DadHammer said:

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I don't understand the problem here.

1. If you don't want to use it then don't.

2. If you want to use then use it.

It's a Decision between you and your Dr.

HCQ, Zinc, Azithromycin are a cheap safe treatment as the Dr has described it.

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On an individual basis it's largely irrelevant. I really don't care if random suburban soccer mom thinks it works or wants to use it, though I'm certainly not going to be the one to prescribe it because doing so with the current information at my disposal would be unethical.

At the 30 thousand foot macro view however, widespread endorsement of this therapy in the absence of evidence is decidedly harmful.

Keegan99 said:

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The Switzerland data seems to be correct.

https://www.newsweek.com/key-defeating-covid-19-already-exists-we-need-start-using-it-opinion-1519535

It's referenced by this Yale faculty member here.

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A reverse natural experiment happened in Switzerland. On May 27, the Swiss national government banned outpatient use of hydroxychloroquine for COVID-19. Around June 10, COVID-19 deaths increased four-fold and remained elevated. On June 11, the Swiss government revoked the ban, and on June 23 the death rate reverted to what it had been beforehand. People who die from COVID-19 live about three to five weeks from the start of symptoms, which makes the evidence of a causal relation in these experiments strong.

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Ignoring for a moment that his math is off, he makes no attempt to provide evidence for a causal link. No data on prescriptions written or filled, no patient demographics before/after the spike, etc.

He also fails to mention that widespread use of dexamethasone in Switzerland began two weeks prior to the decline in death rate, a therapy for which there is currently substantially more powerful data on than HCQ.

Just a textbook case of correlation =/ causation

Bonfire1996 said:

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Bonfire1996 said:

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That's amazing. Trump has completely broken these people.

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Fact check: true

The results will be written in history. As the world used HCQ with great success, America chose to attempt the samurai version of seppuku in order to keep Donald Trump from leading the way out of COVID crisis. The data was always going to win out, as it always does. Simply amazing.

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You do realize hundreds of thousands of American doctors who both voted for Trump AND refuse to push HCQ, no?

Philip J Fry said:

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Of course. Hopefully those docs are mostly in hospital settings where HCQ isn't as effective. The fact we haven't seen many studies of using it early in the disease course, or better as a prophylactic is really frustrating.

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The problem isn't with the body of evidence, it's the shifting goalposts. There's always a caveat, intended to create a narrower and narrower scope of patients for whom it is supposedly effective, ultimately serving to render the claim effectively unfalsifiable. Those making such attempts fail to realize however that simply isn't how science and medicine works. The burden of proof always ultimately falls on the person making the affirmative claim (HCQ works). Nobody had to prove it doesn't work, any moreso than they have to prove smelling smalls don't effectively treat COVID.

As far as I can remember, the goal post was always set at early onset. Who in their right mind would think it's effective after a patients lungs are turned to jelly? Second, it's been HCQ +zpack+zinc since Trump first spoke about it. The pushback on some of these studies is that they didn't actually study the right cocktail given at the right time.

Sure seems like the "studies" have been set up for this cocktail to fail. There's no money to be had in a drug that's already on the market. This is what makes it so suspicious when they test it late in the game, or with missing ingredients.

Democrats have a vested interest in it not working. The media is so over the top TDS that you can't trust what they are telling you. FNC is so pro Trump that you have to take what they say with a grain of salt. It's really a quite horrible situation when it comes to the truth.

Philip J Fry said:

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As far as I can remember, the goal post was always set at early onset. Who in their right mind would think it's effective after a patients lungs are turned to jelly? Second, it's been HCQ +zpack+zinc since Trump first spoke about it. The pushback on some of these studies is that they didn't actually study the right cocktail given at the right time.

Sure seems like the "studies" have been set up for this cocktail to fail. There's no money to be had in a drug that's already on the market. This is what makes it so suspicious when they test it late in the game, or with missing ingredients.

Democrats have a vested interest in it not working. The media is so over the top TDS that you can't trust what they are telling you. FNC is so pro Trump that you have to take what they say with a grain of salt. It's really a quite horrible situation when it comes to the truth.

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I think it's beyond nuts to claim that people in our government find its beneficial to keep the pandemic going.

