Thanks again for your articles and podcasts on Covid-19! It’s getting harder & harder to find decent, non-politicized, non-hysterical coverage of this virus. You also manage to demystify a lot of stuff for the lay person. Great, necessary work!
With respect to HCQ, I also read that it was only useful if used early (as you said) but also best if used in combination with zinc & an antibiotic like azithromycin (sp?). Here’s a quote:
“Studies and medical reports from various countries in Asia and the West recommend a combination protocol of zinc (which inhibits the RNA replication of coronaviruses), the antimalarial agent HCQ (which promotes the cellular uptake of zinc and has other anti-viral properties), and, if necessary, an antibiotic (to prevent bacterial superinfections) and a blood thinner (to prevent thrombosis and lung embolism).
Yale professor and physician Harvey A. Risch argues in a recent commentary that early treatment with HCQ and zinc as well as an antibiotic has proven to be “highly effective”. In the USA alone, according to Professor Risch, 70,000 to 100,000 deaths could have been prevented by the systematic use of HCQ. Risch is therefore calling for an immediate and prescription-free release of this medication, as is already the case in many other countries.” https://swprs.org/a-swiss-doctor-on-covid-19/#latest
I don’t begin to know anything about it, but the interesting thng is that HCQ is cheap. So probably not so interesting to those who want to make money off the treatment. just sayin.
As to college football, very interesting. I’m not a fan but college basketball, yeah. Wonder what the winter holds for that….
First, that assumes that the 165,000 deaths number is close to correct. Please see earlier posts on “died with” versus “died of” COVID. My personal belief is that the iFR is likely somewhere less than 1 in 200. US population multiplied by that number is 1.6M. 10% of that is 160,000K. That would mean that either the IFR is lower than 1 in 200 or that we are miscounting COVID deaths.
Thanks. 1 in 200 (0.5%) is in line with my belief (for what it’s worth). It appeared to me that you were getting behind the 0.05 to .1% IFR based on the Mumbai data which again looked low by about 5x.
Undercounting versus over counting is debatable. The CDC and Journal of American Medical Association have published studies regarding excess deaths. Five years of data for deaths due to all causes where the statistcal upper bounds for expectations were exceeded lining up in time with Covid. For at least the early months it seems unlikely to me that can all be explained away because people were deferring their medical care.
The issue is that the scale of the early death “undercount” would be quickly swamped by the scale of COVID “overcount” in mid to late pandemic. Meaning the number of total deaths in Jan-March would be far less than the number of deaths from April-August or the end of the year.
Open letter to Fauci regarding the use of Hydroxychloroquine for treating Covid-19
As experience accrued in treating COVID-19 infections, physicians worldwide discovered that high-risk patients can be treated successfully as an outpatient, within the first five to seven days of the onset of symptoms, with a “cocktail” consisting of hydroxychloroquine, zinc, and azithromycin (or doxycycline). Multiple scholarly contributions to the literature detail the efficacy of the hydroxychloroquine-based combination treatment. There is unequivocal evidence for the early and safe use of the “HCQ cocktail.” If there are Q-T interval concerns, doxycycline can be substituted for azithromycin as it has activity against RNA viruses without any cardiac effects. Those of us who prescribe hydroxychloroquine, zinc, and azithromycin/doxycycline believe fervently that early outpatient use would save tens of thousands of lives and enable our country to dramatically alter the response to COVID-19.
You (Fauci) are well aware that there were no randomized clinical trials in the case of penicillin that saved thousands of lives in World War II. Is it not misleading for you (Fauci) to repeatedly state to the American public that randomized clinical trials are the sole source of information to confirm the efficacy of a treatment?
The FDA statement regarding hydroxychloroquine and cardiac risk is patently false and alarmingly misleading to physicians, pharmacists, patients, and other health professionals. The benefits of the early use of hydroxychloroquine to prevent hospitalization in high-risk patients with COVID-19 infection far outweigh the risks. Physicians are not able to obtain the medication for their patients, and in some cases are restricted by their state from prescribing hydroxychloroquine. The government’s obstruction of the early treatment of symptomatic high-risk COVID-19 patients with hydroxychloroquine, a medication used extensively and safely for so long, is unprecedented.
