The Data that Matters - South Korea - Chloroquine -China take 2

The Data That Matters

You can make numbers tell any story you want. For example, let us assume for a moment that the actual CFR (Case Fatality Rate) of Covid-19 is 1%.

-One person tells you that this is 10x the CFR of the flu (.1%) and should be cause for concern.

-Another person tells you that the survival rate of Covid-19 is 99% and when compared to the 99.9% survival rate of the flu, this deviation is statistically insignificant.

Since both of these people are accurately calculating the numbers, which viewpoint should drive our decision making and response to this emerging threat?

I have seen such drastically different responses in the media and from individuals who are all (supposedly) looking at the same data. A fair number sounding alarm bells and urging extreme action and caution, and seemingly just as many (if not more) people frustrated with the economic slowdown and impacts, claiming the danger posed by the virus is completely overblown and not significant enough to justify the drastic mitigation measures.

With so many voices out there and so many numbers being thrown around, it would be prudent to see what the DATA actually tells us. Most importantly, which aspects of the data are useful for making future projections and which are not.

The Number or Rate of Increase of Confirmed Cases is not helpful.

- If you do not test for Covid-19, you cannot have a confirmed case. Testing has just picked up in the last 2 weeks here in America, prior to that we had pretty low numbers of confirmed cases. Around 1,000 cases 2 weeks ago, now over 64,000. If we really only had 1000 cases two weeks ago and we have precisely 64000 cases now, that would mean the numbers have doubled on average every 2.3 days. I would suggest that many of those positive confirmed cases were out there 2 weeks ago, we just couldn’t see them yet because they had not been tested, thus the infection is likely NOT moving quite that fast.

- It is also certain that we have not identified everyone who currently has the virus. Testing is still uneven and insufficient. There are also many who potentially had it and recovered from it already. (Perhaps the new Antibody tests being developed will allow us to recover some of this hidden data soon.)

- So although the confirmed cases can help us see where the virus is currently spreading. It is not helpful for accurate projections of future impact. There could be 10-20 times as many people who have or have had the virus as there are confirmed cases. Attempting to put a number on this unknown mass of people would be pure speculation.

The current CFR is not helpful

- The way most people calculate CFR is by dividing the number of confirmed cases by the number of Confirmed deaths. This is inaccurate in two ways.

- As we have seen above the number of confirmed cases does not reflect the number of actual cases. Using the numbers we have, would give us a higher CFR number then if we used the TRUE, actual, unknown number.

- The number of Confirmed Dead is an incomplete number also. There are more who are currently infected who will DIE in the future. There are more who have already died in the past who were never tested and thus never identified as a Covid-19 death. Using our current number instead of the TRUE, actual number (which includes deaths in the past and deaths in the future, an obvious unknown) would calculate a lower CFR then reality.

An example of this would be during the midst of the original SARS outbreak, they calculated the CFR between 3-5%. Yet after all the cases resolved they recalculated it closer to 10%. This number could just as easily be argued the other way under the suggestion that there were MORE survival SARS cases out there that were never identified. You cannot make accurate calculations with unknown numbers.


There really are only TWO data points that we can use to give us a reasonable glimpse into our potential future. Not an inevitable prediction, but rather a fairly solid idea of the consequence of action or inaction.

The only two metrics that really matter right now, in the midst of the pandemic, are the Growth Rate of Covid-19 deaths and the Growth rate of Hospitalizations. Not the current number of deaths or hospitalizations, as that number is changing on a daily basis, but the RATE at which that number is changing.

I’ve heard plenty of people look at the confirmed deaths from Covid-19 (under 1000 currently in the USA) and compare it to how many more people die from other causes every year. Traffic accidents, the Flu, Bath Tub drownings and the like, thinking that this proves we are over reacting to Covid-19. I would ask them, what number of dead would be worthy of some mitigation measures? Answer that question for yourself. Put a number on it. Decide what that line is, beyond which you would agree it is reasonable to let the economy take a hit in order to lessen the loss of life. After you have a number settled on in your head, let us look at the growth rate of Covid-19 deaths to see how fast we could get there if we take no mitigation action.

