Covid-19 Prophylaxis

[maldorf]

Is it really ethical to withhold treatment to one group of sick patients while giving it to others? That's one big obstacle. Its common sense to not give patients like me with cardiac arrhythmia the medicine, it would be unethical to just randomly give it to me.

I'm sure the patient and family have some say in this too.

 

[waterscholar]

I don't have a dog in this race since I haven't taken a position on HCQ thus far. Also, I'm a Trump supporter, hate the MSM, and believe that the early use of HCQ was justified given the anecdotal evidence and the great safety profile of HCQ.

But now that we have more evidence, it's time to reevaluate our assessment of HCQ, even if it turns out that in hind sight, we were wrong.

There's two types of studies, 1) observational studies and 2) randomized trials. The former are essentially useless, given the massive omitted variable bias arising from the fact that treatment is not allocated randomly, but correlates with (unobserved) patient characteristics and co-treatments, which both also influence disease outcomes. Consequently, there have been observational studies showing that HCQ does massive harm (hyped by the MSM), and also some showing HCQ to have massive benefits (hyped by right-wing media). The most recent study (**broken link removed**) mentioned by maldorf above is again an observational study with massive flaws.

So what are some of those issues?

First one is illustrated well by this quote from one of the authors:

Study finds hydroxychloroquine may have boosted survival, but other researchers have doubts

Hydroxychloroquine helped Covid-19 patients, a study in Detroit found.

edition.cnn.com

So to oversimplify a bit, you have 2 groups. A healthy group without cardiovascular risk factors, and an unhealthy group with cardiovascular risk factors. You only give HCQ to the healthy people and observe that their survival is higher than for the unhealthy group. But this outcome would have been the same if there had been no treatment at all! Sure, there are statistical techniques to try and control for the bias, but they are highly imperfect.

There are a couple of more issues. For example, the use of other medications was not constant across groups:


**broken link removed**

Also, the time from hospitalization until HCQ was given did not significantly differ between this and other studies, so the difference in timing cannot actually explain the differing findings. The exclusion 10% of the sample due to those patients not being discharged yet could also skew results. The finding that azithromycin alone is even more effective than HCQ is also highly dubious, and further indicates that omitted variable bias is driving the results regarding HCQ. There was also no addition of zinc supplements which proponents of HCQ claimed to be crucial when they criticized earlier studies.

So all in all, it is a terrible, useless observational study, just like the ones that came before and showed opposite results. The only type of study one can rely on are randomized trials. And the one randomized trial we have seen did not show statistically significant effects of HCQ treatment. You can criticize that study for being underpowered and argue that it actually does provide some evidence for HCQs effectiveness. But to claim victory (see Rex Feral above) because one of the very flawed observational studies is in line with your priors is disingenuous at best.

I really like this, it's a well thought out response. It is all about the preponderance of evidence (and the appropriate weighing of strong vs weak evidence) and the ability to change beliefs as new evidence comes in. Rex's posts and others on here made me excited about the possibilities of HCQ at first as well - now that the evidence has come in, I think we have enough to make a decision.

This is not to say that it might have a beneficial effect in certain subgroups of patients; however, I think the cost of examining differential treatment effects is too high much given the high risk of examining failing treatments (e.g., the risk of death).

For those interested in clinical trial design and how researchers make decisions in high risk situations, I came across this recently during a talk: https://journals.sagepub.com/doi/fu...XcyzsEVJfeITPzIISL0CVfviGWb7o4R0mNBB2wkgQ6OWp

These are the types of decision making rules that are likely being employed in this current situation, and this is likely why drugs are being abandoned earlier than they might be otherwise.

I also have a bit of time to look into the research on positive treatments, so I will start to do that as well.

 

[waterscholar]

Is it really ethical to withhold treatment to one group of sick patients while giving it to others? That's one big obstacle. Its common sense to not give patients like me with cardiac arrhythmia the medicine, it would be unethical to just randomly give it to me.

I'm sure the patient and family have some say in this too.

