Hydroxychloroquine (HCQ) is a known antimalarial drug with antiviral and anti-inflammatory properties. It is the less toxic brother of Chloroquine (CQ). It is commonly used as a prophylactic or preventative, starting before one goes into a malaria region, or immediately after malaria infection as an early treatment. HCQ is very safe when used as prescribed and it is a cheap drug which is widely available. It is also used as a medicine for treating autoimmune diseases like rheumatism. HCQ and CQ were also repurposed in relation to SARS-CoV and MERS-CoV. In 2005 CQ was shown to bea potent inhibitor of SARS coronavirus infection and spread. HCQ has been used all over the world since the beginning of the COVID-19 crisis. It is not intended to be a cure for COVID-19 as many opponents wrongfully claim, but it has been shown to be effective in reducing symptoms of COVID-19 when used in an early stage of the infection and in low doses, usually in combination with zinc, as will be shown later on. Since its effective use HCQ has become a highly politicized topic and the media, especially the western media, are all over it in a very negative sense.
We believe that the two-phase division is very important: the first immune defense-based protective phase and the second inflammation-driven damaging phase. Doctors should try to boost immune responses during the first, while suppressing it in the second phase.
Boosting immune responses in patients in the early-stage or mild stage of infection is certainly the key to prevent progression to severe disease.
It is used at an early stage in low doses and only with patients without comorbidities, which could be complicated by hydroxychloroquine.
Hydroxychloroquine is obviously not a panacea for severe cases of Covid-19. Given early, it helps reduce mortality by about half, compared to those not given the drug. It should be noted that conditions apply.
Although these drugs also have anti-inflammatory effects, the antiviral mechanisms take place at viral entry or early in replication, and indicate that the earlier CQ/HCQ are used in the course of COVID-19 infection, the more likely they could have a clinically useful effect.
HCQ should be used as preventative or early treatment...
South Korea was hit hard by COVID-19 early in 2020 and Korean medical professionals recommended to use HCQ in the early stage of the infection * Apparently early treatment with HCQ made a difference in the amount of patients ending up in hospital beds and requiring intensive care. Early treatment was also already known from in vitro studies like those of for example Martin J Vincent et al, Manli Wang et al and Xueting Yao et al. From the beginning the recommendation is to use HCQ as a prophylactic or in the early stage of COVID-19 infection, immediately after infection. This is also how HCQ is used as antimalarial. HCQ works by obstructing the novel viral infection from developing into severe illness. It is being used as prophylactic by health care workers all over the world and that would never happen if HCQ had no effect whatsoever.
Exposure to chloroquine and hydroxychloroquine was reported in six and five cases of sudden death, respectively. In four of these cases, overdose was listed as the indication. ... Long-term use of chloroquine or hydroxychloroquine may cause myopathy, which may involve cardiac muscle. ... Reported deaths following chloroquine and hydroxychloroquine have been associated with use in overdose. ... There have been no reports of sudden unexplained death suggestive of cardiac arrhythmia at the doses used for malaria treatment.
Eligible participants were allocated to receive orally or via nasogastric tube high dose CQ (600mg CQ twice daily for 10 days or total dose 12g); or low dose CQ (450mg for 5 days, twice daily only on the first day, or total dose 2.7g). ... The high dosage CQ arm presented more QTc>500ms (18.9%), and a trend toward higher lethality (39%) than the lower dosage.
Although HCQ has had a substantial margin of safety, its use in critically sick patients like those with COVID-19 has caused several instances of serious cardiac events and deaths. These events are more likely to occur under three circumstances: a) with higher doses of the drug; b) with concomitant use of azithromycin, which potentiates the effect on QT interval; and c) in patients who have underlying co-morbid conditions...
The safety of CQ/HCQ is well established in malaria or autoimmune disease. However, some serious side effects (cardiotoxicity, retinopathy and neuromypathy) may occur with long-term usage of high doses or in overdose.
HCQ should be used in low doses...
In 2017 the World Health Organization itself published a peaper in which it warned for HCQ or CQ overdose because it was related to cardiac death because of QT prolongation. That same paper also implies that overdose is defined as a dose higher than is commonly prescribed for treating malaria. Common prescription for preventing malaria is 400mg/week starting two weeks prior to entering malaria region, each week on same day until 4 weeks after leaving malaria region. Prescription for treating malaria immediately after infection is 800mg as initial dose, then 400mg at 6 hr, 24 hr, and 48 hr after initial dose. On top of that, by April 2020 it was clearly mentioned in scientific literature that using high doses of HCQ on patients with comorbidities, like heart disease, and/or severe illness is very dangerous and can possibly even lead to death. This confirms its use as preventative or early treatment and it also means that these drugs should only be prescribed by medical professionals, which a lot of them succesfully did around the world. Later we will see that the high profile UK and WHO studies used a very high dose of HCQ or CQ on severely ill patients with comorbidities which basically amounts to intentional murder because the usage of this drug was widely known.
It turns out that zinc inhibits replicase’s activity. An obstacle to the action of zinc is the problem with the penetration of this element into the cell. What is needed here is a substance that causes the zinc to transfer from the external environment of the cell to its interior, where the virus potentially replicates. These substances are so-called ionophores, and their function is to transport ions through the cell membrane. Ionophores include hydroxychloroquine and chloroquine.
Metal ionophores [like HCQ] have been proven over the years to exert overt antiviral and anticancer properties especially when coupled with enough doses of metal ion additives [zinc] that will galvanize their functions in living tissues.
Chloroquine and hydroxychloroquine reduce the glycosylation of the ACE2 receptor and the viral penetration into the cell, due to the alcalisation of endocytic compartments—when not glycosylated, they will have lower affinity towards the viral spike proteins, which probably impedes the virus—receptor binding, resulting in the inhibition of the infection development
Zinc inhibits viral replicase when inside the cell. For zinc to enter into cells an ionophore is needed. HCQ is a zinc ionophore.
As zinc deficiency frequently occurs in elderly patients and in those with cardiovascular disease, chronic pulmonary disease, or diabetes, we hypothesize that CQ/HCQ plus zinc supplementation may be more effective in reducing COVID-19 morbidity and mortality than CQ or HCQ in monotherapy. Therefore, CQ/HCQ in combination with zinc should be considered as additional study arm for COVID-19 clinical trials.