Remember what matters in the end is how many people die and how quickly they die. It is somewhat irrelevant how many infected people it took to yield those deaths. What has been the growth rate of Covid-19 deaths? What would happen if that growth rate continues at its current pace?

The best way to illustrate the growth rate is to calculate the doubling time. How many days does it take to go from 100 deaths to 200 deaths? Then how long from 200 to 400? Look at the numbers for the USA.

March 12th – 41
March 13th – 48
March 14th – 57
March 15th – 69
March 16th – 87
March 17th – 110
March 18th – 150
March 19th – 206
March 20th – 255
March 21st – 301
March 22nd – 414
March 23rd – 555
March 24th – 780
March 25th – 922 (so far reported)

These daily increases may seem small and somewhat insignificant. Yet look at the time it is taking for the death number to double. Roughly 3 days, though it is slightly accelerating now and is slightly more than doubling every 3 days. Let us project a similar growth rate out another month assuming it would stabilize and precisely double every 3 days.

March 27th – 1,560
March 30th – 3,120
April 2nd – 6,240
April 5th – 12,480
April 8th – 24,960
April 11th – 49,920
April 14th – 99,840
April 17th – 199,680
April 20th – 399,360
April 23rd – 798,720
April 26th – 1,597,440

Correlated to this is the hospitalization rate.

The Feb 28th W.H.O. report regarding the China data (since destroyed) put the hospitalization rate at 20 percent. I’ve seen some early reports from different areas of the USA as high as 31% and as low as 12%. Lets assume the low end of 12% of the currently active 64,468 cases in the USA

Most cases start and remain mild for the first 10-14 days yet in the end it seems roughly 20% end up requiring hospitalization at some point during the duration of the disease. Scaling up the hospitalizations even at the lower 12% number looks like this.

March 25th - 7,736
March 28th – 15,472
March 31 – 30,944
April 3rd – 61,888
April 6th – 123,776
April 9th – 247,552
April 12th – 495,104
April 15th – 990,208
April 18th – 1,980,416
April 21st – 3,960,832
April 24th – 7,921,664

Hopital beds in the USA

“According to a 2018 survey by the American Hospital Association, hospitals in the United States have a total of 924,100 beds, about 2.8 hospital beds per 1,000 people. (This includes all of the beds currently occupied by patients.)”

So even if we discharged every single non-Covid-19 patient, we would still over run hospital capacity by mid-April. We run out of ventilators and ICU beds much, much sooner.

Will there be over 1.5 million dead one month from now? What can prevent this growth rate from continuing? There are only two ways to slow this down.
- One is people changing their behaviors, adhering to social distancing and taking other precautions to limit infectious spread. (this is already happening)
- The other is a large enough portion of the population having immunity either from surviving the Virus or through effective vaccination.

The death numbers and reflected growth rate over the past 14 days, reflects the actual exponential spread of Covid-19 through a target rich environment of uninformed and unconcerned people that occurred 2-4 weeks ago. Most cases that will resolve to death do so in a window 2-4 weeks from initial infection.
We will certainly NOT have 1.5+ million dead by the end of April. The social distancing measures that we began taking a little over 2 weeks ago will already start showing up in the next 2 weeks. We will see more deaths, but the doubling rate should slow down. Even hard hit Italy has a doubling rate right now of roughly 5 days as the mitigation they took weeks ago is starting to have an effect. The more we social distance, the more we slow it down.

It is important to acknowledge that if nothing had been done to slow it down, we would have remained on track for 1.5 million dead (in the USA) before the end of April.

