Hydroxychloroquine

About 2 patients out of 450 dying, it can be easily explained by selection bias. Perhaps the majority of patients that will die end up in the ER before they call their doctor. For people that call their doctor before they need to go to the ER the chance of dying is apparently 0.1%-0.5% (for the general population it is likely between 1%-2%, just most get really sick and need the ER before they call their regular doctor). So Zelenko’s numbers are completely consistent with the data, unless you have some data that disputes this conclusion.

As an aside, I have another question with Zelenko. How well did he follow up with his patients as to whether they actually took the protocol as prescribed. That he prescribed it can be believed, but to what extent people completed or even filled the prescriptions and/or took the drugs is not in his data.

Does this need this repeating again? Without a proper study it is really very difficult to tell if Zelenko’s protocol actually works. Further there are now many questions about the safety of taking HCQ so not sure how anyone can recommend this at this time.

P.s., Trump suggested yesterday something about sticking powerful lights in your body and injecting yourself with bleach or some other disinfectant to cure this. Just be wary about anything he suggests.

Where can I buy syringes to inject myself with Lysol and Clorox? And what’s the bracha to make before doing so? Maybe Shema followed by Kaddish.

So basically he didn’t say it. Thank you for clarifying. What he says is usually dumb enough not to require distortion to something worse, which then is defined as no longer honest reporting. But that seems to work for people somehow.

JAMA literally just released the results of a clinical study that raises big RED warning flags on variations of this drug (in various formulations) and combinations. Bottom line. No demonstrated efficacy in most patients with Corona 19 with “DEATH” listed as “a primary negative outcome” . JAMA article says it hould be used ONLY in a hospital setting under strict supervision by cardiologists. FDA immediately issued warnings that use by physicians outside of hospitals should be discontinued although they have limited enforcement authority given how much of the drug is now in the hands of doctors and pharmacists.

Again, it MAY be helpful to certain patients under very limited circumstances. but otherwise you might have better outcomes by following Dr. Trumpkopfs other suggestion of pushing the patient in a wheelchair into the hospital parking lot in bright sunlight and injecting him/her with high concentrations of Lysol .
The newly published study can be accessed through the JAMA website and possibly other medical news links.

I think the point of all the sarcasm is that at a time like this, the nation needs a President who can rally the people and maintain a positive outlook under the most dire circumstances but also retain the TRUST of the people . We have many examples in history of leaders like Churchill who have been able to do so. What we don’t need is this almost daily circus show of “happytalk” with frequent doses of truly dangerous nareshkeit. There are many trials ongoing where there is reason to expect positive outcomes but hyping one or two that were whispered in his ear by political cronies or even well meaning experts w/o credentials in epidemiology and clinical drug diagnostics is where he goes off the rails on almost a daily basis. Fortunately, we have Fauci, Birx and a few other experts who have learned to immediately clean up after these dumb comments without damaging his fragile ego. They are the true heroes of the public information and outreach effort.

Ready now
“I am writing now, that, “chance”, can be said of any study, that is the point of aggregating numbers of people who all have very different susceptibilities into a result.”

Yes! you are writing this now, but I said that on the first page. That is why ideally you randomize and blind the participants (and even the testers) Of course even this doesn’t eliminate chance. In every study there is a small element of chance (look up “p value” if you want more information). But Dr. Zelenko’s “study” is close to worthless, in terms of using it to extrapolate data. This is exactly what Ive been saying all along

Ready

“already naturally randomized”

Sorry. That’s not a thing .

“they all have various underlying medical conditions, all types”
says who? what are the conditions they have?

” and the control group are the ones who have not yet developed any underlying medical conditions as yet”
thats not a control group.
A control group is comparable to the studied group to see if there is a difference between the two.

You don’t seem to understand much about how studies are done, as your past few posts are full of very basic errors. you dont know what a control group is, you don’t understand randomization no0t to mention how studies avoid (Though not eliminate) chance.

I’d be happy to explain it to you. but you’d have to listen as I’m beginning to suspect you aren’t reading my posts since you are repeating lots of pints that have been addressed several times.

“Says Dr Zelenko, he said that.”
You skipped the second question
What are they?

“A control group is comparable to the studied group to see if there is a difference between the two.”
Correct. Key word is COMPARABLE. In your last post you wrote “, and the control group are the ones who have not yet developed any underlying medical conditions as yet” A group that has not yet developed underlying conditions, is NOT COMPARABLE to a group that has.

“So you want other people with underlying conditions without corona virus to be given HOQ?”
No that would be to study safety, and has been done.

A control in this case would be to take a similar group to the one getting HCQ and NOT giving HCQ.