A significant, relatively stable, but negative correlation of Zn-deficiency with cases per million for the time period (...) and a steady improvement of covariation with deaths per million (... on 26 May 2020) was observed.
Most of the risk groups described for COVID-19 are at the same time groups that were associated with zinc deficiency. ... Zinc deficiency can probably be added to the factors predisposing individuals to infection and detrimental progression of COVID-19. Finally, due to its direct antiviral properties, it can be assumed that zinc administration is beneficial for most of the population, especially those with suboptimal zinc status.
Patients with coronavirus disease 2019 (COVID-19) had significantly low zinc levels in comparison to healthy controls. Zinc deficient patients developed more complications (70.4% vs 30.0%, p = 0.009). Zinc deficient COVID-19 patients had a prolonged hospital stay (7.9 vs 5.7 days, p = 0.048).
At least since March 2020 there was knowledge of zinc deficiency in COVID-19 patients which resulted in more complications and prolonged hospital stay. One would expect an organization like the World Health Organization (WHO) to bring an end to zinc deficiency as soon as possible. But after a search on the WHO COVID-19 information page here's what it provides about zinc...
FACT: Vitamin and mineral supplements cannot cure COVID-19
Micronutrients, such as vitamins D and C and zinc, are critical for a well-functioning immune system and play a vital role in promoting health and nutritional well-being. There is currently no guidance on the use of micronutrient supplements as a treatment of COVID-19.
There's exactly one article about zinc! Of course vitamins and zinc can not cure COVID-19, but something as simple and cheap as zinc supplements can take away zinc deficiency and therefore this can significantly bring down the development of complications and prolonged hospital stay. But the WHO is obviously not promoting the use of cheap zinc supplements that can make a big difference, because it states there's "no guidance on the use of micronutrient supplements as a treatment of COVID-19". Incredible.
HCQ should be used together with zinc...
Zinc plays important roles in immunity and viral infection. For many years it has been known that Zinc deficiency is common in the elderly, especially those aged over 75. Zinc deficiency is characterized with impaired immune function. It is also known that older people are most at risk with COVID-19 infection. It is shown that zinc deficiency is prevalent among COVID-19 patients with severe illness resulting in higher development of complications and prolonged hospital stay. Despite this fact the World Health Organization does not promote the use of zinc supplements. HCQ is a zinc ionophore and may derive an anti-cancer and antiviral action from increasing intracellular zinc uptake. But as we'll see, HCQ is also not very popular at the WHO which most likely has to do with financial interests, certainly not with public health.
Studies (March-June 2020)
A lot of official statements and scientific papers from medical professionals are mentioned here. The papers are listed mostly in chronological order by (released or published) date. Most papers are available online in PDF format. Below each research paper I put the outcome (positive, neutral or negative) w.r.t. HCQ's effect on COVID-19 and I highlight some important information of that study. A "neutral" outcome means that HCQ had no effect under the given circumstances.
Positive ... 100 people ... ?mg for ?days ... early treatment
Positive ... 20 people ... 3x200mg/day for 10 days ... start treatment after infection not sure.
Positive ... prophylactic ... 200mg single dose repeated every three weeks plus vitamin C and zinc once a day
Negative ... 63 people ... 2x400mg/day for 1-2 days + 200-400mg/day for 3-4 days ... how many days after infection when treatment starts is not sure.
Positive ... 142 people ... mild symptoms ... 400mg/day for 5 days ... early treatment
Positive ... 80 people ... mild symptoms ... 3x200mg/day for 10 days ... early treatment
Positive ... 205 people ... mild symptoms ... 400mg/day for 14 days ... early treatment
Neutral ... 37 people ... all were dialysis patients and had comorbidities ... median dose of 300 mg/day and for a median time of 6.5 days ... doesn't seem like an important study on HCQ
Positive ... 100 people ... ? symptoms ... 2x200mg or 400mg/day(+Lopinavir/Ritonavir) ... early treatment
Neutral to slightly positive... 868 people ... database study ... "A very high percentage (85%) required hospital admission, 8% in intensive care units" requiring mechanical ventilation ... high percentage of patients with fever, pneumonia and lymphocytopenia ... no information about the dose or the duration use
Positive ... letter of two Doctors of Medicine ... see also # in which he mentions the importance of early usage.
Positive ... 1,061 people ... mild symptoms ... 3x200mg/day for 10 days (+AZ) ... early treatment
Negative ... 173 people ... patients with severe symptoms at baseline ... 600mg/day for ? days ... "received hydroxychloroquine within 48 hours of admission to hospital" implies these patients were already pretty sick before getting HCQ ... patients who started HCQ before admission to hospital were not included ... implies late treatment ... long list of "personal fees" from pharmaceutical companies (competing interests)
Positive ... 932 people ... ? symptoms ... 400mg for 1 day + 2x200mg/day for 4 days (+ AZ and zinc) ... early treatment
Neutral to slightly negative? ... 94 people ... no mention of the dose! ... many comorbidities ... many already with fever and other symptoms ... "The finding of worse outcome of hemodialysis patients with SARS-CoV-2 infection may be explained by a high prevalence of comorbidities, as well as other risk factors." ... "patients who do not require hospital admission experienced a better disease course compared to patients who required hospitalization."
Positive ... 166 people ... 800mg+400mg/day for 1 day + 400mg/day for ? days ... early treatment
Neutral ... 150 people ... 1200mg for 3 days + 800mg for 11 days (mild to moderate) or 18 days (severe) ... trial was stopped early
Neutral ... 2,512 people ... majority of patients received 800 mg on day 1, and 400 mg on day 2-5 (80%, n=1533) ... "at least one dose" = unclear ... "Patients were included in the database based on the following inclusion and exclusion criteria: ... Were not discharged to home within 24 hours." Hospitalization implies these patients already had serious illness. Tabel 1 shows comorbidity rates, a high percentage of HCQ patients had comorbidities, hypertension, fever, shortness of breath. "The median time from self-reported onset of symptoms to hospitalization was 5 days" which implies these patients were treated in a late stage.
