So, does that make it untrue? Or affect the $1.2 million that the head of Novartis paid Michael Cohen for access to Trump?
So, does that make it untrue? Or affect the $1.2 million that the head of Novartis paid Michael Cohen for access to Trump?
I am not trying to highjack the thread. I sincerely appreciate MF123 for providing frontline updates and also for what all our medical providers have done and are doing to care for us, our friends and our family.
Once this is over, I am quite positive that there will be numerous hearings and studies on what should have been done and when so we can be better prepared next time.
But, I believe the original article to be a NY Times hit piece where they are trying to politicize something that should not be political.
Trump may be completely wrong about the effectiveness of this drug, but I don't think he is bringing it up in the hope that out of the millions or perhaps billions of $ he has invested that one of his Trusts increases in value by $5000.
I think, of course I don't know this for a fact so don't ask me for a Link
, Trump is "hopeful" that is may prove to be a benefit to people that may otherwise die. What if it turns out to be proven that this drug helps some % patients? IMHO, whether to try it (or anything else for that matter) or not is a decision that should be left up to the Patient and their DR.
https://abc7.com/coronavirus-drug-covid-19-malaria-hydroxychloroquine/6079864/
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That's a great question. My response is not a political one in any way, but I know that in a situation like this the ONLY opinions I care about are the ones coming from the medical doctors. That is my stance whether the person in office is a republican or a democrat, man, woman, etc. Anyone other than that has an agenda IMO.
Oh man, the way you tear that paper up is beautiful. There’s plenty of journals that are publishing garbage papers without legitimate vesting, and uninformed readers can be fooled. There is a lot more bad interpretation of data than there is bad research.
Appreciate everything you are doing man but randomized double blind trials are for another day and I'd say there is zero chance we use enough Plaquenil in our efforts regarding Covid 19 to put any lupus patient at risk. It would be interesting to know though if those taking Plaquenil for another reason are protected in any way from Covid.
I do agree that we really have no data driven idea if this drug is effective at all at this point.
A
anon_yqoaxol227dby
Guest
None of the current studies provide good evidence supporting its use for COVID. Enrollment for randomized trials are happening now, so not sure what you mean by “for another day”.
the study you should suggest brings about a whole set of issues
I think your last sentence is spot on. Just not enough data to determine the effectiveness yet.
Dr. Daniel Wallace at Cedar Sinai hospital in Los Angeles has some interesting comments about Plaquenil and its effectiveness. He just talked about how safe the Drug is when used correctly and he's used it for over 40+ years and is a Lupus expert.
Evidently he is treating alot of Covid 19 patients with it.
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anon_yqoaxol227dby
Guest
he’s a rheumatologist. Why’s he treating COVID patients
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If everyone used the same electronic health record system it would be really great right now. With the click of a button you could see how many people have tested positive, died, etc... that are already taking the meds for other issues. You could also see the same instantly for the ones that have received it for the virus.
Agree on the lack of evidence and count me out of the study if I'm on deaths door from Covid. I was merely asking wouldn't it be interesting if folks on Plaquenil were protected in some way from Covid.
A
anon_yqoaxol227dby
Guest
they’re enrolling for that trial right now. You have to have had exposure to someone with COVID within 3 days, I think
His statement was he's treating 2,000 patients now but not sure if that meant Lupus patients or Covid patients in L.A?
A
anon_yqoaxol227dby
Guest
i really can’t see a rheumatologist treating 2,000 COVID patients. I have a lot of respect for rheumatologists, but it just doesn’t make sense, and frankly it wouldn’t be appropriate.
Confident he’s referring to lupus patients
yes, this ordeal is exposing several glaring blind spots the current system has.
I do think there is some percentage of hospital EMRs that report data to the cdc.
Question I ask myself as I head to the hospital to intubate a Covid/PUI patient- should I have gotten some Plaquenil to go with the Zpack in the medicine cabinet haha?
Appreciate all you have been doing and will do.
Thoughts on the new info coming out about the killing mechanism for COVID being basically attack the heme group on a red blood cell and dissociate the iron ion rendering the cell unable to bind and carry O2?