Now of course that is assuming that nobody changed their behaviors at all. This is unrealistic. As the deaths began to mount, people would change their behaviors on their own even without a government mandate. At a certain point, the carnage becomes undeniable and actions to slow the spread become the only SANE response. In every country we have seen the exponential growth manifested early with a doubling roughly every 3 days, then eventually seen it slow down as every country has been FORCED to take mitigation action.

Unhindered, this virus would have burned through the population at this 3 day doubling rate until it started to run out of new viable incubation targets. They estimate it would take roughly a 60-70% saturation of recovered and immune individuals to drop the R0 of the virus down below 1 and then have slowly winded the pandemic down. This is why some people have suggested that 80% of the world will eventually get the virus, because it seems impossible to contain. This may still happen eventually. If it does, it will have infected 6.2 billion people and with an actual CFR of even 1%, will have killed over 62 Million.

How long would it take to hit those marks? In a fantasy world where everyone is dumb and nobody takes precautions, it would only take another 36 days from today. So this little virus is capable of killing over 62 million by the end of April unless we prevent its unhindered spread. We of course will not allow this to happen and have been actively slowing it down ever since China locked down Wuhan on Jan 23rd.

In reality we can drastically slow this thing down and perhaps with better treatment methods, mitigation efforts, and potentially a vaccine that works, prevent it from ever coming anywhere close to those numbers.

South Korea

South Korea has dropped their doubling rate all the way down to 14 days. In the world of Exponential Math, this makes a massive difference. It shows already, even in the short time window of the last 2 months, as their death toll is at a mere 126 deaths. How are they doing it?

South Korea Mitigation Actions

South Korean authorities banned large gatherings, shut down educational institutions and other public spaces – such as parks, sports facilities and daycare centres – and cancelled all major sports events soon after discovering the first major eruption of disease in the country.
…
“City hall asked people on 20 February, when the outbreak had been barely discovered, to only leave their places when absolutely necessary. That’s what a majority of citizens have kept doing and continue to do for almost a month now,” said the woman, whose entire family lives in the city.
…
The national mobile phone alert system warns residents of the respective districts or localities when a fresh case is detected and carries a link to detailed information about the last few places which the patient had passed through. This alerts people who have visited the areas to monitor and report possible symptoms.
…
The government has developed two mobile phone applications to follow potential patients, with one of them being mandatory for people arriving in South Korea from high-risk areas – currently China, Hong Kong, Macao, Iran and the entirety of Europe – who are forced to answer daily questions about their possible symptoms.

The app forwards users to telecalling executives for arranging testing if they report developing symptoms.

The other app warns public officials whenever someone in quarantine leaves the isolation zone, although this depends on personal responsibility as downloading the application is not mandatory.”

South Korea has been able to remain fairly functional because they have been aggressive with their testing and taken calculated and measured mitigation action. They have also been transparent with their population and been committed to keeping everyone as informed as possible of the evolving situation. They have not needed to completely shut down their society (like China did) because they started these measures early and comprehensively.

Any country that relaxes the mitigation measures and goes back to normality, will merely start the exponential growth rate all over again. This virus is not going away. We need to figure out how to live with the reality of it and still maintain a somewhat functional society. South Korea has given us a model, it is as reasonable and effective a response as I think we could hope for.

Age is not the only Risk factor.

I can’t tell you how many times I’ve heard someone comment that it is really only dangerous for old people. I could list you articles showing over 50% of hospitalizations in many countries or states being people under the age of 60. Even so it is true that even with severe cases, the young are more likely to survive (albeit with some lasting damage) then the old. There are however some major factors which may lead to a more critical outcome that can be common to ALL age groups.

The most common Comorbidities that lead to critical cases

Common Comorbidities in Critical Cases

“Denson said nearly all of his most critically ill patients have a combination of three specific underlying medical problems: obesity, high blood pressure and type 2 diabetes.”

Consider that 36.5 percent of U.S. adults are obese, nearly 1/3 of all adults in American have high blood pressure and nearly 10 percent of Americans have type 2 diabetes.

