immunological derangement beginning around day 7 to 9. At this point, no anti-viral is effective and therapy must be directed towards immunosuprression.

But the study shows that for a subset of patients (hospitalized, comorbid) hydroxychloroquine has a detrimental effect. So what is it about this subset that makes HCQ dangerous? We don’t know but we can speculate. Patients who die with COVID-19 have a low T cell count. T cell activation requires glucose. Hydroxychloroquine can induce hypoglycemia in rare instances. It i possible that the combination of hydroxychloroquine and oral hypoglycemic agents in diabetes makes a powerful synergistic brew that further keeps T cells from activating. The lesson to be learned is not to use HCQ in patients with comorbidity of diabetes on oral hypoglycemic agents. But that is the only lesson t be learned.

Diabetes type 2 is particularly susceptible to cardiotoxicity due to increased levels of furan. Furan is a cardiotoxin and the natural substrate for TMPRSS2. TMPRSS2 is the fusion protein expressed by AEC2 cells that allows viral entry. Increased TMPRSS2 then binds the furan to the cardiocyte.

It is actually interesting to note that, while the incidence of life-threatening cardiac arrhythmias was 2-5 time higher in the treatment groups, the increased mortality was only 34-45%. One possible explanation is that we’re very good at treating such arrhythmias in hospitalized patients on cardiac monitor

As it is getting into the red states now and Memorial Day is soon upon us, I wonder how many Ethels will ask their John Boys to pop up onto the ridges because their Billy Bobs are late for the annual family grave decoratings and bbqs and they are not answering their phones (there were those tiffs with the Gertrudes, last week; but still).

The John Boys arrive at the Billy Bobs’ cabins and discover them in a somewhat unalive states next to stinking, buzzing piles of half-dressed squirrel, bottles of HCQ, and spilled growlers of bourbon and coke. /morbid

I mostly know of them as drugs for lupus patients. My understanding is that they aren’t the anti-malarials of choice these days for actual malaria?

Perhaps not, Roadsterguy – and I don’t mind being corrected on this point – but note this sentence in the CDC leaflet, ‘Medicines for the Prevention of Malaria while Traveling: Hydroxychloroquine’ (CS237187-C): ‘Hydroxychloroquine can be prescribed for either prevention or treatment of malaria.’

Some strains of P. falciparum have developed resistance to chloroquine, and HCQ is along for the ride.

There are four big proponents of hydroxychloroquine among world leaders:
Trump, Putin, Bolsonaro and Boris Johnson. Not coincidentally, the four countries with the worst response to the pandemic (by the numbers) are the US, Russia, Brazil and the UK.

Remember, Trump’s plan here was to put out a big contract for this stuff (which would have greatly profited one of his big campaign donors) and mass distribute it through commercial pharmacies, all before any controlled studies came in. And the supply was going to have been manufactured in fairly sketchy facilities in South Asia, which was part of what got Dr. Bright to blow the whistle on the scheme…

Sanofi’s largest shareholders include Fisher Asset Management, the investment company run by Ken Fisher, a major donor to Republicans, including Mr. Trump.

Another investor in both Sanofi and Mylan, another pharmaceutical firm, is Invesco, the fund previously run by Wilbur Ross, the commerce secretary. Mr. Ross said in a statement Monday that he “was not aware that Invesco has any investments in companies producing” the drug, “nor do I have any involvement in the decision to explore this as a treatment.”

As of last year, Mr. Trump reported that his three family trusts each had investments in a Dodge & Cox mutual fund, whose largest holding was in Sanofi.

https://www.nytimes.com./2020/04/06/us/politics/coronavirus-trump-malaria-drug.html

In the 1980s, Donald Trump’s three casinos in Atlantic City were under threat of foreclosure from lenders. Ross, who was then the senior managing director of Rothschild & Co, represented investors in the casino. Along with Carl Icahn, Ross convinced bondholders to strike a deal that allowed Trump to keep control of the casinos.

Ross had threatened to fire high-level staff of the National Oceanic and Atmospheric Administration (NOAA) unless the agency fixed its contradiction of President Trump. Previously on September 1, Trump claimed that Hurricane Dorian may hit Alabama, while minutes later the Birmingham, Alabama branch of the National Weather Service (under the NOAA) stated that Alabama was not at risk. The New York Times also reported that Ross’ threat led to the September 6 NOAA statement from an unidentified spokesperson endorsing Trump’s position and declaring that the Birmingham, Alabama branch of the National Weather Service’s contradiction of Trump was incorrect.

https://en.wikipedia.org/wiki/Wilbur_Ross

Bunch of Yes Men, cronies, Gouliani is in there to — all geriatric, all very lemonparty (dot)org ish. /NSFW

The failure to distinguish infection (due to SARS-2), cases (with symptoms or COVID-19) and deaths in patients with COVID-19 paints a very distorted picture of the virulence of the organism.
The number of cases will clearly go up as testing becomes ever more widespread. The infection death rate (not the absolute number of deaths) is plummeting.
The case rate (symptomatic/ (symptomatic and asymptomatic and immune) is likely to plummet.
The case death rate is already plummeting; both in absolute and relative numbers.
This is the expected standard epidemiology curve. The most vulnerable in a society will succumb before the infection is even recognized or action can be taken against it; in parallel herd immunity will emerge and slow the infection rate.
The best we can do is tweak the near term death rate but in the end, the natural death rate and numbers due to the virus will prevail. We see this with the flu. There is no reason to suspect a different type of response to the Corona virus.

Sweden decided to do the rational thing: protect the vulnerable and let everyone else go on with their lives.
Review of data to date indicates that lock downs did nothing to change the shape of the curve but may decreased the upfront (near) death rate. In all likelihood displaced the number of deaths (phase shift) to the future by several months, long after the issue with the corona virus will have faded from the news cycle.
Of note: The majority of death in the US and Canada were due to the legal requirement that nursing homes take COVID-19 infected patients.

In the US, we have a Federalism meaning that political power is divided between the Central Government and the States, with the power not conferred to the Central Government Reserved to the States. The decision to coerce nursing homes to take COVID-19 positive patients is clearly a decision made by the States; and the leader is New York under Cuomo.

In Italy, the elderly live with their offspring, in high density populations; not to dissimilar at a mechanistic level of forcing nursing homes to take COVID-19 positive patients.

Some true believers say that HCQ should be paired with some form of zinc supplement. Not having a medical background, I cannot judge the plausibility of this suggestion. I did find mention of a preprint, from the NYU Grossman School of Medicine, which compared Covid-19 patients given HCQ, zinc, and azithromycin against those given only HCQ and azithromycin. The study found that patients given zinc had a 1.5 times greater probability of getting better from the disease.

How plausible is it that the addition of zinc would make such a significant difference?

https://www.sciencetimes.com/articles/25658/20200512/hydroxychloroquine-azithromycin-zinc-triple-combo-proved-effective-coronavirus-patients-study.htm

The study found that patients given zinc had a 1.5 times greater probability of getting better from the disease.

You might want to read the actual preprint and also find a news aggregator that knows medRchiiv is not the author’s site. I’m tired, but this appears to be a negative study, even leaving aside the problem of HCQ’s not helping in the first place.

I did read the study. The authors note quite a few confounding factors, and conclude that the study “should not be used to guide clinical practice.” An excerpt from the Discussion:

“This study has several limitations. First, this was an observational retrospective analysis that could be impacted by confounding variables. This is well demonstrated by the analyses adjusting for the difference in timing between the patients who did not receive zinc and those who did. In addition, we only looked at patients taking hydroxychloroquine and azithromycin. We do not know whether the observed added benefit of zinc sulfate to hydroxychloroquine and azithromycin on mortality would have been seen in patients who took zinc sulfate alone or in combination with just one of those medications. We also do not have data on the time at which the patients included in the study initiated therapy with hydroxychloroquine, azithromycin, and zinc. Those drugs would have been started at the same time as a combination therapy, but the point in clinical disease at which patients received those medications could have differed between our two groups. Finally, the cohorts were identified based on medications ordered rather than confirmed administration, which may bias findings towards favoring equipoise between the two groups. In light of these limitations, this study should not be used to guide clinical practice. Rather, our observations support the initiation of future randomized clinical trials investigating zinc sulfate against COVID-19.”

i have an extensive medical ground. I am a pathologist with 4 fellowships. Zinc has generic anti-viral properties. The problem in the past is how to get the zinc to a location where it will be virocidal and not toxic to human cells. Zinc is highly toxic regulated by the body. Adding zinc makes sense if it gets into the cells. This is done by adding quinine in small amounts. The result is that electrostatic force of the Calcium channel is altered to allow more zinc into the cell. Although zinc is considered toxic in high doses, studies have shown it is safe to at least 2,000 mg per day. The standard supplement is 50 mg per day and this is sufficient.

