# Hydroxychloroquine and diabetes



## Jaydee70 (Apr 8, 2020)

Why are diabetics in the UK still being advised to self isolate when they show symptoms of covid19 when clinical evidence from live patient treatment centres in New Jersey and los  Angeles is showing that diabetics who receive h .ca and azithromycin therapy within 72 hours 
do my need to be ventilated and have an80% survival rate than diabetics not given the therapy. As diabetics with covid 19 die 2 -3 days earlier than non  diabetics why is diabetes UK not taking this issue up with the govt. See Dr Stephen Smith of the Smith institute of new Jersey who has 80 patients diabetics on the therapy no deaths and only one patient requiring ventillation.another doctor who has 2000 patients  with lupus and on hcq reports no deaths or ventiliation for his patients


----------



## SB2015 (Apr 8, 2020)

W


Jaydee70 said:


> Why are diabetics in the UK still being advised to self isolate when they show symptoms of covid19 when clinical evidence from live patient treatment centres in New Jersey and los  Angeles is showing that diabetics who receive h .ca and azithromycin therapy within 72 hours
> do my need to be ventilated and have an80% survival rate than diabetics not given the therapy. As diabetics with covid 19 die 2 -3 days earlier than non  diabetics why is diabetes UK not taking this issue up with the govt. See Dr Stephen Smith of the Smith institute of new Jersey who has 80 patients diabetics on the therapy no deaths and only one patient requiring ventillation.another doctor who has 2000 patients  with lupus and on hcq reports no deaths or ventiliation for his patients


Welcome to the forum @Jaydee70 
I have not heard of the treatment that you have mentioned being used over here.
Are you in New Jersey yourself?


----------



## Deleted member 27171 (Apr 8, 2020)

Hi @Jaydee70
Welcome to the forum. There have been no studies robust enough to declare a success of any drug used treat COVID-19 in people with any specific pre existing condition including this treatment which is among those being investigated by the World Health Organisation. This is not a recommended treatment anywhere.

I haven’t read either of the studies you mention, the New Jersey or ’other doctor‘ but the numbers in both are very small for a start without knowing any further detail.

People with diabetes and COVID-19 symptoms are still being advised to self-isolate as this is the approach best thought to reduce the virus spread and in many cases the illness will be manageable at home, though of course those who need further assistance should seek it. Hydroxychloroquine has not been indentified as a cure or treatment for COVID -19, which is why people are not being offered it.

Diabetes UK are working closely with government to ensure advice to those with diabetes is correct in relation to the limited knowledge there is about this virus. For information about what that advice is as well what else Diabetes UK is doing please see the information here: https://www.diabetes.org.uk/about_us/news/coronavirus


----------



## everydayupsanddowns (Apr 9, 2020)

Welcome to the forum @Jaydee70 

It is a worrying time for everyone, and it’s only natural to wish that there was a ‘silver bullet’ that could fix everything for people with long-term conditions and those at increased risk.

These things take time though, and if there are promising results from some centres you can be absolutely sure that these are being investigated and examined elsewhere.

Diabetes UK has announced a significant amount of funding for new/urgent research projects into potential treatments for Covid-19, and new research is being published at a phenomenal rate. The situation is changing weekly, of not daily, and new approaches and understandings are being developed and shared all over the world. 

The cream will rise, and the good stuff, which is robust and repeatable at scale will emerge


----------



## mikeyB (Apr 9, 2020)

Those trials mean nothing. An 80% survival rate in diabetics is appalling, far worse than it should be. And very few people die from Covid 19. Personally, I think that dying 2-3 days earlier than a non diabetic is a hardly a bonus. I’d prefer not to die at all.

The hydroxychloroquine original paper that was picked up by Trump has been withdrawn by the author, who is shocked that Trump has seen this and run with it. It does nothing to Covid 19. The government here has quite rightly ignored this. That’s because the government is advised by scientists who know what they are talking about. So is Trump, but he chooses to ignore them.


----------



## Robin (Apr 10, 2020)

Jaydee70 said:


> Why are diabetics in the UK still being advised to self isolate when they show symptoms of covid19 when clinical evidence from live patient treatment centres in New Jersey and los Angeles is showing that diabetics who receive h .ca and azithromycin therapy within 72 hours
> do my need to be ventilated and have an80% survival rate than diabetics not given the therapy. As diabetics with covid 19 die 2 -3 days earlier than non diabetics why is diabetes UK not taking this issue up with the govt. See Dr Stephen Smith of the Smith institute of new Jersey who has 80 patients diabetics on the therapy no deaths and only one patient requiring ventillation.another doctor who has 2000 patients with lupus and on hcq reports no deaths or ventiliation for his patients


Side effects include permanent eye damage, heart failure, and one pertinent to people with diabetes, severe hypoglycaemia. I’ll take my chances with Covid, thanks.