There is more risk in our population then just the elderly.


I have recently heard more people start suggesting that this virus has been spreading around for longer than we think and that the majority of Americans have already had a mild case and recovered. Thus this is all a big panic over nothing. The numbers simply do not support this suggestion. I agree that there are people who have been infected and recovered without being tested over the past few months. Certainly not a majority or anything close to what we would need for herd immunity. 198 million people would have to be recovered and immune from this virus for us to get into that ballpark. This is unlikely for two reasons.

1.) We have been able to track infection vectors from the origin site “Wuhan” into hundreds of countries within the same time frame and most importantly we have been tracking its genome changes. There simply isn’t evidence of this virus running through that high a percentage of the population when we look at the deviation of the strains and are able to track them all back to Wuhan.
Next Strain

2.) The obvious pattern of growth rate in the death stats can not only be run forwards to speculate on potential future deaths, but can also be run backwards to see when the FIRST deaths occurred. Now of course there can be some missing data in the past and present, yet not enough to throw us all that far off. If we run the growth rate of confirmed deaths in the USA back to 0, it is very likely that initial exposure and emergence into the population occurred no more then 4-6 weeks max before that date. This virus starts out as a slow burn before picking up speed. The first Death reported in the U.S. was on March 5th in Kirkland, WA. If you look on Next Strain the Genome tracking puts first transmission into the USA around Jan 19th and into Washington state around January 28th.



Now let us consider the supposed miracle “cure” for Covid-19, Chloroquine.

It is my opinion that it should not be seen nor used as the standard drug therapy for Covid-19 infections. I think it should be available as an option for the most severe cases as a last resort if the immune system seems to be failing. Everyone else should steer clear of it if possible.

Fatal with just 2 Grams

“Wuhan Institute of Virology study found that the drug can kill an adult just dosed at twice the daily amount recommended for treatment, which is one gram.
….
The drug is known to have short-term side effects such as nausea, diarrhea and tinnitus while long-term use can irreversibly impair eyesight.
…..
The drug cannot be given to pregnant women, those with heart disease, terminal liver and renal disease, retina and hearing loss and patients on antibiotics such as azithromycin and steroid.”

This is NOT a safe drug and can cause significant disruption to cardiac rhythms. Also it does not play well with antibiotics, however many ARDS patients will be put on antibiotics to prevent a secondary bacterial infection.
Perhaps as concerning are the potential for long term neurological effects.

Neurotoxic drug

“The same endosomotropic properties that likely underlie the effectiveness of quinoline antimalarial drugs such as chloroquine and hydroxychloroquine against the virus may also underlie their dangers, ” said Dr. Remington Nevin, MD, MPH, DrPH, a Johns-Hopkins trained psychiatric epidemiologist and drug safety expert and former U.S. Army public health physician, who now serves as Executive Director of The Quinism Foundation. “These are not safe drugs.”

“In susceptible individuals, these drugs act as idiosyncratic neurotoxicants, potentially causing irreversible brain and brainstem dysfunction, even when used at relatively low doses,” said Dr. Nevin. “This drug-induced dysfunction causes a disease of the brain and brainstem called quinoline encephalopathy, or quinism, which can be marked acutely by psychosis, confusion, and risk of suicide, and by lasting psychiatric and neurological symptoms.”

“Symptoms of chronic quinoline encephalopathy include tinnitus, dizziness, vertigo, paresthesias, visual disturbances, nightmares, insomnia, anxiety, agoraphobia, paranoia, cognitive dysfunction, depression, personality change, and suicidal thoughts, among others, ” said Dr. Nevin. “Particularly among military veterans, in whom these drugs have been widely used for decades as prophylactic antimalarials, these symptoms can mimic and be mistaken for those of post-traumatic stress disorder and traumatic brain injury.”

Best to just stay away from this drug if you can.