As to this study: it is vital to understand that the only time HCQ was detrimental was to a small subset of patients: hospitalized with significant combidities and advanced disease. At this point HCQ is not likely to be beneficial (as is the case with all anti-virals). This is because the disease changes its nature from a “viral syndrome” to a “dysfunctional immune syndrome”. To treat this condition potent immuno-suppressives, such as corticosteroids are required. And as there is usually endotoxemia due to a bacterial infection, a broad spectrum antibiotic (macrolide in this article) such as azithromycin is required. But without immuno-suppression the patient is likely to die.

Death is due to an exhaustion of the activated T cell (a cell necessary to keep infection under control).

I notice that they tend not to respond to you. I want you to know I appreciate your posts. Keep it up, as one blogger says, Knowledge is Good.

I notice that they tend not to respond to you.

Might have to do with things like this:

i have an extensive medical ground [sic]. I am a pathologist with 4 fellowships. Zinc has generic anti-viral properties. The problem in the past is how to get the zinc to a location where it will be virocidal and not toxic to human cells. Zinc is highly toxic regulated by the body [sic]…. Although zinc is considered toxic in high doses, studies have shown it is safe to at least 2,000 mg per day.

You don’t say. If “studies have shown,” then show the fucking studies.

P.S. http://www.snopes[.]com/fact-check/zinc-lozenges-coronavirus/

I read that study too. For me the problem with it was that it only compared the effectiveness of hydroxychloroquine with and without zinc, and with and without azithromycin, which shows a benefit of adding zinc but doesn’t have controls where HCQ was not given.

No, it never showed promise, the data continues to be pretty clear. What’s weird is you think you know something. Your popcorn is so tasty. Keep us informed of your ignorance! Thanks.

If you could, don’t recommend that people kill their children because you feel that vaccinations did something to you. We cool? Bump.

Best and kiss kiss.

@ 1000,

Omgosh, when Orac wrote:

“… evidence is trending (and has been for nearly two months now) in the direction that hydroxychloroquine is very likely ineffective against COVID-19 (or, at best, so mildly effective ) …”

I thought he meant that almost two months ago, hydroxychloroquine was thought by some to be possibly effective against covid!

Oh! And when Orac said that the EUA for hydroxychloroquine should never have been issued by the FDA? I thought that meant that the FDA actually HAD issued an EUA for hydroxychloroquine!

Which would mean, you know; that hydroxychloroquine, an antimalarial, had at one time, shown promise against covid.

And I don’t have to tell anyone not to vaccinate. All’s I have to tell them … is that I did.

@Christine: No, what that shows is that Trump or his cronies pressured the FDA into issuing a compassionate use declaration, despite the absence of good evidence for it.

I am startled to see you as the person arguing that the FDA is a reliable authority on medication and appropriate treatments for disease. which always acts on the best available evidence and never makes mistakes.

Hey, look at the bright side. The time Christine spends shilling for this drug is time that she won’t have for laughing at the suffering of dying children.

Isn”t it weird, someone who accuses us of being pharma shills, is shilling for hydroxychlorine, so for big pharma?

@ christine kincaid

You seem, as usual, to miss the point. Based on an in vitro study, they found hydroxychloroquine reduced virus shedding. So much for in vitro studies. But it is used for some autoimmune diseases because it has a moderate effect on suppressing the immune system. But moderately suppressing the immune system doesn’t come close to dealing with cytokine storms. But, it was a reasonable hypothesis. Only problem was Raoult’s fraudulent study and Trump’s jumping on it and promoting it.

Also, the fact that one blood type is less likely to suffer from plasmodium falciparum, doesn’t mean it hasn’t in the past worked for other blood types and even some with type 0 nor that it didn’t work for the other three types of malaria.

However, resistance has been developing for many years; but, isn’t relevant, as still used successfully with lupus and rheumatoid arthritis.

Once more you jump in without knowing what you are talking about. MORON!

I could recommend some good books on history of malaria; but I’m sure you wouldn’t be interested.

Probably not as weird as you think. The question is how significant. Red blood cells (and all cells) are decorated in sugar proteins called a glycan. The body uses glycans to modulate certain types of cellular signaling. The SARS2 virus also has a glycan coat that is quite similar to human glycan. The glycan coating of the O blood type may help in keeping the virus from entering the cell or act as a natural vacuum cleaner to suck up the virus. Additional investigation would be necessary to determine the exact mechanism.

@ Pathcoin1,

Thank you for your reply, that is interesting.

@ Vicki, Analysis & Renate,

So now I’m shilling for Pharma because I quoted Orac when 1000 Links to a furlong said:

“No, it never showed promise”?

I actually agree that hydroxychloroquine won’t be the way to go. Follow the damn thread, I never said it was promising; I said there was a time when some thought it might be.

the hydroxychloroquine con men, grifters, and cultists are unrelenting

I don’t know if you saw this. Yes, people in Zelenko’s community kept dying of COVID-19 at the same rate as everywhere else, but that was totally the fault of other people – HCQ cannot fail, it can only be failed.

Zelenko released a video over the weekend, addressed to the Kiryas Joel residents, in which he accused town leaders of orchestrating multiple investigations against him. Zelenko accused three men — Gedalye Szegedin, the town administrator; Mayer Hirsch, a developer and Joel Mittelman, the chief executive of the main health care provider in Kiryas Joel, where Zelenko used to work — of being responsible for the deaths of 14 Jews who died of Covid-19. The three did not act quickly enough in closing the town’s synagogues and schools at the beginning of the pandemic, he said.
https://forward.com/fast-forward/447020/zelenko-hydroxychloroquine-kiryas-joel-hasidic/

PSA.

Perhaps it is just me. And, there is a CF avenue for that to single me out. CF fingerprints and allows one to be identified without the use of cookies or js and this tracking information is passed on to the customer. CF also has super secret options to show differing content to differing users {shadow banning}.

Now, I would like to protest that perhaps this is being implemented by Orac to ‘slow me down’; Fine. But he is doing it wrong. There is a ‘cool down’ on any interaction with the page but it is iterative in that, if I refresh, it just keeps going backwards from stale caches. I have to make a comment and go to a different device (after it has cooled down) to see that it even arrived (I have been trying to read Smut Clydes’ comment for over two hours and It is not even on this page where I’m making this comment currently); If I do a refresh, it delivers a previous state, and so forth. This is not the way.

Cloudflare is entirely free to get started, whereas other CDN services cost money.

i.e, it is evil.

Google Analytics or any other analytics that you may use in HTML relies on the fact users have JavaScript enabled, and the page loads to the point where you have the tracking code. With Cloudflare, stats are way more accurate than JavaScript-based stats because they catch all the traffic stats that JavaScript may miss because of blocked JavaScript content or page not loaded completely.

https://imtips.co/cloudflare.html

Don’t be evi… fuck it.

When I check my homepage with different IPS and devices, I see different pages served for the very same homepage. I test it with DISABLED CLOUDFLARE is keeping it in Development Mode.

Is this something happening by an option from WPSC?
Is there any way to send same cached paged to all users?

For different mobile/desktop user agents, it is sending different cached copies. I don’t understand how this happens and if there is any option to make 1 cache file for all mobile and desktop and all users.

https://wordpress.org/support/topic/different-cached-pages-served-to-different-users/

You see folks? What we have here is a Malcolm In The Middle scenario.

‘Malcolm’ loves it. He loves it. Malcolm is very very happy. He gets pumped and filled with all kinds of ‘data’, and he pumps and pumps and sometimes even pretends to do a reach around.

Orac loves throwing it into Malcolm. He loves it. It is novel. It feels good. To him, it is slick and ‘responsive’.

Some of Orac’s users like it to (because doesn’t 10% of everybody?); Others are amazed at this gayification and why the entire webosphere is embracing getting fucked by Malcolm or fucking his diseased ass when only 10% don’t seem to mind.

