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Hydroxychloroquine
$cience
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.
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, but it has been shown to be effective in reducing symptoms of COVID-19 when used in the correct way. Since its effective use HCQ has become a highly politicized topic and the media are all over it in a very negative sense.
Early treatment
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 be the case if health care workers knew that HCQ had no effect whatsoever.
Low dose
HCQ should be used in low doses

In 2017 the World Health Organization itself published a paper 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 recommended usage of this drug was widely known.
Zinc
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.
So, one would expect an organization like the World Health Organization to bring an end to zinc deficiency as soon as possible, zinc supplements are very cheap and easy. But after a search on the WHO COVID-19 information page here's what it provides about zinc...

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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 on the WHO website! 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 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)
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. 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. The addition of zinc seems beneficial.
These mainly positive outcomes have turned HCQ in a highly politicized topic...
WHO against HCQ (May 2020)
On 25 May 2020 NPR reported: The World Health Organization says it is temporarily halting its clinical trials that use hydroxychloroquine to treat COVID-19 patients over published concerns that the drug may do more harm than good. The move comes after the medical journal The Lancet reported on Friday that patients getting hydroxychloroquine were dying at higher rates than other coronavirus patients. *
The paper published by The Lancet on which the WHO based its decision to halt its clinical trials for HCQ was later shown to be a fraud and retracted. This will be mentioned a little later on this webpage.
On 27 May 2020 Harvey A. Risch published an article stating: Five studies, including 2 controlled clinical trials, have demonstrated significant major outpatient treatment efficacy. ... These medications need to be made widely available and promoted immediately for physicians to prescribe.
On 29 May 2020 The Statesman reported: The Indian Council of Medical Research (ICMR) has written to the World Health Organization, expressing its disagreement with the global health body's advisory against the use of anti-malaria Hydroxychloroquine in treating Coronavirus patients. The ICMR, in the letter, cited the difference in dosage administered to patients and said that international dosages are four times higher than Indian trials. *
This is crucial, HCQ doses prescribed in the West, as recommended by for example the WHO, are much higher than the commonly prescribed optimal doses of HCQ which have shown to be effective in countries like India and many others! Later more about this.
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.
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 has been used worldwide and effectively since the beginning — as "disinformation".
Fraud against HCQ (June 2020)