You might rely on treatment as usual which would arguably be ethical in certain situations (especially those where the experimental treatment might be harmful)

 

[muscle96ss]

Is it really ethical to withhold treatment to one group of sick patients while giving it to others? That's one big obstacle. Its common sense to not give patients like me with cardiac arrhythmia the medicine, it would be unethical to just randomly give it to me.

I'm sure the patient and family have some say in this too.

I think Watersholar would volunteer for the non-HCQ group!

 

[waterscholar]

I think Watersholar would volunteer for the non-HCQ group!

Haha, probably

 

[maldorf]

If my kids or wife got sick, I'd want them to try it on them.

We had someone on here taking the 2 for treatment. Anyone know how that worked out? I can't remember the member's name.

 

[Rex Feral]

Have you not payed attention in med school? The part where they told you that you cannot rely on anecdotal evidence when assessing treatments? Do you understand what a counterfactual is, and how you lack it in your clinical practice?

Have you not paid attention in elementary school? Do you know how to use "payed" properly in a sentence? Does basic grammar escape you yet you espouse to be brilliant and an expert in all areas while admitting you have zero actual experience in what you speak of? Do you make grammatical errors that I would have not made as a 4th grader without the benefit of the internet and spell check?

I understand that you are vehemently opposed to any type of anecdotal evidence. The reason for that is simple, you have never done anything. You are a keyboard clinician with bad grammar who has never treated a patient in his life. You have never turned a vent off and watched your patient die. You have never had to make an actual decision that could mean life or death for a person. I could literally give a fuck what you have to say about anything. You are a moron who doesn't have sense enough to realize it.

I've had the experience of assessing literally hundreds of very unhealthy women who have been using 400 mg qd of HCQ for decades. Every test you can possibly imagine. Morbidly obese women who never exercise with multiple comorbidities. I have never seen one problem associated with this drug. Same for Zpak though it may not be necessary. This is not a "victory lap." I merely stated we know about as much we did 4 months ago with the exception of PEEP which I can assure this little bitch of a keyboard clinician Jeff really knows nothing about because it would require actual experience vs reading studies.

Rex.

 

[MyNameIsJeff]

Have you not paid attention in elementary school? Do you know how to use "payed" properly in a sentence? Does basic grammar escape you yet you espouse to be brilliant and an expert in all areas while admitting you have zero actual experience in what you speak of? Do you make grammatical errors that I would have not made as a 4th grader without the benefit of the internet and spell check?

I understand that you are vehemently opposed to any type of anecdotal evidence. The reason for that is simple, you have never done anything. You are a keyboard clinician with bad grammar who has never treated a patient in his life. You have never turned a vent off and watched your patient die. You have never had to make an actual decision that could mean life or death for a person. I could literally give a fuck what you have to say about anything. You are a moron who doesn't have sense enough to realize it.

I've had the experience of assessing literally hundreds of very unhealthy women who have been using 400 mg qd of HCQ for decades. Every test you can possibly imagine. Morbidly obese women who never exercise with multiple comorbidities. I have never seen one problem associated with this drug. Same for Zpak though it may not be necessary. This is not a "victory lap." I merely stated we know about as much we did 4 months ago with the exception of PEEP which I can assure this little bitch of a keyboard clinician Jeff really knows nothing about because it would require actual experience vs reading studies.

Rex.

Thanks for pointing out that embarrassing grammar mistake. I am not a native speaker, if that's an excuse.

I don't claim to be an expert in all areas, but in terms of epistemology, the scientific method and statistical analysis, I am quite competent and PAID attention in grad school myself.

I never questioned the safety of HCQ, see my quote from earlier: "great safety profile of HCQ ". But that assessment was based on the literature, i.e. on proper scientific evidence. I am also not opposed to the use of anecdotal evidence, but you have to acknowledge that it is highly imperfect and strictly inferior to scientific evidence. I did, in fact, find the early anecdotal evidence on HCQ compelling enough that, given its "great safety profile", I agreed with its wide spread use on COVID-19 patients. But you have to update that assessment of efficacy once the clinical trials have come in, and not stubbornly insist on your initial assessment by cherry-picking one of the flawed studies whose results you like.

