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Health, I looked at the underlying hcqmeta site referred in Medscape Aug 21 article. Here is what results actually say. I am looking at only RCT (randomized controlled) not “early” tests:
Prophylaxis gets some 20% on average improvement
Late treatment shows 50% improvement
Early treatment results – many show improvement 505 on average, but most are very small. biggest ones Recovery, Solidarity show that HCQ is worse than controls. These studies also seem to be on sicker patients (10-25% dying in controls), while many positive studies have 1-10% dying.There is also 2x less benefit in North America comparing with all other regions
Overall, it seems it seems from this analysis that HCQ is moderately beneficial, but not under all conditions and not for all people.
Avira, I presume you meant “minim”, these are people who attack us with religious differences – Tzdikim, Notzrim, Reformim …. Are you applying this term to Israelis playing soccer on Shabbat? Confused.
> bracha for safe travel will reduce the balding of tires.
probably only if you checked the pressure before travel and drove carefully. I doubt that bracha absolves of personal responsibility.
2scents, actually numbers you are quoting show some HCQ benefit across multiple studies. Even if each of them is below stat significance, they jointly will not be.
24% v 30% in placebo had symptoms
4 hospitalized v 8 or 10
1 died in both
0.27 events per year v 0.38
11.8 % v 14.3%Cochrane review is a gold standard for meta-studies, trying to evaluate significance from multiple independent trials. Feb 2021 B Singh et al Chloroquine or hydroxychloroquine for prevention and treatment of COVID‐19 shows no benefit for HCQ in both treatment and prophylactics.
Syag> This is NOT the case according to the er nurse and healthcare workers I’ve been checking in with. Please,acknowledge that your assumption on this is NOT the case.
Baruch Hashem, I am saying – to watch, I do not have definite data. As I mentioned, a friend recently got back from ICU – did not vaccinate because he was slightly sick before, and there were some cases in the news also.
The question is – how to monitor and mitigate. I do not have confidence that the same people who were not careful first time, will now be able to monitor the situation.
your ER nurses mention unvaccinated – do they ask them if these unvaxed had symptoms last year? used this to make a decision not to vax? I would presume that unvaxed people in general commmunity would be similar in behaviors to the ones in the community – the ones who were not isolating before, probably younger, etc. Maybe you can clarify more what they said.
Syag> This is exactly what’s happening. I have been trying to get you to acknowledge/hear that for months.
Syag, if you are saying that your community indeed did not take precautions and got so sick early on, and this is indeed true, then you should all put black clothes on and sit and fast for the great number of people that were killed and sick, rather then explaining that now is a great time to go to vacations.
2sc> noting an observation.
I see. It may be true that communities that were not careful were more exposed at the beginning, had very high rates then, and lower rates later. I don’t think it gave any overall benefits though, unless older people were strictly isolated. More than 50% of transmissions happen in the family, so if kids got it, they will transmit to parents and then to grandparents.
But your observation highlights importance of the discussed question whether previously sick require a vaccine, especially if those sick were in the early months and now more than a year passed and new variants are around, so some people might think that they are still protected when they are not.
and there is probably a positive correlation between those who were not careful l’hathila and got sick and vaccine hesitancy, so this cluster – sick early and not vaccinated – is one to watch for increase in disease, and, presumably, recommend to take one does of mRNA or JJ.
Sometimes I miss someone’s posts and fail to ask a question, and the poster may feel that his position is unquestionable. Sorry for that?
Avira > daven three times a day for apikorsim to die.
you are messing up my davening! I was looking and looking for apikorsim in Amidah. Something is wrong with mine or with yours… The brocha seems to be concerned with people who seek to harm us – minim (not in my version), malshinim, zeidim … you might have a real old siddur if it says “notzrim”, but who has apikorsim in this brocha?
Gadol> Its the only show in town that will provide temporary comic diversion from the tragedy evolving from Biden’s misguided Afghanistan withdrawal.