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In June two studies with very negative results for HCQ were published in well respected scientific papers, one in The Lancet: Hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19..., and the other in New England Journal of Medicine (NEJM): Cardiovascular Disease, Drug Therapy, and Mortality in Covid-19. These papers were later retracted because of fraud.
The fraudulent study published by The Lancet resulted in the World Health Organization announcing the halt of the HCQ test for COVID-19 on 25 May 2020 while none of the abundantly available genuine scientific research papers with positive results for HCQ were ever taken into account.
The focus of the 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. Another paper published by Oxford University and authored by Mandeep R. Mehra, titled Conducting clinical trials in heart failure during (and after) the COVID-19 pandemic... contains a section "Conflicts of interest" showing that each researcher gets "personal fees" from pharmaceutical companies. Roughly two pages are neccessary to get all the "personal fee" links listed. Big Pharma and these kind of researches from "high profile scientists" are basically two sides of the same coin.
Then there's a certain Jyoti Mehra who is Executive Vice President of Human Resources at Gilead Sciences *, the pharma company that produces the expensive Remdesivir, a competitor of cheap 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 for example a 2014 paper titled 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 the 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 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) revoked 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, 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)
As early as June governments pre-ordered vaccines on a massive scale. Big business. There's a close relationship between 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. While we hear very little criticism in the media about this, we do hear a lot about 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 wrong usage against the safe use guidelines mentioned earlier. "High profile" trials from the UK and WHO will be mentioned later.
Studies (June-July 2020)
Meanwhile more studies kept confirming what we already knew about HCQ.
UK RECOVERY Trial (July 2020)
At the beginning of July the WHO came 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. The WHO does not mention anything about HCQ's effectiveness in an early stage of COVID-19 as was strongly suggested by scientific research.
Mid July Peter Horby et al published their so-called UK RECOVERY Trial paper. Some observations:
1,561 people ... severely ill (hospitalization), 60% were on oxygen, 17% on mechanical ventilation, comorbidities ... number of days since symptom onset 9 days, ... 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. ... 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. ... hydroxychloroquine 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.
The findings indicate that HCQ is not an effective treatment for hospitalized patients with COVID-19. But this trial 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. 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.
Nevertheless, based on this research alone the WHO quickly concluded that HCQ has no effect and interrupted its Solidarity Trial on July 4.
This research was funded by the Medical Research Council (MRC) and National Institute for Health Research (NIHR). MCR has several partnerships with industry * * *. Both Peter Horby and Martin Landray, who led this UK RECOVERY Trial, are Professors at the University of Oxford which is partnered with AstraZeneca and funded by for example Novartis and Boehringer Ingelheim, and it collaborates with Merck on vaccine manufacturing *.
There is a strong relation between pharmaceutical industry, academia, and researches like this one.
Studies (July-August 2020)
Meanwhile more studies kept confirming what we already knew about HCQ.
Meta-analysis Fiolet et al (August 2020)
SciTechDaily reported: 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.”
This article is based on a meta-study by Thibault Fiolet et al which concludes: 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 did a selective meta-analysis of existing researches. The reference 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:
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.
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.
So, referenced papers #13, #15, #41 have already been criticized. Most of the referenced papers by Fiolet et al have been mentioned in the long list of scientific studies earlier ("Fiolet #"). The remaining papers will be briefly discussed here:
#17: Luis Ayerbe et al - The association between treatment with heparin and survival in patients with Covid-19
This paper talks about Heparin, I don't see any significant information about HCQ.
#18: Eli S. Rosenberg et al - Association of Treatment With Hydroxychloroquine or Azithromycin With In-Hospital Mortality in Patients With COVID-19 in New York State
This paper doesn't even mention the dose of HCQ, nor the duration as far as I can see.
#19: Awadhesh Kumar Singh et al - Hydroxychloroquine in patients with COVID-19: A Systematic Review and meta-analysis.
Positive.
#45: Emma Wilkinson - RECOVERY trial: the UK covid-19 study resetting expectations for clinical trials
This is not a paper or a study, but a letter. It doesn't mention any dose, nor the duration.
#47: Donna R. Rivera et al - Utilization of COVID-19 Treatments and Clinical Outcomes among Patients with Cancer: A COVID-19 and Cancer Consortium (CCC19) Cohort Study
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". But without the dose we can't compare.
#49: J. Luo et al - COVID-19 in patients with lung cancer
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.
#52: Paolo Cravedi et al - COVID‐19 and kidney transplantation: Results from the O International Transplant Consortium
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.
#53: Shruti Gupta et al - Factors Associated With Death in Critically Ill Patients With Coronavirus Disease 2019 in the US
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.
#60: Guilhem Bousquet et al - ADL-dependency, D-Dimers, LDH and absence of anticoagulation are independently associated with one-month mortality in older inpatients with Covid-19
There is no definitive conclusion about HCQ in this paper?

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. It even seems that the researchers cherry-picked studies that are negative.
On top of that Thibault Fiolet is linked to the World Health Organization * and to the World Economic Forum *, powerful organizations run by the power elite and the ultra-rich with a globalist agenda. 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 says: My PhD at Institut Gustave Roussy is about food exposure to Persistent Organic Pollutants ... and breast cancer risk in the European EPIC Cohort coordinated by IARC/WHO. The European EPIC Cohort is sponsored by the World Health Organization.
Studies (September-October 2020)
Meanwhile more studies kept confirming what we already knew about HCQ.
WHO SOLIDARITY Trial (October 2020)
Picture is taken from an article on Thibault Fiolet's webpage *, the author of the negative meta-analysis mentioned earlier. The WHO did a study into HCQ as well, the so-called WHO Solidarity trial, and it 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, similar to Thibault Fiolet, 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...