I'm sure that there are good reasons to use PEEP therapy, and that many clinicians and policy makers made errors when it came to mechanical ventilation. I'm sure that you and other doctors have accumulated a fair bit of anecdotal evidence about which type of ventilation treatment is best. And I agree that until actual trials have been conducted, clinicians should rely to a large extent on that theoretical reasoning combined with their experience. But you and other clinicians have to be open to changing their preconceived notion once the scientific evidence comes in.

I'm sure I could have conveyed this in a more pleasant manner than I did in the earlier post. But from earlier discussions we had, I know that you are pathological contrarian who needs to feel superior and always be right, which is why you are not open to changing your stance no matter what arguments you are presented with.

 

[waterscholar]

Is it really ethical to withhold treatment to one group of sick patients while giving it to others? That's one big obstacle. Its common sense to not give patients like me with cardiac arrhythmia the medicine, it would be unethical to just randomly give it to me.

I'm sure the patient and family have some say in this too.

Just to answer your question more directly here is some info from the remdesivir trial:

"The second SIMPLE study is evaluating the safety and efficacy of 5-day and 10-day dosing regimens of remdesivir, compared with standard of care alone, in patients with moderate COVID-19. "

Press Releases | Gilead

Read the latest news about Gilead's work in COVID-19, HIV, viral hepatitis, cancer and other areas.

www.gilead.com

 

[Rex Feral]

Thanks for pointing out that embarrassing grammar mistake. I am not a native speaker, if that's an excuse.

I don't claim to be an expert in all areas, but in terms of epistemology, the scientific method and statistical analysis, I am quite competent and PAID attention in grad school myself.

I never questioned the safety of HCQ, see my quote from earlier: "great safety profile of HCQ ". But that assessment was based on the literature, i.e. on proper scientific evidence. I am also not opposed to the use of anecdotal evidence, but you have to acknowledge that it is highly imperfect and strictly inferior to scientific evidence. I did, in fact, find the early anecdotal evidence on HCQ compelling enough that, given its "great safety profile", I agreed with its wide spread use on COVID-19 patients. But you have to update that assessment of efficacy once the clinical trials have come in, and not stubbornly insist on your initial assessment by cherry-picking one of the flawed studies whose results you like.

I'm sure that there are good reasons to use PEEP therapy, and that many clinicians and policy makers made errors when it came to mechanical ventilation. I'm sure that you and other doctors have accumulated a fair bit of anecdotal evidence about which type of ventilation treatment is best. And I agree that until actual trials have been conducted, clinicians should rely to a large extent on that theoretical reasoning combined with their experience. But you and other clinicians have to be open to changing their preconceived notion once the scientific evidence comes in.

I'm sure I could have conveyed this in a more pleasant manner than I did in the earlier post. But from earlier discussions we had, I know that you are pathological contrarian who needs to feel superior and always be right, which is why you are not open to changing your stance no matter what arguments you are presented with.

Apologies, I was not aware that English was your second language. Honestly, I thought you were a med school student here in the US for whatever reason. It is certainly not my intent to act in a manner that makes me appear unfavorable. I will attempt to be mindful of this in the future.

We apparently are not in disagreement. Perhaps I should have been more clear in order to avoid confusion. I don't believe I've posted even one study here on HCQ. The results I mean. I posted the Boulware PEP study for enrollment to help further research. Every HCQ study has been flawed to the point where I do not want to post it. It's my assumption, perhaps erroneously, that people understand that I know when a study is useless, i.e. doesn't advance our knowledge with regards to efficacy. Given that I write these protocols for a living and I'm not a biased moron. I was perhaps misleading when speaking of deaths r/t to the withholding of HCQ. We do not know yet if HCQ can prevent people from dying. There is no medication oral or otherwise, that has shown efficacy past 24-48h of symptom onset for a pulmonary viral infection. I am not stupid enough to believe that HCQ will be the first. That's why I posted what I did in my first post 4 months ago. I never cherry picked anything. I didn't post the most recent study for that reason. Just like I haven't posted Zalenko's "study" which he published yesterday. I don't consider them to be studies that advance our knowledge of efficacy. What these "studies" did prove to us is that HCQ is safe in COVID the same as it is in everyone else. It costs $20 and it does no harm and it might keep you from being hospitalized if initiated within 24-48h of sx onset and it might cut your risk of death in half in initiated within 24-48h of hospitalization. I will be the first to come here when we know it shows no efficacy. The fact that you act as I have ever behaved otherwise is insulting but I'm willing to concede I may have played a role in this. The fact that you want to try to explain my business to me, which is clearly not your business, is also insulting. As if I don't already understand the weaknesses in a trial when trials are my business solely x 16 years until this pandemic when I started doing some COVID work.

