Picadillo said:

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Randomized, controlled double blind studies. Taking a group of patients sick with a potentially deadly virus and giving half of them a placebo.

Geesh maybe my mom will be one of the lucky ones.

Do medical schools still teach medical ethics? Only a Fauci type would do this.

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A RCT does not require a placebo control group. In reality such studies usually involve a novel therapy vs standard of care, and often the novel therapy is given in combination with standard of care. You really think we study say, new antibiotics by having a control group that receives no antibiotics?

Also, before you go accusing arguably the most decorated physician scientist of the last 40 years of obscene ethical, research and human rights violations you might comb through his history a touch more closely.

It's becoming clear how you are arriving at your unfounded opinions on this topic.

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Yours is an incredibly absurd request, that simply because a proposed treatment with a poor mechanistic basis is endorsed by a given number of people it MUST be falsified before you'll believe it doesn't work. That thinking is the antithesis of medication and science as a whole.

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That's absurd. There have been trials with HCQ + zpack, but when we note there is a missing ingredient, then the experts through their hands up and say we are asking for too much. If you are going to go through the effort of a trial, then do it right. Looks kind they were purposefully set up to fail.

Philip J Fry said:

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Yours is an incredibly absurd request, that simply because a proposed treatment with a poor mechanistic basis is endorsed by a given number of people it MUST be falsified before you'll believe it doesn't work. That thinking is the antithesis of medication and science as a whole.

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That's absurd. There have been trials with HCQ + zpack, but when we note there is a missing ingredient, then the experts through their hands up and say we are asking for too much. If you are going to go through the effort of a trial, then do it right. Looks kind they were purposefully set up to fail.

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Again, a misunderstanding of the scientific nuance plays the major role in the disconnect here.

HCQ has several well founded in vitro mechanisms by which it would inhibit viral replication and propagation. One, not the predominant one mind you, is that it acts as an ionophore of multiple compounds including zinc. In vitro, zinc has been shown to inhibit the replicative capacity of certain viruses and it is known that zinc deficiency can have an immunosuppressive effect. So there is a baseline level at which normal zinc levels help modulate immune function. Here's the problem with saying giving a lot more zinc helps: The relative concentration of zinc in vitro required for this mechanism of increased direct viral inhibition (not simply baseline immune function) is prohibitively high. It's why this mechanism has literally NEVER worked for ANY real world viral infection in vivo at safe doses, despite being tested on numerous types of viral infections. People have tried it with the flu, with and without ionophores, for decades. You can still buy zinc lozenges over the counter for colds/flu, but there is no good data for it.

In other words, even if this in vitro mechanism translates in vivo (and that often isn't the case) you'd never reach the concentrations necessary without giving massive doses of zinc that would cause devastating side effects to our own cells.

So giving zinc as part of this "cocktail" (a word I've grown weary of, much like "toxins") isn't being done largely because WE KNOW IT DOESNT WORK IN THE HUMAN BODY BASED ON DECADES OF RESEARCH. It's failed again and again and again.

With respect to azithromycin, this too is a failed mechanism. It's be studied for decades for its antinflammatory properties and has no good evidentiary support apart from acute exacerbations of chronic obstructive lung disease. Some lung doctors use it in end stage COPD chronically but the evidence for this is very minimal. And the claim some make about it preventing pneumonia is equally silly as most microbes that cause pneumonia (especially pneumonia secondary to a viral respiratory illness) are already resistant to it. Apart from atypical organisms, which don't generally cause bacterial pneumonia superimposed on viral pneumonia, it's fallen so out of favor that it is no longer recommended as mono therapy for community acquired pneumonia. You should not be getting a Z pack for your "respiratory infection" anymore unless in combination with another antibiotic.

So all that to say that no, it is not in fact absurd and frankly it's only to satisfy illogical outcries that many of these studies were conducted in the first place. The anomaly here is that this was entertained at all, not that more wasn't done. The initial look into HCQ AS MONOTHERAPY was worthwhile, as it's most encouraging potential mechanisms within the realms of real science (such as altering endosomal pH) needed no additional support from other medications. That was done and has not revealed promising benefits in the treatment of mild, moderate or severe disease or in primary/secondary prophylaxis.

Meanwhile, a very cheap drug without the backing of "big pharma" (and not endorsed or denounced by a notable member of either major political party) has increasingly strong evidence for benefit in hypoxic patients and almost nobody is talking about it. Why? I'll leave that for another time and another board but it's not difficult to figure out.

This isn't about trying to attack a president I voted for, and it's not about getting a cut from the pharmaceutical industry (of which I have absolutely no stake in). It's about what the evidence indicates, and what it doesn't. And frankly I'm tired of being told what I should and should not believe in and endorse by people who understand less than half of what I just typed above.