Positive ... 550 people (48 HCQ) ... mild symptoms ... 2x200mg/day for 7-10 days ... early treatment
Neutral ... data analysis research via TriNetX database ... no information about the dose or the patients consitions at start treatment ... info in Table 1 implies high comorbidity level
Positive ... 1069 medical records ... cancer patients ... HCQ positive, HCQ+AZ better
Neutral to slightly negative ... 807 people ... 400-480mg for 5 days ... unclear when treatment started after infection
Neutral ... 7,592 people ... no mention of dose ... just summarizes existing studies.
What can be concluded from the studies so far is that studies which use HCQ in an early stage of COVID-19 are very likely to have positive outcome. This was expected knowing that basically the whole world was using it succesfully. Most positive studies use a low dose of around 400-800mg on first day followed by 200-400mg/day for several days. HCQ doesn't seem to have a positive effect on COVID-19 patients with comorbidities and/or severe illness which confirms that it should be used in an early stage of infection. Also higher doses seem to be ineffective which was already confirmed earlier. The addition of zinc seems beneficial as was already known. However, these positive signs have turned HCQ in a highly politicized topic...
Politicization against HCQ (June 2020)
According to the European Commission...
Disinformation on the coronavirus is thriving. It is important that you get updated information from authoritative sources only. ... We suggest that you follow the advice of your public health authorities, and the websites of relevant EU and international organisations: ECDC and WHO. ... Think twice before sharing any information that you see on social media about treatments and be sure to crosscheck information on new developments with trusted sources. One such example is the discussion around Hydroxychloroquine (a drug used to prevent and treat attacks of malaria), which has received a lot of attention, despite evidence from controlled studies so far showing the that drug is ineffective against the coronavirus.
Of course it's true that there is a lot of disinformation on the internet of which people should be aware. But the message of the president of the EU implies to only trust information from authorities like ECDC and World Health Organization (WHO) and at the same time it also implies to distrust everything else. Also note the wordcontrolledincontrolled studies showing HCQ is ineffective against the coronavirus. It is implied here that we can only trust science which is "controlled" by organizations like the EU or WHO. More about these "controlled" studies later. The article also gives the advice to "get updated information from authoritative sources only". So apparently the power elite dismiss all objective scientific literature and research around the globe so far as not authorative.
Since its effective use HCQ has become a highly politicized topic. Highly politicized topics are usually also highly suspicious and controversial. That's because politicization usually happens when government officials and high level power elite involved in powerful organizations have (private or corporate) interests in the topic. The COVID-19 crisis shows that globalist organizations like EU and WHO are trying to gain more "control" over information in the world. Despite its widespread use and effectiveness, the authorities oppose the use of HCQ as a treatment of COVID-19 and regard all information that confirms HCQ's effectiveness — including scientific research, official statements of medical professionals and the fact that HCQ is being used worldwide and effectively since the beginning — as "disinformation".
Fraud against HCQ (June 2020)
In June two studies with very negative results for HCQ were published in well respected scientific papers, The Lancet and the New England Journal of Medicine (NEJM). These papers were later retracted because of fraud. Links to retracted articles: here and here. In an interview one of the perpetrators of the first paper, Sapan Desai, saidwith data like this, do we even need a randomized controlled trial?* The 2018 World Hospital Congress sponsored by pharma company Novartis stated about him that heis a certified lean six sigma master black belt, and a certified professional in healthcare quality* In an interview by TRT World it seems he reads from a script * The first fraudulent study, which wasn't a randomized controlled trial (RCT) but a computer-generated observational study, resulted in the World Health Organization announcing the halt of the HCQ test for COVID-19 while none of the abundantly available non-fraudulent scientific research papers with positive results for HCQ were ever taken into account. The focus of the mainstream media was largely directed at Sapan Desai who owned the company Surgisphere from which the fraudulent data supposedly came. Much less attention was directed at the main author of this fraud, namely "well-respected" Mandeep R. Mehra, despite the fact that the NEJM fraudulent paper clearly mentions thatall the authors reviewed the manuscript and vouch for the accuracy and completeness of the data provided. If one takes a look at the sponsors of for example another paper published by Oxford University, authored by Mandeep R. Mehra and many other "high profile scientists", (see 'Conflicts of interest'), then it becomes obvious that Big Pharma and these kind of researches from "high profile scientists" are basically two sides of the same coin. On top of that there's a certain Jyoti Mehra who is Executive Vice President of Human Resources at Gilead Sciences *, the pharma company that produces the much more expensive Remdesivir, a competitor of HCQ. She is married to Uneek Mehra who is currently Chief Financial Officer at PACT Pharma * after having worked for other pharma companies. It's one happy pharma family. Mandeep Mehra was a participant at an online information session called 'Update on SARS-CoV2 and COVID-19' in Barcelona which was sponsored by Gilead Sciences. In a 2014 paper called 'Right heart failure: Toward a common language' he declared consultancies for Gilead Sciences. Etcetera. It's obvious what's going here. After the fraudulent Lancet paper was retracted WHO reluctantly continued testing HCQ for a little while to no avail. Of course it never was WHO's intention to finish it or to produce objective results. Richard Horton, pictured above, is editor-in-chief of The Lancet and has served in various roles with the World Health Organization. Birds of a feather flock together.
FDA against HCQ (June 2020)
Based on its ongoing analysis of the EUA and emerging scientific data, the FDA determined that chloroquine and hydroxychloroquine are unlikely to be effective in treating COVID-19 for the authorized uses in the EUA. Additionally, in light of ongoing serious cardiac adverse events and other potential serious side effects, the known and potential benefits of chloroquine and hydroxychloroquine no longer outweigh the known and potential risks for the authorized use.
On May 27 France banned hydroxychloroquine to treat COVID-19, after having been used for months. On June 15 the Food and Drug Administration (FDA) revokes the Emergency Use Authorization (EUA) for Chloroquine and Hydroxychloroquine in the United States, after having been used for months. On June 16 Britain's drug regulator suspended hydroxychloroquine trial recruitment after having been used for months. So I wonder whether all those months that medical professionals used HCQ and CQ on themselves (as a prophylactic) and on patients (as a treatment) was just a completely useless practice without any positive effect. Impossible. The FDA, which was formed in 1906 with the aim of protecting public health, has close ties with the pharmaceutical industry. The result after more than a century of FDA's existence is that there is a very unhealthy American population plagued by obesity and many other health issues. see also UNhealth.