That's a conspiracy theory. Not founded in reality. You're just irresponsibly making stuff up.

BallerStaf2003 said:

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Philip J Fry said:

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As far as I can remember, the goal post was always set at early onset. Who in their right mind would think it's effective after a patients lungs are turned to jelly? Second, it's been HCQ +zpack+zinc since Trump first spoke about it. The pushback on some of these studies is that they didn't actually study the right cocktail given at the right time.

Sure seems like the "studies" have been set up for this cocktail to fail. There's no money to be had in a drug that's already on the market. This is what makes it so suspicious when they test it late in the game, or with missing ingredients.

Democrats have a vested interest in it not working. The media is so over the top TDS that you can't trust what they are telling you. FNC is so pro Trump that you have to take what they say with a grain of salt. It's really a quite horrible situation when it comes to the truth.

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I think it's beyond nuts to claim that people in our government find its beneficial to keep the pandemic going.

That's a conspiracy theory. Not founded in reality. You're just irresponsibly making stuff up.

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Yes, I remember when Trump first brought up the drug how fair the dems and press treated him.

Because he's not a doctor. He shouldn't be touting stuff without solid clinical evidence.

Infection_Ag11 said:

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Keegan99 said:

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The Switzerland data seems to be correct.

https://www.newsweek.com/key-defeating-covid-19-already-exists-we-need-start-using-it-opinion-1519535

It's referenced by this Yale faculty member here.

Quote:

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A reverse natural experiment happened in Switzerland. On May 27, the Swiss national government banned outpatient use of hydroxychloroquine for COVID-19. Around June 10, COVID-19 deaths increased four-fold and remained elevated. On June 11, the Swiss government revoked the ban, and on June 23 the death rate reverted to what it had been beforehand. People who die from COVID-19 live about three to five weeks from the start of symptoms, which makes the evidence of a causal relation in these experiments strong.

---

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Ignoring for a moment that his math is off, he makes no attempt to provide evidence for a causal link. No data on prescriptions written or filled, no patient demographics before/after the spike, etc.

He also fails to mention that widespread use of dexamethasone in Switzerland began two weeks prior to the decline in death rate, a therapy for which there is currently substantially more powerful data on than HCQ.

Just a textbook case of correlation =/ causation

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I researched the French and German newspapers and could not find any mention of HCQ being banned in Switzerland. I might check with a friend in the Swiss medical community.

Also, the Swiss deaths during this period are not broken down by demographics. The peak number of deaths in the period is 15. This could easily be a nursing home problem.



Again, if there is solid evidence that HCQ is working we should be using it. The proof seems to be elusive.

BallerStaf2003 said:

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Because he's not a doctor. He shouldn't be touting stuff without solid clinical evidence.

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I am not a Gynecologist, but I'll have a look.

Philip J Fry said:

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As far as I can remember, the goal post was always set at early onset. Who in their right mind would think it's effective after a patients lungs are turned to jelly? Second, it's been HCQ +zpack+zinc since Trump first spoke about it. The pushback on some of these studies is that they didn't actually study the right cocktail given at the right time.

Sure seems like the "studies" have been set up for this cocktail to fail. There's no money to be had in a drug that's already on the market. This is what makes it so suspicious when they test it late in the game, or with missing ingredients.

Democrats have a vested interest in it not working. The media is so over the top TDS that you can't trust what they are telling you. FNC is so pro Trump that you have to take what they say with a grain of salt. It's really a quite horrible situation when it comes to the truth.

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There's no money to be made with dexamethasone, yet it's become the standard of care for hypoxic patients. Why? Because incredibly strong randomized prospective trials show quality evidence of significant benefit.

And as I've broken down before, scientifically there is little reason to believe in the theoretical mechanism of HCQ/Zinc/Azithromycin.

goodAg80 said:

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Infection_Ag11 said:

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Keegan99 said:

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The Switzerland data seems to be correct.

https://www.newsweek.com/key-defeating-covid-19-already-exists-we-need-start-using-it-opinion-1519535

It's referenced by this Yale faculty member here.