This is patently false. He's not saying no one should be allowed to use it. He's saying we have no reliable evidence that it works.

This is one of the worst examples of taking something a poster said and completely change it into something else I've ever seen in this board.

This thread is fascinating.

We have doctors..like people actually treating this disease on one side of a debate saying this stuff needs more study before saying it works.

Then we have internet epidemiologists and one ophthalmologist who says WE SHOULD USE IT NOW AND Y'ALL ARE WRONG.

JJMt said:

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Infection Ag relies on the classic defenses of the lifetime bureaucrat, i.e., no one should be allowed to do anything until it's been fully vetted and approved. If he had his way on everything, nothing would ever change. His attitude is that we cannot try or use any medicine or treatment until it has been completely and fully vetted, no matter how much the anecdotal evidence suggests that it works, and no matter how many lives are lost in the meantime.

Sometimes, in the heat of a crisis or emergency, people have to make decisions with the best evidence that they have, evidence that is typically deficient. Sure, in an ideal world, perfect evidence is best. Unfortunately, however, we do not live in a perfect world and we do not have the 3 years necessary or money required to do the tests that Infection Ag requires.

Generals launch battles with imperfect intelligence, businessmen make decisions with imperfect intelligence, but Infection Ag demands perfection before anyone or their doctor should be allowed, on their own, to make independent decisions based on the available intelligence.

Infection Ag also wholly fails to show what harm would occur if people are allowed to try the HCQ cocktail. Following his logic, all vitamins and OTC supplements should be banned because they also have not been fully vetted to his satisfaction. Following his logic, the government should be able to ban any food it wants because that food has not been vetted to his satisfaction.

Infection Ag seems to fail to understand that most everyone knows that the cocktail hasn't been fully vetted, but want to take it anyway. He keeps repeating his mantra of "science" assuming that no one else on here has his intelligence or deep understanding of science. Well, Infection Ag, we understand the science and the imperfect understanding of the cocktail, but don't see that it presents any serious risk and might actually be beneficial.

Science is a tool for our use. Don't allow your understanding of it to make it our master.

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JFC! Infection Ag was literally giving patients HCQ months ago prior to additional evidence coming out that finally tipped the scales in favor of avoiding it given a clear lack of benefit coupled with known very rare, but serious side effects (QT prolongation causing cardiac arrhythmias). No one is taking anything away from you. No one here is calling for a ban. Neither him nor I is keeping you from strolling down to your own personal physician and getting a prescription for HCQ. His assumption that most on this thread do not have anywhere near the knowledge of the science we are discussing that he does is accurate. To claim otherwise is hilariously absurd. He is an expert in the field being discussed, and is a huge asset to this board. Amazingly, however, you have a bunch of F16 posters flaming any post he makes for reasons I'm not quite clear of.

We come here to pass on our current understanding of the evidence, give people some of our experiences regarding COVID, and try to correct misconceptions or inaccuracies that are being circulated, but it is a bit disheartening to see posts like the one quoted.

Charpie said:

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This thread is fascinating.

We have doctors..like people actually treating this disease on one side of a debate saying this stuff needs more study before saying it works.

Then we have internet epidemiologists and one ophthalmologist who says WE SHOULD USE IT NOW AND Y'ALL ARE WRONG.

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Actually we have doctors treating this disease on one side saying it needs more study.

Then we have on the other side doctors treating this disease that say it works.

Then we have internet epidemiologists watching that debate and choosing sides.

I'm not sure you can discount Reveille's and Marcus' experience here. Just like you can't discount Infection Ag's.

It is fascinating to watch, quite frankly.

JJMt said:

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Infection Ag relies on the classic defenses of the lifetime bureaucrat, i.e., no one should be allowed to do anything until it's been fully vetted and approved. If he had his way on everything, nothing would ever change. His attitude is that we cannot try or use any medicine or treatment until it has been completely and fully vetted, no matter how much the anecdotal evidence suggests that it works, and no matter how many lives are lost in the meantime.

Sometimes, in the heat of a crisis or emergency, people have to make decisions with the best evidence that they have, evidence that is typically deficient. Sure, in an ideal world, perfect evidence is best. Unfortunately, however, we do not live in a perfect world and we do not have the 3 years necessary or money required to do the tests that Infection Ag requires.

Generals launch battles with imperfect intelligence, businessmen make decisions with imperfect intelligence, but Infection Ag demands perfection before anyone or their doctor should be allowed, on their own, to make independent decisions based on the available intelligence.

Infection Ag also wholly fails to show what harm would occur if people are allowed to try the HCQ cocktail. Following his logic, all vitamins and OTC supplements should be banned because they also have not been fully vetted to his satisfaction. Following his logic, the government should be able to ban any food it wants because that food has not been vetted to his satisfaction.

