Is Covid-19 just a hype?

[OrbitalDawn]

The politics are now getting dirty.

Chloroquine and remdesivir has now been politicized, it is now longer about whether or not the drug works.

https://twitter.com/i/web/status/1255835517511483394

Science | AAAS

www.sciencemag.org

The popular faith in hydroxychloroquine stands in stark contrast to the weakness of the data. Several studies of its efficacy against COVID-19 have delivered an equivocal or negative verdict, and it can have significant side effects, including heart arrhythmias.

Raoult’s positive studies have been widely criticized for their limitations and methodological issues. The first included only 42 patients, and Raoult chose who received the drug or a placebo, a no-no in clinical research; the International Society of Antimicrobial Chemotherapy has distanced itself from the paper, published in the society’s International Journal of Antimicrobial Agents. The second study, published as a preprint without peer review, didn’t have a control group at all.

Raoult has dismissed the criticism and complained about the “dictatorship of the methodologists” who insist on randomization and control groups in clinical trials.

 

[Nicodeamus]

Science | AAAS

www.sciencemag.org

He addressed it in French on the radio. According to him its unethical to not give a drug to patients if its proven to be efficient i.e. it doesn't matter if it is the placebo, the immune system or the drug. What matters is that the patient is healed. His argument is that in the absence of a randomized controlled clinical trial, we cannot wait months before we decide to treat people. Basically you use a rusted knife if you have only that to fight.

Just to show you his results in Marseilles.


its the lowest levels in the Western World and he has over 40 years of experiences in using HCQ, not your random idiot.


And after Aspirin, chloroquine is the most prescribed drug in the world. Its safety profile has been known for 70 years.

It is also the most used drug currently by all medical practitioners and that is thanks to him.


The science mag article is just a bad smear and a bit dishonest.

If you want to know what he said then listen to this podcast (but you need to understand French before you can do so).

 

[OrbitalDawn]

He addressed it in French on the radio. According to him its unethical to not give a drug to patients if its proven to be efficient i.e. it doesn't matter if it is the placebo, the immune system or the drug. What matters is that the patient is healed. His argument is that in the absence of a randomized controlled clinical trial, we cannot wait months before we decide to treat people. Basically you use a rusted knife if you have only that to fight.

If that is actually his argument it's garbage. Without proper trials you don't know if it works!

And it's also garbage because there were already randomised control trials happening on hydroxychloroquine with results available now, and more coming.

And surprise, it shows it doesn't work.

No Hydroxychloroquine Benefit in Randomized COVID-19 Trial

The 150-patient trial has problems of confounding, according to two experts, and is unable to answer definitively whether hydroxychloroquine can benefit COVID-19 patients or harm them.

www.medscape.com

Hydroxychloroquine Trial for Treating COVID-19 Disappoints

"The best available evidence does not support the use of hydroxychloroquine in COVID-19."

reason.com

Not to mention the adverse health effects participants experienced in other trials.

And after Aspirin, chloroquine is the most prescribed drug in the world.

Source?

It's 128th in the US, but you're claiming it's the 2nd most prescribed in the world...?

 

[tetrasect]

I remember reading that china tried hydroxychloroquine months ago with no or negative effect. Dunno why anyone decided it was worth looking into further.

If it was working they would not need be doing trial after trial searching for a different result.

 

[Nicodeamus]

If that is actually his argument it's garbage. Without proper trials you don't know if it works!

Its not garbage if you did a small controlled study before giving it to your patients.

You cannot do a RCT during a crises. You know what the current doctor protocol is? Wait 7 days till you're in hospital. He suggested early intervention so people don't end up in hospital and he has the numbers to show for it. Marseilles has the lowest fatality rate in the whole Western World.

Only 15 deaths is remarkable.



The Chinese and Koreans used it in their guidelines in January. If you're facing an unknown virus then you cannot not give a patient any treatment before a RCT isn't available.

He treatment protocol was replicated by Dr Zelenko in New York and is not the standard protocol in Russia, Algeria and Moroco.

