A Dallas doctor on her experience treating covid-19 patients

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technovelist
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A Dallas doctor on her experience treating covid-19 patients

Post by technovelist » Tue May 19, 2020 10:34 am

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Re: A Dallas doctor on her experience treating covid-19 patients

Post by pp4me » Tue May 19, 2020 10:52 am

I have never seen anything like this controversy over hydroxychloroquine before. Go to foxnews, especially Laura Ingraham, and you will learn that it is being used effectively to treat Covid-19 all over the world and that it is a very safe drug that has been used for years to treat malaria, lupus, and rheumatoid arthritis. One doctor said he had written thousands of prescriptions over the years and had never once seen any serious side effects.

Then go to CNN or MSNBC and you will learn that it has been proven to be ineffective in treating Covid-19 and that is a drug with potentially dangerous side effects.

So go figure. Both can't possibly be true.

Personally, I think Foxnews is probably telling the truth and the rest of the media is gaslighting because that seems to generally be what happens (see the Russia Hoax, the Covington kids, etc.)

Stranger still, is that the FDA apparently came down on the side of the gaslighters.

The whole thing just feeds my mistrust of the practice of medicine in general.
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Re: A Dallas doctor on her experience treating covid-19 patients

Post by technovelist » Tue May 19, 2020 10:56 am

pp4me wrote:
Tue May 19, 2020 10:52 am
I have never seen anything like this controversy over hydroxychloroquine before. Go to foxnews, especially Laura Ingraham, and you will learn that it is being used effectively to treat Covid-19 all over the world and that it is a very safe drug that has been used for years to treat malaria, lupus, and rheumatoid arthritis. One doctor said he had written thousands of prescriptions over the years and had never once seen any serious side effects.

Then go to CNN or MSNBC and you will learn that it has been proven to be ineffective in treating Covid-19 and that is a drug with potentially dangerous side effects.

So go figure. Both can't possibly be true.

Personally, I think Foxnews is probably telling the truth and the rest of the media is gaslighting because that seems to generally be what happens (see the Russia Hoax, the Covington kids, etc.)

Stranger still, is that the FDA apparently came down on the side of the gaslighters.

The whole thing just feeds my mistrust of the practice of medicine in general.
Understandably, but I'm more mistrustful of the bureaucrats than I am of the actual medical practitioners themselves.
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Re: A Dallas doctor on her experience treating covid-19 patients

Post by Cortopassi » Tue May 19, 2020 12:19 pm

I don't know the history of hydroxychloroquine, so I would ask:

1) It is used commonly for malaria, or is there something more effective that is more widely used?
2) If it is used for malaria, for example, if I was traveling to a malaria prone region, would I be expected, or wise, to take it prior to going and while I was there?
3) If yes, would the dosage be the same as used in Covid?

If all these are yes, I assume millions of people are/have taken it before traveling to malaria prone places, so why the big deal on heart issues, and has that been clearly articulated if you actually took it for malaria?

I have looked at four difference medicine sites on hydroxychloroquine side effects, and only one lists "slow heartbeat" as a possible issue?

The negativity surrounding this drug is very puzzling.
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Re: A Dallas doctor on her experience treating covid-19 patients

Post by pp4me » Tue May 19, 2020 1:06 pm

Cortopassi wrote:
Tue May 19, 2020 12:19 pm
I don't know the history of hydroxychloroquine, so I would ask:

1) It is used commonly for malaria, or is there something more effective that is more widely used?
2) If it is used for malaria, for example, if I was traveling to a malaria prone region, would I be expected, or wise, to take it prior to going and while I was there?
3) If yes, would the dosage be the same as used in Covid?

If all these are yes, I assume millions of people are/have taken it before traveling to malaria prone places, so why the big deal on heart issues, and has that been clearly articulated if you actually took it for malaria?

I have looked at four difference medicine sites on hydroxychloroquine side effects, and only one lists "slow heartbeat" as a possible issue?

The negativity surrounding this drug is very puzzling.
Laura Ingraham said she has taken it herself before travelling to Africa on several occasions.