A pretty round-about way to say it, but who said teshuva is easy … Maybe contact your elected officials and let them know how you feel to help reverse whatever is possible? People who voted (D) but are disappointed now are the ones who can move the politicos.
2scents, you seem to consider an advantage for the community to get natural immunity quickly. If you mean that almost anyone gets sick, then it means that everyone at risk got sick and possibly died. I don’t think you mean that. I see two ways to get advantage of natural immunity:
1) expose young mobile population to virus. they are responsible for propagation, and thus protect elderly as yungeles will not be infecting them. Interesting idea, but it requires some discipline during that early stage – youngsters get sick but do not communicate with elders. Might have worked with those elders who isolated, like it seem R’ Edelstein @ Ponevezh did. Still, a lot of propagation goes through middle age working age population and exposing them all might mean a lot of death. Maybe this could have worked early on – ship all younsters – or all elderly – to a different location (Catskills, Florida) for a month, let youngsters get sick, and bring everyone back.
2) get early virus to avoid later deadlier variant. So far, it seems that “popular” strains alpha, delta are more contagious rather than more deadly.
In regards to Risch paper, there is a March 2021 Lancet paper (see at the end) that refers to Risch and concludes that were no benefits. There was also a letter showing that described non-randomized experiments were not statistically valid. To trace this further, you can go to medline or pubmed or google scholar or any other citation system, find the paper you care about, and then look up later papers that cite your paper. Some may just include it into a list, but some might actually be a follow-up.
from a quick review pf Risch paper, I noticed 2 things:
1) a way to correct non-randomized trials is to match patients by their demographics – age, gender, health status. I don’t see this done
2) paper quotes one result that HCQ-AZ achieves 25x benefit, while HCQ by itself achieves 4x benefit. Given that later argument shifted to HCQ-AZ helps while HCQ does not, the quoted 4x benefit is a red flag – if this is a false conclusionChristine Johnston et al, Hydroxychloroquine with or without azithromycin for treatment of early SARS-CoV-2 infection among high-risk outpatient adults: A randomized clinical trial
> alwaysask, you dont own this country so please refrain from giving advice as if you are some sort of ruler.
I am giving an advice as a friend, rulers do not advise, they order. We live in a country/world that is ruled by many nations. You don’t need to run out of your wits if not everything is perfect. Generations of Jews lived honestly while being governed by much worse rulers than we do.
2sc > Re the data for the lack if increase in Covid cases, more so hospitalized cases, I am not sure it’s possible to obtain such data.
In a previous discussion here, when someone asked a similar question, I compared publicly available numbers for Lakewood with nearby counties. At that point, the deaths were, I recall, 2x higher and 4x higher if you correct by (lower) percentage of old people in Lakewood. That poster did not reply. Check the archive. Feel free to re-do the numbers for current period – maybe immunity safeguarded Lakewood community going forward and the comparison looks better now. Or look up some other Charedi town in US or Israel. Your move.
Possibly stand corrected: an online source that I can not fully vet mentions the story of R Kook potential visit to two communities as sourced from Yated Neeman (undated) and it says that this is what Hazon Ish replied to someone saying that he heard the rumor of Ch. Ch coming to EY. That explains why I read this in Hazon Ish Hagada …
A possible piece of evidence – a 1928 letter, a pretty late period. Maybe you can trace this and verify whether the letter and the translation I am quoting below are genuine:
from Rav Aharon HaKohen .. Author of the book ‘Avodat HaKorbanot’ Son in law of the Gaon Israel Meir HaKohen Shlit”a author of the book Chafetz Chaim and Mishna Brura.