Its a sorry state of affairs that people are willing to take a useless and potentially dangerous drug on the word of a man who might struggle to find his own arse with both hands.

That being said I’m skeptical Trump is actually taking this drug, he’s a famous coward and I can’t imagine he’s unaware of the danger, and his craven impulse would be avoid it. though he also needs to keep banging about it and claim he taking it cos he can never admit he might have changed his mind or was wrong back in March when he first started pushing it. Also it took all the oxygen out of the stories of Pompao’s abuse of power and Trump firing yet another AG.

That being said I’m skeptical Trump is actually taking this drug, he’s a famous coward

Oh, the last part may also be why he decided to take it, after a few people in the WH were tested positive for the virus.
Finding suddenly that the virus was next to him may have decided him to grasp for anything with a supposed protecting effect.
Saying “I’m talking a pill” may also be his excuse for not wearing a mask.

Good thing anyway that the WH staff managed to hide the bleach bottles when Trump was looking for something to take.

Do you have an argument against HCQ being a zinc ionophore? I don’t believe this, but I’m trying to counter misinformation where I can, and I’ve had this thrown at me a few times. Unfortunately there do not seem to be any studies that have tested with zinc? That I’ve found? (well except the execrable ones by Didier Raoult) and I’m an electrical engineering student not a biologist so I can’t really make arguments from that direction.

It is a zinc ionophore. But why HCQ? How about quercitin? (I’m mildly surprised that nobody has been sent from Central Casting for resveratrol.)

Zinc is not an ionophore in the traditional sense of the term. What happens is zinc is competiive with the Ca++ channels. Quninine alters the electrostatic properties of the Ca++ channel to favor zinc.

I think the main driver and what got the worlds attention about HCQ was Didier Raoults terrible study. (Summary. I gave HCQ and some people survived.) Although an awful man by all accounts he has charisma unfortunately. Because of him millions have been spent on buying the drug and performing trials. Averting far too much time and money from other possible treatments. He has a lot to answer for.

In my country, the pro-Raoult are doing the usual denials. Accusations of Big Pharma shill, of cherry-picking only the study you like, etc.
Also, apparently, only the French authorities are saying that HCQ is dangerous, because people in all these other countries are prescribing it. This “my country is alone in doing that I consider to be bad stuff” viewpoint will be familiar to many of the regulars here.
I haven’t seen many mentions of zinc so far among French supporters (not like I did an extensive study – I should cut on this, I think I’m getting an ulcer out of the whole affair). I don’t expect it, as zinc is not in the Raoult protocol, But I guess that may comes in the following days, as the story will evolve.

Also, now, the mot d’ordre is that HCQ is only effective if given early, as the holy guru Raoult said from the start (Narrator: he didn’t said that – he said that his HCQ protocol should be started ASAP on diagnosed people, under supervision, and claimed miracle outcomes on hospitalized people)
In this Lancet study, they looked at patients receiving some form of CQ/HCQ treatment within 48 hr of diagnosis. The only way to give it earlier than that, would be to give it preemptively to the susceptible population at large. Now that’s a different kettle of fish altogether.

OT, well almost…
Over At The Pipeline, I noticed an old visitor of this blog (haven’t seen him for a while). Full on the HCQ+Zinc bandwagon. He hasn’t started yet on how zinc should replace fruits de mer-laden vaccines, but anytime soon…

Over At The Pipeline, I noticed an old visitor of this blog

Is that “Kurt,” who spells ‘ionophore’ as ‘ionosphere’? I don’t recall him at all from here.

No, no, I mean the antivaxer who publishes on ResearchGate.
Look up ‘vitamin C’ in the pipeline thread.

Gosh, he even has an ORCID number now. Oh, well, no law against it.

This is an impressive study in terms of stats, attempts to match variables, involvement of prestigious institutions and investigators. However, it needs to be subject to science and logic. Science and logic should be our guiding principles. The first principle: ask the right question. The second principle: association is not causality. The third principle: are we seeing information or noise? The fourth principle: Is it clinically significant or is it just statistically significant? The fifth principle: how many hidden assumptions and biases are built into the model so that the conclusions look valid but are not.

What is the right question? What is the hypothesis to be tested? I think HCQ advocates would say that the HCQ regimens prevent progression of the disease from a viral like syndrome to a out of control immunological syndrome and this can be easily measured by comparing the number of hospitalizations required between a treated and non-treated group.

To answer the right question it is good to start with what we know:
It is not the virus that kills, it is the cytokine storm.
Anti-virals are active against viruses. They are not active against a cytokine storm (an out of control immune response).
HCQ has an anti-viral effect on SARS-1 and the mechanism is known. It is reasonable to speculate that it has the same properties against SARS-2.

COVID-19 as two distinct stages that are temporally separated: A viral like syndrome (somewhat akin to the flu or cold) and a severe syndrome with all the hallmarks of a out of control immunological response. On average, the separation appears on day 7. The clinical hallmark is shortness of breath and increasing evidence of coagulopathy. Fortunately the number of patients progressing beyond the viral like stage is small and most have known or unsuspected comorbidity.

We have two models that we can look at to help us understand the real question:
The first is influenza and Tamiflue: Tamiflu only is effective if given very early in the disease, within the first 48 hrs and most effective as a prophylactic. In a small minority of patients, influenza A progresses to a cytokine storm. Clearly Tamiflu is ineffective at this stage.
The second is Steven-Johnson’s Syndrome due to a drug reaction: . Once the reaction is initiated, stopping the drug is insufficient. Immuno-suppressive therapy is required. But both are needed: stopping the drop and introduction of immuno-suppressives.

Conceptually the disease progresses in stages from infection to death from cytokine storm; with each stage being smaller than the previous stage. Logically, if the progression can be stopped before day 7, then the number of hospitalizations and deaths from COVID-19 should be reduced. To test the real hypothesis is to compare the hospitalization rate of patients treated with HCQ/macrolide to those who were NOT treated with HCQ/macrolide.

Just as in our models, at the point of hospitalization HCQ/macrolide is likely to be ineffective; or possibly due detrimental (as shown in this study). There should be no surprise here.

Despite its impressiveness, it suffers the basic problem: the wrong question is being asked, From this study, the only conclusion that can be drawn is that HCQ/macrolide may be detrimental in a selected population of hospitalized patients and the reason is not known.

Me too – but, since Orac’s article refers to steps 4 and 5 and then omits them, let’s fill in the rest of the Hoofnagle Progression:

‘4. Is immune to study by academics because they’re owned by pharma and there is no money to be made on generic;

Doesn’t work to treat severe disease but merely progression of the disease (modified missed window)’

HCQ does have a mild immunosuppresive action as well as being anti some malarias. So was worth looking at. Azithromycin has an anti inflammatory action as well as antibacterial. Again worth looking at. Now we have evidence against HCQ. But did the study show anything about azithro or is it all too messy.

@Fergus ‘Azithromycin has an anti inflammatory action as well as
antibacterial . Again worth looking at.’ .

Can you clarify for me – I have no idea – how many compounds in the pharamacopoeia have those two properties?

For another point of view:
Another poorly designed interpretation of a #HCQ data set for #COVID19. A larger poorly designed “trial” only leads to larger erroneous conclusions. For analysis, see the thread👇@JamesTodaroMD @niro60487270 @danaparish @marybethpf

@Narad
No, I remember. Todaro may be reaching at straws, reporting every study he comes across, some good some not. I am appalled people still refer to the Li and Liu study as if they did clinical research and it is a proven finding, when they are not even biologists, never mind virologists. However, I do believe someone may have thought the pathophysiology possible and asked them to do it. I am very skeptical of Chinese research in general, however, so who knows.
I read the study under discussion as best I could. I was looking for flaws, I well admit it. It was over my head for the most part. But I did notice a few things myself before I looked online for a rebuttal. (Nothing on PubPeer).
They only included people who were treated no later than 48 hours from diagnosis. Good, BUT there were a lot of patients from the US; mostly already hospitalized, and testing results took a while here in the beginning. Did they separate out institutions, or just conglomerate all the institutions together? An honest question, just looked at the results again and it seems not. Did they include the very flawed VA study patients?
The dosage was higher than what I have seen some doctors say they are using (VA was quite a bit higher). And the best results seem to be with zinc, which they completely left out.
I have already admitted my inability to analyze studies outside of my sphere… doesn’t mean I’ve lost my crap-detector. So I looked for other opinions, since I do not trust a lot of studies because of funding issues (something I DID figure out from reading in my own field.)
People like Todaro and myself maybe seem to you to be morons and idiots, but really we are desperate to find answers, and just don’t trust all the science too much anymore, so we look all over. Now my daughter has a stomach ache, has been exposed to Covid patients before they were known and diagnosed, so of course any little thing and I worry.
Here’s something I found informational:

https://knowledgeisgood.net/2020/05/02/a-report-from-the-front/#prettyPhoto

Not expecting any pleasant responses here. Oh well.