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.
But HCQ is not supposed to be used on severely ill patients in a late stage of disease!
Researchers use a very high dose of 4x200mg + 6 hours later 4x200mg + 6 hours later 2x200mg/day for 10 days. 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.
But HCQ is not supposed to be used in very high doses!
This study also mentiones "a 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.
As expected, the outcome of this study is neutral to negative because HCQ was used completely contrary to how it should be used, it should be used as a preventative in the early stage of infection, not as a cure in a late stage of severe illness! Although this research adds very little to what we already knew about HCQ, it confirms that organizations like the WHO and related "high profile" scientists and governments are involved in strong negative bias against HCQ. More about this later.
Global usage of HCQ

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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 the UK and the 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 must have been done by design because it's impossible that all the intelligent professors of these highly esteemed universities are that ignorant of observable reality. That which should have been tested, namely the use of HCQ in an early stage of infection to prevent severe illness as is recommended and proven effective everywhere in the world, 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 and they were quick to ban HCQ from the western world, based on their own suspicious and incomplete research, while it was being used effectively in the rest of the world.
Studies (October-... 2020)
Meanwhile more studies kept confirming what we already knew about HCQ.
Hierarchy of evidence
The hierarchy of evidence is a standard by which evidence is valued. But it's not the holy pinnacle of science. If for example 100s of observational studies around the globe conclude that a certain medicine or method is effective in treating a certain condition, then one randomized controlled trial with a negative outcome doesn't necessarily undo all previous scientific research and knowledge, it might as well indicate that something is wrong with that trial, as we've seen with for example the large UK and WHO trials.

On 22 June 2000 John Concato et al concluded: 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. So, well-designed observational studies are a very good indication, there is no need for randomized controlled trials (RCT) to come to decent conclusions about what works or what doesn't.
On 10 January 2011 Dong Heun Lee et al concluded that more than half of the current recommendations of the IDSA are based on level III evidence only. So, most recommendations are based on observational studies, not on randomized controlled trials. It's common in the medical world.
On 29 April 2014 Andrew Anglemyer et al concluded that On average, there is little evidence for significant effect estimate differences between observational studies and RCTs...
On 25 December 2017 Angus Deaton et al said that 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. This study into HCQ made me trust more in the science of many independent observational studies from real life around the globe than in the so-called "science" of "high profile" scientists from "highly esteemed" universities who are paid too much for delivering the kind of incomplete studies with biased conclusions like those of the UK and WHO. For the much hailed peer-review process pretty much the same applies. True science is unbiased and does not exclude possibilities from its research and conclusions, like these overpaid 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 or a tool for the power elite to increase their profit, which brings us to the following topic...
Money, money, money
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On 22 March 2020 Awadhesh Kumar Singh et al concluded:
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.
On 24 August 2020 Lucy Catteau et al concluded:
Considering the availability and cheapness of HCQ, it seems worth further investigating the clinical effect of an optimised dosage of HCQ.
As shown extensively on this webpage, which is only the tip of the iceberg, many medical professionals and scientists of different and independent studies around the world suggest to use HCQ not only because it has been proven effective against preventing severe illness after infection with COVID-19 when used correctly, but also because it is cheap and widely available. Zinc and vitamin D are also widely available and cheap and can be implemented with the blink of an eye.
But 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 cheap HCQ can prevent the majority of people with COVID-19 infection from progressing to severe illness when used properly, then the power elite in control of the pharmaceutical industry and globalist organizations like WHO will not make enough profit from very expensive vaccines.
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EU President Ursula von der Leyen is worried that those behind those claims exploit people's fears about the virus, just to make money. The misinformation about, and the suppression of HCQ and Ivermectine is a crime against humanity supported by clowns like Ursula.