I know that my master and teacher, the Chafetz Chaim Shlit”a – who honors and is very fond of the honorable Gaon Avraham Yitzchak HaKohen Shlit”a and whose heart was greatly sickened when he heard of the persecutions against [the Rav] – did not come out with public rebuke regarding this, saying that silence regarding such matters and the reduction of their publicity is [the proper way] to repair them – [that is] to lessen and reduce their value. (nevertheless, no one dares utter words of disparagement against our teacher Rav Avaraham Yitzchak HaKohen Shlit”a in front of our master[, the Chafetz Chaim,] and he would turn his eyes with contempt from any posters
However, when I recently saw that a periodical that has appeared – which arrogantly dares to call itself “meeting place of the sages” – wrote horrible, cursed, and blasphemous words against our teacher Rav Avaraham Yitzchak HaKohen Shlit”a – [words which] are forbidden to even put in print – I find it a holy obligation in my soul not to be silent (as is explicit in the Rambam הלכות ת”ת פ”ו הל’ יא-יב). [This is because] someone who disparages a Torah scholar has no portion in the world to come, and is in the category of one who “despises the Word of Hashem” (כי דבר ה’ בזה), and we are obligated to banish him.
missed the reply from Avira> they meticulously keep sefardi minhagim and mesorah, and the yeshiva dress is just that – because they are bnei Torah. .. My point was that they dropped their goyishe dress that is common in the uneducated elements
I know of Sephardi Rabbis who explicitly teach their community to meticulously follow the general community, such as using Asheknazi Eruvim (that some Chasidim would not using their understanding of “Sefard”) – and dress like the Ashkenazi Bnei Torah.
And how is their Goyishe Turban is worse than a Goiyishe Kapota or a German suit? We all pick up things, sometimes worthy, sometimes not.
> abtibodies might not work for delta variant, whereas the vaccine does.
should we say, the difference is b’dieved v. lehathilah?
2scents,
also anecdotally, in my community that has people coming from very different backgrounds, all clusters that I heard of came after people came from visiting those “normal” communities and then immediately going to shul or sending kids to school. In some cases, clusters grew somewhat due to some local individuals not staying in quarantine, but otherwise were stopped by adherence to quarantine and school closing protocols. Again, this is anecdotal, but no less solid that your statement that many communities were not affected.RW > They have slowly taken away peoples liberties,
Look, you have to come to terms that you live in an imperfect democratic country that has a Supreme Court ruling from a 100 years ago that enables (state?) government to force vaccinations. Jews lived in many countries over centuries that had much more difficult policies. You can either get a shot, hire a lawyer, or move to another country. Last I heard, Talibs do not require shots, and I am sure they’d love to have 2 Jews in their Emirate.
2sc> but as an individual we cannot decide to make this into a torah ruling and even compare this to the mitzvah of sukkah. At least until our Rabbis and leaders do not tell us so.
You are free to ask your posek, of course for precise boundaries. Let us know what he says, please. But you probably aware that there are some mitzvot that are defined very precisely (tefilin, mezuza, more often bein Adam l’Makom), and sometimes generic ones – ahavta reeha kamoha. I apologize not listing all relevant mitzvos, dont have energy right now to go back to all halakhic sources I read, you are welcome either to look up teshuvot or, again, ask your posek, and let us know.
2scents: have normal minyanim and normal gatherings, have not seen any worrying increase in covid cases
I would appreciate the data. All the data on Israel and several zip codes in US hat I checked indicated higher rates, unfortunately. A number of elderly Rabbis passed away. You might be deceived by the highly clustered nature of this virus – it might be raging in one community and go around a similar nearby one by pure chance. We saw many stories written about countries, like Sweden, that found magic solutions – and then, over time, they regressed to a mean. Or, maybe you are talking about young communities with less older people.
healyj > I honestly don’t know what you’re talking about.
you can see all trials registered at gov ClinicalTrials site.
conbat covid HHS site lists 19 trials, 11 of them active
UK Recovery trial has trials at 186 sites with 40,000 patients
WHO/International Solidarity trial at 600 sites, 14,000 patientsI am not saying that everything they do is perfect, but it is a considerable effort.
