How to (Not) Hydroxychloroquine COVID-19
The medical journal The Lancet published a study Friday which showed anti-malarial drug hydroxychloroquine (HCQ) — the same drug repeatedly pushed by Trump — does not work as intended against the virus which causes COVID-19.
NEW Research—No evidence of benefit for #chloroquine and #hydroxychloroquine in #COVID19 patients, urgent randomised trials are needed: finding from a large observational study of nearly 15,000 patients with #COVID19 & 81,000 controls https://t.co/P4YbYVhRDZ
Thread (1/4) pic.twitter.com/dxo120ngy9
— The Lancet (@TheLancet) May 22, 2020
Hydroxychloroquine’s precursor drug, chloroquine, has shown mild antiviral action in vitro against the Borna disease virus (an orthobornavirus), the minute virus of mice MVMp (a parvovirus), and the avian leukosis virus (a retrovirus) as well as the coronavirus which causes SARS. It has also shown promise against Hepatitis A (a hepatovirus).
But both hydroxychloroquine and chloroquine posed inherent risks to patients as they increased the risk of heart arrhythmia.
Ideally, HCQ’s antiviral effect would prevent the coronavirus SARS-CoV-2 from replicating, allowing the body to attack and remove the virus before it could attack human cells and spread through the body, resulting in earlier recovery from the infection.
Patients who received both HCQ, or its precursor chloroquine, with or without an additional antibiotic, did not recover faster than the cohort which didn’t receive chloroquine.
Further, the patients receiving the drug therapies were more likely to die than those who didn’t.
– 1 in 11 patients in the control group died
– 1 in 6 patients treated with chloroquine or hydroxychloroquine alone died
– 1 in 5 treated with chloroquine and an antibiotic died
– 1 in 4 treated with hydroxychloroquine and an antibiotic diedhttps://t.co/mLtnZCaEWg
— Ryan Struyk (@ryanstruyk) May 22, 2020
This study is the latest showing HCQ or chloroquine both didn’t work and increased patient mortality. Previous negative studies included:
Effect of High vs Low Doses of Chloroquine Diphosphate as Adjunctive Therapy for Patients Hospitalized With Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection – A Randomized Clinical Trial
Mayla Gabriela Silva Borba, MD; Fernando Fonseca Almeida Val, PhD; Vanderson Souza Sampaio, PhD; et al
JAMA Network Open. 2020;3(4):e208857. doi:10.1001/jamanetworkopen.2020.8857
Of particular note:
Findings In this phase IIb randomized clinical trial of 81 patients with COVID-19, an unplanned interim analysis recommended by an independent data safety and monitoring board found that a higher dosage of chloroquine diphosphate for 10 days was associated with more toxic effects and lethality, particularly affecting QTc interval prolongation. The limited sample size did not allow the study to show any benefit overall regarding treatment efficacy.
Outcomes of hydroxychloroquine usage in United States veterans hospitalized with Covid-19
Joseph Magagnoli, Siddharth Narendran, et al
Pre-print; posted April 23, 2020. medRxiv 2020.04.16.20065920; doi: https://doi.org/10.1101/2020.04.16.20065920
Of particular note:
CONCLUSIONS: In this study, we found no evidence that use of hydroxychloroquine, either with or without azithromycin, reduced the risk of mechanical ventilation in patients hospitalized with Covid-19. An association of increased overall mortality was identified in patients treated with hydroxychloroquine alone. These findings highlight the importance of awaiting the results of ongoing prospective, randomized, controlled studies before widespread adoption of these drugs.
We still don’t know why Trump is pushing this drug. It’s no longer under a patent and now a generic medication; it’s cheap to produce. If there’s money to be made by promotion of this medication it’s not clear how Trump profits.
We still can’t be certain he’s taking it himself though he claims he is; the letter from his doctor does not clearly state that Trump has been prescribed HCQ and at what dosage for what period of time nor has there been any information provided with regard to the nature of monitoring Trump receives while taking HCQ.