Now my daughter has a stomach ache, has been exposed to Covid patients

That is a scary place to be. Don’t let her smell her farts. And don’t you smell them to assess based on past experience what might be wrong. I am not trying to be funny (it is just that it is fukkin’ funny people admiring their own brand for lack of good health information and going on the cart because of it).

More and more, this virus acts more like warts or poison ivy. You might can have it in your digestive tract, or you might can have it in your eye but you have to breath it for it to get into your lungs. That is, it doesn’t necessarily spread allthroughout the body just because it got in your eyes or mouth or lungs. Thus, the weak signalling from current saliva tests.

It may be possible that a person can get COVID-19* by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes. This is not thought to be the main way the virus spreads, but we are still learning more about how this virus spreads.

https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/how-covid-spreads.html

^^That is kind of a weasly way around admitting it is ‘airborne’. Remember, though, that they have a lot of egg masks to wear because the whole administration, and even the W.H.O. were telling people not to wear a mask early on (even saying it would make things worse because people would touch their face more or would put it on upside down like so many ‘conservatives’) — There were no masks to be had and nurses and doctors and frontline responders needed them. That is the big failure here. That is the squandering of two months to come up with them and educate people about them.

*the lung disease and associated coagulopathy precipitated by SARS-COV-2 that is killing the most people.

“It may be possible that a person can get COVID-19* by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes. This is not thought to be the main way the virus spreads, but we are still learning more about how this virus spreads.”
I’m not really sure what your point is. She’s a nurse, intelligent and careful. Some of her patients were in for other reasons than Covid or were unconfirmed, then tested positive. They were only using surgical masks unless their patients had a positive dx. A few of them subsequently died. One was a 26 yo in for drug detox, worst pt she ever had, kept going in and out of his room etc etc
She’s fine btw.
“the whole administration, and even the W.H.O. were telling people not to wear a mask early on”
I agree – there was a video online by Dr David Price, end of March I think. Always wondered if he escaped getting it, seemed a little cavalier about masks.
“and even the W.H.O.”
EVEN the WHO? As if they have a shred of credibility left?
I noticed you didn’t single out Fauci there.
“would put it on upside down like so many ‘conservatives’ “ I am going to take the high road here.
“There were no masks to be had and nurses and doctors and frontline responders needed them. That is the big failure here. That is the squandering of two months to come up with them”
You realize that is on the CCP. They bought up all the PPE around the world in January. Highly suspicious.
You realize they blocked travel from Wuhan to the rest of China, but let them out to seed the world with Covid19.
They have a regime every bit as bad as was Germany’s under Hitler (organ harvesting from dispensable Falun Gong, Christians and Muslims; torture of and disappearance of dissenters, to name just a few of their atrocities); and the MSM and the left carries water for them.
We need to bring home manufacturing. Should have been done years ago.

But I did notice a few things myself before I looked online for a rebuttal. (Nothing on PubPeer).

Horseshit. You trotted it out on May 13 and were provided with the PubPeer link (it started on April 8) by Smut Clyde six hours later.

“There were no masks to be had and nurses and doctors and frontline responders needed them. That is the big failure here. That is the squandering of two months to come up with them”
You realize that is on the CCP. They bought up all the PPE around the world in January. Highly suspicious.

The only thing “highly suspicious” is your attempts at reasoning, Peter “Immunity Cards” Navarro notwithstanding, given China’s rather prompt manufacturing capability.

@Narad
“Horseshit. You trotted it out on May 13 and were provided with the PubPeer link (it started on April 8) by Smut Clyde six hours later.”
I am talking about the paper under discussion here:
https://t.co/wl3OBKjNUs
It seems you only superficially read my posts.

I am talking about the paper under discussion here:
https://t.co/wl3OBKjNUs
It seems you only superficially read my posts.

Um, no. What did I quote?

I am appalled people still refer to the Li and Liu study as if they did clinical research and it is a proven finding, when they are not even biologists, never mind virologists. However, I do believe someone may have thought the pathophysiology possible and asked them to do it. I am very skeptical of Chinese research in general, however, so who knows.
I read the study under discussion as best I could. I was looking for flaws, I well admit it. It was over my head for the most part. But I did notice a few things myself before I looked online for a rebuttal. (Nothing on PubPeer).

It seems you can’t think, are intellectually dishonest, or both.

People like Todaro and myself maybe seem to you to be morons and idiots, but really we are desperate to find answers

I missed the human-shield part earlier.

^ And just to make this absolutely clear, Mehra et al. was not in play in that thread. It was only mentioned by Orac in this one.

@Narad
“ ^ And just to make this absolutely clear, Mehra et al. was not in play in that thread. It was only mentioned by Orac in this one.” I was referring to this thread, and this paper, “The one under discussion” – I assumed you would know I meant the one in this thread. And again, last I checked nothing on Pub peer about it.

You realize they blocked travel from Wuhan to the rest of China, but let them out to seed the world with Covid19.

That was originally Niall Ferguson’s fabrication. He has belatedly admitted that it was bullshit.
https://www.econlib.org/update-on-flights-from-china/

Do you get off on being called stupid and ignorant? I am loath to become an enabler.

Oh, wait, I really have to thank you for mentioning Todaros’s (three) Twatter accounts — they’re a riot. I hope you’ve stocked up on Bitcoin before the impending Götterdämmerung.

@Narad
I have zero interest in investing strategies, but my husband does. With whatever stocks he has control over, we are down 0% vs the stock market 6-8% since the downturn.
He doesn’t invest in bitcoin. Thinks this is one thing he says Buffett is right on, although he thinks he’s over the hill.
No one knows everything. Time will tell.

@Narad
You’re right, and I even looked up Götterdämmerung.
Btw since the beginning of this year the market is down 12%, we are up 13%.
I should make my husband respond to these posts. But he is too pithy and obnoxious.

Read the other articles on this blog about it.

The facts do not support this treatment.

Are you just talking about HQC? Or the treatment protocol of the Front Line COVID-19 Critical Care Consortium? I didn’t see that addressed but might have missed it.

Good article that goes with the others for this month, pretty much highlights that a couple of ethically shallow people with some power felt there was an opportunity to shill and make a little headline. The reality as this blog post states very clearly along the way to the very end is that, HQC with high probability kills more people than is helps. There are other positions that last statement applies. Data and consistency are better than anger and ignorance to solve problems. Have a decent day tomorrow.

@Narad:
Me: EVEN the WHO? As if they have a shred of credibility left?
As in a metric ****-ton more than Drumpf has?
Huh? Are we talking about the same WHO? The one that knew there was human to human contagion and lied and said it didn’t? The one that scolded Trump for closing the border to China? That WHO? Just as responsible as the CCP.

I suspect that, if one were to really drill down into it, W.H.O was being pressed to message what the US wanted it to. Just like the UN. Hegemony is what hegemony does…

No, I’m not letting China off the hook. I actually think they were of the mind of “why should we be the only ones to suffer (economic qualms)? But when they started squeeking, Trump was all like “we got one case from,,, China … soon to be zero. Why should we let the ship in — it will just make our numbers double.

Thank God someone sees the light. Except I’m not sure why you think they were doing the US’s bidding. The rumor is that they do China’s bidding.

Human to human contagion was not proved when WHO made the statement. Not knowing a thing is not saame thing an lying.

@Sheila

I read the yahoo link — It does sound like a little too much footsie is going on there and WHO should have taken/revealed better notice of “patients are in isolation” from day one even when China didn’t explicitly say ‘human to human’. But, that isolation would have been prudent anyways and they may have truely not known yet.