Around 1,000 cases 2 weeks ago, now over 64,000. If we really only had 1000 cases two weeks ago and we have precisely 64000 cases now, that would mean the numbers have doubled on average every 2.3 days.

I appreciated reading your post. Please don't laugh at me but I'm wondering how you figured the math out. Just out of curiosity. I'm not incredibly math-savvy but it seems like a cool thing to be able to do.

a reply to: SoulReaper

China

Finally I am very curious to watch China for the next 4-6 weeks. I have heard it all over the media that China successfully defeated SARS-CoV 2 and are basically only reporting new IMPORTED infections from other countries. This is the message they are telling their own people and the message the media is dutifully reporting.

They are trying to return to normalcy now and will attempt to get their economy ramped back up. They just recently released all the people that have been walled up in Wuhan. They have primed their own people to believe that when the second wave emerges, that it was brought in by foreigners whose own countries have failed to contain their own outbreaks, thus the CCP should not be held responsible for it.

The following are some of the reasons I do not believe the official narrative out of China.

Political over Medical considerations

“Despite claims made by mainland authorities that there have been no new local infections of the coronavirus in Wuhan in the last few days, people there have told RTHK this is simply not the case.

They say patients are being turned away from hospitals without testing to back the official data, which one person described as a "not medical, but political treatment".

Infected patients released back into society

“BEIJING - The number of novel coronavirus patients in Wuhan, the epicenter of China's virus outbreak, was manipulated in time for President Xi Jinping's visit last week, a local doctor told Kyodo News Thursday.

A number of symptomatic patients were abruptly released from quarantine early while a portion of testing was suspended, the doctor said.
But the doctor, who works at a quarantine facility, said the government tally "cannot be trusted."

The number of patients currently undergoing treatment is deliberately being reduced in an effort to show the Xi government's success in combatting the epidemic, he said.
….
But according to the doctor, from around the time of Xi's visit, even though his patients still exhibited signs of pneumonia, the patients were released from quarantine at the discretion of a "specialist" from the epidemic prevention and control authority.

From then on, the criteria for discharging patients became loose, and "a mass release of infected patients began," he said.

Also, patient interviews with those exhibiting symptoms such as fever were simplified, and blood tests to detect antibodies produced during infection were discontinued. As a result, "suspected patients were released back into society," he said.”

China destroyed their data around Feb 23rd and into the following week. This was simultaneous with W.H.O. releasing their report on the situation in China. Since that report was released, China has systematically reported lower and lower numbers until they eventually brought it down to almost zero. They limited their testing, excluded positive tests that were mild or asymptomatic, and basically only reported deaths from existing cases and a low number of NEW cases that were serious enough to make the cut.

Now that they have their official narrative in place and they are sending everyone back to work. I imagine they will start testing more widely again to help prevent another Wuhan. It will be interesting to see how long they can go without having to lockdown again.

Soul

a reply to: SoulReaper


Excellent post!

I've always known, and a first-year algebra student would see through the ridiculous notion that they can have an accurate death rate. They can’t.

After considering all the perspectives and information I have concluded the problem boils down to the ignorance of the medical/scientific profession of the elements of this new virus. It is that which is propelling the narrative and actions.
Not even the data. The data inst there yet so they’ll say any half-truths just to get their agenda done. Actually a reasonable methodology.

One proof of that is two things: One, in America they tell people don’t wear masks. A ridiculous notion and only serves the interest of the medical establishment, not the people.

Two, they keep giving out this FALSE death rate nonsense, which you acknowledge is inaccurate. Why do they keep perpetuating these falsehoods?

Because this issue is all about the ignorance of the scientific and medical profession about coronavirus.

They have to pretend they know things they don't and put out information in order to keep the process moving the way it's going.

Bottom line: They don’t know what it can do.

originally posted by: DictionaryOfExcuses

Around 1,000 cases 2 weeks ago, now over 64,000. If we really only had 1000 cases two weeks ago and we have precisely 64000 cases now, that would mean the numbers have doubled on average every 2.3 days.