Vaccine race (June-July)
AstraZeneca has reached an agreement with Europe’s Inclusive Vaccines Alliance (IVA), spearheaded by Germany, France, Italy and the Netherlands, to supply up to 400 million doses of the University of Oxford’s COVID-19 vaccine, with deliveries starting by the end of 2020.
The vaccines are being researched by an alliance between the pharmaceutical companies BioNtech and Pfizer as well as the firm Valneva. The new deal is on top of 100 million doses of the Oxford University vaccine being developed by AstraZeneca.
AstraZeneca and many other leading pharma companies have received billions of dollars of public money to develop their COVID-19 vaccines at the earliest. Other companies that are producing COVID-19 vaccines have also signed pacts with governments across the world on different terms.
The U.K. is poised to become the first country to approve Pfizer Inc. and BioNTech SE’s COVID-19 vaccine... The U.K. had long signaled it would move fast on any promising vaccine candidate. ... The government invoked a special rule allowing the U.K. drug regulator to bypass its European Union counterpart...
In July 2020, Pfizer and BioNTech announced an agreement with the U.K. to supply 30 million doses of the BNT162b2 mRNA-based vaccine, once authorized for emergency use. That agreement was increased to 40 million doses in early October. The delivery of the 40 million doses will occur throughout 2020 and 2021, in stages, to ensure an equitable allocation of vaccines across the geographies with executed contracts.
As early as June governments pre-ordered vaccines on a massive scale. It's big business. This confirms the close relationship of government and pharmaceutical industry. One of the pharmaceutical companies involved is AstraZeneca which is closely related to the UK RECOVERY Trial mentioned later. Another aspect worth mentioning is that these COVID-19 vaccines were already on the market, only one year after COVID-19 broke out. Normally the development of a new vaccine takes about 10 to 15 years when done correctly. That's because vaccines face a tougher safety standard than most pharmaceutical products. It's impossible to compress 10 to 15 years into only 1 year while maintaining the same safety level. Therefore these pharma companies have nogotiated non-liability with governments in case these vaccines cause future damage. See also VacciNATION. Yet we hear very little criticism from the scientific community, the doctors, the authorities or the media about this. But they do focus much attention on the possible side effects of HCQ which has an extremely safe antimalarial track record around the world for decades and while any side effects are mainly the result of its wrong use against the safe use guidelines mentioned earlier. High profile trials from the UK and WHO will be mentioned later.
Studies (June-July 2020)
Neutral ... 117 people ... 2x200mg for 10 days ... patients were all hospitalized which implies more advanced stage of disease, not early treatment
Positive ... 4,642 people ... 600mg on day 1, followed by 400mg daily for 9 additional days (+AZ) ... no reduction in mortality but significantly higher rates of discharge home.
Positive ... ? people ... mild symptoms ... 2x200mg/day for 7-10 days ... early treatment
Note: HCQ did not offer therapeutic benefits to severe COVID-19 cases, and was associated with increased mortality. But that goes for late treatment.
Positive ... 3,737 people ... ? symptoms ... 3x200mg/day for 10 days (+AZ) ... early treatment
Positive ... 3,737 people ... 3x200mg/day for ten days ... early treatment
Positive ... 6,493 people ... A multicenter retrospective cohort study ... "using multivariate regression analyses and the IPTW method, which revealed that hydroxychloroquine use was associated with decreased risk of in-hospital mortality."
Positive ... 2,541 people ... 400mg twice daily for 2 doses on day 1, followed by 200mg twice daily on days 2–5 (+AZ)... reduction in mortality ... "our patient population received aggressive early medical intervention"
Neutral ... 80 people ... critically ill, late treatment ... 200mg twice a day versus a loading dose of 400mg twice a day followed by 200mg three times a day ... "hydroxychloroquine ... potential benefit ... in critically ill patients has not been evaluated". "our results cannot confirm or refute the conclusion ... that there is insufficient evidence to issue a recommendation on the use of chloroquine or hydroxychloroquine in critically ill adults with COVID-19-related pneumonia".
Meanwhile new studies kept confirming what we already knew.
UK RECOVERY Trial (July 2020)
Beginning of July the WHO comes with the following statement...
Interim trial results show that hydroxychloroquine and lopinavir/ritonavir produce little or no reduction in the mortality of hospitalized COVID-19 patients when compared to standard of care. Solidarity trial investigators will interrupt the trials with immediate effect. ... The interim Solidarity results are now being readied for peer-reviewed publication.
So these WHO studies have not yet been peer-reviewed and the authorities already made the decision to stop any further research into HCQ as a remedy against COVID-19. That's peculiar to say the least. WHO does not mention anything about HCQ's effectiveness in an early stage of COVID-19 as was strongly suggested be previous scientific research and is the common use of HCQ in the first place. Mid July Peter Horby et al published their so-called UK RECOVERY Trial paper which concluded that there is no effect of HCQ on COVID-19. Here are some observations from this research...
Negative ... 1,561 people ... severely ill (hospitalization), 60% were on oxygen, 17% on mechanical ventilation, comorbidities ... number of days since symptom onset 9 days, late treatment ... 800 mg at zero and 6 hours, followed by 400mg starting at 12 hours after the initial dose and then every 12 hours for the next 9 days or until discharge. That is 2000mg on the first day! ... "A history of diabetes was present in 27% of patients, heart disease in 26%, and chronic lung disease in 22%, with 57% having at least one major comorbidity recorded." ... "The findings indicate that hydroxychloroquine is not an effective treatment for hospitalized patients with COVID-19 but do not address its use as prophylaxis or in patients with less severe SARS-CoV-2 infection managed in the community."
