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The featured image above this post is a rendering of the chemical structure of the drug Hydroxychloroquine. That pleasant looking image has set off a quite a stramash in the White House among Covid-19 Task Force members Dr. Anthony Fauci and economist Peter Navarro who is the Defense Production Act Coordinator for President Donald Trump. Oh my stars, when egos collide.
Axios.com reported on the Saturday Task Force meeting where the wheels fell off of the wagon:
Toward the end of the meeting, Hahn began a discussion of the malaria drug hydroxychloroquine, which Trump believes could be a “game-changer” against the coronavirus.
Hahn gave an update about the drug and what he was seeing in different trials and real-world results.
Then Navarro got up. He brought over a stack of folders and dropped them on the table. People started passing them around.
“And the first words out of his mouth are that the studies that he’s seen, I believe they’re mostly overseas, show ‘clear therapeutic efficacy,'” said a source familiar with the conversation. “Those are the exact words out of his mouth.”
Navarro’s comments set off a heated exchange about how the Trump administration and the president ought to talk about the malaria drug, which Fauci and other public health officials stress is unproven to combat COVID-19.Fauci pushed back against Navarro, saying that there was only anecdotal evidence that hydroxychloroquine works against the coronavirus.
The President’s son-in-law and adviser, Jared Kushner, stepped in and calmed things down. But, it who knew such a little pill could cause so much trouble. Dr. Fauci has used the word “anecdotal” to smear the hydroxychloroquine. The Guardian reported:
The president has repeatedly said Americans concerned about the virus should take hydroxychloroquine, which is commonly used to treat malaria, lupus and rheumatoid arthritis.
Fauci has repeatedly said there is no clinical evidence it can help against Covid-19 and evidence of the drug’s efficacy is anecdotal.
Dr. Mehmet Oz disagreed with Dr. Fauci on Fox & Friends this morning:
If you cannot watch the video, here is the relevant portion of the transcript, provided by Media Matters:
DR. MEHMET OZ (HOST, THE DR. OZ SHOW): By the way, the word “anecdote” is used a lot — that is an incorrect description of where this medication is now. There’s no question it’s not proven to be beneficial in the large clinical trials we expect in America, and certainly the FDA and medical societies would desire. But these have been supported with case studies. I just got off the phone with Didier Raoult, who’s the well-respected French physician who’s done a lot of this work. Thousand series of patients — 1,000 patients in a row he’s treated, and he’s not published yet, he’s going to be published over the next two weeks. But he’s got seven people who have died, they were all older and had other co-morbidities, 20 people have gone to the ICU of that trial. Now, it’s not a randomized trial, but that’s not anecdotal. The data from China we discussed last week for the first time on Fox & Friends also, pretty evident that it’s a randomized trial. That is the opposite, if I had to create an opposite of an anecdote. So when those words get thrown around and I saw us this morning in some of the papers, it’s an error on the part of journalists.
On the other hand, Dr. Michael Haseltine, biologist and former Harvard Medical School professor, was even more vehement against the drug on The Daily Briefing with Dana Perino. He described it as quack cure:
Haseltine explained that one study “concludes it has no effect,” and another “concludes it has a mild effect,” before claiming, “The net result is that whatever effect it has it will be very mild. That drug has been used for years against many other viruses to no effect.”
“The thing that makes me sad about that story is some people may take it who are on other medications or have other underlying conditions and may have very serious, even life threatening consequences,” he warned. “It is not something to take unless a doctor prescribes it.”
Today, I was accused of not believing in doctors because I said on social media that I thought the states of Montana, South Dakota and North Dakota had the right not to have shut down order. I think that President Trump is right not to order a 50 state shut down. The above states have been practicing social distancing forever. But, I do believe in doctors. The question is which doctors? It is each patient’s right to discuss a treatment plan with his/her doctor. The patient should have a frank and honest discussion about other medications he/she is on and all underlying conditions. Then, that patient and doctor can use any drug they think will help.
Dueling experts and a media with rabid Trump Derangement Syndrome are not helping the situation. Now, they are politicizing Hydroxychloroquine. To what end? To sow more seeds of doubt in our medical community and President Trump.
Featured Image:
“File:Hydroxychloroquine.png” by Jovan Gec is licensed under CC BY-SA 4.0
GWB says: Fauci pushed back against Navarro, saying that there was only anecdotal evidence that hydroxychloroquine works against the coronavirus.
And, Dr Faucci is FULL OF BOVINE EXCREMENT. I first read about the chloroquine weeks ago – long before Trump began discussing it – when the first “We tried it” trial came out of France.
You want to know what’s interesting?
They tried it because they already used for anti-viral work on virus-caused pneumonia. That included SARS. You know, that other coronavirus? (Winnie The Flu is also known by another clinical moniker: SARS-CoV-2. Imagine that!)