https://www.thezelenkoprotocol.com/

I'll add r/t Zalenko's new study. He had 2200 subjects who were given the protocol. I don't say his protocol because it was adopted from research in other countries such as China and South Korea. There were 2 deaths. The problem with this study is the same as the Boulware PEP study. We don't know if these people actually contracted SARS-CoV-2. He was able to confirm only 140 out of 2200. One subject died out of the 140. That is pretty much in line with what we'd expect the mortality rate to be at this point. So this could suggest that it is useless. I'm not a moron. I understand this. But it doesn't change the fact that for $20 with no other intervention available and knowing you will do no harm, you'd have to be a fool not to try. I have never said otherwise. I've said since the beginning that if HCQ was going to prove efficacious for COVID it needed to be initiated within 24-48h of sx onset exactly like Tamilflu and Xofluza. These studies will never likely be done due to the falsehood of death from arrhythmias which was entirely media driven and based on political affiliation. I promise you cannot list an instance of false data on a drug being published in Lancet other than HCQ. The physician listed Stanford as a research partner. When they called Stanford they said they had never heard of him. Completely fake data made into the Lancet due purely to political reasons and studies were halted because of the fake data/study. Never has this happened before. So you have to ask yourself why did this happen. They don't know if it works any more than me or you or anyone else at this point, yet they were intent on sinking it without any regard as to whether it would cost lives. Why?

Rex.

 

[Swifto]

Apologies, I was not aware that English was your second language. Honestly, I thought you were a med school student here in the US for whatever reason. It is certainly not my intent to act in a manner that makes me appear unfavorable. I will attempt to be mindful of this in the future.

We apparently are not in disagreement. Perhaps I should have been more clear in order to avoid confusion. I don't believe I've posted even one study here on HCQ. The results I mean. I posted the Boulware PEP study for enrollment to help further research. Every HCQ study has been flawed to the point where I do not want to post it. It's my assumption, perhaps erroneously, that people understand that I know when a study is useless, i.e. doesn't advance our knowledge with regards to efficacy. Given that I write these protocols for a living and I'm not a biased moron. I was perhaps misleading when speaking of deaths r/t to the withholding of HCQ. We do not know yet if HCQ can prevent people from dying. There is no medication oral or otherwise, that has shown efficacy past 24-48h of symptom onset for a pulmonary viral infection. I am not stupid enough to believe that HCQ will be the first. That's why I posted what I did in my first post 4 months ago. I never cherry picked anything. I didn't post the most recent study for that reason. Just like I haven't posted Zalenko's "study" which he published yesterday. I don't consider them to be studies that advance our knowledge of efficacy. What these "studies" did prove to us is that HCQ is safe in COVID the same as it is in everyone else. It costs $20 and it does no harm and it might keep you from being hospitalized if initiated within 24-48h of sx onset and it might cut your risk of death in half in initiated within 24-48h of hospitalization. I will be the first to come here when we know it shows no efficacy. The fact that you act as I have ever behaved otherwise is insulting but I'm willing to concede I may have played a role in this. The fact that you want to try to explain my business to me, which is clearly not your business, is also insulting. As if I don't already understand the weaknesses in a trial when trials are my business solely x 16 years until this pandemic when I started doing some COVID work.