This research was funded by the Medical Research Council (MRC) and National Institute for Health Research (NIHR). MCR has several partnerships with industry, for example the MRC/AstraZeneca Mechanisms of Disease Initiative. It haspartnerships with more than 500 companies, ranging from the large pharmaceutical companies to small and medium sized healthcare companies* AstraZeneca is a supplier of vaccines and is partnered with the University of Oxford. Both Peter Horby and Martin Landray, who led this UK RECOVERY Trial, are Professors at the University of Oxford. So obviously there is a strong relation between pharmaceutical industry, academia, and researches like this one. The University of Oxford is also funded by big pharmaceutical companies Novartis, Boehringer Ingelheim, and it collaborates with Merck on vaccine manufacturing as is promoted by the World Health Organization (WHO). Stephen Evans, another researcher of this study, is linked to the WHO because he was a committee member of WHO Global Vaccine Safety. NIHR is a UK government agency. Lots of parties with lots of interests. Anybody who follows the news a little bit knows that all these people are pushing for their desired vaccines to save the world from disease while at the same time the pharmaceutical industry they represent has not been making the world more healthy with all its pharmaceuticals. Of course this involves a lot of money. It smells like the kind of science I would rather not put my faith in.
The UK RECOVERY Trial by Peter Horby et al had a neutral to negative outcome. It concludes thathydroxychloroquine was not associated with reductions in 28-day mortality but was associated with an increased length of hospital stay and increased risk of progressing to invasive mechanical ventilation or death.But this paper tested HCQ on severely ill patients in the late stage of COVID-19 while we know from previous research that HCQ is most effective when used in the early stage in order to prevent COVID-19 from developing into severe illness. This study merely confirmed what we already knew, namely that HCQ most likely does not have any meaningful mortality benefit in severely ill patients hospitalised with COVID-19. Simply because it's too late. On top of that, the dose given to patients was very high, against the safe use guidelines mentioned earlier. Already in 2017 it was shown that high doses of antimalarial drugs are related to sudden death, especially in patients with heart disease. On top of that, this research was funded by MRC and NIHR which have a strong relationship with pharmaceutical industry, government and WHO. The WHO quickly concluded that HCQ has no effect and interrupted its Solidarity Trial on July 4 which will also be mentioned later.
Studies (July-August 2020)
Neutral ... 236 people ... 800mg once, followed by 600mg in 6 to 8 hours, then 600mg daily for 4 more days ... early treatment was aimed for, but experienced limitations ... "Only 58% of participants received SARS-CoV-2 testing because of severe U.S. testing shortages" ... private donors
Neutral ... 293 people ... many patients with coexisting diseases ... 800mg on day 1, followed by 400mg once daily for 6 days
Positive ... 1,645 people
Positive ... Letter
Neutral or positive ... conclusion differs from actual measured data because of the method used to interpret the data ... see also letter and article. The conclusion by Boulware et al is most likely the result of bias, perhaps fraud, but certainly misleading and bad scientific practice. Another problem with this study is that it enrolled people through the internet and social media and participants were not all tested for the coronavirus but were diagnosed as COVID-19 cases based on symptoms in many cases. This means that there are a lot of uncertainties. After this study Boulware said "While we are disappointed that this did not prevent COVID-19, we are pleased that we were able to provide a conclusive answer. Our objective was to find an answer." * A "conclusive answer" from this incomplete study is a very bad scientific practice from a so-called "professor".
It is known that David R. Boulware is sponsored by Gilead Sciences which is a pharmaceutical company that produces Remdesivir, a competitor to HCQ. In another article Boulware promotes Remdesivir despite it being very expensive * Gilead is not mentioned anywhere in the "Funding and Disclosures" section of the paper while David Baszucki is mentioned as financial sponsor. David Baszucki is also sponsor of other studies with negative outcome for HCQ. A quick search on Google for "David R. Boulware" gives several media appearances. Later more about the role of "high profile" scientists and the mainstream media with their typical extreme negative bias of HCQ. On the same day a reaction to this paper was published...
However, it would appear that to some extent the media and social forces — rather than medical evidence — are driving clinical decisions and the global Covid-19 research agenda. ... The results reported by Boulware et al. are more provocative than definitive, suggesting that the potential prevention benefits of hydroxychloroquine remain to be determined.
Positive ... 8,075 people ... ? symptoms ... 480mg/day for 5 days ... early treatment
Note: see #.
Negative ... meta-analysis ... based on late treatment studies and possibly bias ... discussed in more detail in the next paragraph...
Meanwhile new studies keep confirming what we already knew.
Meta-analysis Fiolet et al (August 2020)
New analysis shows hydroxychloroquine does not lower mortality in COVID-19 patients, and is associated with increased mortality when combined with the antibiotic azithromycin. ... The authors conclude: “There is already a great number of studies that have evaluated hydroxychloroquine alone or in combination and it seems unlikely at this stage that any efficacy will ever emerge. Our results suggest that there is no need for further studies evaluating these molecules, and the European DisCoveRy and WHO international Solidarity clinical trials have already discontinued treatment arms using hydroxychloroquine.”
Here is the study on which this is based...
Hydroxychloroquine alone was not associated with reduced mortality in hospitalized COVID-19 patients but the combination of hydroxychloroquine and azithromycin significantly increased mortality.
How did this study come to the opposite conclusion and why do these people pretend there is no evidence whatsoever for HCQ's positive effect when used under the right conditions as is extensively documented? The authors of this paper basically do a selective meta-analysis of existing researches under certain conditions which will be discussed later. The studies they use for this conclusion are listed by reference numbers...
Studies included 27 articles for hydroxychloroquine [14-19,23,24,36,39-56] and 12 articles for hydroxychloroquine + azithromycin [18,36,41,42,47,48,50,51,57-60].
The first referenced study is paper #14. This paper was already mentioned earlier on this webpage, it supports the use of HCQ. To my surprise it also contains direct criticism of three of the research papers used by Thibault Fiolet et al in their negative meta-analysis. This is what these researchers say about it...
We also noticed a couple of negative reports about CQ and HCQ (Geleris et al., 2020; Mahevas et al., 2020; Magagnoli et al., 2020). However, based on the results in these studies, it is very likely that they used high doses of HCQ, which might induce cardiotoxicity and death. They might also have used high doses of HCQ as antiviral agents rather than for anti-inflammation. ... Recently, Geleris et al. (2020) reported their observation study, showing that there was no significant association between hydroxychloroquine use and intubation or death. By carefully re-analyzing this report, however, we noticed that in this study, HCQ-treated patients were more severely ill at baseline (even if after propensity score-matched) than NHCQ-treated patients. In addition, the time of treatment for patients is too short (5 days) to show the efficacy of HCQ. Another concern of this study is that about 60% HCQ-treated patients received azithromycin simultaneously, which increases risk of QT-interval prolongation and sudden death.