We don’t know why Trump would claim to take HCQ on the advice of some unknown person alleging to be a doctor. We’ve no further information about the letter, the letter’s author, whether a letter even existed since Trump has a proven propensity for making up shit.
“I happen to be taking it … right now, yeah” — Trump claims he’s taking hydroxychloroquine, a drug he’s touted as a potential coronavirus treatment despite a lack of evidence that can lead to potentially fatal heart problems pic.twitter.com/zxiNxlyfEs
— Aaron Rupar (@atrupar) May 18, 2020
All we can be sure of at this point is that more patients with COVID-19 may have died, potentially because of HCQ’s promotion by Trump, than may have died had he refrained from practicing medicine without a license by pushing HCQ.
In the case of the study of HCQ at Veterans Health Administration medical centers, former service persons who’ve already paid a price for our freedoms have been used in human experimentation in what might have been an attempt to validate Trump’s claims about HCQ — and some of them died for it.
It seems odd VA doctors used it out of the clear blue when the Food and Drug Administration hadn’t formally approved this drug for COVID-19 patients. (It’s probably just a coincidence the Center for Disease Control lifted its guidance on off-label use of HCQ two weeks before the VA study was published, right?)
It’d be nice to know if Trump’s three golf buddies at Mar-a-Lago — one of then a doctor — had anything to do with the use of HCQ and chloroquine at VA hospitals on COVID-19 patients.
There’s simply no good reason for Trump’s plugging this particular drug therapy except to harm and kill Americans.
I feel like I need to point out again that in vitro and in vivo are very different kinds of studies; hydroxychloroquine has only only looked good in vitro. We still do not have large scale randomized clinical studies on this drug for use against COVID-19. Based on what these preliminary studies tell us, I don’t think this drug should proceed to randomized trial. Our time and resources would be better invested in an antiviral which does not increase mortality at this stage.
Oh, and comedian Sarah Cooper is amazing.
This girl is on 🔥 fire . Thank you
One of his Mar-a-Lago buddies (a doctor, IIRC, but not one of the three VA pals) was involved in pushing HCQ to states like NY & NJ, with some detail re Turkey providing raw materials for India to manufacture it. I’ll see if I can grab quote(s) in a minute…
Thanks, Eureka. I’m heading to bed, will look for your find when I’m back online next. ;-)
Sleep tight ;)
I love Sarah Cooper’s videos, too.
**removes Friday night goggles**
LOL, my bad — not a doctor but a “vitamins executive”; the Turkish connection “sells products to these guys in India who are making the drug” so not _necessarily_ raw materials wrt HCQ (though who knows if this manufacturer makes more than HCQ, and the point was the cash circuit in any case):
There are a few comments here on Rayne’s prior thread about the India angle with lots of links (and starting with quotes from Rick Bright re admin demands that NY and NJ be “flooded” with HCQ from unapproved labs in India and Pakistan):
*This reminds me — Jared’s intention to announce a theraputics overlord (function of actual FDA?!?) was noted in this thread; since-announced Slaoui with Moderna links are another commentary job…
Yeah it is incredibly naive to believe Frankel’s claim of “at cost” Somewhere, the profit is built in, most likely later if the Trumps are voted out of office and agree to go, which is becoming increasingly unlikely. People should be able to sniff the corruption, it stinks, one can feel it.
“A guy I know sells products to these guys in India” sounds really legit. /s
(Most businesspeople would insist on more details than that.)
Yuck. We really need a list of Mar-a-Lago members to know who’s influencing him besides hostile foreign actors and what their agenda is in doing so. The balls of a vitamin salesman to insist Trump call California and completely bypass the CDC, FDA, and state health department…how do such assholes walk?
Thanks for that, Eureka.