As he is with all world dictators*, somebody else also is not exactly visibly flaccid over Xi (winni the poo) Jinping —

Jan. 22, Twitter:

“One of the many great things about our just signed giant Trade Deal with China is that it will bring both the USA & China closer together in so many other ways. Terrific working with President Xi, a man who truly loves his country. Much more to come!”

Jan. 24, Twitter:

“China has been working very hard to contain the Coronavirus. The United States greatly appreciates their efforts and transparency. It will all work out well. In particular, on behalf of the American People, I want to thank President Xi!”
.
.

Feb. 7, Remarks before Marine One departure:

“Late last night, I had a very good talk with President Xi, and we talked about — mostly about the coronavirus. They’re working really hard, and I think they are doing a very professional job. They’re in touch with World — the World — World Organization.** CDC also. We’re working together. But World Health is working with them. CDC is working with them. I had a great conversation last night with President Xi. It’s a tough situation. I think they’re doing a very good job.”

https://www.politico.com/news/2020/04/15/trump-china-coronavirus-188736

https://www.theatlantic.com/international/archive/2018/03/trump-xi-jinping-dictators/554810/

** If that was from twitter and not the yellecoptor conference then I’d say, “he be leanin’ on the purple drank.”

I have an attraction to intelligent people. Vocabulary, sentence structure, creativity, knowledge; you guys have the whole package. Which is particularly distressing to me.
Did you ever read The Gulag Archipelago? Or re-read Tale of Two Cities? You know I’m sure that the people in Germany around the concentration camps knew what was going on there.
What is my point? Propaganda works, even on the brightest minds. It works to make one group hate another.
I was talking to my neighbor, a retired ER doc. I told him what infuriated me the most about this pandemic, that the CCP prevented Wuhanites from going into other areas of China but did not prevent them from going all over the world. He did not know that. Did you?
And before you try to turn this post around on me- I do not hate Chinese people. I have Chinese friends, had lots of Chinese students and they were amazing in many ways.
You might want to try the Epoch Times once in a while for news about China, and the Spectator for commentary- intelligent, sometimes humorous, and they even have a few liberal writers.

@ Sheila,

I enjoy your posts. Well educated intellectuals with social standing in the community are actually the most susceptible to propaganda, as is evidenced here.

I prefer the misanthropic genius types. Brilliant but flawed.

I do not hate Chinese people. I have Chinese friends, had lots of Chinese students and they were amazing in many ways.

Can’t win for losing, can you?

I have an attraction to intelligent people. Vocabulary, sentence structure,

People just don’t understand me… That is not what I meant; I meant, people don’t know who I really am. Now I got to worry about my diction to? How, how’s my sentence structure?

Huh? Are we talking about the same WHO?

Apparently, I’m talking about the real one while you’re talking about the Drumpf whipping-boy distraction.

It seems you only superficially read my posts.

Sheila, do you have another organization in mind to replace the WHO? To lead the global efforts to eradicate malaria, HIV/AIDS, TB, Ebola, cholera, measles, polio, etc? To organize the emerging infectious disease surveillance systems?

Yes, the WHO could have done better with COVID-19. But I’m not seeing anyone who could take their place. And nothing is far, far worse than an organization of humans that makes human mistakes.

The media constantly makes two points”. 1. Donald Trump is taking Hydroxychloroquine and he should not be because it’s dangerous. 2. Hydroxychloroquine has a number of disturbing side-effects which could potentially result in death. Question: Given that prior to the corona virus, HCQ sales were approximately 8.5 million pills/week, why is anybody taking this drug with all these known harmful and potentially fatal side effects?

HCQ is given to patients suffering from the auto-immine diseases lupus and rheumatoid arthritis. The diseases treated are far worse than the potential side effects, which are well known and monitored for. Also HCQ is given for these conditions at lower doses than being used to treat COVID-19. The side effects are less common with lower doses.

Precisely. Which is why the studies are crap and show more side effects than Zelenko reported, who used the same dosage as lupus etc pts get, 400mg/day.

Obviously Trump do not ask any medical advice. He think he does know everything.

@Smut Clyde
It is worth adding that the Chinese government did, in one respect at least, prioritize domestic over international measures. As Nikkei pointed out on March 19: 
The Chinese government locked down Wuhan on Jan. 23, halting all public transportation going in and out of the city. The following day an order was issued suspending group travel within China. But in a blunder that would have far reaching consequences, China did not issue an order suspending group travel to foreign countries until three days later, on Jan. 27.

http://www.niallferguson.com/blog/six-questions-for-xi-jinping-an-update

Sumner dismisses this by saying it didn’t have significant results, and that we must hold western governments equally responsible. Maybe there wasn’t a large impact, but it belies the question, why did they wait 3 days? And as far as who to hold more accountable, that is too big for a discussion here.

Just curious what you think of this (calm down I’m not saying whether it’s true or not, just want your thoughts)
https://www.telegraph.co.uk/news/2020/04/23/coronavirus-dies-within-70-days-no-matter-tackle-claims-professor/

Honest question: If this is true, does it lend any credence to it being manufactured, as Luc Montagnier has theorized? He also said:
“Nature does not accept any molecular tinkering, it will eliminate these unnatural changes and even if nothing is done, things will get better, but unfortunately after many deaths.”

He also said:
“Nature does not accept any molecular tinkering, it will eliminate these unnatural changes and even if nothing is done, things will get better, but unfortunately after many deaths.”

Yah. Unfortunately for Dr. Teleportation, there’s Bt corn.

@ Narad

Yep, corn, according to most experts, was developed from teosint, a small growth, that by splicing, eventually led to corn.

However, an even better example, one that I love and have loved my entire life, is DOGS.

An even wilder example than that exists.
Apparently broccoli, brussels sprouts, cabbage, cauliflower, mustard and turnip all came from one species. I saw a diagram somewhere, but I can’t locate it.

@Joel, Narad is talking about Bt corn rather than corn in general. Bt corn is a variant of maize that has been genetically altered to express one or more proteins from the bacterium Bacillus thuringiensis. It is also not even close to the only crop where we have done this or similar.

Coronavirus dies out within 70 days no matter how we tackle it, claims professor

But an Israeli professor claims all efforts will lead to the same result, because the disease is self-limiting and largely vanishes after 70 days – with or without any interventions.
… Major General Ben-Israel, who was also head of the analysis and assessment division of the Israeli Air Force Intelligence Directorate and former chief Cybernetics adviser to Israeli prime minister Benjamin Netanyahu,…”

.
God save us from “experts” driving out of their lane… particularly computer scientists/programmers, “Cybernetics” experts, etc. (Yes, engineers as well)
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Hey, Professor-General Ben-Israel:
1st US COVID case – Jan 21, 2020
New daily cases May 23-24, 2020 – +20,286
New daily cases May 15-16, 2020 – +24,527
New daily cases May 10-11, 2020 – +17,779
Looks like new daily cases continue apace.
Jan 21 to May 24 = 70 daze /sarc 123 days.
.
Hmmmm…
Something doesn’t look right with that Ben-Israel COVID opinion.
That statement/prediction/opinion didn’t last too long, did it?

Something I thought as well. And to add lately we have seen a lot of cases in the meat-industry. A restaurant in Germany that had a party, where several people were infected and a church that had 170 infections. So not much prove of this statement. Besides we have a case that is suspected to have jumped from a mink on a mink farm to a human being.

@ Sheila:

Don’t you think that intelligent people have studied or investigated advertising, propaganda, religious conversion, learning, coercion and persuasion, how they function and how they affect people’s thinking and decisions? I know that I have. There are whole fields of research considering how groups influence individuals, how language affects choice, how cults limit information and how media slants information. One of the characteristics of adult thought includes abilities involving self-monitoring of learning and evaluation of information based on its source.

Sceptics include rigorous use of scientific methodology in order to keep us from “fooling ourselves” by examining the cognitive traps into which we may fall. I suggest looking into writers like Ben Goldacre and Steven Novella ( at Science Based Medicine blog) as well as that David guy- he’s easy enough to find.

When you cite a source like Epoch Times it shows me that you haven’t looked into the particular biases which it may display: it is associated with a specific brand of politics ( anti-Communist) and a particular religious group, the Falun Gong- thus it represents a biased view- although they may occasionally include some meaningful reporting. In fact , someone Orac’s minions know well, Jake Crosby, even wrote for them for a while: he is a virulent anti-vaxxer, supports right wing politics ( even working for Trump’s campaign) and conspiracy theorist. I doubt that a reasonable news outlet would allow his material in its pages. Wikipedia has an entry about this news source worth reading.