Infection Ag seems to fail to understand that most everyone knows that the cocktail hasn't been fully vetted, but want to take it anyway. He keeps repeating his mantra of "science" assuming that no one else on here has his intelligence or deep understanding of science. Well, Infection Ag, we understand the science and the imperfect understanding of the cocktail, but don't see that it presents any serious risk and might actually be beneficial.

Science is a tool for our use. Don't allow your understanding of it to make it our master.

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That's not what I said, at all. I have repeatedly said it shouldn't be used with the expectation it will work, not that it should be banned from use. Nor should OTC vitamins be banned.

Your post is so divergent from what I've said it borders on complete fabrication.

JJMt said:

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I have repeatedly said it shouldn't be used, not that it should be banned from use.

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When someone with your credentials says that "it shouldn't be used", it's awfully hard to distinguish that from "it should be banned from use". That's a mighty thin distinction that is not readily apparent to the casual observer. Your opinion, and the opinion of experts like you, operate as an effective ban within much of the medical community.

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Perhaps that's your perception, but the reality is the distinction is massive.

I don't think you should use OTC red yeast rice as a replacement for your statin for heart disease. That shouldn't be done because there is no evidence that they offer similar benefits, and quite a bit of evidence that in fact they do not. I'm not asking anyone to ban red yeast rice or ban you from making that decision, but I do recommend you shouldn't do so.

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What do you think that the harm is in using it, especially if prescribed and monitored by doctors?

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The direct potential harm from any medication, especially when prescribed by those physicians who do not regularly use the drug, has to be weighed against the potential benefit. In the absence of good evidence for any benefit whatsoever, the decision is easy. In the absence of any potential harm whatsoever (essentially non existent with prescription meds), the decision is also easy. In this case, HCQ is a relatively low risk drug with known but uncommon dangerous side effects. When prescribed by an experienced provider and for a condition we know it works for, the benefit far outweighs the risk. This is not the case in COVID however, and providers are in fact opening themselves up to liability in the event a patient they give this to has a bad reaction to the drug because of current evidence and guidelines.

The other danger however lies in the indirect consequences, the false sense of security that blanket endorsement of this provides. It will lead to decisions, both medical and societal, based on unfounded claims.

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What do you think that all of the folks disagreeing with you here, including doctors, are saying?

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I think you exaggerate the difference between myself and most doctors who "support this". By that I mean you take dismissive indifference and the shrugging of shoulders, as opposed to outright denouncement, as a form of support. Simply put, and sorry if this offends anyone, many doctors don't see the point in debating nonsense with non doctors. They pat you on the head and move along to doing their job with things they have evidence for. I'm actually trying to convey WHY it likely doesn't work instead of being dismissive.

With regards to the physicians who do overtly support its use, I would say their reasons for doing so are diverse. Some are ill informed or ignorant of the current evidence (generally those outside the relevant fields and those far removed from academic medicine and evidentiary analysis), some have political motivations, some enjoy the contrarian role, some simply believe too strongly in their own personal perception of efficacy, etc. If you're asking if I believe most doctors who support it are doing so with ill intent or lying then no I do not believe that at all.

Philip J Fry said:

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I'll reiterate. 256 trials have been done on HCQ. Only 3 in progress with H/Z/A. As much as I respect Infection's expertise in this, I still contend that if you are going to go through the effort of clinical trials, you should be looking at the entire cocktail.

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Refer to my previous post

We don't do trials just to satisfy the curiosity of a select group of people.

EyeBalz said:

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Infection_Ag11 said:

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There is no literature on it in the US, nobody has done a proper study on it.

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This is incorrect

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I want to see a randomized controlled study of HCQ with Zinc and Azithromycin given soon after significant symptoms emerge.

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I'd like to see a randomized controlled trial of essential oils in combination with colonic cleanses vs placebo for treatment of celiac disease. Millions of people, including some medical doctors, endorse these treatments after all.

I say this as politely as possible, but you really should know better than this. Yours is an incredibly absurd request, that simply because a proposed treatment with a poor mechanistic basis is endorsed by a given number of people it MUST be falsified before you'll believe it doesn't work. That thinking is the antithesis of medication and science as a whole.

Moreover, such a study would take YEARS worth of data and ultimately large meta-analysis to reveal any benefit even if it were feasible that such a benefit exists. This is always the case with assessing the efficacy of treatments for low mortality illnesses on an outpatient basis.

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There is way too much at stake for the backers of a vaccine to let some ancient malarial mineral tonic save the day.