----------



## Jaydee70 (Apr 10, 2020)

LucyDUK said:


> Hi @Jaydee70
> Welcome to the forum. There have been no studies robust enough to declare a success of any drug used treat COVID-19 in people with any specific pre existing condition including this treatment which is among those being investigated by the World Health Organisation. This is not a recommended treatment anywhere.
> 
> I haven’t read either of the studies you mention, the New Jersey or ’other doctor‘ but the numbers in both are very small for a start without knowing any further detail.
> ...


there is a difference between isolating to stop the spread and diabetics getting no therapy while self isolating with the usa france and india now using this drug widely for covid patients and even the w,h,o not opposing its use now surely diabetics should be offered the treatment  without having to wait to go into hospital.by your definition of waiting then you would have been opposed to the tetanus injections as there never was a clinical trial


----------



## Jaydee70 (Apr 10, 2020)

mikeyB said:


> Those trials mean nothing. An 80% survival rate in diabetics is appalling, far worse than it should be. And very few people die from Covid 19. Personally, I think that dying 2-3 days earlier than a non diabetic is a hardly a bonus. I’d prefer not to die at all.
> 
> The hydroxychloroquine original paper that was picked up by Trump has been withdrawn by the author, who is shocked that Trump has seen this and run with it. It does nothing to Covid 19. The government here has quite rightly ignored this. That’s because the government is advised by scientists who know what they are talking about. So is Trump, but he chooses to ignore them.


thanks for reply but this has nothing to do with trump as the us govt and french govt have been widely using this drug and have ordered almost 100million doses between them the fda and the w.h.o are now not oppossed to its use for the covid patients i am arguing that instead of waiting to go into hospital to get it diabetics should get the therapy before they become seriously ill.by the way medical ins records of 800 lupus patients in new york show no medical claims for covid19 treatment.is that not interesting as these patients are all on hcq


----------



## Jaydee70 (Apr 10, 2020)

SB2015 said:


> W
> 
> Welcome to the forum @Jaydee70
> I have not heard of the treatment that you have mentioned being used over here.
> Are you in New Jersey yourself?


thank you for reply this treatment is now being trialled here but only in hospital whereas the chinese ,french,usa.and indian govts  are weeks in front of us.i am arguing that diabetics should be given this therapy at home instead of waiting to get seriously ill and getting it in hospital.my friends daughter has been on it for lupus treatment for years with no side effects


----------



## SB2015 (Apr 10, 2020)

Jaydee70 said:


> thank you for reply this treatment is now being trialled here but only in hospital whereas the chinese ,french,usa.and indian govts  are weeks in front of us.i am arguing that diabetics should be given this therapy at home instead of waiting to get seriously ill and getting it in hospital.my friends daughter has been on it for lupus treatment for years with no side effects



Thanks for the information.
From what I have now read it is not something I would want to try without more evidence


----------



## Jaydee70 (Apr 10, 2020)

dr stephen smith  smith institute for infectious diseases and urban health so far all patients treated with hcq have not required to go on a ventillator


----------



## Jaydee70 (Apr 10, 2020)

LucyDUK said:


> Hi @Jaydee70
> Welcome to the forum. There have been no studies robust enough to declare a success of any drug used treat COVID-19 in people with any specific pre existing condition including this treatment which is among those being investigated by the World Health Organisation. This is not a recommended treatment anywhere.
> 
> I haven’t read either of the studies you mention, the New Jersey or ’other doctor‘ but the numbers in both are very small for a start without knowing any further detail.
> ...


dr stephen smith  smith institute for infectious diseases and urban health new jersey , since starting using hcq on all patients no one has required to go on a ventillator this the reason the governor of new york had to relent and allow the therapy to be used in ny hospitals to try and cut ventilator use and now new york has a surplus of ventillators


----------



## Jaydee70 (Apr 10, 2020)

dr daniel maxwell has 2000 lupus patients getting hcq therapy and so far the patients on regular dailly doses have no insurance claims for covid 19 do you not find that interesting  dr maxwell is one of the top lupus specialist worldwide and has been prescribing hcq for 42 yrs with no medical emergencies with its use i am talking about diabetics being offered the treatment for 5-7 days