Again the question we are trying to answer is does HCQ (with zinc) help or not. Just giving it doesnt tell us much. We want to know what would have happened if they didnt get it . Again keep in mind, The vas tvast majority of those who get it do fine without hCQ. Even the vast majority of those at risk do fine without HCQ Do MORE at risk patients do fine with HCQ than without? THAT is te question

To answer that just giving HCQ without a control doesnt tell us much if anything.

“What about the antibiotic and zinc, you want them to take that too?”
who?

“Oh and of course the invasive intubation, why not?!”
Wait, what?

“Was it found to be safe? ”

Safe is relative, it is safer than dying of malaria or winding up on dialysis from lupus. Not as safe as not taking it if you dont need it. Some place in between those two

“They have done this, but without zinc in the HOQ group.”
aaaaannnnd? don’t keep us all in suspense

“I don’t think it is ethical to stand around and not intervene when people are getting very sick”
Beseder, if you think it works go for it.
In fact a physician is protected legally if a patient dies as a result of a reatment he/she thought would help against COVId summary from our malpractice insurance” The Secretary of the Department of Health and Human Services has declared, pursuant to the Public Health Service Act § 319F-3 (42 U.S.C. § 247d-6d), that a covered person’s activities related to medical countermeasures against COVID-19 will be immune from liability under Federal and State law.” (I’m not a lawyer double check with your lawyer for details)

Again to remind you we are not discussing whterh HCQ works. We are not discussing whether it is reasonable to give it anyway and hope for the best. So if you are now saying “Ok it might not work, but what is thee to lose. ” Well I said that in my first post in this long repetitive thread

“Let’s not forget the zinc. People are giving HCQ without zinc and that defeats the purpose, ”
I have not seen it given without Zinc. that said, Zinc deficiency is quite rare, so I’m skeptical that it makes such a difference adding some more. But even less likely to cause harm, so why not?

Excuse me!!! Where I wrote Hydroxycycline, I meant hydroxychloroquine.

People are giving HOQ without zinc and that defeats the purpose, it is the zinc that completes the cure in combination with the HOQ.

That is the mechanics of the virus.

a) the Brazilian study was not giving zinc, other studies did not mention it I think.

b) The more susceptible patients are deficient in many nutrients, they need the zinc to enable the HPQ to function

c) the first signs in some coronavirus patients is the loss of sense of taste and sense of smell. This indicates a zinc deficiency, as all the zinc in the body has been utilized in fighting coronavirus, so it shows zinc is a must to treat it.

ubiq: see the following 2 videos showing Dr. Zelenko: Positive updates: The plague will end!
and showing Dr Zelenko 3 min and you will see that zinc is indispensable for treating coronavirus.

See video, -Hydroxychloroquine Benefits Are Beyond Killing the Virus
•May 6, 2020 Dr. Eric Berg DC

ubiq -“Are you opposed to using HCQ now?”

HCQ is a recommended Tx. for Covid19.

“OVer the past weeks hospital where I work started checking Zinc levels on patients almost none have been Zinc deficient.”

Zinc has to be given for Covid19 even when they aren’t deficient.
Obviously Ready Now is Not a Medical Professional!

Ubiq -“Recommended by whom?”

Ya’know you should stick to Nephro & Don’t worry about ID.
I posted this in the other topic:

From Science Based Medicine:
Proof that HCQ Works against Covid19.
“One minor side effect of the pandemic is that perhaps more people will learn about what drug research and clinical trials can really be like. Today’s example: we have a clinical trial of hydroxychloroquine from Wuhan that has just published on a preprint server. What’s good is that this one is blinded, randomized, and controlled (like the earlier hydroxychloroquine which one I blogged about here from Zhejiang University, so we can actually talk about it rather than just spend all our time wondering what the heck is going on.
This time there were 31 patients in the treatment group and 31 in the control group. Median age was 44.7 years, male-female ratio almost even. Both groups got standard-of-care (oxygen therapy, antiviral drugs, antibiotics – presumably against suspected bacterial pneumonia – and immunoglobulin, with or without corticosteroids). In addition, the treatment group got 5 days of hydroxychloroquine, 200 mg b.i.d. All were diagnosed with (relatively) mild illness, but all had pneumonia by CT scan. More patients in the treatment group presented with fever and cough as compared to the control group.
After five days of treatment, the treatment group showed significant improvements in comparison to the controls in fever, in cough, and in pneumonia (by CT scan). This is actually the first controlled study to show any benefit for chloroquine or hydroxychloroquine therapy against the coronavirus – it may sound odd to say that, but all the positive reports we have had up to now are anecdotal reports and open-label studies without control groups. The one controlled study we have seen, as mentioned, showed no effect.”