It even seems that the experiments done in one of these papers (Geleris et al) had known high risks attached to them. It also implies that these studies were incomplete by not mentioning the doses used for example. Here is criticism from another research team...
Recent observational studies in 1446 consecutive, non-randomized patients suggest that HCQ administration was not associated with either a greatly lowered or an increased risk of the composite end point of intubation or death [Geleris et al]. Still, HCQ-treated patients were more severely ill at baseline than those who did not receive HCQ. More, the toxic side effects were minimal.
The criticisms are clear and known. So referenced papers #13, #15, #41 have already been criticized. Most of the referenced papers by Fiolet et al have already been mentioned in the long list of scientific studies earlier (search for "Fiolet #"). The remaining papers (less significant) will be briefly discussed here..
This paper talks about Heparin, I don't see any significant information about HCQ.
This paper doesn't even mention the dose of HCQ, nor the duration as far as I can see.
Positive ... meta-analysis
This is not a paper of a study, but a letter. It doesn't mention any dose, nor the duration.
This paper is about a test on people with cancer. Cancer is a comorbidity. Nowhere can I find information about the dose. I'm not sure about the duration, it mentiones "primary evaluation of 30-day all-cause mortality within the context of hydroxychloroquine exposure". Without the dose we can't compare anyway.
Again a research involving cancer patients. Cancer is a comorbidity. I can't find information about the used dose, not about the duration of use. It strongly seems that HCQ was not tested intensively since it is merely mentioned on the side.
Scanned the paper and as far as I could see there's not even mention of the dose, nor the duration of use. Seems therefore not suitable to draw conclusions from this.
Same here, scanned the paper and as far as I could see there's not even mention of the dose, nor the duration of use. After all it's about critically ill patients. Seems therefore not suitable to draw conclusions about HCQ from this.
Not sure what to make of this, as far as I'm concerned there is no definitive conclusion about HCQ in this paper.
According to Thibault Fiolet's LinkedIn page he is a PhD Student in Public Health, food contaminants and cancer at the University of Paris-Saclay of which he says the following: "My PhD at Institut Gustave Roussy is about food exposure to Persistent Organic Pollutants (POPs) and breast cancer risk in the European EPIC Cohort coordinated by IARC/WHO". The European EPIC Cohort is sponsored by the World Health Organization.
In August 2020 Thibault Fiolet et al conclude thatHydroxychloroquine alone was not associated with reduced mortality in hospitalized COVID-19 patients but the combination of hydroxychloroquine and azithromycin significantly increased mortality.
It strongly seems to me that, after scanning the referenced papers, this conclusion does not correctly represent the conclusions and content of those referenced papers. Furthermore, I believe that all the scientific research papers, available at that time, with positive outcomes for HCQ, can not simply be waved away as insignificant. Most of the neutral or negative research papers either do not mention the dose or they use a higher dose than in positive studies. But more importantly, those researchers used HCQ in a late stage of COVID-19, on severely ill patients, of which we know from previous studies that it's less effective and possibly dangerous according to the safe use guidelines. On top of that Thibault Fiolet is linked to the World Health Organization * and linked to the World Economic Forum *, powerful organizations run by the power elite and the ultra-rich with a globalist agenda.
Studies (September-October 2020)
Neutral ... 504 people ... mild to moderate ... 400mg twice daily for 7 days or 400mg twice daily plus azithromycin (AZ) ... "with 14 or fewer days since symptom onset" implies very late treatment. See also criticism of this paper and a reply. This paper was used as reference paper by Fiolet et al who must have used the released paper before it was published.
Positive ... 7,892 people ... mild to moderate symptoms ... 400mg/day for one day + 2x200mg/day for 4 days ... early treatment
Positive ... 932 people ... zinc ... low dose HCQ ... late treatment
Neutral to positive ... conclusion differs from actual measured data, dose dependent response measured in Fig. 2 ... See also letter. The biased conclusion in this paper is likely due to interests other than science. The sponsors of this study were, among others, Jan and David Baszucki who were already involved in other papers (e.g. Boulware et al) with biased conclusions mentioned earlier.
Positive ... cell theory ... early treatment ... "HCQ blocks viral replication by inhibition of cell entry of SARS-CoV-2 and prevents virus-cell fusion by interfering with glycosylation of ACE2 receptor and its binding with spike protein."
Positive ... 1,064 people ... ? symptoms ... 400mg/day for one day + 2x200mg/day for 4 days ... early treatment
Positive ... cell theory ... "As reported, SARS-CoV-2 used ACE2 as a single receptor31,34. Inhibiting the interaction between spike protein and ACE2 is of great signifi-cance for anti-coronavirus therapy. CQ is thought to play an antiviral role by blocking the binding of the spike protein of coronavirus to ACE232. In addition to its antiviral activity, CQ also has immunomod-ulatory activity, which can synergistically enhance the antiviral effect invivo. CQ has been used in clin-ical practice for more than 70 years, with high safety and low cost.
Positive ... 106 people ... pre-exposure prophylaxis ... dose as per ICMR guidelines
Positive ... cell theory ... "A critical step of the infection cycle is the binding of the virus spike S protein to the cellular ACE-2 receptor."
Meanwhile more studies kept confirming what we already knew.
WHO SOLIDARITY Trial (October 2020)
Picture is taken from an article on Thibault Fiolet's webpage *, the main author of the negative meta-analysis mentioned earlier. According to his LinkedIn page * he is a PhD Student in Public Health, food contaminants and cancer at the University of Paris-Saclay of which he saysMy PhD at Institut Gustave Roussy is about food exposure to Persistent Organic Pollutants (POPs) and breast cancer risk in the European EPIC Cohort coordinated by IARC/WHO. The European EPIC Cohort is sponsored by the World Health Organization which did a study into HCQ as well, here's what the authors of that WHO study concluded...