Here’s what Wiki has to say (from Biochemical and Biophysical Research Communications):
In October 2004, a group of researchers at the Rega Institute for Medical Research published a report on chloroquine, stating that chloroquine acts as an effective inhibitor of the replication of the severe acute respiratory syndrome coronavirus (SARS-CoV) in vitro.
IOW, they tried it with WTF patients BECAUSE IT ALREADY WORKED WITH OTHER SIMILAR VIRUSES. It works in a similar fashion to its anti-malarial effects in blocking some cell functions.
To even try to say “It hasn’t been shown to work” you have to ignore DECADES of actual clinical work and prescriptive use.
Fauci has repeatedly said
The question is whether it’s because he’s an a-hole or he’s ignorant.
That drug has been used for years against many other viruses to no effect.
Then Dr. Michael Haseltine is an ignoramus or a liar, too. Why did the French dude try it? Because it worked against the effects of OTHER viruses.
some people may take it who are on other medications
Same question about this jackass: ignorant or liar? Because you can only get it with a prescription. It is NOT an OTC. (It seems even the aquarium version you have to get a vet to prescribe it, but I don’t have any authoritative word on that.)
It is not something to take unless a doctor prescribes it.
No Shit, Sherlock!
I was accused of not believing in doctors
Damn straight I don’t believe in doctors. I generally trust that doctors have a lot more knowledge than me in the area of medicine. And they have lots more medical books on their shelves than I do. But they are not necessarily smarter than me* – given good information I can come to conclusions as well as they. So, I ask for information and examine whether they seem to know what the heck they’re talking about.
(* Remember: what do they call a guy or gal who got all C’s through medical school? “Doctor”.)
To what end? To sow more seeds of doubt in our medical community and President Trump.
Yes. And no. A lot of it has to do with the authoritarian streak in some doctors. Plenty of them out there who will berate you for seeking a second opinion. Or for asking lots of questions because you want to see how they arrived at their conclusion (diagnosis or treatment). Or asking them to explain obscure numbers and terms.
I think few of those end up for long in a medical practice. A few more end up in hospitals. Loads more end up as academicians and bureaucrats. IOW, all the people you’re hearing from about NOT using hydroxychloroquine. (They were also the ones who told you that wearing a mask won’t protect you – 100%, that is.)
There’s also the issue of Zero Infection or Zero Risk, which those same academicians and bureaucrats are generally stricken with, where something like “FDA approval” is a papal ex cathedra, even though it technically, legally, isn’t. (Doctors can use approved drugs “off-label” if they can justify it, regardless of whether that drug is approved for the specific treatment for which they’re using it.)
Sorry, another long-winded rant. But it chaps my hide that someone like Dr Faucci would say things that are so very untrue.
Toni Williams says: Chaps my hide too. One of my h.s. friends was getting her PhD at LSU 30 years ago. Fauci was brought in to lecture. When students pushed back at him, he went off on them. When I first praised Fauci weeks ago, she told me that story. She said he is an asshole whose ego won’t let him hear any dissent. She was too right.
Rick Caird says: I have said Fauci is old school. He will not endorse anything not proven in clinical studies, The problem is that is a multiyear process and then the FDA starts it evaluation. If we have a disease that kills in a week, thhen a multi year process is a death sentence. I guarantee if Fauci got the Wuhan virus, he would be first in line to try this treatment. He would not wait on the clinical trials.
The Demon Slick says: Will anyone ask Fauci why he supports off label use of puberty blockers for transgender children without clinical trials, but opposes off label use of hydroxychloriquine because of the lack of clinical trials?
me&my says: I work at a big hospital in the midwest and our treatment protocol calls for every COVID positive person to be prescribed Hydroxychloroquine & Zithromax. That goes for inpatient and ones sent home.
The Demon Slick says: Thank God for that, because it seems to work, and there’s really nothing else. The coordinated effort by the media to discredit the drug is a tell. A 30 cent pill? Can’t have that, there’s no money in it! No no no, we need a new drug and a vaccine, complete with yearly government contracts worth hundreds of millions of dollars. Look how they try to pretend that the side effects of the zpack are caused by hydroxychloriquine. There’s no heart attack ever caused by hydroxychloriquine in the 70 years we’ve been using it. The doctors guidelines don’t even mention cardiac issues. They certainly don’t call for an ekg. But the zpack guidelines do reccomend that. The only side effects of hydroxychloriquine are retinal deposits appearing after 5-10 years of constant use. And some people get a rash or the trots. Nobody dies from hydroxychloriquine ever. Doesn’t happen. Nobody has a heart attack because of it. Never happens. When we deploy troops to Afghanistan we give them hydroxychloriquine to prevent malaria and other fun 3red world diseases. They’re fine. When American tourists visit Africa they usually take hydroxychloriquine during their trip. They’re fine too. I could go on and on about the safety of a drug that’s been in use for over 70 years. When I see TV doctors saying they don’t know what the side effects are I want to yell at the TV “look it up dummy!”