I appreciated reading your post. Please don't laugh at me but I'm wondering how you figured the math out. Just out of curiosity. I'm not incredibly math-savvy but it seems like a cool thing to be able to do.

a reply to: SoulReaper

To go from 1000 cases to 64000 cases requires the cases to Double 6 times.
1.) 1000-2000
2.)2000-4000
3.)4000-8000
4.)8000-16000
5.)16000-32000
6.)32000-64000


So in a 2 week or 14 day period you can simply divide the number of Days by the number of times the cases doubled. This yields an average doubling time of 2.3 days.

Soul

Great work done. BUT I think your numbers are too random to garner any accurate data from simply because they lack an algebraic fact in the equation that tries to determine any of the facts you seek: that is the actual number of people with the virus.

You’re right about one thing. The key to what is going on is the hospitalization of so many people.

That’s it, anything else is irrelevant simply because what is ONLY relevant is the ignorance of the medical science community, not all these peripheral ‘ facts” you seek.

Even the death rate is irrelevant because it is no more than the flu death rate and is probably less.


This, in the end, will all boil down to a medical scientific issue. Saying the medical science community is ignorant is not a critique but an expression of existential relaity.

a reply to: DictionaryOfExcuses

He's probably a statistician

He does do great work

originally posted by: Willtell
Great work done. BUT I think your numbers are too random to garner any accurate data from simply because they lack an algebraic fact in the equation that tries to determine any of the facts you seek: that is the actual number of people with the virus.

The real concern is that NOBODY has sufficient data. China destroyed theirs and is now lying. Iran is hiding their numbers to not appear weak. Most of the other developed countries have been abysmal at providing and deploying accurate testing. South Korea likely is the most reliable model to look at, but their mitigation actions are not being followed elsewhere.

Everyone is attempting to make projections based on quite small and definitively incomplete data sets.

There is one reality which seems to be consistently emerging in EVERY country that has experienced significant community spread.
If you do nothing, it is only a matter of time before your hospitals will get crushed.

Soul

Stay the # away from Hydroxycholorquine!

Not only are the sideeffects massive (you can go blind from using it, I get tested every 6 weeks!), you are trying to buy up a medicine other people need to actual life their lives!

I am not saying that I would die without it, but my Rheuma sure would not get better without it... And I am not the only person who has to take it. BTW, Rheuma is an autoimmune disease - and this Chloroquine is *reducing* my immune response.

If this medicine really works against Cov-19, thats a nice one, but right now I am in homeoffice because I am a person with high risk to infections... Because I take Hydroxycholoroquine.

a reply to: SoulReaper
One nit to pick...

First, hydroxychloroquine, which is what Trump mentioned and what Dr. Zelenko is using, is supposedly much less toxic than plain chloraquine phosphate (at least that is what I recall hearing).

Second, Dr. Zelenko is only using 400mg per day (in 2 200mg doses), as opposed to your claim of 1,000mg per day, and that is with the much less toxic hydroxy version.

Personally, I'd be much much happier to see Doctors start using high dose IV Vitamin C (only in a hospital/Doctors supervisory setting of course), as it has zero negative side effects, and promises to be just as, if not more effective.

a reply to: SoulReaper

You are ignoring a very big factor: The number of dead caused by the extreme measures being taken.

How high would that number have to be for you to want easing of those measures?

Isolation and economic uncertainty can and does lead to suicide. Many of these people would otherwise remain perfectly healthy. A large number of people dying from Corona already have a relatively low quality of life, due to existing medical issues.

Also, try and imagine the mental health issues that will undoubtedly skyrocket due to these measures, and what all of that is going to mean down the road. This includes all the children being kept from seeing their friends, and many children in toxic families that are getting extra abuse now because their parents are home all the time.

soulwaxer

CALCULATIONS OF INCREASES MEAN NOTHING UNLESS THE PERIODS HAVE CONSISTENT TESTING!