Hello, Rayne and thank you for these essential and informative posts. While I agree with your sentiment vis-a-vis the ballsiness of the drug salesman, I believe you misapprehended the ask:
“Frankel . . .said the president asked him to call California Gov. Gavin Newsom (D) on his cellphone and try to make a deal for the nation’s largest state to buy millions of tablets of hydroxychloroquine from an Indian manufacturer. Frankel said he got Newsom’s phone number from Trump.”
Eureka mentioned that here in comments. But I don’t think it was Frankel who plugged HCQ to Trump for personal use, nor do I think Frankel pushed it specifically to the VA. IMO, Frankel fits more into the meeting with Modi in India.
Evangelical-funded Israel Charity Hopes to Cash in by Getting Cozy With Trump
Turkey claims success treating COVID-19 with hydroxychloroquine, the drug touted by Trump
April 30, 2020 / 7:09 AM / CBS News
(internal links removed; emphasis added)
Related (tho that first quoted sentence needs an agency re-write):
Bolsonaro bets big on ‘right-wing’ drug against virus
AFP•May 20, 2020
Brazil’s Bolsonaro Expands Use of Controversial Hydroxychloroquine After Daily Coronavirus Deaths in Country Hit Record High
5/20/20 at 11:05 AM EDT
Recall the POTUS and all of the bots are at pains to tell us lately how HCQ must be started early on (or prophylactically). Imagine all of the positive low/asymptomatic folks who might otherwise never require treatment (or “treatment”) taking this, because at the outset no one knows the course their infection will take. As Rayne notes, the drug is cheap. Mass-conscripted consumption would water the money tree.
About that emphasis on “early”,
mass-conscriptedwidespread use, and appealing to health minsters or their facultative equivalents, Trump Saturday night:
It’s not right that harming and killing Americans is a GOOD reason to plug the drug. Obviously it’s a terrible reason. But I don’t believe that’s Trump’s intention. He’s convinced himself he knows more about the treatment of COVID-19 than anyone, and that hydroxychloroquine is both safe and effective. Being a pig-headed egotistical oaf, he cannot bear to have his opinions questioned, so the more he hears people suggesting caution in using the drug, the more his ego requires him to insist it is a terrific treatment. That’s not a good reason either, but I think it’s the plausible explanation for his behavior. His insistence that a hurricane was heading for Alabama, even to the extent of making an utter fool of himself by altering a forecast track, was another example of this kind of mania.
Reminds me that a number of Chinese emperors throughout history have died taking the magic elixir, (mostly mercury) to gain immortality, we couldn’t be that lucky.
It’s called ‘oppositional defiant disorder‘ which when combined with Trump’s malignant narcissism puts the entire country at risk.
I’m beyond explanations and excuses for Trump’s personal behavior. He needs to be held accountable for his bad decisions and he needs to be removed from power; he’s killing Americans no matter the explanation or excuse.
I think I know where Trump is going with this. During the campaign, Trump will boast of the tremendous amount of wealth he has facilitated transferring to a younger generation, sooner than expected, (and without the draining effects of chronic geriatric illness).
And it may well bring him votes, I’m pretty sure the MAGA-virus is self-replicating.
Does he still have Wilkie pushing it on vets?
You mean Robert Wilkie, Secretary of Veterans Affairs? Sure would like to know how a supporter of the Confederacy ended up nominated for that role.
The coverage of this study in military news outlets suggests both active and former military aren’t happy with this situation, and Wilkie is ass covering when quoted.
The persistence and longevity of the Myth of the Lost Cause is an example of how, contrary to Bill Barr, history is not always written by the winners.
I believe Trump has returned to this just for the satisfaction of seeing his fans dance to his tune. To see tens of thousands of his fans and true believers take up the ’cause’ in words and even deeds. People doing their own trials and possibly sacrificing themselves. Especially if they sacrifice themselves. I am coming to believe there is a sadistic element to it. Seeing people literally killing themselves on his word is a profound proof of his power which I believe he enjoys.
I am serious about this. It makes me fear what is to come.