Quote:

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A reverse natural experiment happened in Switzerland. On May 27, the Swiss national government banned outpatient use of hydroxychloroquine for COVID-19. Around June 10, COVID-19 deaths increased four-fold and remained elevated. On June 11, the Swiss government revoked the ban, and on June 23 the death rate reverted to what it had been beforehand. People who die from COVID-19 live about three to five weeks from the start of symptoms, which makes the evidence of a causal relation in these experiments strong.

---

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Ignoring for a moment that his math is off, he makes no attempt to provide evidence for a causal link. No data on prescriptions written or filled, no patient demographics before/after the spike, etc.

He also fails to mention that widespread use of dexamethasone in Switzerland began two weeks prior to the decline in death rate, a therapy for which there is currently substantially more powerful data on than HCQ.

Just a textbook case of correlation =/ causation

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I researched the French and German newspapers and could not find any mention of HCQ being banned in Switzerland. I might check with a friend in the Swiss medical community.

Also, the Swiss deaths during this period are not broken down by demographics. The peak number of deaths in the period is 15. This could easily be a nursing home problem.



Again, if there is solid evidence that HCQ is working we should be using it. The proof seems to be elusive.

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Correct

BallerStaf2003 said:

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Now would you please post this on the politics board?

They think it's all a conspiracy to keep trump from being re-elected.

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I've tried, and immediately get accused of being a liberal shill. This despite the fact that I've never voted for a democrat in a national election and voted for Trump, albeit begrudgingly, in 2016.

They also like to scoff at my "exponential growth" claim early in the pandemic claiming we'd quickly hit the 10 million cases mark worldwide, and we've now well surpassed that with documented cases despite it taking longer than I expected. However, the current serology data coming out shows we likely hit 10 million actual worldwide cases even sooner than I said we would.

Infection_Ag11 said:

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BallerStaf2003 said:

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Now would you please post this on the politics board?

They think it's all a conspiracy to keep trump from being re-elected.

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I've tried, and immediately get accused of being a liberal shill. This despite the fact that I've never voted for a democrat in a national election and voted for Trump, albeit begrudgingly, in 2016.

They also like to scoff at my "exponential growth" claim early in the pandemic claiming we'd quickly hit the 10 million cases mark worldwide, and we've now well surpassed that with documented cases despite it taking longer than I expected. However, the current serology data coming out shows we likely hit 10 million actual worldwide cases even sooner than I said we would.

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I'm sorry man. That must be incredibly frustrating given you're a doctor and should be respected and listened to.

It boils down to politics. These people ha e to have someone to blame other than trump and this is the latest conspiracy theory to try and protect him.

The board doesn't deserve you, or any doctor.

Quote:

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I have read many studies on the cocktail showing an effect but none really reach that gold standard of statistical significance but many show some clinical significance or at least anecdotal evidence that it helps if used early. In other words it may never gain that standard but refusing to use it based on it meeting that criteria seems like you are not doing all you can if you're a frontline PCP.

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I would say walk a mile in a doctors shoes before questioning their embrace of the Hippocratic oath. The world is besieged by shoddy medical quackery during the best of times. There are processes that have been developed to separate effective treatment from ineffective treatment and they are being applied in this case.

You may not like the results but they are there for a reason.

Fenrir said:

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BallerStaf2003 said:

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Now would you please post this on the politics board?

They think it's all a conspiracy to keep trump from being re-elected.

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Would you say anyone that believes HCQ/Zinc is effective at any point is a liar or playing politics?

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No, apart from a select few almost none of them are lying (which requires they know what they are claiming to be false). The vast majority are simply ignorant on the topic (either willingly or unwillingly).

Now one could argue the majority of those touting the drug in this country have a bias towards desiring it to work on the basis of their politics, and that's probably true, but bias in and of itself doesn't man they are "playing politics". We're all biased to some degree about a great many things and often don't even realize it.

I'll also say anyone who hopes it doesn't work is far more likely to be doing so simply on political grounds, especially since it would be great if it did work. To hope such a simple thing isn't effective is to put ideology over people. Such people just happen to appear to be on the "right" side of the debate, but for the wrong reasons.

Fenrir said:

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Infection_Ag11 said:

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Fenrir said:

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BallerStaf2003 said:

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Now would you please post this on the politics board?