My wife,who suffers from lupus, has taken these drugs for years with little to no side affects. There, of course is no cure for lupus, but the anti-malaria drug has definitely helped her deal with the problems associated with lupus.
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anon_yqoaxol227dby
Guest
link?
curious , how would it dissociate the iron ion? Is the iron converted from ferrous to ferric ? I guess that would be like Methemoglobinemia, which would be a pretty straightforward fix
https://chemrxiv.org/articles/COVID...e_Metabolism_by_Binding_to_Porphyrin/11938173
Let me be clear here. I’m not a doctor. I just find this interesting. I don’t know if this is accurate, a strong source, etc. I’m asking/deferring to the experts on the board for opinions. Really have no desire to dissect the politics involved.
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anon_yqoaxol227dby
Guest
I skimmed the abstract. It’s a thought. It doesn’t explain other things like myocarditis , acute renal failure, etc
A
anon_yqoaxol227dby
Guest
Plaquenil is indicated for discoid lupus and lupus nephritis. It’s been shown to be effective in situations in multiple double blind randomized controlled trials
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What % of COVID+ patients that are intubated or even just admitted are diagnosed with ARDS?
He apparently has a small stake in Sanofi through a diversified fund he has an investment in. Not a big deal.
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It is also good to remember that Doctors take the Hippocratic Oath becoming an MD. A tenet is "do no harm."
That puts them in a very tough spot with off-label medications without good testing.
They are damned if they do and damned if they don't.
That puts them in a very tough spot with off-label medications without good testing.
They are damned if they do and damned if they don't.
And, there are more than 220 million cases of malaria per year. The number of COVID-19 cases currently reported worldwide is roughly .5% of that number.
Yep.
During a Pandemic, I am not one to favor listening to someone spout groupthink where folks that issue an opinion are doing so mostly based on a learned behavior during “normal” times to say what they say- until a double blind 3-phase clinical trial and FDA politics play out. Screw that.
In this case, the data that does exist would make one lean toward it being most helpful in the early stages, not as a last resort. Some say it saved thier life...who knows.
if I get the damn virus, I will take it. It should be a tool in the toolbox for now. We will get better ones soon.
If you disagree fine. But shut up.
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anon_yqoaxol227dby
Guest
there is no data that it helps in “early stages” or ANY stage
and clinical trial is how people get free drugs, by the way. You enroll a patient in a trial involving Kaletra, and Novartis or whoever gives the patient and the hospital free drugs.
this isn’t a trial where a NEW drug is being created. They are just giving people the drug and then a high end statistical analysis will be made later. Enrolling people in trials is how they get access to these drugs to begin with. How do you all think that patients get medications which haven’t even been approved ? It goes through insurance ?? Of course not
People don’t really get this
Here is the most recent update from my doc, who is a close friend.
Hydroxychloroquine + Azithromycin appears to be working... although this is a small sample size and It is acknowledged this regimen has not been put through the rigor required for large scale adoption.
The key is early diagnosis and getting on meds quickly. Note symptoms common among those who have tested positive below.
———
I want to update you on our office’s work related to Covid-19 during the week of March 25 through April 3:
• My office has tested 9 additional patients for Covid-19. That brings the total patients tested to 36.
• Those tests have been administered at my office with no physical contact between my staff and patients.
• We have had a total of 15 positive Covid-19 test results.
• All positive Covid-19 patients have been treated with Hydroxychloroquine (Plaquenil) and Azithromycin. We have seen great results when using this combination of drugs to treat Covid-19.
• I have had no hospitalizations.
• The patients I have tested are from all over San Antonio, not just 78209.
• The positive test results from this week (9) have been through community spread, not travel related.
The symptoms of infection for Covid-19 that I have observed remain the same: high fever (over 101.0), fast onset, body aches, and cough. I have continued to test people with other symptoms, such as loss of smell, gastrointestinal issues, nausea, vomiting, diarrhea, and low grade fever, but I am not seeing positive results with those symptoms.
———
Hope this adds to the conversation in a positive way. Appreciate @MF123 and the entire medical community who is on the front lines of this.