I also think Trump is simply looking for a way to justify his own opinion of himself; namely, that he is smarter than anyone else. I get the impression he has been fumbling around for a long time to find an impressive ‘win’ on a long-shot –anything–so he can spike the ball and do a victory dance. The longer he is deprived of that, the more dangerous he will be. He likes being a contrarian. He likes being a gambler against all odds because the man thinks it is his destiny to win in the final analysis.
You have just described “Jonestown” to a T.
“Drink the CoolAid….” ( I wonder if it was orange?)
Great work Rayne.
You know, these personality traits are the very ones which Ian Kershaw identifies in his massive biography of Hitler, particularly the tendency to gamble on long-shots which the experts tell him will never pay off. In the end, like all gamblers, Hitler ran himself out past the end of his luck, and there’s every chance Trump will end up doing the same thing. I realize that yes, of course, one ought to be cautious about making facile comparisons with the Nazis, but it really does seem to me that the two men share some basic personality similarities. We are just lucky (sorta, kinda, I guess) that the political and economic conditions right now are nothing like Weimar Germany.
I’m visualizing MAGA rallies with Trump egging the crowd to pop the droxy “all at once.”
A sadistic element to it is right. His taunting of McCabe and getting him fired just before full benefits kicked in was only one of many petty, sadistic moves from this idiot. It seems like ages ago, but this article was in Salon just last month:
Psychologist John Gartner: Trump is a “sexual sadist” who is “actively engaging in sabotage”
The article ends with this…
“Like in a relationship, Donald Trump is the abuser. He is the husband or father who is abusing his partner or children or other relatives. The American people are like a woman who is leaving her abuser. She tells her abuser, “That’s it! I am done with you!” She has her keys in hand and is opening the door of the house or apartment to finally leave. What happens? The democidal maniac Donald Trump will attack us, badly. Make no mistake. Donald Trump is going to find a way to attack and cause great harm to the American people if he believes that he will lose the 2020 election.”
I keep worrying that a war breaks out. Iran, China, or North Korea are my 1, 2, & 3 picks. Maybe as an act to gain support or to destroy America in retaliation or both.
I think the President is so desperate to avoid what happened to Boris Johnson–i.e., being laid up and hospitalized for weeks with the coronavirus–that he’s willing to try almost anything that will help him maintain his pose of health and strength in the midst of the pandemic, including taking a medication with such serious potential side-effects. Trump realizes that if he gets the virus despite all the safeguards provided by the White House it will send the clear message that anyone can get the virus, and if anyone can get the virus then anyone can become seriously ill and die from it. That’s not how Trump wants the public to think of the coronavirus. He also knows he will look like a complete schmuck if he gets sick now after months of downplaying the seriousness of the virus, not wearing a mask, and encouraging the country to open up. He will look weak and vulnerable. He probably squirms inwardly at the thought of CNN giving regular updates on his medical condition. By comparison, Joe Biden will be able to present himself as someone who can be trusted to look after the country because he knows how to look after himself.
I also think Trump wants to promote the use of hydroxychloroquine in order to give people the (false) idea that the risk posed by the coronavirus can be easily managed, that you can just get in the habit of taking this medication as a preventive measure the same way you put on sun screen to help protect against skin cancer.
With the election fast approaching, Trump wants Americans to think that the bad dream is all over and that it’s full steam ahead with his Transition to Greatness despite the mounting death toll across the country. If he had his way, the President would like people to think of the coronavirus as no more of a danger to the average person than a peanut allergy.
I rather think Ken L had it right.
We over-intellectualise Trump. He genuinely is quite stupid, though very cunning. He does not analyse. He does not read his briefings properly. That’s probably why, when he announced churches were essential, he stopped completely after “synagogues” before he read out “mosques” which he had probably not even thought out. If it wasn’t so serious it would be funny.