Algeria has had zero deaths so far using his protocol. Again, if you're on a ventilator, this won't work, but works when the virus is in incubation. So its not a silver bullet.

Covid-19: No complications among patients treated with chloroquine

ALGIERS- The patients with coronavirus and under chloroquine-based protocol haven’t had any complications, said Professor Reda Mahiaoui, a member of t...

www.aps.dz

And it's also garbage because there were already randomised control trials happening on hydroxychloroquine with results available now, and more coming.


And surprise, it shows it doesn't work.

No Hydroxychloroquine Benefit in Randomized COVID-19 Trial

The 150-patient trial has problems of confounding, according to two experts, and is unable to answer definitively whether hydroxychloroquine can benefit COVID-19 patients or harm them.

www.medscape.com

Hydroxychloroquine Trial for Treating COVID-19 Disappoints

"The best available evidence does not support the use of hydroxychloroquine in COVID-19."

reason.com

Not to mention the adverse health effects participants experienced in other trials.

Go read those trials, they are not following his protocol.

Chloroquine only works for early intervention. Here is a list of the evidence below (see how it only fails in long term treatment).

• A non-randomized, prospective study in Sao Paulo, Brazil of 636 symptomatic outpatients treated with hydroxychloroquine for 7 days and azithromycin for 5 days vs control group showed a significant decrease in need for hospitalization. Only 1.9% versus 5.4% of patients in the treatment group needed hospitalization compared to the control group (p < 0.001) with a number needed to treat (NNT) of 28. In a subgroup analysis of outpatients who started treatment within the first 7 days of symptoms, the need for hospitalization decreased to 1.17%. Of note, the treatment group was clinically sicker at baseline than the control group with dyspnea of 22.1% vs 16% (p < 0.0001). Lastly, inclusion criteria was based on flu-like symptoms as opposed to positive COVID-19 testing.
• Randomized controlled trial in China of 150 patients hospitalized for COVID-19 who received either hydroxychloroquine or standard therapy for 2-3 weeks with a primary endpoint of negative conversion rates at 28 days. There was no significant difference in conversion rates between the two arms, but authors did note greater symptomatic relief in patients who received hydroxychloroquine over standard therapy. There were no safety concerns observed in the hydroxychloroquine arm and the most common adverse event was diarrhea (10%). Also of note, treatment was started an average 16.6 days after symptom onset.

See why your study failed? The treatment started after 16.6 days. The patients in in a diferent stage by then and Chloroquine won't work.

Now let's look at what works, again Chloroquine for early treatment.

• Randomized controlled trial of 22 COVID-19 positive, symptomatic patients treated with either chloroquine 500mg twice daily or Lopinavir/Rotinavir 400/100mg twice daily for 10 days. All chloroquine treated patients were PCR negative for SARS-CoV-2 by day 13 and 92% of Lopinavir/Rotinavir treated patients were PCR negative by day 14. All chloroquine treated patients were discharged from the hospital by day 14 compared to only 50% of Lopinavir/Rotinavir treated patients. Of note, the average time from symptom onset to treatment was 2.5 days and 6.5 days in the chloroquine and Lopinavir/Rotinavir groups, respectively (P = < 0.001)
• Case report of symptomatic COVID-19 positive patient admitted with irregular ECG, prolonged QT interval and diagnosis of acute myocarditis. The patient was then treated with hydroxychloroquine and lopinavir/ritonavir. Shortly thereafter, ECG normalized, prolonged QT resolved and the patient was discharged.
• Of 3005 COVID-19 positive patients at the Méditerranée Infection hospitals (APHM/IHU) in France (as of April 4), 1818 patients have been treated with HCQ and AZ. Below are the outcomes:

Here is a list of all the evidence (good and bad).

Compilation of evidence on treatment of COVID-19 and infection fatality rates

docs.google.com

 

[Nicodeamus]

I remember reading that china tried hydroxychloroquine months ago with no or negative effect. Dunno why anyone decided it was worth looking into further.