I investigate alt med proselytisers who constantly excoriate standard news and governmental/ academic sources as all being “biased” HOWEVER if you look deeply into their own backgrounds, business activities and untruthful reporting, you quickly find reasons to question their authority even more so. Standard sources may get things wrong and show bias BUT they rely upon multiple sources and expert opinion and CORRECT themselves- so whilst one news company may laud Trump’s medical recommendations, another will urge caution and cite research that illustrates how questionable his ideas are. Multiple sources are your friend.

Sceptic writers try to include most of their tactics when they criticise alt med and woo but they don’t always go into the weeds to illustrate exactly how they come to their conclusions because they assume people have already read about cognitive biases, logical fallacies and forms of obfuscation used by the less-than-trustworthy.

@ Denice Walter:
May 25, 2020 at 12:07 pm

Hey, great post! Some folks are simply incapable or bound in other ways to their own way of viewing the world. That’s fine. Most of the time it is harmless to think that ‘hey I will win the lottery sometime next week’. No one will gain much from explaining that a sucker parting with money is a bad thing. In fact, people get irritated when you tell the customer they are getting a bad deal and should stop throwing away a valuable resource for nothing.

Yeah, being an adult is about learning. Learning is knowing when you are wrong and changing how you apply yourself in the world (IMHO). Knowing when you are wrong ought not be a difficult thing. Apparently it is or there is huge resistance to desiring change.

Science provides the basis for knowing — what works – how it works – how much it works — etc. I learn by reading studies from the best sources or listening to the best credentialed researchers and weighing the results of this and that. I like making a little bit more if I can. Being better I suppose. I firmly believe health care workers want to save more lives and make life better. Most have it down to standard. It’s sort of simple in that respect. The vast majority of professionals know what works and why. They are very happy to explain it in great detail. Love them for that!

I do get irritated that there are those people out there who know very well they are harming people with their advice. They know. They continue with ignorance or at worst subversion.

Anywho — my sermon for the month! All opinion but wanted to support your post because it was good!

As an example, let’s say that a certain writer gives you “inside information” about a drug or vaccine, he has “secret papers” concerning what is involved and “evidence” of tampering with research figures: he even has been threatened by the powers-that-be because he is uncovering their many crimes..
HOWEVER, no one else has anything remotely like this. You search his own background and find suspicious entries that are validated NOWHERE else.; he discusses his career and education but you fail to find outside validation- he lists institutions that have had trouble with accreditation or that offer “alternate paths” to degrees, he writes about his own research that never appeared in standard journals; he brags about his genius but mispronounces simple words and misuses standard concepts. As you write, a person’s speech and writing offer us clues about their abilities: most people with terminal degrees, even foreign speakers, use language more carefully and know how to check pronunciation and usage if they aren’t sure. He misquotes and cherry picks research to support his own ideas while other writers see the same studies as unrelated or as supporting the opposite conclusion

If nothing adds up, is it more likely that the writer is an unrecognised Galileo or a con artist trying to bilk people? There has only been one Galileo but there are many, many charlatans..
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Thank you for the thoughtful reply, I appreciate that you do not attack me. And I do mean that I consider all you posters here to be of high intellect, and don’t consider myself to be on par.
I’m glad that you think the posters here look at things from all angles, and I believe that, but to be honest, don’t we all have prejudices that color our conclusions? I admit to jumping to conclusions myself because of mine, and am trying to be more careful. I have learned in the past to see if something new is out there, to wait and see it verified from multiple sources before I jump on the bandwagon. Perhaps in my desperation I’ve neglected that principle. Do you think maybe it’s possible that some here are also guilty once in a while?
I do know that the Epoch Times is anti-communist, they even advertise themselves that way. I didn’t know their Falun Gong connection. But that certainly would explain their stance on the CCP! They are brutalized by them, and that I know from other sources.
Again, ty. I am sure Orac would prefer I stop posting off topic and I shall.

“Do you think maybe it’s possible that some here are also guilty once in a while?”

False equivalence.

You seem to hold opinion to be the same value as science, then you attempt to drag everyone down to your level by JAQing off. It won’t work because opinion and science are not of equal value. Your continued attempts to assert the false equivalence is evidence of dishonesty, not of lay ignorance.

You hunt down the fetid droppings of the brain farts of others, carry them out of the dark crevices of the internet and drop them here, much as a fly spreads malaria. Thankfully there is a vaccine to the spread of those brain farts: education.

Of course I don’t equate opinion with science. It’s just that unfortunately, much of science of late (not all) has been invaded by opinion. And I’d course you will try to turn that statement back on me, which is fair, but it works both ways.
You just have to have a high degree of suspicion when reading papers; especially in looking at funding .

“You just have to have a high degree of suspicion…”

Read Orac’s latest article. Perhaps you’ll recognize yourself reflected there. But like a vampire you probably see nothing when you look in a mirror.

Much of science has been invaded by opinion?

Science is commonly opposed by people whose beliefs or interests science threatens. In response they try to undermine science with pseudoscience, misrepresentation and lies.

That much is true.

Thanks.
in addition to sceptics’ methods for uprooting misinformation, people in general have a capacity for dealing with the world that develops during adolescence and young adulthood ( which NOT everyone achieves) called executive functioning ( formal operational thought, metacognition and social cognition may be aspects of it) that includes diverse abilities for using information and dealing with people as well as self-checks and specific skills like abstraction, sarcasm and overviews. It is worth reading about in detail. How to weigh information, evaluate material, discern others’ motives and many other important facets of living in reality. Often, studies about these abilities involve their lack or mis-functioning.

Way over my head Denice. I switched from psych to bio in college because I preferred the concrete to the abstraction, my brain didn’t work that way.
I have learned about human interaction and motivation from being on the planet for more decades than I want to admit… but also from reading pre- mid 20th century classic literature. I find writers from before the radio/tv era had an incredible grasp of and ability to describe human nature and interaction (and their writing skills blow modern authors out of the water).
Enjoyed your post nevertheless. Will re-read it at some point to glean what I can.

@ Christine Kincaid

You write: “I enjoy your posts. Well educated intellectuals with social standing in the community are actually the most susceptible to propaganda, as is evidenced here. I prefer the misanthropic genius types. Brilliant but flawed”

You do realize that historically, for every “misanthropic genius type” who was right, thousands were wrong and consigned to the dust bins of history. And some, for instance, eugenicists, not only wrong; but led to Nazis and Stalinist Russia, Nazis killing anyone but master race, Stalinists trying to mold everyone into sameness. But, typical of you to be against those who have extensive scientific educations. Actually, I would be willing to bet if those with extensive educations confirmed what you chose to believe, then you would extol them. Your litmus test is based on who ever confirms your beliefs. In other words, you consider yourself to have god-like certainty, to be the judge of what is correct and what is not. Once again you are a despicable moron; but, unfortunately, represent a substantial segment of American society.

Here’s a few more books I’m sure you will NEVER read:

Carl Sagan. The Demon-Haunted world: Science as a Candle in the Dark.
Thomas Gilovich. How We Know What Isn’t So: The Fallibility of Human Reason in Everyday Life.
Michael Shermer. Why People Believe Weird Things: Pseudo-Science, Superstition, and Bogus Notions of Our Time.

SUDDEN INFANT DEATH SYNDROME.

A good collection of peer-reviewed published research articles can be found at:

https://www.chop.edu/centers-programs/vaccine-education-center/vaccines-and-other-conditions/vaccines-sudden-infant-death-syndrome-sids

And I suggest once more a great book that gives extensive examples of why lightening actually does strike twice and sometimes more in the same place, so, given number of SIDS deaths, though plummeting at same time as two new vaccines added to schedule, there will be SIDS deaths following vaccines and SIDS deaths with no preceding vaccines. Post Hoc Ergo Prompter Hoc. Kids die, a horrible tragedy; but the overwhelming evidence not caused by vaccines. Correlation doesn’t equal causation. Correlations found between increase in cell phone use and ASD. Correlations found between increase in eating organic foods and ASD and on and on it goes. And once more, one can’t prove a negative, so no matter how many studies find no association between vaccines and ASD or SIDS, scientifically impossible to “prove” no association; but, as some point, normal reasonable people, Christine excluded, will accept this.