I keep hearing how the cases in the US have skyrocketed. Well of course they have because now we are testing - it's not necessarily from an actual increase in cases.

Yes, I think we need to look at hospitalizations to determine how much "social distancing" is needed but you can't use the increase in cases to calculated until testing is consistent.

The cruise ship the Diamond Princess is actually a decent way to calculate the increases over time. You have to do the math to adjust to a higher proportion of older people on the ship than you would have in ordinary populations.

www.sciencenews.org...

"These ratios depend on available health care and public health measures, Russell cautions. And there are still uncertainties in the data, he notes. For example, some patients initially counted as asymptomatic may later develop symptoms, or even die. So the true fatality rate may be somewhat higher, “0.6 or 0.7 [percent], but it’s still a good ratio.”

originally posted by: soulwaxer
a reply to: SoulReaper

You are ignoring a very big factor: The number of dead caused by the extreme measures being taken.

How high would that number have to be for you to want easing of those measures?

Isolation and economic uncertainty can and does lead to suicide. Many of these people would otherwise remain perfectly healthy. A large number of people dying from Corona already have a relatively low quality of life, due to existing medical issues.

I am not advocating for complete lock down or complete social isolation. Rather social distancing whenever possible and smart mitigation measures that allow the economy to continue while at the same time doing everything we can to minimize community spread.

South Korea is not in complete lock-down. Those who are confirmed infected should isolate for a time, but when they are no longer infectious should be free to reenter society. Aggressive testing, targeted isolation, aggressive contact tracing, and real time information disseminated to the public are all mitigation actions that will help without causing undue stress.

It isn't all or nothing.

Are you suggesting that the unhindered virus is less dangerous then the mitigation measures?
If so, do you have projections that more then 1.5 million people would be dead as result of mitigation measures by the end of April?

Are you suggesting that we should do nothing to hinder community spread?

Soul

originally posted by: tanstaafl
a reply to: SoulReaper
One nit to pick...

First, hydroxychloroquine, which is what Trump mentioned and what Dr. Zelenko is using, is supposedly much less toxic than plain chloraquine phosphate (at least that is what I recall hearing).

Second, Dr. Zelenko is only using 400mg per day (in 2 200mg doses), as opposed to your claim of 1,000mg per day, and that is with the much less toxic hydroxy version.

Personally, I'd be much much happier to see Doctors start using high dose IV Vitamin C (only in a hospital/Doctors supervisory setting of course), as it has zero negative side effects, and promises to be just as, if not more effective.

Do you have any studies which explain how Hydroxychloroquine is less toxic? I have seen people claim that elsewhere, but have yet to see any clinical study proving this claim. I would be very interested to read the study and see what mechanism is driving that claim.

As I understand it, Hydroxychloroquine is a synthetic that is nearly identical in structure to Chloroquine and shares ALL the same side effects.

In fact the more I look into Hydroxychloroquine, the less I like it.

Study involving Hydroxychloroquine and Immune Suppression

Hydroxychloroquine and chloroquine are very similar in structure, and the biological mechanisms of action appear identical.
....
Patients taking hydroxychloroquine had a significant reduction in total CD4 cell count
....
Total CD8 cell count and total lymphocyte count were also significantly reduced in the hydroxychloroquine group by week 48
...
Viral load increased significantly in the hydroxychloroquine group compared with placebo
...
Adverse events were similar in the 2 groups apart from a higher rate of influenza-like illness in the hydroxychloroquine group (29% vs 10%, P=.03) with a non-significant increase in upper respiratory tract infections observed in the hydroxychloroquine group.
....
Contrary to our original hypothesis, we found that hydroxychloroquine accelerated the decline in CD4 cell count
....
The CD8 cell count and total lymphocyte count declined in parallel with the CD4 cell count, indicating that the CD4 cell change was part of a generalized lymphopenia.
...
The increase in viral load of approximately 0.4 log10 copies/mL that we observed in the hydroxychloroquine group may have resulted from down-regulation of the innate immune response
...
We found an excess of influenza-like illness and upper respiratory tract infection in the hydroxychloroquine group. A pandemic of H1N1 influenza occurred during the follow-up period of this trial, and it is therefore likely that a number of these reports represent genuine cases of influenza. Although chloroquine decreases influenza virus replication in vitro, our findings of an increased risk of influenza are consistent with the results of a clinical trial of chloroquine for the prevention of influenza that suggested a higher rate of influenza in participants taking chloroquine.32,33 We can postulate that the same cellular immune changes that may have led to enhanced HIV replication in the present trial also led to a permissive environment for influenza virus replication.