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Vaccines are generally not big money makers for the pharmaceutical industry, accounting for less than 3% of worldwide revenues annually.

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Please direct me to the outpatient study that evaluates the use of the H/Z/A cocktail advocated that starts treatment within the first few days of symptom onset before hospitalization is needed.

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There have only been two, one was underpowered and useless and the other was canceled early due to poor follow up and study design. Others were not approved by IRB on the basis of no feasible benefit as I discussed earlier. The fact that any were done at all shows the remarkable diligence offered by modern medical research, even when such efforts are unwarranted.

My response was meant to convey that appropriate trials based on what may work have been done and the fact that they don't meet your increasingly narrow treatment scope is really not relevant. The fact that the goalposts keep moving, and that we aren't testing things we already know won't work, has no relevance to the scientific questions worth posing.

fig96 said:

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I'm just waiting for the truth to come out about the biotech company working on a vaccine that you heavily invested in and aren't telling us about.

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I'm still paying off that med school debt. If someone offers to pay that off in exchange for pushing a vaccine you might need to worry.

Staff-

We are VERY fortunate to have doctors and experts in the field posting here. Please protect them from the less informed people who have now started to attack them personally. PLEASE.

Red Fishing Ag93 said:

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Beware of Doug said:

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Motis B Totis said:

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Are there any recommendations of doctors that will prescribe it?

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If you are in Houston...
Dr. Stella Immanuel 1-281-506-7475

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Trolling in the Covid 19 forum is probably the lowest form on Texags.

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Trolling? She is a MD. She is the face of the American Frontline Doctors. She has the praise from the POTUS. She has the praise of many on this site. She posts on facebook giving out her number if you want HCQ. Seems like the perfect solution for Houston people looking for it.

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Trolling in the Covid 19 forum is probably the lowest form on Texags.

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There was a thread yesterday on the Politics forum where posters were eagerly discussing how they were going to celebrate the death of George Soros. One poster felt his entire family needs to die before he will relax.

https://texags.com/forums/16/topics/3128412/1

But yeah . . .that comment represents the lowest form on Texags.

Picadillo said:

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https://www.winchesterhospital.org/health-library/article?id=21849


https://www.verywellmind.com/what-is-a-double-blind-study-2795103

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What's your point?

You seem to believe placebo = no care provided. A placebo is generally given IN ADDITION TO standard of care. Moreover, not all such trials even have a placebo given at all (though most do, it is not a requirement of all such studies).

Windy City Ag said:

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Trolling in the Covid 19 forum is probably the lowest form on Texags.

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There was a thread yesterday on the Politics forum where posters were eagerly discussing how they were going to celebrate the death of George Soros. Some posters felt his entire family needs to die before he will relax.

https://texags.com/forums/16/topics/3128412/1

But yeah . . .that comment represents the lowest form on Texags.

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To be fair, mine was probably worse.

Board16 is just talk, me recommending a trump endorsed "doctor" is dangerous.


To be clear.

I do not recommend that anyone go to a doctor that believes in the medical risks of alien DNA and demon dream sperm, no matter how much the leader of the republican party praises them.

It is really frustrating when these threads devolve, as most seem apt to do, into arguing, dick measuring, and preaching. On my end I really appreciate the contributions of the Doc's on here, proffering their opinions and insight. I can honestly say that the combination of Doc's on here and other health care scientists have provided me with more lucid, from my stand point, information that I have gotten from speaking personally with a few docs that I know personally.

At the same time, given the current crisis, uncertainty, and ignorance (not meant in a deragotary manner) about this virus I can't help but think all individuals, of age of consent, should be allowed to pursue the course of action they think best if it doesn't infringe on others nor harm others.

In American society, where Physicians are held in very high esteem, the populace has come to take them as almost infallible and many Physicians gladly grab on to that mantra. I see this quite a bit in the situation we are in now. People in general look for validation, and one way to have that is via "group think". Those feelings and desires need to go out the window right now. If a Doc doesn't believe in Hydrox.Clor. then he/she shouldn't offer it, if the patient wants it real bad he should have the right to get it under his/her personal responsibility. That is what should happen. In the US, it won't be that way and that is going to cause some recriminations when this all plays out. Equally, if Doc's want to prescribe it, they should be empowered to do so.

On a personal level I know dozens, no inflated number, of folks out of the US that are taking it. A friend of mine that lives in a remote jungle area in Central America has been taking it for years, he relates no issues other than really weird sleep patterns and dreams. He takes it on his own. Maybe it has helped him with Malaria and other things, who knows, but he continues taking it.

At this point in time if eye of newt, bat wing, and simple syrup helped the general population have some confidence (not saying take the place of precautions) I think it would serve the world well for competent adults to be able to have access to anything that might offer hope.