https://www.thezelenkoprotocol.com/

I'll add r/t Zalenko's new study. He had 2200 subjects who were given the protocol. I don't say his protocol because it was adopted from research in other countries such as China and South Korea. There were 2 deaths. The problem with this study is the same as the Boulware PEP study. We don't know if these people actually contracted SARS-CoV-2. He was able to confirm only 140 out of 2200. One subject died out of the 140. That is pretty much in line with what we'd expect the mortality rate to be at this point. So this could suggest that it is useless. I'm not a moron. I understand this. But it doesn't change the fact that for $20 with no other intervention available and knowing you will do no harm, you'd have to be a fool not to try. I have never said otherwise. I've said since the beginning that if HCQ was going to prove efficacious for COVID it needed to be initiated within 24-48h of sx onset exactly like Tamilflu and Xofluza. These studies will never likely be done due to the falsehood of death from arrhythmias which was entirely media driven and based on political affiliation. I promise you cannot list an instance of false data on a drug being published in Lancet other than HCQ. The physician listed Stanford as a research partner. When they called Stanford they said they had never heard of him. Completely fake data made into the Lancet due purely to political reasons and studies were halted because of the fake data/study. Never has this happened before. So you have to ask yourself why did this happen. They don't know if it works any more than me or you or anyone else at this point, yet they were intent on sinking it without any regard as to whether it would cost lives. Why?

Rex.

Thats extremely worrying.

If one of the oldest and most respected medical journals can be influenced like this, then perhaps impartiality is dead!

I'll go back to my post alluding to the massive sums involved here and profits. HCQ isn't going to make anyone billions of dollars.

 

[Swifto]

Oh and you two should disagree more often. When two of the brightest minds we have in this community collide, it makes fascinating learning and reading!

 

[waterscholar]

I promise you cannot list an instance of false data on a drug being published in Lancet other than HCQ. The physician listed Stanford as a research partner. When they called Stanford they said they had never heard of him. Completely fake data made into the Lancet due purely to political reasons and studies were halted because of the fake data/study. Never has this happened before. So you have to ask yourself why did this happen. They don't know if it works any more than me or you or anyone else at this point, yet they were intent on sinking it without any regard as to whether it would cost lives. Why?

Rex.

Thanks for responding with a little bit more detail. It's nice to hear a little more about your work etc.

I think this part though is a pretty strong assumption given that there are many other reasons why one might fake data or commit research fraud other than for political reasons. Just to name two: a) prestige and fame. The lancet is the number one medical journal in the world. Who doesn't want to get something published here? and, b) increased likelihood of future funding or a stronger case for tenure.

The lancet has also published other fraudulent drug studies. Just one famous example: https://retractionwatch.com/category/by-journal/lancet/

I don't know why this has to go straight towards political bias when there are other probably better reasons that this may have happened.

There does seem to be a particular bias you seem to be pushing. That's ok, but this is why i think there was some reaction by Jeff (and me previously).

 

[Rex Feral]

If an

Thanks for responding with a little bit more detail. It's nice to hear a little more about your work etc.

I think this part though is a pretty strong assumption given that there are many other reasons why one might fake data or commit research fraud other than for political reasons. Just to name two: a) prestige and fame. The lancet is the number one medical journal in the world. Who doesn't want to get something published here? and, b) increased likelihood of future funding or a stronger case for tenure.

The lancet has also published other fraudulent drug studies. Just one famous example: https://retractionwatch.com/category/by-journal/lancet/

I don't know why this has to go straight towards political bias when there are other probably better reasons that this may have happened.

There does seem to be a particular bias you seem to be pushing. That's ok, but this is why i think there was some reaction by Jeff (and me previously).

How about you? Do you study or treat the disease? Are you a licensed medical professional? Or just someone else who loves to run their mouth about things they have no experience with? Ever seen a patient in your life in any type of professional capacity? Ever turned a vent off and watched your patient die? Ever had to make a potentially life and death decision on a patient? Let me guess, just another keyboard clinician "academic." You have absolutely zero clue what you are talking about. Literally, even the liberal Trump hating physician Boulware who conducted the two outpatient studies admits political bias. But I guess a person like yourself with zero actual experience knows more than the people who actually do the work. How stupid you must be to believe this.

David Boulware MD. MPH - "There were/are ~9 HCQ outpatient randomized trials that are in very stages. Two are complete. Some are abandoned. Many / most having problems enrolling, either: 1) because of the politicization of HCQ; or 2) located in other countries where Covid-19 cases are now very low."