The above is a clinical study where they were trying to slow down HIV using Hydroxychloroquine. Interestingly, they found it actually increased viral load and made them more susceptible to respiratory infections.

This is due to the adverse effect that hydroxychloroquine has on the immune system. It induces lymphopenia, knocking down your CD4 and CD8 cells and inhibiting their ability to clear a viral infection.

Many of the severe and critical cases are suffering from an out of control immune response. I would guess that hydroxychloroquine is acting as a rapid immune suppressant, thus causing rapid decrease in symptoms. I think it will be interesting to see the long term outcomes of many of these "recovered" patients. This drug is reducing symptoms, but may actually be preventing the immune system from clearing the virus and possibly is increasing the viral load in their systems like it did in this study.

Hydroxychloroquine takes a long time to leave the body and can continue to suppress the immune system for up to 6 months after cessation of treatment. Watch to see if those who take hydroxychloroquine are more prone Covid-19 relapse or reinfection.

At best I think this drug should only be used as a short term immune suppressant to calm down cytokine storms.
Even then, use of the drug will leave you immunocompromised and more prone to a secondary viral infection, including influenza. This thing interferes with both your innate and adaptive immune system responses. I still recommend avoiding this drug if at all possible.

Soul

originally posted by: SoulReaper
Do you have any studies which explain how Hydroxychloroquine is less toxic?

No, hence the (at least that is what I recall hearing) disclaimer...

I have seen people claim that elsewhere, but have yet to see any clinical study proving this claim. I would be very interested to read the study and see what mechanism is driving that claim.

As I understand it, Hydroxychloroquine is a synthetic that is nearly identical in structure to Chloroquine and shares ALL the same side effects.

In fact the more I look into Hydroxychloroquine, the less I like it.

...snip...

This thing interferes with both your innate and adaptive immune system responses. I still recommend avoiding this drug if at all possible.

Interesting... I don't pretend to understand all of the science... I wonder what it does to the other aspects of the immune system - the Interferon system, and especially the Microbiome.

Makes me wonder if it isn't the other two substances doing the magic, or even just the Zinc. Zinc is extremely important for proper immune system function.

Like I said - I'd insist/demand that whatever doctor(s) treat me or my loved ones with high dose IV Vitamin C anyway (and can do so via the Right to Try Law).

Sorry if this has been asked then, but what is your opinion on both the French trials and the NY trials which showed immense success in combining both azithromyicin and hydroxychloroquine and zinc?



a reply to: SoulReaper

a reply to: chris_stibrany

My understanding is that it isnt the hydroxy chloroquine that is the treatment, its that the hydroxy chloroquine enables the zinc (large dose) to penetrate the cells.

One, or the other, on their own might not have much results (if any).

Probably also important to note that the vast majority of modern medications can have some serious side effects. Frequently in seeming contradiction with what they are treating. My asthma medication lists "serious breathing problems" (essentially) as a side effect.

Not to say that the hydroxy chloroquine/zinc/zpak combo is some wonder cure, but it seems the mechanism that needs to be examined (not a doctor here) is frequently overlooked.

Thanks for putting a lot of data in one thread SR!