Not sure of the dosage but I believe one of the doctors on her show said that in the studies that proved it ineffective it was either too small of a dose or administered too late to do any good. Like all viral medications it needs to be administered as early as possible and that is now the big problem with the FDA saying it should only be used in a hospital setting.

Yes, the negativity is puzzling, to say the least.
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Re: A Dallas doctor on her experience treating covid-19 patients

Post by Tyler » Tue May 19, 2020 1:38 pm

Hydroxychloroquine has been around for decades, is a tier-1 generic option on virtually every insurance formulary, is an OTC medication in many countries, and is regularly used by all sorts of people with no issues. Any substance used incorrectly can harm you, and the verdict is still out on just how effective it is in treating COVID-19. But anyone claiming hydroxychloroquine is inherently dangerous and needs to be avoided even under medical supervision is lying to you. The only question is why.

Call it a conspiracy theory if you like, but it wouldn't surprise me at all if the over-the-top anti-hydroxychloroquine propaganda is at least partially a huge marketing blitz by big pharma. With the insane amount of potential profits on the table for anyone who can offer a patented treatment or vaccine, having a cheap generic that helps people is a real buzzkill for the guys thinking they could get rich off of this.
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Re: A Dallas doctor on her experience treating covid-19 patients

Post by sophie » Tue May 19, 2020 2:54 pm

Can I, as someone with a bit of relevant knowledge, offer some possibly useful information?

First, studies of hydroxychloroquine for COVID-19 are being conducted in multiple locations. You may recall that after I poked through the literature on it, I told you guys I doubted it would work out, but all the same I wholeheartedly supported doing studies based on that unsubstantiated report from China. The results are not promising. Here is a recent article, which I already posted elsewhere:

https://www.nejm.org/doi/full/10.1056/NEJMoa2012410

Since it's an observational study it's not conclusive proof that the drug doesn't help, but you can safely conclude from it that if there is a positive effect, it's not a big one.

Second, the concern about side effects of hydroxychloroquine in COVID-19 is about cardiac arrhythmias. Yes, the drug is usually pretty safe - when given to patients with conditions like rheumatoid arthritis. (It's not been used for malaria for many years now because the parasites are almost all chloroquine-resistant.) The problem with COVID-19 is that there is a high incidence of cardiomyopathy in severely affected cases - who are exactly the population who might be treated with this drug. So this population could be at higher risk than those who have previously used the drug. It's still a small number of cases so not clear just what the risk is yet, but it's certainly concerning.

The risk might be acceptable if the drug had a significant effect on the disease, but since it doesn't, the benefit/risk tradeoff is most definitely NOT GOOD. Let's put it this way: if my mom was in the ICU on a vent, I wouldn't want her treated with hydroxychloroquine. Remdesivir is a better option - that drug has been showing benefit in studies so far.

I really, really hate that the above medical information is being used as a political football by both sides. It should be about the facts. Leave your emotions and opinions out of it. Wishing that this drug works (or doesn't work) is not going to change anything.
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Re: A Dallas doctor on her experience treating covid-19 patients

Post by technovelist » Tue May 19, 2020 3:03 pm

sophie wrote:
Tue May 19, 2020 2:54 pm
Can I, as someone with a bit of relevant knowledge, offer some possibly useful information?

First, studies of hydroxychloroquine for COVID-19 are being conducted in multiple locations. You may recall that after I poked through the literature on it, I told you guys I doubted it would work out, but all the same I wholeheartedly supported doing studies based on that unsubstantiated report from China. The results are not promising. Here is a recent article, which I already posted elsewhere:

https://www.nejm.org/doi/full/10.1056/NEJMoa2012410

Since it's an observational study it's not conclusive proof that the drug doesn't help, but you can safely conclude from it that if there is a positive effect, it's not a big one.

Second, the concern about side effects of hydroxychloroquine in COVID-19 is about cardiac arrhythmias. Yes, the drug is usually pretty safe - when given to patients with conditions like rheumatoid arthritis. (It's not been used for malaria for many years now because the parasites are almost all chloroquine-resistant.) The problem with COVID-19 is that there is a high incidence of cardiomyopathy in severely affected cases - who are exactly the population who might be treated with this drug. So this population could be at higher risk than those who have previously used the drug. It's still a small number of cases so not clear just what the risk is yet, but it's certainly concerning.