Again, if you think Zelenko protocols superior to official trials, organize a real trial according to established practices – register your trial before you do it, use randomization, etc.Health,
there are multiple trials going on around the world for treatments, not just vaccines, including the drugs you are mentioning. If you think that they were not tested under a correct protocol, which is completely plausible, go to some “fund me” site, have you and 1000 of other like-minded people donate 1,000 each, and have your own trial going somewhere in Latin America or India. In fact, if you so sure in your theory, I am not sure what justifies you not doing that? each of you probably spend 100 hours researching this topic, that is worth more 1,000 dollars, go act on that!When non-Jews will complain that they were not given a fair chance, they would be given a mitzva of Sukkah that they are gonna to kick due to minor inconvenience (Sukkah is making us too hot and preventing flow of oxygen!). So, maybe COVID provides a similar pre-Moschiach test, giving everyone first a simple mitzva to wear a mask and SD. When even that was hard, Hashem sent a 2-shot vaccine – or a one-shot for those who found a 2-shot hard. Hopefully, more people will avail themselves to these simple mitzvos instead of kicking them and the world will be in the right spot.
Teiku!
It is such a sod that Eliahu did not even teach the proper kavanos to Elisha, leading to untimely death of several union thugs in Yericho.
If Hashem wouldn’t want us to worry, he wouldn’t tell us to make a fence on the roof. We were talking a lot about going to shul, but why bother if you don’t listen to the message.
US State has hard time expediting visas for Afghan contractors in Kabul, is your emergency more than that?
>> I am completely bewildered that even if we could compare this pandemic to the flu season
Original estimates were that several million people in US would have died if no measures were taken. These estimates sounded over the top, but seem to be close to reality. Not even counting, how more virulent COVID would have become if it were allowed to run wild. Note the country names that are now sanitized from the variant names: British, Indian, Brazil, South Africa. There are (so far) no German/US/French/Canadian/Japanese/Ozzy variants because many countries dealt with the issue.
>> The change in death rate was observable but not significant
I think it is to world CREDIT that the world more-or-less responded and is dealing with the pandemic. If we look at the world as half-full: how many people changed their routines, doctors caring for patients, researchers coming up with solutions, government officials doing unpopular things. We, especially I, tend to focus on the visible phenomena of those who do the bad stuff, but a lot of people do the right things. They are often not visible, sitting at home, listening to shiurim, or doing a second masters degree, or just watching movies instead of going to the bar…
> if there is a chiyuv to love your wife
I am not sure. I’ll have to ask a shailah (youall happy?)
And I’ll do whatever my wife answers.
RW > Second of all noone said you should try to get covid we are discussing if you already had covid after the fact and you now have natural antibodies.
I agree, nobody wants to experiment with getting COVID to prevent it in the future. Then, for practical applications, the question is not – is vaccine protection better or worse than having COVID, BUT for a person who had COVID, should they take a vaccine?
from the papers, it seems that ONE mRNA vaccine decreases infection chances by 3x. While one paper dismisses it, but I am not sure why. The argument might be if you want to donate this vaccine to the poor countries.
RW > everyone would have gotten reinfected by now.
RW, you are appealing to (your own) emotions. You first find articles that uncover problems with vaccines, then you find other articles that talk about immunity from COVID. And then you combine these two stories without knowing how they align.
I quoted articles that compare people under same conditions – some with vaccines, some with COVID.
RW > there is no test to determine variants. They just assume that the people getting sick got the variants
there are tests for variants. They are done on a random sample of collected samples.
ourworldofdata, for example, has statistics of variants by country and time.RW > first of all the article said that people who had covid likely develop antibodies for most of their life.
RW, I think I see why we disagree. This is a very complicated issue and changing over time. you seem to read popular articles where reporters digest research papers for us. This is often fine. When we know a lot about, say, flu, and a new article about flu comes out and adds one more item about it, a popular article would easily explain it to us. Here we have research papers done very quickly, often preprints, sometimes written in a hurry, that address multiple issues. Your healthline reporter will have to simplify to make it readable, even presuming he understood the article.
If you click on the actual research paper, you will see that the paper does not say what you just said. I tried to summarize what the paper say. I may be mistaken also.