They think it's all a conspiracy to keep trump from being re-elected.

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Would you say anyone that believes HCQ/Zinc is effective at any point is a liar or playing politics?

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No, apart from a select few almost none of them are lying (which requires they know what they are claiming to be false). The vast majority are simply ignorant on the topic (either willingly or unwillingly).

Now one could argue the majority of those touting the drug in this country have a bias towards desiring it to work on the basis of their politics, and that's probably true, but bias in and of itself doesn't man they are "playing politics". We're all biased to some degree about a great many things and often don't even realize it.

I'll also say anyone who hopes it doesn't work is far more likely to be doing so simply on political grounds, especially since it would be great if it did work. To hope such a simple thing isn't effective is to put ideology over people. Such people just happen to appear to be on the "right" side of the debate, but for the wrong reasons.

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The question was not directed at you.

I do not disagree with much of what you said although I am not sure I could bring myself to call Reveille ignorant (since lying or ignorant seem to be the only two options you presented).

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Ignorant carries a negative connotation but the reality is we are all ignorant on most topics. It's impossible to know a lot about most things.

Among physicians, especially those who have spent a great deal of time outside academic medicine and the research setting, there is very often a relative degree of ignorance when it comes to interpretation of medical research and what constitutes good evidence. What constitutes good evidence also varies amongst specialties. Quality evidence for the efficacy of antibiotics is very different than quality evidence for the efficacy of appendectomies, to give an obvious dichotomy. And outpatient medicine is very different from inpatient medicine, something I can confidently claim as I do both and in ID we often double as the patients PCP (especially in the case of HIV and some chronically immunosuppressed patients).

Someone I think that is escaping those who do largely outpatient medicine is that many of our inpatients are no more I'll than the patients they are sending home with HCQ. Many people with COVID are admitted without hypoxia early in the disease due to either being high risk for worsening disease or social factors (homeless, from a facility, etc.) The argument "those treated in the hospital are all sicker than those coming into the clinic" isn't necessarily true. Moreover, those who do have truly milder presentations are almost all going to be fine no matter what you do.

We are very lucky to have an infectious disease doctor from Texas A&M working on the front lines with COVID patients to inform us on this virus and the treatments. It still surprises me that lay people still try to argue with him on the science. Consider what it means if you reject everything he says because you do not like what he is saying, but readily accepted the views of a non-specialist doctor who talks about demon sperm, alien DNA, the religious gene, etc. just because she claims to have anecdotal success.

Your argument sucks because most of us are listening to Drs. like Revellie and many, many other, and a long list of research, not the lady doctor you enjoy demonizing.

And as far as academia, don't get me started.

Every week I come back to this board and I still don't understand why the discussion on hydroxcholorquine is still taking place.

There is not a single well controlled, large sample size study that shows it works.

In fact, more and more research comes in weekly that it is not effective.

https://www.medrxiv.org/content/10.1101/2020.07.20.20157651v1

https://www.nature.com/articles/s41586-020-2575-3

https://www.nature.com/articles/s41586-020-2558-4

At this point, we need to putting our limited resources into something else. We did the science, and it does not work as hoped. Let's move on.

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And as far as academia, don't get me started.

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You got your answer right there in the post above you. Some folks just want to ignore best practices in medical research because of Alex Jones.

If some folks want to put all their trust a Nigerian Faith healer because she said something similar to a tweet from Donald Trump Jr., we should just all move on and let them do their thing.

Red Fishing Ag93 said:

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Your argument sucks because most of us are listening to Drs. like Revellie and many, many other, and a long list of research, not the lady doctor you enjoy demonizing.

And as far as academia, don't get me started.

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Academic medicine =/ University academia, at least not with regards to the perverse liberal *******ization of academia commonly associated with universities and liberal arts colleges

Life in the academic hard sciences is very different from the soft sciences and liberal arts. There's still a very strong "facts don't care about your feelings" mindset among academic physicians, largely because the research and practice habits due to it have immediate real world consequences. Just look at the personal and professional consequences for publishing bad research (let alone fraudulent research) in the hard science fields as compared to sociology, ELA, etc.