These Remdesivir, Hydroxychloroquine, Lopinavir and Interferon regimens appeared to have little or no effect on hospitalized COVID-19, as indicated by overall mortality, initiation of ventilation and duration of hospital stay. The mortality findings contain most of the randomized evidence on Remdesivir and Interferon, and are consistent with meta-analyses of mortality in all major trials.
Incredible. After all the positive results from around the world the researchers at WHO, similarly to Thibault Fiolet et al, conclude that there is no evidence for any positive effect of HCQ. Let's examine this study further...
The protocol was designed to involve hundreds of potentially over-stressed hospitals in dozens of countries ... Hydroxychloroquine (oral): Hour 0, four tablets; Hour 6, four tablets; Hour 12, begin two tablets twice daily for 10 days. Each tablet contained 200mg Hydroxychloroquine sulphate (155mg base/tablet; a little-used alternative involved 155mg chloroquine base/tablet). ... Neither trial recorded dosage/kg, obesity...
Summary: Outcome is neutral to negative ... 11,266 people ... patients were severely ill with comorbidities ... very late treatment ... very high dose of 4x200mg + 6 hours later 4x200mg + 6 hours later 2x200mg/day for 10 days. First day in total 2000mg!
The first criticism is that it involves a study of mainly already hospitalized people with moderate to severe illness. As we've seen in all available studies so far, HCQ has most potential when used in the early stage, as soon as possible after infection, when viral load is still low. And previous studies even show that there are risks involved in using HCQ in the later stage of COVID-19 during severe illness. The official WHO recruitment form * states that already hospitalized patients are being used. An official WHO statement * explains what it means to be hospitalized with COVID-19. Severe illness of the HCQ patients is confirmed in Table 1 of the study: 55% were on oxygen at entry and more than 11% already ventilated, 70% with bilateral lung lesions, 21% diabetes, 21% heart disease.
The second criticism is that it involves a very high dose of HCQ compared to previous studies, namely 4x200mg + 6 hours later 4x200mg + 6 hours later 2x200mg/day for 10 days. That means first day in total 2000mg while most previous studies do not exceed 800mg on the first day and most suffice with 400/200mg for a few days starting in the early phase of infection. This study mentionesa little-used alternative involved 155mg chloroquine, which can make a big difference because CQ is more toxic than HCQ. This was already concluded in April 2020 by Mayla Gabriela Silva Borba et al. This WHO study does not mention how many patients were given CQ instead of HCQ, neither does it mention different doses for the more toxic variant, neither does it mention the dose/kg body weight of patient which can make a difference.
The WHO study concludes with a neutral to negative outcome for HCQ. But also this study is plagued by the same criticism as the previous negative studies mentioned. It tests HCQ on severely ill patients with comorbidities and even uses a very high dose on these patients, against the safe use guidelines mentioned earlier. The researchers didn't test HCQ as it was intended to be used according to the many positive studies available. Instead they concluded, after an incomplete study, that HCQ has no effect on COVID-19, without any nuance. Because of WHO's tremendous influence globally this has a very strong effect on the rest of the world. Although this research adds very little to what we already knew about HCQ, it confirms that organizations like WHO and related "high profile" scientists and governments are involved in strong negative bias. More about this later.
Global usage of HCQ
Because of the WHO recommendations HCQ is currently not longer used in large parts of the Anglo-American western world. But it was being used for several months prior to this recommendation, also in the United States. And it is still being used in pretty much the rest of the world. This begs the question whether those months of HCQ usage were a total waste of pharmaceuticals, money and false hope... or not. As shown in previous studies there are a lot of positive outcomes of HCQ use on COVID-19 under certain conditions. It would be highly unlikely that so many medical authorities all over the world were using HCQ if it didn't show any positive effect on COVID-19 patients at all. The conclusions of several high profile studies, by for example UK and WHO, simply excluded known preconditions for effective use of HCQ. And given the fact that this knowledge was widely available (it took me relatively little time and effort to find it out) it is highly suspicious that top scientists of high profile studies do not mention anything about these preconditions at all. This could have only been done by design since all the smart professors involved are certainly not that ignorant. That which should have been tested was, in my opinion, left out intentionally by whoever was in charge of the UK and WHO studies. The highest responsibility is with the World Health Organization whose power elite are in control of worldwide policy.
Studies (October-... 2020)
Positive ... cell theory ... "The glycosylation event is thought to be essential for virus attachment to ACE2 and its priming in the endosome for the membrane fusion required for its cytoplasmic entry. Inhibition of the ACE2 glycosylation by CQ can successfully decrease the SARS CoV2 viral load"
Positive ... 305 people ... 400mg/day for 5 days (+AZ) ... early treatment
Positive ... 141 people ... 2x200mg/day for 5 days (+ AZ and zinc) ... early treatment
Positive ... 3,473 people ... 2x400mg first day then 2x200mg for four days ... zinc
Positive ... 717 people ... 2x400mg first day, 400mg/day days 2–5 ... early treatment
Positive ... post-exposure prophylaxis (PEP)
Positive ... early treatment ... vitamin D, vitamin C, zinc ... ACE2 ... less than seven days of symptoms
Neutral to negative ... very late treatment
Positive ... letter
Positive ... see "Supplementary data" Fig. 2 Panel 3 and 4
Slightly negative ... late treatment
Positive ... study involving better selection of patients to treat with HCQ because most (negative) studies don't do that.
Neutral ... late treatment on hospitalized patients
Neutral ... confirms what we already knew: do not use HCQ in high doses on patients with heart disease
Neutral to slightly negative ... very late treatment because HCQ-receiving patients were more severely ill on admission.
Positive ... corrects previous studies ... early treatment (within 4 days after infection)
Neutral to negative ... patients "were stratified by mild or moderate illnesses within 4 days of diagnosis." which implies it was not known how many days they already were infected. ... patients with pneumonia were included. Pneumonia is an infection that inflames the lungs due to bacteria. HCQ is meant to prevent the infection from becoming severe, so pneumonia is already late for HCQ ... no mention of zinc
Meanwhile more studies kept confirming what we already knew.
Hierarchy of evidence
The hierarchy of evidence is a standard by which evidence is valued. Here's a scientific criticism...
The results of well-designed observational studies (with either a cohort or a case–control design) do not systematically overestimate the magnitude of the effects of treatment as compared with those in randomized, controlled trials on the same topic.