If it was working they would not need be doing trial after trial searching for a different result.

because they gave it to patients when it was already too late.

Randomized controlled trial in China of 150 patients hospitalized for COVID-19 who received either hydroxychloroquine or standard therapy for 2-3 weeks with a primary endpoint of negative conversion rates at 28 days. There was no significant difference in conversion rates between the two arms, but authors did note greater symptomatic relief in patients who received hydroxychloroquine over standard therapy. There were no safety concerns observed in the hydroxychloroquine arm and the most common adverse event was diarrhea (10%). Also of note, treatment was started an average 16.6 days after symptom onset.

Here is the list of evidence. The window of treatment for Chloroquine is when the virus is in incubation. Brazil, Algeria, and Senegal have adopted this approach.

If a patient comes to a hospital or is on a Ventilator than Chloroquine no longer works. Exactly what Raoult said in the beginning.

Compilation of evidence on treatment of COVID-19 and infection fatality rates

docs.google.com

 

[Nicodeamus]

https://mybroadband.co.za/forum/thr...ment-of-covid-19.1074837/page-6#post-25284985

if people want to continue the Chloroquine discussion.

 

[Geoff.D]

And the above posts illustrate so many things that plague modern society.
1 Failure to read and comprehend.
2. Ridicule anyone that does not adhere to to the herd's pre determined "everybody knows already" views.
3. Fail to understand the diff between theory and practice.

He had a different goal, he was treating his patients early with the purpose of deliberately keeping the virus under control BEFORE it was too late. He was selecting patients that WOULD benefit not just using a shotgun approach. He was not interested in doing a trial, he was treating sick people with the purpose of getting them to recover.

 

[Nicodeamus]

And the above posts illustrate so many things that plague modern society.
1 Failure to read and comprehend.
2. Ridicule anyone that does not adhere to to the herd's pre determined "everybody knows already" views.
3. Fail to understand the diff between theory and practice.

He had a different goal, he was treating his patients early with the purpose of deliberately keeping the virus under control BEFORE it was too late. He was selecting patients that WOULD benefit not just using a shotgun approach. He was not interested in doing a trial, he was treating sick people with the purpose of getting them to recover.

And not to mention that he is the world’s most cited expert in his field. If you have spend your life treating and studying infectious diseases then you’re allowed to do what he did.

 

[borro]

 

[Nicodeamus]

Raoult was interviewed on French Tv last night.

He makes the point that medical community have approached the problem using a wrong paradigm. Basically we are used to inventing new drugs to treat modern problems without asking the question if old treatments can also work.

The Research funding for using existing medication for cross medication is largely underfunded, because there is no money in it.

He also pointed out that its the first time in modern history that a virus killed more people in the Western Countries than the Eastern ones. The reason being that in the east they treated people, in the West the mindset was risk aversion, they wanted a randomized control trial before people were treated. Your mindset during a crises cannot be the same as during peace time.

 

[tetrasect]

because they gave it to patients when it was already too late.

If that was the case then patients would have to take it as soon as they get infected. That means everyone would have to take it because you don't know who is likely to develop serious symptoms. That would be extremely risky seeing that the side effects of this drug are so damaging.

Sorry but this drug is not the answer. They should focus elsewhere.

 

[Nicodeamus]

If that was the case then patients would have to take it as soon as they get infected. That means everyone would have to take it because you don't know who is likely to develop more serious symptoms. That would be extremely risky seeing that the side effects of this drug are so damaging.

Sorry but this drug is not the answer. They should focus elsewhere.

The side effects come when you're in high doses (like any medication). His protocol was to test everyone that had a light fever, people were standing in queues in Marseilles to get tested. If positive they get the drug, but before they get it a Cardiologist did an electrocardiogramme.

This is a much more sensible solution then locking down everyone. It makes a strong case for early treatment. I don't see why a doctor should wait for your toe to rot away before he gives you an antibiotic. It makes no sense.

He is currently developing a treatment for the at risk group to also prevent them to go into hospital.

