There's a nice diagram from Science that shows how Remdesivir and other potential anti-coronavirus drugs work: https://science.sciencemag.org/content/sci/368/6493/829/F1.l...
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E.g. June 23, 2020 "NIH: Trial Investigating Hydroxychloroquine for COVID-19 Stopped"
https://www.empr.com/home/news/hydroxychloroquine-trial-halt...
17 June 2020 "“Solidarity” clinical trial"
https://www.who.int/emergencies/diseases/novel-coronavirus-2...
"hydroxychloroquine does not result in the reduction of mortality of hospitalised COVID-19 patients, when compared with standard of care."
And before, Jun. 9, 2020: "Three big studies dim hopes that hydroxychloroquine can treat or prevent COVID-19":
https://www.sciencemag.org/news/2020/06/three-big-studies-di...
"AAPS files with the court a chart showing how countries that encourage HCQ use, such as South Korea, India, Turkey, Russia, and Israel, have been far more successful in combatting COVID-19 than countries that have banned or discouraged early HCQ use, as the FDA has."
However: that chart is totally misleading, it's a typical "non sequitur". "Case fatality rate" is just a ratio "death" through "cases". Where those with weaker symptoms are recognized as "cases" the rate is lower. How they are recognized is not the same across different countries.
Note, you seem to be posting studies that did not pair HCQ with zinc, _and_ are not using it prophylactically. Is my understanding correct?
For example: https://www.sciencemag.org/news/2020/06/three-big-studies-di... links to https://www.recoverytrial.net/files/hcq-recovery-statement-0... which does not mention zinc, and it's patients admitted to the hospital (not prophylactic). Digging further, to the source given in that pdf, not a mention of zinc: https://www.recoverytrial.net/@@search?SearchableText=zinc which is the whole point of using HCQ in the first place.
I'm just posting studies that were the basis for what FDA decided June 15, 2020 (1):
"FDA has revoked the emergency use authorization (EUA) to use hydroxychloroquine and chloroquine to treat COVID-19 in certain hospitalized patients when a clinical trial is unavailable or participation is not feasible. We made this determination based on recent results from a large, randomized clinical trial in hospitalized patients that found these medicines showed no benefit for decreasing the likelihood of death or speeding recovery."
And I don't have more information than that.
1) https://www.fda.gov/drugs/drug-safety-and-availability/fda-c...
From Wikipedia:
"The Association of American Physicians and Surgeons (AAPS) is a conservative non-profit association founded in 1943. The group was reported to have about 5,000 members in 2014. The association has promoted a range of scientifically discredited hypotheses, including the belief that HIV does not cause AIDS, that being gay reduces life expectancy, that there is a link between abortion and breast cancer, and that there is a causal relationship between vaccines and autism. It is opposed to the Affordable Care Act and other forms of universal health insurance."
https://en.wikipedia.org/wiki/Association_of_American_Physic...
Thus, HCQ without Zinc is like using a bucket but forgetting the water to stop the fire. Just throwing buckets at the fire isn’t gonna work much when there’s no water in the bucket.
Have a look at this [1] studies that shows around a 9% less mortality when treated with Zinc and a even more when treated EARLY with HCQ PLUS Zinc. (Please take a look at the numbers in the last table, it’s very clear that HCQ + Zinc reduces mortality)
[1]: https://www.medrxiv.org/content/10.1101/2020.05.02.20080036v...
https://www.medrxiv.org/content/10.1101/2020.05.02.20080036v...
https://www.biorxiv.org/content/10.1101/2020.06.22.164665v1....
This was then picked up by a crowd of "right wing deplorables" up to and including the orange man in the white house.
The scientific establishment can not allow this bunch of clowns to turn out right, thus further inquiry is being suppressed.
Call it a conspiracy theory, but that's exactly how human egos have played a role in the history of science.
"This was an observational retrospective analysis that could be impacted by confounding variables"; "We also do not have data on the time at which the patients included in the study initiated therapy with hydroxychloroquine, azithromycin, and zinc." "The cohorts were identified based on medications ordered rather than confirmed administration, which may bias findings towards favoring equipoise between the two groups." "In light of these limitations, this study should not be used to guide clinical practice."
230 studies looking at Hydroxychloroquine [1]
Only 10 studies looking into HCQ and Zinc [2]
[1]:https://clinicaltrials.gov/ct2/results?cond=Covid-19&term=hy...
[2]:https://clinicaltrials.gov/ct2/results?cond=Covid-19&term=hy...