Hydroxychloroquine + Azithromycin appears to be working... although this is a small sample size and It is acknowledged this regimen has not been put through the rigor required for large scale adoption.
The key is early diagnosis and getting on meds quickly. Note symptoms common among those who have tested positive below.
———
I want to update you on our office’s work related to Covid-19 during the week of March 25 through April 3:
• My office has tested 9 additional patients for Covid-19. That brings the total patients tested to 36.
• Those tests have been administered at my office with no physical contact between my staff and patients.
• We have had a total of 15 positive Covid-19 test results.
• All positive Covid-19 patients have been treated with Hydroxychloroquine (Plaquenil) and Azithromycin. We have seen great results when using this combination of drugs to treat Covid-19.
• I have had no hospitalizations.
• The patients I have tested are from all over San Antonio, not just 78209.
• The positive test results from this week (9) have been through community spread, not travel related.
The symptoms of infection for Covid-19 that I have observed remain the same: high fever (over 101.0), fast onset, body aches, and cough. I have continued to test people with other symptoms, such as loss of smell, gastrointestinal issues, nausea, vomiting, diarrhea, and low grade fever, but I am not seeing positive results with those symptoms.
———
Hope this adds to the conversation in a positive way. Appreciate @MF123 and the entire medical community who is on the front lines of this.
A
anon_yqoaxol227dby
Guest
When People say there’s small evidence to benefit of this drug, what studies are they referring to? Its like this thing gets perpetuated and nobody can cite the paper they are leaning on
At this point it’s anecdotal. I think the French doc was working on a paper. Haven’t seen a formal paper yet. But, we’re in unchartered waters and have been for several weeks. Keep in mind I’m asking this as a biology major turned financial analyst/advisor (read: I know slightly more than nothing), but if the downside risk is limited and there is a decent body of anecdotal evidence from other doctors treating a novel disease in heavily impacted areas for which there is no cure, does the potential for success outweigh the potential downside?
I was referring to the small sample size (which I thought spoke to the absence of studies— assuming you are talking about the double blind standard)
And, I’m also saying this is coming from one of the top docs in Texas who has had 15 positive tests with 0 hospitalizations.
Not claiming statistical significance, but a useful data point IMO.
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anon_yqoaxol227dby
Guest
That study was an absolute joke. It’s not even worth mentioning. It’s dubious at best - don’t know how anyone cane come to any conclusion from that French paper
There’s actually been a ton of good news. Most places are way over prepared. By May most of America should open business with rules. By June, even New York and New Orleans should be open. I don’t see this hitting what H1N1 did or most flu seasons.
With the testing lag, is your doctor friend starting treatments on a patient with these drugs if they’re exhibiting the major symptoms? Or do they have faster test result turnaround?
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anon_yqoaxol227dby
Guest
hey Earle , around 12,000 people died in the USA from H1N1 over a 12 month span. Deaths related to covid in this country has already surpassed that mark
I believe it starts with a faster test result turn around. I think that’s true because you need a positive test to be able to prescribe that regimen.
From an earlier email:
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The Texas Pharmacy Board has shut down the ability to preemptively prescribe this medication, unless you have a positive test result of Covid-19. To reiterate, if anyone we test is positive, this office has medication for you.
My experience thus far in treating 8 patients has shown me that hydochloroquine and azithromycin work in treating early to moderate stages of Covid-19. The earlier the patient begins treatment, the better. I have observed that this combination of medication can make the patient feel better in less than 24 hours. As much as I believe in this combination of drugs to treat Covid-19, I am aware that there are several physicians locally and nationally, who disagree. Nothing is without controversy.
There are medications that are known to interact with hydroxychloroquine, which could make it dangerous for you to take this combination of drugs. There is also a medical condition (Prolonged QT), which is an electrical abnormality of the heart that would make it dangerous for a patient to take this combination of drugs. Some medications that are known to interact badly with this combination are: amiodarone, dronedarone, escitalopram (Lexapro), and sotalol. This is not a complete list, but rest assured that if you test positive for Covid-19 and we need to treat you, we will take all due precautions when prescribing new medications. There is a website, Drugs.com, that allows you to input your medications list and hydroxychloroquine to see if there are interactions.
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