Recommended book, a fun informative read: David J Hand. The Improbability Principle: Why Coincidences, Miracles, and Rare Events Happen Every Day

@ Sheila:

Thanks.
My own background- believe it or not- was primarily in the arts ( literary and visual) and life sciences ( bio etc) only later in grad schools did I focus upon social science ( psych, econ).A person can approach psychology from the biological side as well as the linguistic/ social- I try to include both because people are both.
If you read sceptics like Drs Goldacre, Novella or DG, you’ll find that they make their ideas accessible to anyone who wants to learn- you don’t need a degree in bio, physio or statistical analyses.
The most important advice I can give involves sources: how to tell whether a source is meaningful or garbage tinged. I had a prof of journalism/ rhetoric who encouraged us to survey multiple sources for comparison and to investigate who they are and their particular “angle” on the subject matter- he had previously been a lawyer and worked in the consulate in Israel during war time so he understood how malleable/ twistable news items could be.

@ Christine Kincaid

You write: “It was obvious by January 13th. They waited until January 30th.”

The informed the world first few days in January that a novel deadly virus had broken out. Trump’s national security team notified Trump, etc. Keep in mind that when WHO issued pandemic warning in 2009 about the swine flu, which was a novel version and killing people, because it didn’t cause a huge number of deaths, WHO was accused of crying wolf and WHO director was forced to resign. So WHO did notify world early on of potential dangerous new virus. If they had issued higher warning and it didn’t pan out, what then? Damned if they do and damned if they don’t. As I wrote elsewhere, a few cases of deadly pneumonia won’t necessarily lead to discovery of a novel virus, only when a larger cluster develops.

I suggest, you evil moron, that you actually do a comprehensive search of the sequence of “warnings,” instead of focusing on what, as usual, confirms what you choose to believe. You are really a sickening despicable example of a human being. And I am dead serious. WHO carefully evaluated the information it received and passed it on; but China also directly passed it on. With hindsight one always has 20-20 vision, so, maybe WHO could have advanced its Jan 30 warning by a few days, maybe; but overwhelming evidence is that if Trump administration had actually acted on the information it received and even implemented measures one week earlier, 30,000 lives would have been saved, if two weeks early, perhaps 50,000 or more lives would have been saved, so it is Trump administration that rejected received information [Lazaro Gamio (2020 May 22). Lockdown Delays Cost at Least 36,000 Lives, Data Show. New York Times]. Trump worry about it affecting his re-election. Typical, Trump thinks only of himself.

For instance: WHO Timeline – COVID-19 at: https://www.who.int/news-room/detail/27-04-2020-who-timeline—covid-19

And for details of when U.S. first aware, try Schwellenbach (2020 May 6). The First 100 Days of the U.S. Government’s COVID-19 Response at: https://www.pogo.org/analysis/2020/05/the-first-100-days-of-the-u-s-governments-covid-19-response/

I’ve got plenty more. As I think I mentioned in a previous comment, since outbreak of COVID-19, I’ve downloaded well over 500 articles on coronaviruses in general and COVID-19, peer-reviewed journal articles, book chapters, news articles, etc. I’ve read over 100 carefully and skimmed the rest. In a previous post I also debunked claim that escaped from Wuhan lab with peer-reviewed journal articles.

if Trump administration had actually acted on the information it received and even implemented measures one week earlier, 30,000 lives would have been saved, if two weeks early, perhaps 50,000 or more lives would have been saved

Seemingly small numbers now, seeing with my grim-goggles on what surely* is to come. They could have been saved only to die after the *measures) from what must be the inevitable re-seeding because of this weekend’s antics.

More months of squandering; Nobody around here is wearing a mask (thx, Obama). It would have helped if they didn’t tell people to not wear them early on:

Adams went on to say that wearing a face mask “can also give you a false sense of security.” He added that “you see many of these pictures with people out and about closer than six feet to each other, but still wearing a mask.”

…“We still have PPE [Personal protective equipment] shortages across the country,” Adams noted. “The WHO mentioned this in their statement so we want to make sure we are reserving PPE for the people who most need it. That’s how you are going to get the largest effect because if healthcare workers get sick, they can’t take care of you when you get sick.”

Last month, Adams said Americans worried about the coronavirus outbreak shouldn’t buy face masks to protect themselves against it because the masks are ineffective for those without symptoms — and the purchases deplete the supplies available for medical professionals.

“Seriously people- STOP BUYING MASKS!” Adams wrote on Twitter, addressing fears over the spread of the virus in the U.S.

“They are NOT effective in preventing general public from catching #Coronavirus, but if healthcare providers can’t get them to care for sick patients, it puts them and our communities at risk!”

https://www.foxnews.com/media/surgeon-general-explains-masks-public-coronavirus

It might have been helpful if they bothered to explain that it IS effective in preventing the general public from spreading it as Dr. Birx is now doing. Even if that mask were just a washcloth.

So, lack of timely truthful education (and projecting an ‘image’: Limbaugh had a guest host on saying nobody should wear a mask because it makes America “look sick and America is not sick”) but even moreso the outstanding leading by example that Trump is pulling off:

…I mean if he’s not gonna wear a mask, I’m not gonna wear a mask. If he’s not worried, I’m not worried.

–The President?

–Yes, sir.

*or maybe not ‘surely’; My predicting Trump would go to church r/agedlikemilk.

Limbaugh had a guest host on saying nobody should wear a mask because it makes America “look sick and America is not sick”

Was Rush off for chemotherapy?

Was Rush off for chemotherapy?

He could have been, but it didn’t show when he shortly returned (maybe radiation?) — that was way back in April(?) when the brit-sounding guy filled in for a more than usual number of shows.

Listening to him on the way to the beer store this morning was actually kind of painful. He has said he didn’t want to turn the EIB microphone into a cancer show but today related that he did have chemo recently. He did not sound long for this world; Maybe that’s just the chemo talking. I might watch a clip or so later, idk. /ignorant* gaslighting mf. /feelsbadman

*Sometimes he spouts shit that I agree with, but if he is going to “tell you folks something about the science, here”, I prepalm the face every time.

— “The secret ingredient in Zmapp? Nicotine.”

— anything about climate science. I don’t like the idea of a C02 tax either and often balk at the hysteria over ‘plant food’ but do think that renewable is the way to go in places where it could easily be done (such as hydroelectric we already have here. good luck finding a charger in BamBAm).

.
.
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— Just the other day, he was harping on the Hitlery/CrowdStrike server and that the logs showed it must have been an inside job** because of the very high rate of data transfer. Conclusion? “A thumb drive”.

**Could have been, but then they obviously SSHed in over gigabit fibre.

This broke my heart a little. Much much worse than what happened this year. Otherwise, I’m happy to read what you suggest on some of them topics. Been I while since I went through the medical literatures. Not the science papers necessarily but that put out for people to get better information about the domains. Be back to ask for something good to read … think you suggested some. Need to get me a list of your suggestions so far.

Thanks!

Pandemic response destroyed in 2018 by current administration.
https://www.statnews.com/2020/05/17/the-art-of-the-pandemic-how-donald-trump-walked-the-u-s-into-the-covid-19-era/

LIFTING LOCKDOWN TOO SOON AND UNMASKED UNDISTANCED DEMONSTRATORS

“the disease progresses slowly. It seems to take an average of four or five days, and a maximum of 14, for an infected person to show symptoms. Those symptoms can take even longer to become severe enough for a hospital stay, and longer still to turn fatal. This means that new infections can take weeks to manifest in regional statistics. May’s declining cases are the result of April’s physical distancing, and the consequences of May’s reopenings won’t be felt until June at the earliest. This long gap between actions and their consequences makes it easy to learn the wrong lessons” [Yong (2020 May 20). America’s Patchwork Pandemic Is Fraying Even Further: The coronavirus is coursing through different parts of the U.S. in different ways, making the crisis harder to predict, control, or understand. The Atlantic. Available at: https://www.theatlantic.com/health/archive/2020/05/patchwork-pandemic-states-reopening-inequalities/611866/

Purely anecdotal and somewhat off-topic….I used to be an academic liaison to the House Science Committee and have kept in touch with two staffers there. They told me back in late Feb/early March that military intelligence had informed Dimwit six months ago–a whole boatful of military people–that something globally horrible was about to hit, and the US was going to be completely unprepared. This is now public knowledge, but the staffers said they passed that through the usual executive branch channels and were basically told to shut up and stop trying to drum up hysteria because it was an election year. They kept trying to stress that this was coming through military sources, and they were utterly ignored. Dimwit had accurate information, but his motivation was not merely protecting his pure stupidity and deluded ignorance but more of not alarming the public and his re-election chances. This continues, of course. He is bored by the pandemic and just wants his spokesbabes to change the subject now–to him and the blessings he is imparting to mankind.