Its not the magic answer and I suspect that there won't be one, but to pretend that it doesn't work is just dishonest.
As posted above, its the most used medication worldwide for COVID19. Thanks to him, the intervention stops many people from going into hospital.

The idea that chloroquine is dangerous for most people is a complete joke. Anyone that has been to a Malaria region always took this medication as a prophylaxis, I took it a few times without a prescription.

The French and Indian Army is now using it as such for Covid19. This also hasn't passed the Randomized control trial yet but it will be out by September, the potential is that it can protect hospital staff and nurses. As per Raoult's recommendation, in a time of crises, you use what you've got, because what matters for a Doctor is to treat a patient not to determine if the treatment had a placebo, that is the role of a researcher.

Here is a list of all the RCT going on to see if hydroxychloquine works as a prophylaxis.

1. Prevention of SARS-CoV-2 (COVID-19) Through Pre-Exposure Prophylaxis With Tenofovir Disoproxil Fumarate/Emtricitabine and Hydroxychloroquine in Healthcare Personnel: Randomized Clinical Trial Controlled With Placebo
2. A Prospective Clinical Study of Hydroxychloroquine in the Prevention of SARS- CoV-2 (COVID-19) Infection in Healthcare Workers After High-risk Exposures
3. Pre-Exposure Prophylaxis With Hydroxychloroquine for High-Risk Healthcare Workers During the COVID-19 Pandemic: A Unicentric, Double-Blinded Randomized Controlled Trial
4. Pre-exposure Prophylaxis for SARS-Coronavirus-2: A Pragmatic Randomized Clinical Trial
5. The PATCH Trial (Prevention And Treatment of COVID-19 With Hydroxychloroquine)
6. Hydroxychloroquine Post Exposure Prophylaxis (PEP) for Household Contacts of COVID-19 Patients: A NYC Community-Based Randomized Clinical Trial
7. Randomized, quadruple-blind, placebo controlled trial comparing prophylaxis of daily hydroxychloroquine (400 mg twice daily for day 1, followed by 200 mg twice daily for days 2-5) versus placebo in household contacts of
8. Chemoprophylaxis of SARS-CoV-2 Infection (COVID-19) in Exposed Healthcare Workers : A Randomized Double-blind Placebo-controlled Clinical Trial
9. Efficacy of Hydroxychloroquine for Post-exposure Prophylaxis (PEP) to Prevent Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection Among Adults Exposed to Coronavirus Disease (COVID-19): a Blinded, Randomized Study
10. Will Hydroxychloroquine Impede or Prevent COVID-19: WHIP COVID-19 Study

Most of the results will be out in July, some as late as September. We cannot wait for a RCT in a time of crises if people are dying. You need to treat them with what you have.

 

[Geoff.D]

If that was the case then patients would have to take it as soon as they get infected. That means everyone would have to take it because you don't know who is likely to develop serious symptoms. That would be extremely risky seeing that the side effects of this drug are so damaging.

Sorry but this drug is not the answer. They should focus elsewhere.

Pathetic response! You are missing the whole point he is making. TREAT the people, don't sit back and wait for a miracle new drug. TRY something and what have you available? The existing drugs that have been used before.
The pharms guys are probably petrified that something already existing will be shown to be the best treatment to prevent people from dying if treated early enough.

No, this nonsense of shooting down someone who has and is still having success with treating Covid 19 is just ridiculous.

But then, The purpose of criticising those who are prepared to treat is going against the current hype are they not? Much better to destroy the World instead of fixing things. It is after all the revolutionary way. First break everything before you rebuild.

 

[sand_man]

He is currently developing a treatment for the at risk group to also prevent them to go into hospital.

was about to ask. All well and good claiming it works but if he's treating a bunch of otherwise healthy 20-50 year old's, they likely to have gotten better on their own in any event.

Has he treated any 70 year old's with diabetes and hypertension?

 

[tetrasect]

The side effects come when you're in high doses (like any medication). His protocol was to test everyone that had a light fever, people were standing in queues in Marseilles to get tested. If positive they get the drug, but before they get it a Cardiologist did an electrocardiogramme.