"The [steroid] drugs suppress the immune system, which could provide some relief for patients whose lungs are ravaged by an overactive immune response that sometimes manifests in severe cases of COVID-19. But such patients may still need a fully functioning immune system to fend off the virus itself."
"no effect on mild infections"
Basically if taken too early it does the wrong action, but it helps some of those already on oxygen. And it's cheap.
I get incredibly annoyed when people act like (a) these strokes / organ damage are happening in significant quantities and (b) that it’s unique to SARS-2
Is it? From all lab confirmed cases in USA until end of May, almost every 200th in age group 20-29 was admitted to ICU. Almost every 100th in age group 30-39. (1)
Admitted to ICU means "probably considered intubation (or received it immediately)" Which is very, very unpleasant thing:
https://en.wikipedia.org/wiki/Tracheal_intubation
Is that "extremely rare" to you?
(In the USA there are 7.2% inhabitants aged 20-29, 6.7% aged 30-39. Even if the number of "unconfirmed but infected" is 10 times higher, that still gives around 24000 people in the USA aged 20-39 needing ICU, or 8 times more than died on 9/11. And those are just provably "non-elderly". All those 40 and older would need even much more ICU beds. I hope it's obvious that if there are not enough ICU beds much more people would die.)
1) It can be calculated from https://www.cdc.gov/mmwr/volumes/69/wr/mm6924e2.htm For 20-29 182469 confirmed, 864 ICU, for 30-39 214849 confirmed, 1879 ICU. (Additionally, males were admitted to ICU almost twice as much as females)
Once again, dexamethasone has to be given to 8 intubated people to save one, and that's considered the drug with the most visible effect in fighting Covid-19 up to now -- i.e. the most successful drug up to now! You can imagine how little effect other drugs produced in the verified trials.
In that context, talking about ICU and intubated is exactly on topic, hand-waving "strokes" isn't.
Moreover, the comment actually said "strokes / organ damage" not "strokes." Nevertheless, the main effect of dexamethasone is on the intubated patients.
- Strokes (and organ damage) are the result of cytokine storms
- Strokes (and organ damage) in COVID-19 are "extremely rare"
That may be true or untrue, but you are not responding to those claims, you are responding to something else. I'm not even sure what that is, because nobody actually wrote it down.
And I claim that the number of patients that could be saved using dexamethasone even in the age groups 20-39, if they get infected, is nothing "extremely rare" among "non-elderly": only before end of May, surely more than 100 US patients aged 20-39 could have been saved. If "non-elderly" means "still working" the number is even much higher.
The comment is about what causes strokes: Is it the virus itself, or the cytokine storm? If it is the virus itself, that would be rather unique. The comment argues that it is the cytokine storm.
This is relevant because there is a hypothesis that COVID-19 is uniquely dangerous because the virus itself directly attacks organs and causes strokes.
Furthermore, if Dexamethasone helps with the cytokine storms and the cytokine storms cause strokes/organ damage, it only follows that it also helps with the strokes/organ damage.
Therefore, nothing in the comment suggests that Dexamethasone wouldn't help patients, regardless of age. To the contrary. You appear to be fighting windmills.
"cytokine release syndrome is highly likely to be causing the (extremely rare) instances of stroke in non-elderly"; "I get incredibly annoyed when people act like (a) these strokes / organ damage are happening in significant quantities"
in his comment replying to dexamethasone effects and I have shown that the "quantities" of those who are helped by dexamethasone are significant. I started by quoting his "extremely rare" and replying "Is it?" (as is "is that really extremely rare" because he is as he writes "incredibly annoyed" in his comment to dexamethasone effects) and showed the numbers.
And you haven't shown anything else.
Note that it was never about "strokes" alone, which was your original claim, but about dexamethasone. For him was "extremely rare": "stroke in non-elderly COVID-19 patients, organ damage, etc." Note the "etc." too. Only you and nobody else here reduced that to "strokes" alone in your first response. Let me state it again, I don't see your comments contributing anything here.
He said "strokes are extremely rare", you showed numbers on ICU admissions. Those are obviously two very different things.
> Note that it was never about "strokes" alone, which was your original claim, but about dexamethasone.
The words "extremely rare" only appear in conjunction with strokes. The word "organ damage" also appears later, as "not significant quantities", which is still different. Dexamethasone does not appear in the comment at all.
I don't know where to go from here. This seems to be the hill you want to die on. May you rest in peace.
...at least that's what the clinical updated from the NYC doctors group is reporting on TWIV podcast each week.