The afternoon when Trump stood up in front of the whole world and seriously suggested injecting disinfectants or somehow shining UV light inside the human body as a possible treatment for the coronavirus was really the Rosetta Stone of his general intellectual goofiness. In that moment–which we all witnessed for ourselves without having to rely on the word of anonymous White House sources–we all realized that every other stupid and clueless thing Trump has been reported to have said or done was now entirely plausible. A close second was his recent comment about testing for COVID-19 being “overrated” because, after all, if you don’t test for the virus you won’t know it’s there; and after all, what you don’t know can’t hurt you.
His comment about getting flu shots three years in a row and he didn’t see why it was necessary to get one every year.
When I saw that speech, and he mentioned “churches”, then “synagogues”, there was a distinct pause, long enough for me to think “is he going to say ‘mosques’?”, and then after a moment, with a distinct grimace on his face, he actually said “mosques”, but it was clear that if he had a choice, he wouldn’t have. However, the the optics of that moment required it. Poor shmuck.
It’s just crazy that so many government resources were put behind this because Trump insisted on this. If he & Fox hadn’t pushed this we wouldn’t have wasted the money & time & resources. He’s the Mad King & the King with No Clothes.
There’s also the old Trump trope of misdirection to consider. What didn’t we notice because we were busy watching his hands?
When you see the president of the United States hawking drugs for drugs like a has been actor that needs the cash, you have to wonder what sort of political debt Trump is in or expects to be in after this election?
TRUMP: I’m NOT the GREATness!!
8:52 AM · May 23, 2020
“Transition to Greatness.” So Make America Great Again either failed outright (Trump never got us to “great”) or the greatness got smothered by all this death. I haven’t been seeing a lot of Keep America Great slogans lately. I guess Trump’s promised greatness still lies in the future, like the green light on Gatsby’s dock.
Thanks. Nice point about the VA doctors. They and their employer are not much given to stepping outside the box. Plus, they’re often busy as hell and their budgets are monitored. Getting an unproven-for-use drug into the system, the resources to monitor its use, and getting it published would take some juice and direction from high in the chain of command.
I think tRump has confused the drug with Hydrox cookies.
No wonder he can’t flatten the curve.
I think Dr. Birx has a crush on Trump.
lol – Took the red pill?
She strikes me as the medical-expert version of Patty Hearst; he’s held her hostage for so long she’s succumbed to a kind of Stockholm Syndrome. I wonder if she can even differentiate between advocating for the public interest and shilling for Trump’s ego, whims, and sociopathic policies.
Perfect! And Dr. Birx’s safe-word with Trmp is “Tania.”
“I think Dr. Birx has a crush on Trump.“
Or as Lucian Truscott IV calls her, “Dr. Shoulder Scarf”
The best commentary I heard on why Trump started pushing the HCQ thing again after some time off from it, and especially with his new claim that he was actually taking it, came from Lawrence O’Donnell’s show where he reminded us that Dr. Bright’s 60 Minutes interview had just aired the night before after his testimony. Dr. Bright was fired because he held the line on Trump’s cray-cray HCQ directive to make it available on demand throughout the land. What’s the best counter move to Dr. Bright’s claim of nefariousness in Trump’s behavior in that regard? “Uhm,…I’m taking it myself, yeah, uh, that’s the ticket! I’m taking it myself. Have been for several weeks now, yeah, that’s it.” (prideful grin) I think (as O’Donnell seems to) that Trump made it up on the spot as his counter move against Dr. Bright’s accusation.
How could he be doing anything nefarious if he was honestly believing the drug would be helpful, and for proof of that, “I’m taking it myself”. I think the staff’s backfill of saying the timing works out that after he got scared with how close Covid-19 got inside his house, he reached for this extra measure of security, because he believed it was helpful, is just the normal backfill that any staff around him has been doing since his days on The Apprentice where he’d do some dumb-ass thing and the staff would have to figure out how to make that not look as dumb-ass as it was. That’s been the story of his entire presidency, has it not?
And that doctor’s note! Trying to walk the fine line between lying about prescribing something he may well could loose his license for prescribing to this man, in his, ahem, “morbidly obese” state and age, and angering Trump for refusing. Ouch! Rock, meet hard place!