I’m an economist. Economists build models, but none of us really believe them, they are just frameworks for thinking and arguing; we even write papers about why we can’t predict the future with them. I’m astonished that these epidemiologists and biologists actually believe their models and are making trillion dollar decisions based on them. These people are pseudoscientists. They have almost no data, no control population, no sampling technique for data they do have, just models they’ve invented.
Their remedy for the virus is for everyone to stop working, stop producing. It’s as if these idiots do not know that people need to eat to live.
Toni Williams says: someone once said, all models are wrong, some are helpful.
“someone once said, all models are wrong, some are helpful.”
George E. P. Box FRS (1919-2013), one of the greatest statisticians of the 20th Century
Rick Caird says: Let’s talk about Mann’s hockey stick. It is helpful if you want to scare people. Other than that, not so much.
GWB says: I’m astonished that
And you’ve been living away from humans for how long, now, Charles?
😉
Lloyd says: I think Fauci loves being in the media spotlight. He will say/do whatever necessary to stay there.
Esteban says: This!
From the few briefings I have watched, Fauci seems to be getting off on the power and fame he is currently wielding. His first and probably last chance at being able to control the whole population and have the press and all the powers that be eating out of his hand. And he feels completely untouchable because he knows Trump would suffer politically if he sidelined the little Napoleon egomaniac.
DAVE says: This is an example of “perfection is the mortal enemy of good enough” — In the IS, the double-bling trial is the gold standard because it is expensive, lengthy, and a sacrosanct institution — Most, if not all, discoveries in medicine (penicillin, vaccination, etc.) are NOT the result of double-blind studies and medical school instruction is rife with the holy case study, which is only an ANECDOTE! I recommend the book “Fear Of The Invisible” to those interested .. an analogy of the current argument might be: You are drowning and I toss you an inflated innertube – at that point the rescue experts yank it away and declare that it is not Coast Guard approved, is not safety yellow and has no testing institute seal of approval — you drown in the approved manner and all is well with the status quo!! I am a practicing physician and have waded through this muck for far too long.
GWB says: What ^HE^ said!
David Lentz says: If I were a cynic, I would suggest that Dr. Fauci wants nobody cured until he can get a Vaccine with his name on it.
Politically Ambidextrous says: Should it have become clear that this treatment regimen showed a benefit to a significant number of patients outside the US, and the US Government (e.g. FDA or CDC) had delayed its use in the US (say, because of the risk of side-effects if the dosage isn’t correct), the press would be swarming with fury.
They would demand to know why the government didn’t do all they could sooner because of the global crisis. And if the treatment results were obtained in a country that had only government-run health care, so much the better, because the delay was certainly the work of clandestine agreements between the government and insurance companies to increase evil profits.
Heads, I win; tails, you lose!
Jim Dahmus says: 35 years ago the standard approved treatment for ulcers was Tagamet or Zantac. These were the first two drugs in America with annual sales greater than $1Billion. Then, someone tried a simple antibiotic – it killed the bacteria that caused the ulcer. Tagamet, and Zantac became much less valuable overnight. Where would Fauci and his kind have been on the argument to try an old, antibiotic against this multi-billion problem? I don’t know. But I am really tired of medical experts who are immune to the economic devastation that their “cure” is causing. We ned to be open to attacking the problems created by this virus with new thinking. We can’t afford the old standards
cirby says: Don’t forget that the medical establishment went into complete denial mode after Barry Marshall and Robert Warren announced that ulcers were primarily caused by H.pylori bacteria. Most doctors refused to believe they’d all been so wrong for so many years.
I was on staff at a medical conference in the early 90s, years after this had been conclusively proven, and some doctors were so resistant to the idea I thought they were going to have a small riot during one presentation.
GWB says: We ned to be open to attacking the problems created by this virus with new thinking.
Or, even older thinking. (Yes, I’m that jerk proposing “Wuhan Parties” to build herd immunity while vaccines are grown.)
A lot of the problem (imo) is the thinking that only technological solutions will work because “new” and nothing “old” will.
Tony says: Facing has served every Peesident since Reagan. In the same job. If he good at his job?or good at keeping it? Would not be surprising if he is let go after this.
AnneG says: Dr Fauci has a classic and incurable case of NIF, Not Invented Here!
JeffH says: I’m not sure that a clash of egos has taken place here. Rather, it seems a few ids have decided to perform a Brownian Movement danse macabre, bumping into those who oppose them, whilst onlookers die in the streets.
Don Hudson says: Maybe someone can help me. I have been searching for the double blind studies on social distancing. Maybe someone can ask Fauci about where that is. To me, it sounds like the same rigorous study that concluded that dietary fat was the root of all evil.
Rex says: Something that is being overlooked here is that the word “anecdotal” has a technical meaning when used with medical studies. Dr Fauci is not being an ass about it; he’s speaking in technical language. And I’ve never heard him say not to use HCQ but simply that it hasn’t been tested for COVID-19 yet. Which is true.
So many people are trying to divide Trump’s task force. Please don’t be one of them.
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