“source please”

From NIH:
“Individual risk management strategy and potential therapeutic options for the COVID-19 pandemic”

“…..Moreover, research has shown that zinc has antiviral effects; it improves immune responses and suppresses viral replication. Therefore, the consumption of up to 50 mg zinc per day may provide a protective role against the COVID-19 pandemic, likely by improving the host’s resistance against viral infection [102]…….”

Health – Your comments using studies as proof of something should hopefully serve as a reminder to others the danger of people lacking the necessary schooling from interpreting results in scientific studies. I am not a doctor or scientist, but it is evident there are serious issues with the Wuhan study you refer to. You should be ashamed of yourself for using it to promote an idea that Hydroxycholorquine is an effective treatment (I am not saying whether it is or not an effective treatment, but you can’t make that conclusion on insubstantial data and studies).

The study you reference was done a short-time after a different study showing no benefit and accordingly given the small sample size in both, you can conclude that maybe there was a benefit, but you have no real evidence. The study you refer to also was initially intended to have 100 patients in the treatment and control group, but for some reason stopped at 31. How the study size came to be finalized can be a major issue. It seems that they recruited people and had results for a bunch of them before they finished designing the study. You just can’t rely on the results of this study. Maybe it is a basis for a further, properly done study, but for anyone to overly rely on this for a basis for treatment seems incredibly irresponsible.

Ubiq -“I’m not sure why you are being antagonistic. Its a legitimate question
Obviously Health is Not a Medical Professional!
Please stick to driving ambuletes and stop dispensing medical advice”

Another Lie.
That’s why I’m antagonistic to you!
Where did you get that from? A Hatzola guy from 30 years ago?

“didnt answer my question Iasked “Who recommends using HCQ”

BTW, my post was based on the American Thoracic Soceity Guideline.
“For hospitalized patients with COVID‐19 who have evidence of
pneumonia, we suggest hydroxychloroquine (or chloroquine) on a case‐by‐case basis.”

Health – I have no idea who you are and not really sure I want to know. Your reference to the American Thoracic Society (ATS) is and your quote of their suggestions has no bearing on my comment. In the very same document that the ATS makes that suggestion (they don’t even call it a recommendation) they explain the rationale for that suggestions which is very different from what you imply. When you quote things out of context and give them meaning, clearly not intended, that is lying.

The ATS suggested hyrdoxychloroquine for patients with pneumonia when various conditions are met. In the actual details they discuss this in the context of hospitalized COVID-19 patients with severe pneumonia, in which case the outcomes were so bad to begin with that there was little concern that hydroxychloroquine will do harm. At no point do they even suggest that there is sufficient evidence to assume that it will help, rather they cast serious doubts on that, but see the value in at least trying it. Notably, they focus very much on collecting data as otherwise there is no way to learn if administering it helps at all.

We can discuss things here, and even something as challenging as medicine, but when people lie about what research studies or medical guidelines mean it is just not helpful to anyone. If your agenda is to simply promote hydroxychloroquine regardless of evidence for or against because you are convinced it works, well just say you think it works but you can’t offer evidence rather than lying about what things mean. On the other hand if you want a serious discussion, then pull out data, or whatever, that legitimately supports your position and you are not misconstruing or overstating and we can discuss that. So far all I have seen is nonsense being promoted, which in my opinion does not do Dr. Zelenko any favors, as rather than allowing his treatment to be considered in a neutral context it is being considered in the context of a bunch of nuts ranting and raving and in general lying about what things mean. It does not make it look good. The same goes for the politicization here of medicine. Trump should have never stepped into the arena to promote medicines that have not (yet) been accepted as proven treatments. Him doing that politicized this and was just not helpful. He is not a doctor and as such he should respect that and leave the medical stuff to the doctors.

“I’m Not your instructor. Ask s/o in your facility that is in ID.”

I did they are skeptical that for patients who are not Zinc deficient, zinc was necessary. But say Hey “wjhy not” when you said “Had to be given”

The USC health piece you cite concludes “In short, if coronavirus is like an SUV, zinc lozenges may well be something like an oil change, though we’ll need many more miles to really know for sure.”

This is a far far far cry from ““Zinc has to be given for Covid19…”

I naively assumed (hoped?) you had an actual source and weren’t making stuff up again

I was wrong

again.

It is ok to give your own suggestions, after all your expertise in health is renowned . but please don;t try to pass off your own thoughts and recommendations as established guidelines as inevitably you get caught and it makes you look foolish .

Ubiq -“This thread wasn’t really about hospitalized patients , we are discussing Dr. Z who treated outpatients.”