An old joke: The Romans were crucifying a thousand a year, likely more.
Q:What distinguished Jesus?
A: Paul

2.I was disappointed in the mildness of the cited responses of scientists. Their language is indistinguishable from what comes from the intimidated.

3.Does this drug and therapeutic regime warrant further interest, COMPARED TO MANY MORE WITH STRONGER PRIORS?

And the posteriors on those are not very strong.

No.

4.’Nail in coffin’, alas, seems too hopeful. F&$k the wake, the mourning, the remembrance services.

Good post, as long as it needed to be.

@ DemostiX

Q:What distinguished Jesus?

I like it. I’ll have to remember this one.

4.’Nail in coffin’, alas, seems too hopeful.

Indeed.
In the last days, French proponents of CQ/HCQ, including Pr Raoult himself, of course, have been criticizing the study.
Which is fine. This is as it should be.
Some arguments may be reaching, some are the usual poisoning of the well (“Big Pharma”).
But some may be fair. It’s a retrospective study, far from being perfect.

Although one weird argument is the accusation of “double standards” – that the critics of Raoult’s first studies pass over similar limitations in the Lancet study (er, which ones?).
Weird because either
– these limitations aren’t sufficient to reject the Lancet study, and in that case its conclusions of HCQ ineffectiveness hold,
– or these limitations are enough to reject it and in that case one should reject Raoult’s studies as well, as they suffer from the same limitations.

I’ve read their letter. I’m not sure what their beef is. As Orac notes, the authors of the Lancet study did control for confounding factors.

I think they need to produce evidence of actual misconduct before they make accusations. This is an observational study not a double blind randomized trial.

The problems with these drugs at the doses being given are well known from when the drugs were introduced in the 50’s or so. We already knew these drugs were dangerous.

Their beef is the dataset isn’t believable, such as having more deaths reported in the four Australian hospitals that participated in the study that the total Covid19 deaths reported in Australia. There were a number of other suspicious aspects of the dataset leading them to want to see the data in order to check the sources and computations for accuracy.

From the article I linked: ““Data from Africa indicate that nearly 25 percent of all Covid-19 cases and 40 percent of all deaths in the continent occurred in Surgisphere-associated hospitals which had sophisticated electronic patient data recording,” the scientists wrote. “Both the numbers of cases and deaths, and the detailed data collection, seem unlikely.” and “Ideally, the database should be made public, but if that isn’t possible, it should at least be independently reviewed and an audit performed”.

Seems reasonable to have a bit of skepticism about the findings until that is done and results reported.

Their beef is the dataset isn’t believable, such as having more deaths reported in the four Australian hospitals that participated in the study that the total Covid19 deaths reported in Australia.

There are only 3 deaths in the Australian hospitals in the data set. Between December 20, the starting date for inclusion in the study to April 21, the closing date for outcomes there had been 69 COVID-19 deaths in Australia.

I am not seeing the problem.

@Chris

Where are you getting 3 deaths in Australia in that report from?

I read that there were 73 deaths reported in the original study from four Australian hospitals which was greater than the number of reported COVID-19 deaths for Australia during that time period and that they have since revised that number downward after discovering that one of the four hospitals was incorrected coded as Australian.

I’ve read their letter. I’m not sure what their beef is.

Not to worry. Beth might not be in midseason form, but she’s just asking questions, as usual.

@ Beth “““Data from Africa indicate that nearly 25 percent of all Covid-19 cases and 40 percent of all deaths in the continent occurred in Surgisphere-associated hospitals which had sophisticated electronic patient data recording,” the scientists wrote. “Both the numbers of cases and deaths, and the detailed data collection, seem unlikely.””

This is a weird complaint in 2 parts. First, of course the data is going to come from the hospitals with “sophisticated electronic patient data recording”, that’s who is doing the testing and has the data available in the format the researchers can use. Only the people testing for, and reporting on, COVID cases are going to have the data. It is a problem with the data, but it doesn’t indicate any kind of malfeasance. It’s a sample bias.

The second problem with that statement is that the doctors writing the letter to the Lancet seem to think that ” the detailed data collection, seem unlikely.” as though they think that there are not hospitals in Africa with electronic patient records. That’s a bizarre thing to say. Africa is a huge continent filled with people. There are lots of hospitals. Why can’t some of those hospitals be in wealthy areas and have sophisticated data collection systems? To assume that everything in Africa is poor and backward is plainly racist.

@Chris, Sorry, found where the 3 came from. The 73 was cases, not deaths, and has been revised down to 63 cases in Australia. The New York Times article says: Another of the critics’ concerns was that the data about Covid-19 cases in Australia was incompatible with government reports and included “more in-hospital deaths than had occurred in the entire country during the study period.”

Another of the critics’ concerns was that the data about Covid-19 cases in Australia was incompatible with government reports and included “more in-hospital deaths than had occurred in the entire country during the study period.”

The trouble with this claim is that it is not supported by the data. In the period of the study there 69 COVID-19 deaths in Australia. Most of those deaths occurred in hospitals. About a dozen occurred in nursing homes. More than enough deaths for there to be 3 deaths in the 4 Australian hospitals participating in the study.

All 4 of the deaths in the state where I live occurred within this period and in the same hospital.

It seems that concerns about the validity of the data used in the Lancet study are not completely unfounded. Both the Lancet and the New England Journal of Medicine have released “expressions of concern” about studies based on data collected by Surgisphere, including the article under discussion here. https://www.theguardian.com/world/2020/jun/03/covid-19-surgisphere-who-world-health-organization-hydroxychloroquine

That said, there is still no decent evidence that chloroquine or hydroxychloroquine have any efficacy in the prevention or treatment of COVID-19.

Thanks DrBollocks – beat me to it. Having read that article, and two others from the Guardian on this study: the one questioning the Australian data (https://www.theguardian.com/science/2020/may/28/questions-raised-over-hydroxychloroquine-study-which-caused-who-to-halt-trials-for-covid-19) and the one reporting the open letter to the Lancet by 120 researchers and medical professionals casting serious doubt on the study (https://www.theguardian.com/world/2020/may/29/covid-19-surgisphere-hydroxychloroquine-study-lancet-coronavirus-who-questioned-by-researchers-medical-professionals), I’d say the case against the validity of the data is unanswerable. Simply put, no firm as small and inexperienced as Surgisphere could possibly have got hold of that much data. I expect to hear shortly that it was all fabricated.

Both Surgisphere-associated papers (in the Lancet and NEJM) have now been retracted, the stated reason being that Surgisphere refused to cough up the raw data.

How does a “research” paper that has 5 people, 1 of whom is a science fiction writer and another one is an exotic dancer, get publish in the Lancet, then written/twitted about in a positive light ?????
I would expect better from the site that claims to be scientific ……………

Can you provide a link to the paper you are talking about, and the names of the authors?

How does a “research” paper that has 5 people, 1 of whom is a science fiction writer and another one is an exotic dancer, get publish in the Lancet

The paper only had 4 authors. One from Bringham and Women’s Hospital, one from University Hospital Zurich, one from University of Utah and only one from Surgisphere Corporation. I can’t find the exotic dancer or the science fiction writer among the authors.

The real concern with the paper is about the quality of data provided by Surgisphere. Surgishpere has been unwilling to provide the underlying data used, so it is right for the paper to be retracted.

Presumably, Scott is referring to two employees of Surgisphere, who appear to be a science fiction writer and an adult model respectively. I guess Scott isn’t strong in the area of reading comprehension.

This study has been retracted, and I have written a followup post explaining why. I’m leaving this post up, even though it embarrasses me, because I’m dedicated to transparency. The only change I’ve made is to add a note about the retraction and a link to my followup post at the top of the page. Finally, I’m going to close comments here. If you want to comment, comment after the new post I’ve linked to in this comment.

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