Interesting article from another Yale doc
https://www.medscape.com/viewarticle/935058?src=mkm_ret_200822_mscpmrk_IN2_trndalrt_PCP&uac=54707EN&impID=2519317#vp_1
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That is a really good article. Thanks.
We are still in a pandemic where hundreds of thousands of people have died. The RCTs that need to be done - early treatment ol high risk outpatients - have not been done. There are lots of observational studies of early treatment of high risk outpatients that show HCQ in combination with other meds is highly effective and safe. The ethical choice is very clear: use it.
Provide evidence that it is not contrails.
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I seem to have missed this point in the midst all these posts: what restrictions are the doctors facing? Canât they get and prescribe hydroxychloriquine if they want to? People, including Trump, have been taking it.
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The data you were discussing back and forth was about reducing early symptoms. Where is the evidence about reducing mortality?
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Pharmacies have stopped filling some prescriptions for it, and insurance companies have been double checking the use prior to approval.
One of the âFrontline Doctorsâ was a GP from my area, and the news reported that heâs had patients turned down at the pharmacy since that âFrontline Doctorsâ video came out. He was writing prescriptions for Covid-19 patients, and they couldnât get them filled.
Meanwhile, the people who legitimately need the drug for their autoimmune disease are having to pay 3 times as much as normal and insurance companies are reviewing their usage before approval. So this controversy is hurting the people who truly need the medication for illness it is approved to treat.
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I read that as HQC doesnât have the advocacy that other drugs have. And it could be creating bias in the system.
He has a useful free course:
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Advocacy by whom? Other drugs that arenât generic have also been knocked out of the running after trials showed them to not be effective. There have been thousands of doctors using these various medications in trials across the world. A tiny handful who didnât use any controls or who havenât treated any patients at all are saying it works. The doctors actually involved in RCTs are saying it doesnât, and a lot of anecdotal reports from doctors and nurses actually working with patients have said it doesnât work.
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Very good article. If anything, he understates the ways that observational studies can be misleading. Even if you manage to match patients in the treated and untreated groups for baseline characteristics, you also have to guarantee that all other treatment they received was identical, which is typically not the case.
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Michelle- yes that correct Pharmacies have stopped filling doctors prescriptions for hcq unless itâs for arthritis lupus or malaria. The doctors are being restricted on how they can treat patients. Amazing after the Steriods fiasco where we where disallowing use of steroids that resulted in tens of thousands of deaths. If not for the Uk steroid study tens of thousands more would be dead. What successful trial has come from US for Covid other than remdisvir?
Now NIH are suppressing the use of convalescent plasma even after a study of 36000 (not rct ) showed effectiveness. This is a political sham to show that will not approve vaccine too soon before trials and not a medical decision. Mayo doctors and others are dumbfounded on this restriction. Shame on these decision makers putting politics before health. We could learn so much from the convalescent plasma use before the vaccine becomes available. Shame
Maybe some places, but not around here. I know several docs currently prescribing it with no problem except the loss of self respect.
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As I said earlier, I donât see any hope for a change in policy. So our discussion is merely intellectual. I take no joy in discussing hundreds of thousands of ongoing deaths on a merely intellectual plane. Early treatment of high risk outpatients with HCQ and other medications will continue to be discouraged. That will not change. I blame Big Pharma. You are welcome to disagree. But the pandemic wonât be over until Big Pharma says itâs over. Just follow the money.
Big Pharma: Follow the Money
Politicans:
FDA:
Besides providing 30% of the FDAâs budget through licensing fees, Big Pharma all donates to the Reagan-Udall Foundation, an important arm of the FDA. Unfortunately, the Foundation wonât tell us how much Big Pharma gives. Why is that?
CDC:
The CDC has its own Foundation, with many corporate sponsors. According to an 2015 article in the BMJ, 21% of their funding comes from Big Pharma:
NIH:
The NIH (which Fauciâs NIAID is a part of) also has its own Foundation. If you scroll down to the list, you can find out who the major donors are.
https://fnih.org/2019-annual-report/donors/
The media:
Big Pharma controls the media through advertising dollars:
Medical Journals:
Big Pharma controls them, also:
The most recent and notorious case is the fraudulent, anti-HCQ paper published in the most respected medical journal in the world, The Lancet. As Dr. Todaro noted in his paper:
âPhilippe Douste-Blazy, former French Minister of Health and Under-Secretary-General of the United Nations, reported a leaked conversation from a conference where editors-in-chief of both The Lancet and NEJM bemoaned big pharmaâs control over publishing, âThese meetings that are completely behind closed doors, only with experts. No one can record, no one is taking any picturesâŚbut still, there was a meeting the other day of the directors of scientific journals like The Lancet, The New England Journal of MedicineâŚand it ended up leaked. The Lancetâs boss, Horton, said âNow we are not going to be able to, basically, if this continues publish any more clinical research data because the pharmaceutical companies are so financially powerful today and are able to use such methodologies, as to have us accept papers which are apparently methodologically perfect, but which, in reality, manage to conclude what they want to conclude.ââ[13] The reality is that without advertising revenue, most medical journals would go bankrupt. The unfortunate downside is that the very survival of journals relies on keeping big pharma happy at the expense of scientific truths.â
Thank you Bilbo. Totally agree. This is really informative and explains well our failure to elicit any successful rct except remdisivir expensive and short in supply. As the saying goes show me the money and I will show you the outcome.
I think that congress should call these guys in to testify what happened with Dexamethasone that they prevented from use that would have saved tens of thousands of lives. Now these same ones were trying to restrict therapeutic plasma that was showing significant benefit n patients. They need to called on this and explain to those that lost family members.( It was only after the UK Dexamethasone trial that the mortality rate percentage significantly reduced). Maybe then this will lead to a change of this big pharma influence.
Well, that would explain why a successful RCT for dexamethasone was never carried out or published.
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Yes this trial was done in the UK not US. US has been gigantic failure to treat this virus starting with Dexamethasone.
Tell these disrespectful doctors to add zinc to their hcq treatment. 
Okay so letâs say youâre on to something here. Just because you might find certain results questionable (anything that disagrees with HCQ for example), doesnât make other evidence stronger. The types of trials that support HCQ are still very weak and have numerous flaws. If you really want to âstick it to Big Pharmaâ (who makes HCQ mind you), the way to establish efficacy is to do better science, not just claim the whole shtick is corrupt.
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I guess Mark Levin (whom I have never watched but have heard bad things about) interviewed Dr. Risch recently. Dr. Risch doubled-down on HCQ, saying that he has never studied anything that had stronger evidence that it works than the evidence that HCQ works for early treatment of Covid-19 for high risk outpatients.
He also compared Fauciâs current behavior with how he rejected the evidence of Bactrim helping HIV patients back in 1987 (starting about the 12:45 mark). Make of it what you will. I donât see more than an intellectual debate. Despite his rhetoric, Trump will never do anything about it. Nor will anyone else.