YS >it’s far safer to take the vaccine than to rely on having had COVID a year ago
I read this that in first 3-6 months and with an at least mild case, and with the same variant, having COVID provides reasonable protection. Significant exception: people over 65, where vaccines are 3x better. And that those who had COVID, one vaccine adds further 3x protection, making it comparable with mRNA vaccine by my count. So, seems like at least one vaccine for older people should be recommended.
Both protections decline with time and with change of variant, we are just finding out. Decline is more in transmission (antibodies) than in protection against serious disease (T- and B-cells)
It is possible that COVID provides longer protection against same variant, but it seems likely that vaccine provides better protection against variants.
If you’re offered an unconventional product, you need to check whether it is legal and ethical before using it
Dear whitecar,
even if I did not volunteer to send you the money,
to you are welcome. Hope you are using them wisely.signed.
TaxPayerRW, thanks for the sources. The Nature article talks about exactly the issue I mentioned – longer lasting protection from B Cells (that will produce antibodies in the future) that are developed both by (at least) mild Covid cases and vaccine. This is indeed hopeful. They have a caveat that variants might block this production of antibodies.
Healthline refers to the paper “Necessity of COVID-19 vaccination in previously infected individuals”. This paper shows 97% effectiveness of mRNA vaccines for those without previous infection and 66%(3x) effectiveness for those with previous infection – the author conclude from the latter that there is no benefit of giving vaccines to previously infected. This judgment is made from the world /WHO perspective that it is better to re-allocate vaccines to poor countries.
My note: High effectiveness of both vaccine and previous infection in this paper comparing to the ones I quoted is due to several factors: other papers I quoted defined previous infection as PCR tests given to everyone. This paper use only highly symptomatic cases as “infected” (those who were sick and went to take a test, with %age of positive test varying over time from 5% to 20% – higher than usual testing). Similarly, they measure 2nd infection as people coming for a test. So, these results are for “at least mild symptomatic COVID”. They also do not seem to adjust for demographics, while acknowledging that unvaccinated were younger (39 v 42 average age).
Bottom line: there is support to say that those with a symptomatic mild case have immunity comparable to vaccines. It could be further enhanced by one does of vaccine – unless you want to ethically donate it to 3rd world. Easy cases may be more risky. All of this pre-Delta.
And, of course, none of these papers suggest any benefit of actually not taking a vaccine and waiting for “natural immunity”.
RW > You do realize that reinfection remains a rarity right?
maybe I did not clarify enough. This data is saying that for pre-Delta COVID:
– reinfections is 5-6x less likely than regular infection. [similar, a little lower, to infections among mRNA vaccines that were 10-20 less likely
– reinfections among 65x older is 2x lower than first-time infectionsmore details in the papers. I don’t think you read them, as there are 8 minutes between our posts. It took me longer to process them.
RW> What numbers will I give for natural immunity when they aren’t reporting on them?
It may be google’s fault that you can’t find the numbers (not kidding). Google adapts their algorithms to what you click on – so you get Reuters, and I get Lancet… Here is what I found (all is for pre-Delta):
PCR-based infected people are 80% protected against re-infection, 47% for those over 65. Does not decrease at 6-7 months. [1] similar 83% result for UK medical personnel [2]. comparisons are in both cases with uninfected unvaccinated people with the same demographics. So, other than with older people, previous infection is close to vaccines.
Kentucky residents with previous infections: those of them who were unvaccinated had 2.3 more infections compared with those who were fully vaccinated [3]. So, vaccination provides additional benefit to those who were previously infected
[1] Hansen Assessment of protection against reinfection with SARS-CoV-2 among 4 million PCR-tested individuals in Denmark in 2020: a population-level observational study, Lancet, March 2021
[2] V Hall Do antibody positive healthcare workers have lower SARS-CoV-2 infection rates than antibody negative healthcare workers? preprint
[2] Alyson M. Cavanaugh, Reduced Risk of Reinfection with SARS-CoV-2 After COVID-19 Vaccination — Kentucky, May–June 2021RW, you keep saying “not effective” while mostly not using numbers, and when you use 97 -> 65, you are not clarifying effective against infection/hospitalization/death. And you are not giving any numbers for natural immunity effectiveness, and no sources for anything. And this is across multiple posts. I gave you some info I found, please reply with more specific data if you want to actually discuss something.
