Friday, July 31, 2020

Use Of Hydroxychloroquine

It has been well-established, and this blog has been a reminder, that one must not only pay attention to what is said, but also pay attention to what is not said.

THE BAN
This week, the FDA revoked use of hydroxycholroquine as a treatment for certain (emphasis mine) Covid-19 patients. Among the reasons given in the article, "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."

The WHO cited the reason as "The Solidarity Trial's hydroxychloroquine arm is being stopped, on the basis of evidence showing it does not reduce mortality for hospitalised #COVID19 patients." (quoted Tweet)

And there is also this Tweet from the WHO: "Aside from #COVID19, hydroxychloroquine is still regarded as a generally safe drug for patients with autoimmune diseases or #malaria. It helps many people with difficult and chronic conditions live better lives."


THE QUESTION
WHY is it "associated" with cardiac adverse events for hospitalized Covid-19 patients facing mortality (death), BUT "generally safe" for patients with autoimmune diseases or malaria???

Answer: Read what is said. Also read what is not said.

The article by the FDA did not infer causation - merely association. In science, one must eliminate all variables except the one being tested, and FDA cannot do that in this instance. Why? Because we already know there are certain comorbidities that increase the likelihood of fatality: cancer, heart conditions (heart disease, heart failure, COPD, etc.), Type 2 diabetes, morbid obesity, kidney disease, and immunocompromised states (organ transplants, sickle cell, etc.).

In summary, people hospitalized with comorbidity factor(s) - and therefore at higher risk of dying due to Covid-19 or the comorbidity or comorbidities, or the combination thereof - do not often get saved by use of hydroxychloroquine (HCQ).

Maybe the use of HCQ is not the cause of the cardiac adverse events. Maybe these comorbidities are the cause of the cardiac events.


THE REAL USE
From another Tweet by the WHO: "This evidence does not apply to the use of hydroxychloroquine for preventing #COVID19 infections or treating non-hospitalized patients, two areas where we still need more evidence on the drug's effectiveness against the #coronavirus."

This statement lines up with the other statement by the WHO, indicating HCQ is "generally safe" for people who need treatment for malaria and autoimmune diseases.


SUMMARY
HCQ is not a miracle drug. Some people are in such a dire state that it cannot help them.
Nevertheless, it is still useful in treatment.
This author would speculate that use of HCQ should continue to be indicated, as the FDA also failed to determine any increase in fatalities due to its use and not due to a comorbidity. If this author was on "death's doorstep" he would certainly want it to be used.

For the record, the author of this post has contracted and survived COVID-19, as evidenced by a positive antibody test. The treatment consisted of everything one normally hears for treating a cold. The symptoms were not as severe as the media claims. The whole thing was over in just a few days. His opinion on Covid-19: "Spicy cold - not as bad as the flu."

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