More than half of the current recommendations of the IDSA are based on level III evidence only.
On average, there is little evidence for significant effect estimate differences between observational studies and RCTs...
RCT results can serve science but are weak ground for inferring ‘what works’.
People like for example Thibault Fiolet et al put much emphasis on the selection of randomized controlled trials (RCTs) over regular observational studies. But many independent observational studies from all over the world which come to similar conclusions is, in my opinion, much better than large clinical trials controlled by huge organizations with ties to the pharmaceutical industry and politics. I believe it makes more sense to trust in honest and unbiased science from real life than in the so-called science of "high profile" scientists who are probably pressured and paid too much for delivering the kind of incomplete studies with biased and incomplete conclusions like those of UK and WHO we discussed earlier. True science is unbiased and does not exclude possibilities from its research and conclusions, like these researchers did. The hierarchy of evidence is a nice theoretical standard, but when it is regarded as the holy pinnacle of science, over evidence from real life, then it becomes more like a religion. For the much hailed peer-review process pretty much the same applies. Anyway, in this case the interests and motivations of these "high profile" scientists are clear by now...
Money, money, money
Therefore, the results of chloroquine and HCQ so far done against COVID-19, more promising than previous trial in other viral diseases. Moreover, these drugs are of low cost, reasonably safe (...), and widely available in countries where malaria is endemic.
Considering the availability and cheapness of HCQ, it seems worth further investigating the clinical effect of an optimised dosage of HCQ.
Many medical professionals and scientists of different studies suggest to use HCQ not only because it is effective against COVID-19, but also because it is cheap and widely available. Zinc and vitamin D are also widely available and cheap. The bleak reality is that we live in an extremely materialistic world with extreme levels of inequality and corruption. Medicine in general works by treating symptoms instead of causes and the pharmaceutical industry thrives by profits made of diseases. If HCQ can prevent people with COVID-19 infection from progressing to severe illness when used in the early stage of infection, then who will not profit and who will loose face and credibility? The ultra-rich and power elite in control of the pharmaceutical industry and globalist organizations like WHO.
Welcome to the world of the mainstream media, where the vilest and most shameless of media whores get together to misinform and mislead the population in the name of their billionaire owners. Just for fun, a small selection of some of the misinformation from some "well-respected" media channels in the west. According to CNNstudy after study has shown hydroxychloroquine does not work to treat the coronavirus, and may be harmful.According to NBCThe 'evidence is clear': Hydroxychloroquine doesn't help Covid-19 patients. According to WiredHydroxychloroquine Still Doesn’t Do Anything, New Data Shows. According to ScienceNewsHydroxychloroquine can’t stop COVID-19. It’s time to move on, scientists say. "Scientists" say a lot, don't they. And then of course the countless highly politicized articles involving the typical anti-Trump rants with the "nothing-good-can-possibly-come-from-Trump"-mentality. According to ForbesTrump has embraced unproven treatments for coronavirus, especially anti-malarial drug hydroxychloroquine, which a new study found is linked to an increased risk of death in patients. Here are all the times Trump has pushed the drug.According to The ConversationA casual remark by a president who is not in any way a medical expert somehow led thousands of U.S. physicians to write prescriptions for a drug that had never before been used to treat a viral illness. What could be happening here?As if Bill Gates is a medical authority. According to The GuardianTrump's hydroxychloroquine habit is the triumph of rightwing quackery. A search for "hydroxychloroquine" on the New York Times website gives more negative articles about Trump than about the drug itself it seems. Is it a coincidence that practically all mainstream media outlets propagate the same negative message?
What a country. And it's leading the western world. Incredible.
All mass media owned and controlled by the power elite spread blatant misinformation and extreme negative bias concerning HCQ. So what are the state media? Obviously, they're tools for spreading the propaganda of their owners based on their political and economical interests.
I'm also worried that THOSE behind those claims exploit people's fears about the virus, JUST to make money, by selling them VERY expensive soap for example that ALLEGEDLY kills Corona virus germs. This NEEDS to stop.
Great act. This globalist EU puppet really tries hard to look worried. The people in the world should be very worried about THOSE who are selling us VERY expensive vaccines while suppressing COMPLETE research into VERY cheap HCQ which has already been SHOWN to be effective because it has been used ALL around the world for SO long now. The longer these globalist power elite of the WHO and other globalist organizations withhold effective medicines like HCQ and other cheap supplements from the population the more people will unncessarily suffer and even die. What happens in the world today is called intentional mass murder and it happens on a global scale. The suppression of HCQ and Ivermectine are the greatest crimes against humanity we have seen in decades. History is very clear. When very powerful people of very powerful organizations start suppressing information and when they start imposing their "controlled" version of reality on the world, it starts smelling awfully bad like the kind of repulsive authoritarianism that the same kind of hypocrites fanatically criticized China and Russia for in the last decades. Now they embrace and implement these authoritarian practices themselves in the western world. See also Agenda 2030 and Great Reset.
27 May 2020 - Harvey A. Risch - Early Outpatient Treatment of Symptomatic, High-Risk COVID-19 Patients That Should Be Ramped Up Immediately as Key to the Pandemic Crisis
29 May 2020 - Jon Cohen - ICMR writes to WHO, expresses disagreement with world body’s assessment of Hydroxychloroquine
3 June 2020 - Science Media Centre - expert reaction to ‘Expression of Concern’ on study on hydroxychloroquine and chloroquine in COVID-19 patients
17 June 2020 - Josh Mitteldorf - Suppression of Chloroquine is Scandalous
6 July 2020 - The Heartland Institute - Coronavirus Conversation With Michael J. A. Robb, M.D.
4 August 2020 - Yogesh Acharya et al - Chloroquine and hydroxychloroquine as a repurposed agent against COVID-19: a narrative review
14 August 2020 - Jon Cohen - Antibodies may curb pandemic before vaccines
15 October 2020 - Robert A. Brown - Sixty seconds on ... vitamin D
28 August 2020 - Smriti Mallapaty - The coronavirus is most deadly if you are older and male — new data reveal the risks
3 November 2020 - Ciro Carafa - Should You Take Vitamin D for COVID Prevention?