So you know more than the people who have actually written and conducted HCQ studies? You are a fool.

I don't mean vaccine studies either in the Lancet you little smart ass.

How many people here believe this little shit that there was no politicization of HCQ? I have bias because I say there is no harm in giving a safe drug. A friend of mine wrote a reply on IG the other day and I'm just going to copy and paste it because I have no patience left for little shits like this. These people, Water Shitscholar and Jeff, do nothing literally in their personal lives related to this. Why aren't they dictating treatment for other illnesses? Because everyone would say what the fuck are you talking about dictating treatment for things you know nothing of and do not have the education to do so. Why are people who have never treated a patient in their life, Water Shit and Jeff, all of a sudden experts on the treatment of disease? Because they don't have sense enough to realize their place. Which is no place. Just another asshole with an opinion about things they have no experience with outside of reading.

Alex Spinoso MD -

"When the rona started to spread, physicians and medical staff were lead to believe the wrong things.

Not only were we told the wrong data and misled by medical leaders who were somehow “the specialists who know more than anyone about this”, but our licenses were also restricted.

How so?

I received a letter from each one of the state medical boards stating that the use of hydroxychloroquine was banned.

Imagine that, the data wasn’t even out yet, there were no peer reviewed journals yet proving anything, yet physicians were not allowed to explore all options when treating patients.

This study from Henry Ford shows some promise when it comes to a treatment for the rona.

It showed that hydroxychloroquine significantly reduces the death rate of COVID-19 patients. Of those treated with hydroxychloroquine alone, 13% of them died, compared to the 26.4% who died and were were not treated with the drug. There was an overall 18.1% in-hospital mortality rate and patients were over the age of 18, with a median age of 64.

This is a small study, but it’s one of the best out there so far as it’s peer reviewed instead of the garbage that’s been published lately which we have found out was faked data.

Haven’t been on much because I’m tired of people who have no idea what they’re talking about talking about a disease like they actually study it.

People who believe garbage their fed and try to talk about it like they know something.

People who think masks stop viruses or its “better than nothing” or their virtue somehow of “saving others” makes them better than others.

Or somehow protests don’t cause a spread of a disease (which we should’ve let spread in the first place to establish herd immunity).

Or governors who say that sitting on a beach is illegal but running on one is fine.

How churches have been closed, but now they can be open, but you can’t sing.

It’s a joke.

Keep following the data.

And if you don’t study the disease or are helping to treat it directly, then keep your mouth shut and definitely don’t make recommendations to me about it.

You have no idea what you’re talking about.

**broken link removed**"

Rex.

 

[Rex Feral]

You little academic fucks, Shit Scholar and Jeff, who wouldn't know your head from your ass in the real world want to do something? Show me the evidence on masks worn by the public vs HCQ and tell me why you would ubiquitously be on board with one but not the other. That's your assignment. You both are great at reading and digging shit up. There you go. You're both academics so you're used to an assignment. Get to it and get back to me and everyone else here.

Start here https://c19study.com/

Rex.

 

[waterscholar]

It’s really disappointing that you tend to immediately jump to personal attacks instead of addressing any of the actually points of substance (I don’t think you even addressed one of the points I mentioned). To me that signals multiple things, but the main one is that usually this occurs when someone doesn’t have a strong evidential base to stand on.

After this response I’m going to back away again for a while – it’s just not fun engaging when personal attacks get involved. I spent a moderate amount of time looking into evidence for other treatments for COVID a few nights ago because I wanted to share that with someone who asked really nicely about my thoughts, but it just seems like a thankless job now.

How about you? Do you study or treat the disease? Are you a licensed medical professional? Or just someone else who loves to run their mouth about things they have no experience with? Ever seen a patient in your life in any type of professional capacity? Ever turned a vent off and watched your patient die? Ever had to make a potentially life and death decision on a patient? Let me guess, just another keyboard clinician "academic." You have absolutely zero clue what you are talking about. Literally, even the liberal Trump hating physician Boulware who conducted the two outpatient studies admits political bias. But I guess a person like yourself with zero actual experience knows more than the people who actually do the work. How stupid you must be to believe this.