I DON’T Care about Dr. Z’s protocol. Actually, I don’t recommend Z-pack, because of one study of the 3 drug combo that caused Torsades dP.

“I naively assumed (hoped?) you had an actual source and weren’t making stuff up again
I was wrong
again”

I think you’re in the Wrong Profession – How about STAND UP COMEDY?!?
Maybe your attitude is prevalent among NY Medical professionals?
Maybe that’s why – NY is the Epicenter in the World of COVID-19?!?

“Thus far as far as I’m aware there is no guideline or suggestion supporting the use of HCQ for those well enough to be managed as outpt.”

Well here it is – Free of Charge:
“04.29.20
AAPS: Hydroxychloroquine Has about 90 Percent Chance of Helping COVID-19 Patients
Source: Association of American Physicians and Surgeons
In a letter to Gov. Doug Ducey of Arizona, the Association of American Physicians and Surgeons (AAPS) presented a frequently updated table of studies that report results of treating COVID-19 with the anti-malaria drugs chloroquine (CQ) and hydroxychloroquine (HCQ, Plaquenil).
The AAPS stated:
“To date, the total number of reported patients treated with HCQ, with or without zinc and the widely used antibiotic azithromycin, is 2,333, writes AAPS, in observational data from China, France, South Korea, Algeria, and the U.S. Of these, 2,137 or 91.6 percent improved clinically. There were 63 deaths, all but 11 in a single retrospective report from the Veterans Administration where the patients were severely ill.
The antiviral properties of these drugs have been studied since 2003. Particularly when combined with zinc, they hinder viral entry into cells and inhibit replication. They may also prevent overreaction by the immune system, which causes the cytokine storm responsible for much of the damage in severe cases, explains AAPS. HCQ is often very helpful in treating autoimmune diseases such as lupus and rheumatoid arthritis.
Additional benefits shown in some studies, AAPS states, is to decrease the number of days when a patient is contagious, reduce the need for ventilators, and shorten the time to clinical recovery.
Peer-reviewed studies published from January through April 20, 2020, provide clear and convincing evidence that HCQ may be beneficial in COVID-19, especially when used early, states AAPS. Unfortunately, although it is perfectly legal to prescribe drugs for new indications not on the label, the Food and Drug Administration (FDA) has recommended that CQ and HCQ should be used for COVID-19 only in hospitalized patients in the setting of a clinical study if available. Most states are making it difficult for physicians to prescribe or pharmacists to dispense these medications.
As the letter to Gov. Ducey notes, “Many nations, including Turkey and India, are protecting medical workers and contacts of infected persons prophylactically. According to worldometers.info, deaths per million persons from COVID-19 as of Apr 27 are 167 in the U.S., 33 in Turkey, and 0.6 in India.”
After Morocco and Algeria began using HCQ, a trend break and sharp reduction in their COVID-19 case fatality rate occurred.
Vaccines and results of randomized double-blind controlled trials of new drugs are at best months away. But patients are dying now, while affordable, long-used drugs would be available except for government restrictions, AAPS states.”

Ubiq -“unclear why you would charge, for providing a source that sort of backs up your claim.”

Now why do I have to back up my claim? The few pts. that I have dealt with – I Never charged.
OTOH, Doc Zelenco who charges should back up his claim of 3 drugs for Covid 19.
Esp. since there is one study of the 3 drug combo that caused Torsades dP!

Best observational study to date of hydroxychloroquine for COVID-19 was published less than an hour ago online by New England Journal of Medicine. They used three different methods to control for potential differences between individuals receiving hydroxychloroquine and those not receiving. No difference between those receiving the drug and those not. nejm dot org.

“Now why do I have to back up my claim?”

you don’t its a free country and a free platform.

however you do often (very often) advertise yourself as some sort of expert, as if your pronouncements carry weight. To be taken seriously you meed to be able to backup your pronouncements. when you say “HCQ is a recommended Tx. for Covid19.” You should be able to (calmly) reply to a simple question as to who recommends it. It is strange that it took you several posts to come up with a relatively obscure group that advised a Governor not to ban the use of HCQ, and to spin that as a “recommendation”

In short you don’t HAVE to back up your claim. but if you want people to listen to you, you should.

Ubiq -“In short you don’t HAVE to back up your claim. but if you want people to listen to you, you should.”

I don’t care if they listen. My own family doesn’t listen. They only come to me, at the last minute.
I post to help people, not to charge. If they listen, then fine, if not, not.

As a doc are you going to tell the pts. the ideas from the AAPS, even though (acc. to you) they’re a relatively obscure group?
“Peer-reviewed studies published from January through April 20, 2020, provide clear and convincing evidence that HCQ may be beneficial in COVID-19, especially when used early, states AAPS.”