It is essential that you (Fauci) tell the truth to the American public regarding the safety and efficacy of the hydroxychloroquine/HCQ cocktail. The government must protect and facilitate the sacred and revered physician-patient relationship by permitting physicians to treat their patients. Governmental obfuscation and obstruction are as lethal as cytokine storm.
Americans must not continue to die unnecessarily. Adults must resume employment and our youth return to school. Locking down America while awaiting an imperfect vaccine has done far more damage to Americans than the coronavirus. We are confident that thousands of lives would be saved with early treatment of high-risk individuals with a cocktail of hydroxychloroquine, zinc, and azithromycin. Americans must not live in fear. As Dr. Harvey Risch’s Newsweek article declares, “The key to defeating COVID-19 already exists. We need to start using it.”
I hope you make the time to go back and review your early posts on Covid-19. We are now ~6 months into this pandemic and over 760,000 people worldwide have died. Probably an undercount. This fall may be as ugly as people move back indoors. Most of your discussions have been about probabilities and railing against the media. This is not helpful as it may give some people a false sense of security. This is a nasty bug and we are just at the tip of the iceberg in understanding its long term effects on the body (heard about the ‘long-haulers’?). You seem to believe we should just keep wading into this virus, and figure it out as we go.
This will not last forever. Vaccines are coming. Patience is a virtue that I would expect a medical doctor would exhibit.
Lorie says
Thanks again for your articles and podcasts on Covid-19! It’s getting harder & harder to find decent, non-politicized, non-hysterical coverage of this virus. You also manage to demystify a lot of stuff for the lay person. Great, necessary work!
With respect to HCQ, I also read that it was only useful if used early (as you said) but also best if used in combination with zinc & an antibiotic like azithromycin (sp?). Here’s a quote:
“Studies and medical reports from various countries in Asia and the West recommend a combination protocol of zinc (which inhibits the RNA replication of coronaviruses), the antimalarial agent HCQ (which promotes the cellular uptake of zinc and has other anti-viral properties), and, if necessary, an antibiotic (to prevent bacterial superinfections) and a blood thinner (to prevent thrombosis and lung embolism).
Yale professor and physician Harvey A. Risch argues in a recent commentary that early treatment with HCQ and zinc as well as an antibiotic has proven to be “highly effective”. In the USA alone, according to Professor Risch, 70,000 to 100,000 deaths could have been prevented by the systematic use of HCQ. Risch is therefore calling for an immediate and prescription-free release of this medication, as is already the case in many other countries.” https://swprs.org/a-swiss-doctor-on-covid-19/#latest
I don’t begin to know anything about it, but the interesting thng is that HCQ is cheap. So probably not so interesting to those who want to make money off the treatment. just sayin.
As to college football, very interesting. I’m not a fan but college basketball, yeah. Wonder what the winter holds for that….
thanks again!
Peter says
Wouldn’t the US need to be at 50% infected for an IFR of 0.1% and 165,000 deaths? I’ve seen estimates of ~10% for the US having been infected.
Chris Centeno, MD says
First, that assumes that the 165,000 deaths number is close to correct. Please see earlier posts on “died with” versus “died of” COVID. My personal belief is that the iFR is likely somewhere less than 1 in 200. US population multiplied by that number is 1.6M. 10% of that is 160,000K. That would mean that either the IFR is lower than 1 in 200 or that we are miscounting COVID deaths.
Peter says
Thanks. 1 in 200 (0.5%) is in line with my belief (for what it’s worth). It appeared to me that you were getting behind the 0.05 to .1% IFR based on the Mumbai data which again looked low by about 5x.
