First – reminder that every April 1 I do my annual April Fool’s post. It usually catches a few folks…you’ve been warned!
Now, a few things of note that crossed my virtual desk.
Chloroquine as a treatment for COVID-19
You may have seen President Trump talking about a malaria medication…
Two news items hit this morning, one noting that a patient just died after taking a version of the chemical.
A very small study found outcomes for patients that took chloroquine were not different than outcomes for patients that received a placebo. Out of 30 patients, 15 patients got the malaria drug and 13 tested negative for the coronavirus after a week of treatment. 15 patients didn’t get hydroxychloroquine; 14 tested negative for the virus.
Last week the drug was touted extensively on Fox and the Glenn Beck Show, with that “science” based on an unpublished paper describing what happened to a handful of patients treated with the medication.
Read the link if you want to understand why the “science” was crap and the “conclusions” total bullshit.
Takeaway – this drug can be very dangerous, is far from proven effective, and current studies are too small and have other limitations that make it impossible to draw any firm conclusions regarding its efficacy and dangers.
US Infection trend
As of 9:35 am eastern March 25, there are 55,238 confirmed cases in the US and 802 COVID-19 related deaths. Caveat – the number of cases is almost certainly significantly higher (not enough tests available) as is the actual number of deaths.
Takeaway – we are nowhere near the peak of this pandemic…here in New York we have over 25,000 confirmed cases…3 in our town of 4,800 people.
Conferences
are pretty much not going to happen. NCCI’s annual confab will go virtual; more details on the free web-based event here. The date is May 12, 2020, and it kicks off at 1 pm ET.
Work-at-Home
Briotix Health has developed a free app to help we work-at-home folks prevent injuries and other nasty stuff. Info is here.
A link to the Virtual Office is here.
Hi Joe,
It is for sure a scary time and there is a lot of false information out there. I do take issue with a couple of your points in your post today.
1. President Trump did not suggest people should take aquarium cleaner. That is precisely what this man took. https://www.washingtonpost.com/nation/2020/03/24/coronavirus-chloroquine-poisoning-death/
President Trump is suggesting that there are some promising results with the combination of hydroxycloroquine and azithromyocin. He’s correct. Trump isn’t just saying that but many U.S. medical physicians are suggesting it may work as well. No one is saying it is proven but there are reports around the world, including the U.S., that there are some promising results. https://www.wsj.com/articles/these-drugs-are-helping-our-coronavirus-patients-11584899438?fbclid=IwAR1G333VVPPp7ZrT1J08kT3XfevDTfw3RLQ8Hx9QB6EKuWHm8mikh8qcDwY
Additional studies are underway now.
2. Hydroxycloroquine has been used for almost 70 years and has a well known safety profile. Certainly it needs to be prescribed under the supervision of a physician.
3. Physicians prescribe medications all the time for off label use. That is exactly what many physicians are doing now when faced with little options for severe patients diagnosed with COVID-19. Do you think that is unreasonable considering it’s relative safety profile?
If someone I loved was faced with the choice between death or hydroxycloroquine, I would hope they would take it as prescribed by a physician.
I have been reading peer-reviewed scientific literature for over 25 years and I certainly understand the need for RCTs to establish efficacy, but in a time of crisis and considering the low risk of taking the medication, what do you have to lose? This should be left to practicing physicians and patients to make those decisions. Don’t you agree?
Best Regards,
Darrell Bruga
Hello Darrell
always good to hear from you.
Allow me to respond.
I disagree with the premise of your 1. above; you are making a strawman argument.
The couple that took hydroxychloroquine – which was precisely what they took – read the label, saw the drug name on the label, and took it because they listened to, and believed, their President’s statement about hydroxychloroquine. He said – as I posted – “if things don’t go as planned it’s not going to kill you”. Well, it did.
2. What “promising results” are you referring to? The Raoult study?
The study had very few participants, was not peer reviewed, was not replicated, Stanford and UAB have disassociated themselves from the study, the initial testing for the viral load was wildly inconsistent across the two groups, 4 of the chloroquine group showed negative viral loads on day 0 (i.e. probably weren’t infected to start with), there was no consistent testing of viral load of the patients during the study (so how could one draw the conclusions they did re the drug’s effectiveness?), and 6 patients from the chloroquine group – which mind you was tiny to begin with – were ultimately excluded because 1 died, 3 were transferred to the ICU, 2 left the facility, and 1 stopped due to nausea.
The second study which I referenced was inconclusive due to its very small size and the fact that there was no difference in outcomes for control vs drug-taking patients.
3. This drug also has a well-known danger profile. A modest overdose can be fatal, and use of recommended dosage can lead to severe cardiac arrhythmia, loss of vision, severe headaches, and a plethora of other ill effects. As Dr Fauci has noted, we just do not know if it is effective.
Physicians prescribed opioids off-label, and look where that got us. I’m surprised that you would be so cavalier about a drug that has numerous dangerous side effects when there is no credible evidence it is efficacious.
I have been reading peer-reviewed literature for 35 years, and understand the need for all of us to understand what is junk science and what is not. There is NO “research” backing this medication’s efficacy for COVID-19. The purported “research” – for the reasons outlined above – barely achieves the level of anecdote.
Frankly the guy that died was a moron. He took fish bowl cleaner. That’s not a strawman argument. He literally self medicated because he saw the ingredient on his fish bowl cleaner. No one recommend people self-medicate, including Trump. Trump was clearly talking about promising anecdotal medications utilized in medical care.
I’m not referring to any study but rather anecdotal reports from physicians. As you know, in many instances, this is how science works. Doctors try something, see some results and then move to scientific study. Studies are going on now.
I’m certainly not saying it’s proven but if I was on my death bed, I’m not waiting for an RCT. Some might but most wouldn’t with informed consent and prescribed by a physician.
Regarding safety, Dr. Fauci also said we know a lot about it’s safety profile and that’s it’s relatively safe. He did say the reports are anecdotal and needs to be studied. Again, people always need to consult their physician.
The plasma intervention may also be promising. We will all get through this. Frankly I think the virus has been here in the U.S. for some time.
Best regards,
Darrell
Darrell – sorry, we will have to agree to disagree. The couple who took the drug did so because their President told them it was safe. He took that cleaner because it was labeled with the drug’s name. Moreover, contrary to Trump’s claim, the actual drug HAS killed people – as abundantly documented in a variety of clinical trials.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3760572/
These anecdotal reports are just that, and are NOT evidence that anyone should be taking this drug, especially given the very real side effects which can be found in many of the sources here.
https://www.webmd.com/drugs/2/drug-8633/chloroquine-oral/details
Re your statement that Dr Fauci said the drug is “relatively safe.” Could not locate that, can you provide a citation please? I did find this, quoting Dr Fauci (source below); “what we don’t know, is when you put it in the context of another disease, whether it’s safe.”
https://theintercept.com/2020/03/20/trump-disagrees-top-immunologist-untested-drug-treatment-covid-19/
Also, this
“I think it probably is going to be safe, but I like to prove things first,” Fauci added. “It’s the hope that it will work, versus proving that it will work.”When asked if the drug was promising Friday, Fauci, standing next to Trump, said “the answer is no” because “the evidence you’re talking about … is anecdotal evidence.”
https://abcnews.go.com/Politics/fauci-throws-cold-water-trumps-declaration-malaria-drug/story?id=69716324
We definitely disagree. We are not likely to convince one another :) Dr. Fauci’s comment was during one of the press conferences. Be Well!
Respectfully,
Darrell Bruga
best of health to you and yours Darrell