So you know more than the people who have actually written and conducted HCQ studies? You are a fool.

I don’t know why this should matter at all on this board. This isn’t a board dedicated to medical professionals or for those who want medical advice. But, if you must know: some may believe my education/training gives me more expertise at synthesizing/commentating on the state of evidence for medical/health research than the average MD (according to side conversations from MD/PhD’s or those just uppity about education). I don’t necessarily agree with this and I don’t think it applies at all to posting on this board (everyone should be able to discuss things in an open and informed way). I admit, I have never treated a patient and I recognize that is an important part of medical decision making, but I nor others have commented on that. I’m simply interested in the results of the clinical trials and what that suggests to me about the positives or negatives for a treatment. Everyone should have the ability to comment on this regardless of their education or training – as long as it is well intentioned and informed.

Everyone has biases even researchers, there is no doubt about that. That doesn’t however mean that that is a main contributor to a drug being tanked or less-researched, especially if there is data indicating that it might not be effective. It is my understanding that even after removing the retracted papers from the literature, that there is moderately strong evidence that these treatments are unlikely to be effective in some contexts. You’re right that this fraud may have contributed to the premature halting of some trials, however, I would be curious to hear from other researchers whether they still think this is warranted (researchers though who are willing to talk nicely and who can provide data). The data so far including the henry ford trial is not convincing to me. There are still trials being conducted though so we will see.

Finally, I very much agree that the handling of this pandemic has been flawed in the US. There have been a tremendous amount of mixed messages regarding public health orders including public officials saying that protesting is ok despite arguing for the necessity of social distancing (this is absurd to me and I’m really disappointed that more researchers didn’t speak out against this). But I believe (and others) that the politicization of this issue is strongly to blame for this. This is why I keep inserting myself into this conversation: because I believe (sometimes I wonder why) that science and evidence should guide these decisions, not emotion or political bias. Do you see though that you’re contributing to this by attacking me and others personally instead of engaging us with data or evidence? This does nothing to positively move this board or anyone forward.



** I recognize that I’ve struggled with being snarky in some of my posts, so I apologize for that. I’m getting frustrated though with what I see as misinformation and am trying to figure out how to approach that on here.

 

[muscle96ss]

It’s really disappointing that you tend to immediately jump to personal attacks instead of addressing any of the actually points of substance (I don’t think you even addressed one of the points I mentioned). To me that signals multiple things, but the main one is that usually this occurs when someone doesn’t have a strong evidential base to stand on.

After this response I’m going to back away again for a while – it’s just not fun engaging when personal attacks get involved. I spent a moderate amount of time looking into evidence for other treatments for COVID a few nights ago because I wanted to share that with someone who asked really nicely about my thoughts, but it just seems like a thankless job now.




I don’t know why this should matter at all on this board. This isn’t a board dedicated to medical professionals or for those who want medical advice. But, if you must know: some may believe my education/training gives me more expertise at synthesizing/commentating on the state of evidence for medical/health research than the average MD (according to side conversations from MD/PhD’s or those just uppity about education). I don’t necessarily agree with this and I don’t think it applies at all to posting on this board (everyone should be able to discuss things in an open and informed way). I admit, I have never treated a patient and I recognize that is an important part of medical decision making, but I nor others have commented on that. I’m simply interested in the results of the clinical trials and what that suggests to me about the positives or negatives for a treatment. Everyone should have the ability to comment on this regardless of their education or training – as long as it is well intentioned and informed.

Everyone has biases even researchers, there is no doubt about that. That doesn’t however mean that that is a main contributor to a drug being tanked or less-researched, especially if there is data indicating that it might not be effective. It is my understanding that even after removing the retracted papers from the literature, that there is moderately strong evidence that these treatments are unlikely to be effective in some contexts. You’re right that this fraud may have contributed to the premature halting of some trials, however, I would be curious to hear from other researchers whether they still think this is warranted (researchers though who are willing to talk nicely and who can provide data). The data so far including the henry ford trial is not convincing to me. There are still trials being conducted though so we will see.