> How come they never did this with the flu btw? To mandate that everyone gets the vaccine?
a good comparison. Several reasons:
1) Flu natural R0 is 1.3, COVID 2+ for the Wuhan original, and 4+ for Delta.
2) Flu a- and pre-symptomatic transmission is not significant (see meta-study below). Thus, if you and your kids just stay home or SD or masked when sick, you won’t transmit
3) Most population has flu antibodies and, thus, only very young and very old/weak are vulnerable
4) Flu vaccines are less effective than COVID
If you multiple these factors together, the difference is hugeEleni Patrozou, MDa,b and Leonard A. Mermel,Does Influenza Transmission Occur from Asymptomatic Infection or Prior to Symptom Onset? 2009
RebE > antibodies might not work for delta variant, whereas the vaccine does.
Seems to be, just talked to a person who relied on previous infection to not vaccinate and just came out of ICU after the second infection. Anecdotes are not data, but those who think the same way please beware.
YS > lot of people I know who don’t want to get immunized because they have antibodies were tested positive for antibodies months ago and never actually showed COVID symptoms nor tested positive at any point.
non-professional understanding of theory: I think the issue is with T-cell protection. Antibodies are very specific and may be less effective with new variants. T-cell immunity is not helping with initial infection, but kicks in later to protect against serious disease and are also longer-lasting. T-cells generalize better and should be more protective against variants. Light cases of disease might not generate T-cell protection at all. Vaccines do, and possibly AZ and J&J more than mRNAs.
Bottom line, suggest to them to get one vaccine, with their initial disease working as a prime.
I quoted before a paper that estimates that vaccine works better than prior infection. I would not say that paper is 100% convincing, but those who claim opposite, should bring their sources.
> Actually, 12-18. So far.
I don’t want to out anybody, but if you have 18 months of antibodies, you probably worked in the Wuhan lab or worked at the proverbial wet market butchering ferrets.
I looked at 2017 FDA paper that identified 22 cases of Phase 3 trials rejecting results of Phase 2 between 1999 and 2017. Out of these, 7 were vaccines, and only one of them, V710 against staph infections in hospitals, was rejected due to safety concerns, the rest due to low efficacy. It took 8,000 patients in Phase 3 to detect the issue. Not stated in the text, but it seems it did not take much time (complications followed vaccinations, not long term effect).
Caveat: authors are saying that not all negative results were published before 2008. After 2008, tests needs to be registered with clinincaltrials site before starting, so all results should be reported, including negstive.
Health > Why does Medication or Vaccines take 9 – 10 years to be approved instead of a few months?!?
There are differences between medications and vaccines. My simple understanding:
medicines – balance between risk and benefit, often can be used in severe cases if there no other hope. On the other hand, medicines taken against chronic diseases, affect patients continuously and have potential of side effects, so require a lot of testingvaccines – on one hand, their effect is time-limited. So, complications are expected only during a short time interval. On the other hand, it is given to millions of healthy people who have low probability of getting a disease, so even very low risk is not acceptable. During pandemic, though, risk of disease is very high, allowing for faster approval due to a higher benefit.
Baal > I can name many poskim that are against this particular vaccine
you are not going around looking for a posek with a view, are you? what is your posek (and your doctor) are saying?
> VACCINES TAKE AT LEAST 12 YEARS (CDC) before approval, as per trial basis,
this is a good point, let’s look at the risk in detail. Could you give us a case of a vaccine where complications were discovered more than a year out in last, say, 40 years, and let’s see if this risk is applicable to COVID vaccines.