Undercounting versus over counting is debatable. The CDC and Journal of American Medical Association have published studies regarding excess deaths. Five years of data for deaths due to all causes where the statistcal upper bounds for expectations were exceeded lining up in time with Covid. For at least the early months it seems unlikely to me that can all be explained away because people were deferring their medical care.
Chris Centeno, MD says
The issue is that the scale of the early death “undercount” would be quickly swamped by the scale of COVID “overcount” in mid to late pandemic. Meaning the number of total deaths in Jan-March would be far less than the number of deaths from April-August or the end of the year.
Sam says
Open letter to Fauci regarding the use of Hydroxychloroquine for treating Covid-19
As experience accrued in treating COVID-19 infections, physicians worldwide discovered that high-risk patients can be treated successfully as an outpatient, within the first five to seven days of the onset of symptoms, with a “cocktail” consisting of hydroxychloroquine, zinc, and azithromycin (or doxycycline). Multiple scholarly contributions to the literature detail the efficacy of the hydroxychloroquine-based combination treatment. There is unequivocal evidence for the early and safe use of the “HCQ cocktail.” If there are Q-T interval concerns, doxycycline can be substituted for azithromycin as it has activity against RNA viruses without any cardiac effects. Those of us who prescribe hydroxychloroquine, zinc, and azithromycin/doxycycline believe fervently that early outpatient use would save tens of thousands of lives and enable our country to dramatically alter the response to COVID-19.
You (Fauci) are well aware that there were no randomized clinical trials in the case of penicillin that saved thousands of lives in World War II. Is it not misleading for you (Fauci) to repeatedly state to the American public that randomized clinical trials are the sole source of information to confirm the efficacy of a treatment?
The FDA statement regarding hydroxychloroquine and cardiac risk is patently false and alarmingly misleading to physicians, pharmacists, patients, and other health professionals. The benefits of the early use of hydroxychloroquine to prevent hospitalization in high-risk patients with COVID-19 infection far outweigh the risks. Physicians are not able to obtain the medication for their patients, and in some cases are restricted by their state from prescribing hydroxychloroquine. The government’s obstruction of the early treatment of symptomatic high-risk COVID-19 patients with hydroxychloroquine, a medication used extensively and safely for so long, is unprecedented.
It is essential that you (Fauci) tell the truth to the American public regarding the safety and efficacy of the hydroxychloroquine/HCQ cocktail. The government must protect and facilitate the sacred and revered physician-patient relationship by permitting physicians to treat their patients. Governmental obfuscation and obstruction are as lethal as cytokine storm.
Americans must not continue to die unnecessarily. Adults must resume employment and our youth return to school. Locking down America while awaiting an imperfect vaccine has done far more damage to Americans than the coronavirus. We are confident that thousands of lives would be saved with early treatment of high-risk individuals with a cocktail of hydroxychloroquine, zinc, and azithromycin. Americans must not live in fear. As Dr. Harvey Risch’s Newsweek article declares, “The key to defeating COVID-19 already exists. We need to start using it.”
https://www.thedesertreview.com/opinion/columnists/open-letter-to-dr-anthony-fauci-regarding-the-use-of-hydroxychloroquine-for-treating-covid-19/article_31d37842-dd8f-11ea-80b5-bf80983bc072.html
Joy says
I hope you make the time to go back and review your early posts on Covid-19. We are now ~6 months into this pandemic and over 760,000 people worldwide have died. Probably an undercount. This fall may be as ugly as people move back indoors. Most of your discussions have been about probabilities and railing against the media. This is not helpful as it may give some people a false sense of security. This is a nasty bug and we are just at the tip of the iceberg in understanding its long term effects on the body (heard about the ‘long-haulers’?). You seem to believe we should just keep wading into this virus, and figure it out as we go.
This will not last forever. Vaccines are coming. Patience is a virtue that I would expect a medical doctor would exhibit.
Chris Centeno, MD says
Joy, you are stoking panic and not looking at the existing data. This blog is all about data first, without the panic.