Finally, I very much agree that the handling of this pandemic has been flawed in the US. There have been a tremendous amount of mixed messages regarding public health orders including public officials saying that protesting is ok despite arguing for the necessity of social distancing (this is absurd to me and I’m really disappointed that more researchers didn’t speak out against this). But I believe (and others) that the politicization of this issue is strongly to blame for this. This is why I keep inserting myself into this conversation: because I believe (sometimes I wonder why) that science and evidence should guide these decisions, not emotion or political bias. Do you see though that you’re contributing to this by attacking me and others personally instead of engaging us with data or evidence? This does nothing to positively move this board or anyone forward.



** I recognize that I’ve struggled with being snarky in some of my posts, so I apologize for that. I’m getting frustrated though with what I see as misinformation and am trying to figure out how to approach that on here.

While I think we can argue back and forth how effective HCQ really is; I wish people could see through the media and political BS that prevents us from looking at things objectively. Rex example of comparing masks to HCQ is spot on where the scientific evidence is inconclusive and arguments could be made for both sides in terms of effectiveness and safety. But somehow people that don't think masks are effective or question the safety are vilified but people who don't think HCQ is effective or question the safety are treated completed opposite and instead those that recommend it are vilified. Wake up people! Please tell me that more people are smart enough to see through all the BS. The drug has 75 years of real world history of being safe. If it can just save 1% of the live's then fucking use it!

 

[maldorf]

While I think we can argue back and forth how effective HCQ really is; I wish people could see through the media and political BS that prevents us from looking at things objectively. Rex example of comparing masks to HCQ is spot on where the scientific evidence is inconclusive and arguments could be made for both sides in terms of effectiveness and safety. But somehow people that don't think masks are effective or question the safety are vilified but people who don't think HCQ is effective or question the safety are treated completed opposite and instead those that recommend it are vilified. Wake up people! Please tell me that more people are smart enough to see through all the BS. The drug has 75 years of real world history of being safe. If it can just save 1% of the live's then fucking use it!

The president was taking it, many claimed he was lying and really wasn't taking it. Just another example.

 

[maldorf]

Something to think about, if you do get covid-19. Might want to adjust what you're taking. 10,000 more men have died in the US from this, as compared to women.

Lowering Testosterone May Reduce Severity of COVID-19

Lowering testosterone may prevent the new coronavirus from entering lung cells and lessen COVID-19 severity, new Columbia University research suggests. A trial has now begun in three VA hospitals.

www.cuimc.columbia.edu

"The new coronavirus cannot enter cells without the help of the TMPRSS2 proteins on our lung cells,” Goldstein says. “Our analysis suggests that decreasing testosterone will lower TMPRSS2, interfere with viral entry, and reduce the severity or duration of COVID-19.”

"A recent study by other researchers reports that the lung cells of men have more TMPRSS2 and that TMPRSS2 levels are greater in older individuals compared with younger people."

 

[pickapeck]

Something to think about, if you do get covid-19. Might want to adjust what you're taking. 10,000 more men have died in the US from this, as compared to women.

Lowering Testosterone May Reduce Severity of COVID-19

Lowering testosterone may prevent the new coronavirus from entering lung cells and lessen COVID-19 severity, new Columbia University research suggests. A trial has now begun in three VA hospitals.

www.cuimc.columbia.edu

"The new coronavirus cannot enter cells without the help of the TMPRSS2 proteins on our lung cells,” Goldstein says. “Our analysis suggests that decreasing testosterone will lower TMPRSS2, interfere with viral entry, and reduce the severity or duration of COVID-19.”

"A recent study by other researchers reports that the lung cells of men have more TMPRSS2 and that TMPRSS2 levels are greater in older individuals compared with younger people."

Interesting article. I haven't dug through the earlier paper but this could be either the S1/S2 cleavage protease or maybe mnore likely the one that cleaves the furin domain and increases affinity for ACEII. This virus also has other receptors such as CD147, DC-SIGN, L-SIGN and probably others. This thing has the keys to the kingdom so to speak.