The risk might be acceptable if the drug had a significant effect on the disease, but since it doesn't, the benefit/risk tradeoff is most definitely NOT GOOD. Let's put it this way: if my mom was in the ICU on a vent, I wouldn't want her treated with hydroxychloroquine. Remdesivir is a better option - that drug has been showing benefit in studies so far.

I really, really hate that the above medical information is being used as a political football by both sides. It should be about the facts. Leave your emotions and opinions out of it. Wishing that this drug works (or doesn't work) is not going to change anything.
I'd rather believe a doctor who says she has had remarkable success treating patients with it than believe observational studies.

Maybe that makes me an ignorant layperson, but I would find a doctor to prescribe it for me if I got the plague.
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Re: A Dallas doctor on her experience treating covid-19 patients

Post by pp4me » Tue May 19, 2020 5:02 pm

technovelist wrote:
Tue May 19, 2020 3:03 pm
sophie wrote:
Tue May 19, 2020 2:54 pm
Can I, as someone with a bit of relevant knowledge, offer some possibly useful information?

First, studies of hydroxychloroquine for COVID-19 are being conducted in multiple locations. You may recall that after I poked through the literature on it, I told you guys I doubted it would work out, but all the same I wholeheartedly supported doing studies based on that unsubstantiated report from China. The results are not promising. Here is a recent article, which I already posted elsewhere:

https://www.nejm.org/doi/full/10.1056/NEJMoa2012410

Since it's an observational study it's not conclusive proof that the drug doesn't help, but you can safely conclude from it that if there is a positive effect, it's not a big one.

Second, the concern about side effects of hydroxychloroquine in COVID-19 is about cardiac arrhythmias. Yes, the drug is usually pretty safe - when given to patients with conditions like rheumatoid arthritis. (It's not been used for malaria for many years now because the parasites are almost all chloroquine-resistant.) The problem with COVID-19 is that there is a high incidence of cardiomyopathy in severely affected cases - who are exactly the population who might be treated with this drug. So this population could be at higher risk than those who have previously used the drug. It's still a small number of cases so not clear just what the risk is yet, but it's certainly concerning.

The risk might be acceptable if the drug had a significant effect on the disease, but since it doesn't, the benefit/risk tradeoff is most definitely NOT GOOD. Let's put it this way: if my mom was in the ICU on a vent, I wouldn't want her treated with hydroxychloroquine. Remdesivir is a better option - that drug has been showing benefit in studies so far.

I really, really hate that the above medical information is being used as a political football by both sides. It should be about the facts. Leave your emotions and opinions out of it. Wishing that this drug works (or doesn't work) is not going to change anything.
I'd rather believe a doctor who says she has had remarkable success treating patients with it than believe observational studies.

Maybe that makes me an ignorant layperson, but I would find a doctor to prescribe it for me if I got the plague.
One of the regular doctors on Foxnews provided anecdotal evidence of his 90 some year old father's miracle cure from hydroxychloroquine and is obviously a firm believer. Another agrees with everything Sophie said. So once again, who to believe?

IMHO, even if it is only anecdotal evidence and the positive results can be attributed to the placebo effect, what is wrong with that? They can do a study later to prove the effectiveness of the placebo effect in dealing with pandemics.

I will ask for it if I get the virus and the symptoms get severe enough.

As for safety, it is less safe than the potential of liver damage from Tylenol?
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Re: A Dallas doctor on her experience treating covid-19 patients

Post by l82start » Tue May 19, 2020 7:03 pm

did something change when i wasn't looking? i thought that hydroxychloroquine was originally not a treatment in and of itself but was being used to boost zinc absorption. (which does help with viruses) ..
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Re: A Dallas doctor on her experience treating covid-19 patients

Post by technovelist » Tue May 19, 2020 7:07 pm

l82start wrote:
Tue May 19, 2020 7:03 pm
did something change when i wasn't looking? i thought that hydroxychloroquine was originally not a treatment in and of itself but was being used to boost zinc absorption. (which does help with viruses) ..
Hcq by itself does have antiviral properties in the test tube but the most commonly recommended combination is hcq, zinc, and azithromycin.
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