This is a much more sensible solution then locking down everyone. It makes a strong case for early treatment. I don't see why a doctor should wait for your toe to rot away before he gives you an antibiotic. It makes no sense.

He is currently developing a treatment for the at risk group to also prevent them to go into hospital.

Its not the magic answer and I suspect that there won't be one, but to pretend that it doesn't work is just dishonest.
As posted above, its the most used medication worldwide for COVID19. Thanks to him, the intervention stops many people from going into hospital.

The idea that chloroquine is dangerous for most people is a complete joke. Anyone that has been to a Malaria region always took this medication as a prophylaxis, I took it a few times without a prescription.

The French and Indian Army is now using it as such for Covid19. This also hasn't passed the Randomized control trial yet but it will be out by September, the potential is that it can protect hospital staff and nurses. As per Raoult's recommendation, in a time of crises, you use what you've got, because what matters for a Doctor is to treat a patient not to determine if the treatment had a placebo, that is the role of a researcher.

Here is a list of all the RCT going on to see if hydroxychloquine works as a prophylaxis.


Most of the results will be out in July, some as late as September. We cannot wait for a RCT in a time of crises if people are dying. You need to treat them with what you have.

Pathetic response! You are missing the whole point he is making. TREAT the people, don't sit back and wait for a miracle new drug. TRY something and what have you available? The existing drugs that have been used before.
The pharms guys are probably petrified that something already existing will be shown to be the best treatment to prevent people from dying if treated early enough.

No, this nonsense of shooting down someone who has and is still having success with treating Covid 19 is just ridiculous.

But then, The purpose of criticising those who are prepared to treat is going against the current hype are they not? Much better to destroy the World instead of fixing things. It is after all the revolutionary way. First break everything before you rebuild.

I agree, if they can use it safely at low dosages then of course they should treat people. If it turns out to be an effective preventative then that's great. At the same time people should stop acting as if it's a cure, since clearly is is not effective at treating people who have already developed symptoms or after x days of infection.

 

[Nicodeamus]

was about to ask. All well and good claiming it works but if he's treating a bunch of otherwise healthy 20-50 year old's, they likely to have gotten better on their own in any event.

Has he treated any 70 year old's with diabetes and hypertension?

Yes he did, but there are some patients with serious cardiovascular issues that will be harmed by chloroquine. So it depends on how severe their conditions is.

His studies are in the above links with the patients profile.

He targeted patients during early treatment to stop them from carrying the virus and therefore to become sick. What some people are missing is that its important to also treat healthy people, because it stops them from being able to infect others. So it has a benefit beyond the patient.

That is why he walked out of Macron’s advisory council, the state only wanted to focus on severe cases and he said its madness.

He tested around 3% of the population of Marseilles. This was his point about an epidemic. You also need to treat those that carry the virus so that they cannot infect others. It makes the loads on hospitals lower.

 

[Nicodeamus]

I agree, if they can use it safely at low dosages then of course they should treat people. If it turns out to be an effective preventative then that's great. At the same time people should stop acting as if it's a cure, since clearly is is not effective at treating people who have already developed symptoms or after x days of infection.

Look Trump and co fed this up. The drug is now a political football. Also something being a “cure” sounds childish. Very few pills on their own cure anything, it’s usually part of a treatment.

A lot of people for example died on ventilators. Thanks to the New York doctor we now know that the hospitals used a wrong protocol and many patients just needed oxygen. Had it not been for a doctor going against the "tested protocol" then we wouldn't have know this.

This small change saved lots of lives, but again it won’t save every one of them.

 

[tetrasect]

Look Trump and co fed this up. The drug is now a political football. Also something being a “cure” sounds childish. Very few pills on their own cures anything, it’s usually part of a treatment.

Yeah sure cure is not the right word but it's been thrown around a lot by the media and people promoting the drug.

 

[Hamish McPanji]

So what was the success rate of the drugs used?