----------



## Jaydee70 (Apr 10, 2020)

everydayupsanddowns said:


> Welcome to the forum @Jaydee70
> 
> It is a worrying time for everyone, and it’s only natural to wish that there was a ‘silver bullet’ that could fix everything for people with long-term conditions and those at increased risk.
> 
> ...


i am not wishing for a silver bullet i am looking for this therapy to given to diabetics early instead of waiting in the queue at hospital to may or not get it. i cant disclose the details but i have personal  of this treatment working at home for a diabetic in florida who was refused to be taken to hospital as his condition was so bad they recommended pallitave care at home but fortunatly his daughter who ia hospital doctor disagreed and went to walgreens got meds and 12 hrs later most of his symptoms were gone  his breathing was the first thing to improve thats why am advocating for diabetics to get this at home


----------



## everydayupsanddowns (Apr 10, 2020)

Jaydee70 said:


> i am not wishing for a silver bullet i am looking for this therapy to given to diabetics early instead of waiting in the queue at hospital to may or not get it. i cant disclose the details but i have personal  of this treatment working at home for a diabetic in florida who was refused to be taken to hospital as his condition was so bad they recommended pallitave care at home but fortunatly his daughter who ia hospital doctor disagreed and went to walgreens got meds and 12 hrs later most of his symptoms were gone  his breathing was the first thing to improve thats why am advocating for diabetics to get this at home



Great that it worked so well for that case @Jaydee70

If those results are repeated more widely, you can be sure that it would become an important treatment option.


----------



## Jaydee70 (Apr 10, 2020)

SB2015 said:


> Thanks for the information.
> From what I have now read it is not something I would want to try without more evidence


i take it you believe in getting a tetanus jag did you know there was no clinical trial for the tetanus jag this drug has been prescribed millions of times in last 60yrs i believe it can buy time for diabetics until a vaccine can be available after all a vaccine is no use if you are dead  should i be in the position of being offered pallitave care or hydroxy then like the lady in london she chose hydroxy for her father and hes on the mend .what would you choose?


----------



## Jaydee70 (Apr 10, 2020)

everydayupsanddowns said:


> Great that is worked so well for that case @Jaydee70
> 
> If those results are repeated more widely, you can be sure that it would become an important treatment option.


having a long clinical trial would involve people dying who were getting a placebo thats why tetanus jags were never trialled as anecdotal evidence showed that it was working in most cases only the doses and timing were left to be worked out there is plenty live and anecdotal evidence that this therapy is working


----------



## everydayupsanddowns (Apr 10, 2020)

Jaydee70 said:


> having a long clinical trial would involve people dying who were getting a placebo thats why tetanus jags were never trialled as anecdotal evidence showed that it was working in most cases only the doses and timing were left to be worked out there is plenty live and anecdotal evidence that this therapy is working




But if it’s a positive treatment for covid-19, and if those results are repeated widely, I would say it should be made available to people with covid-19, rather than offered to all people with diabetes (the vast majority of whom don’t have covid-19 and who would only have it mildly if they did get it).

Just my opinion.


----------



## Jaydee70 (Apr 10, 2020)

everydayupsanddowns said:


> But if it’s a positive treatment for covid-19, and if those results are repeated widely, I would say it should be made available to people with covid-19, rather than offered to all people with diabetes (the vast majority of whom don’t have covid-19 and who would only have it mildly if they did get it).
> 
> Just my opinion.


i would agree but as there is no test available then as this drug is much cheaper than going into hospital and a five day dose would be very cheap .my doctor gave me 5 day steroids and 5 days anti biotics as an emergency pack  but as far as i can see these products would be of little effect against the virus surely a therapy which has live and anecdotal evidence in its favor would be worth a shot


----------



## Jaydee70 (Apr 10, 2020)

Jaydee70 said:


> dr daniel maxwell has 2000 lupus patients getting hcq therapy and so far the patients on regular dailly doses have no insurance claims for covid 19 do you not find that interesting  dr maxwell is one of the top lupus specialist worldwide and has been prescribing hcq for 42 yrs with no medical emergencies with its use i am talking about diabetics being offered the treatment for 5-7 days


i apologize its dr daniel wallace not maxwell wallace is the doctor ive been working with


----------



## Jaydee70 (Apr 10, 2020)

LucyDUK said:


> Hi @Jaydee70
> Welcome to the forum. There have been no studies robust enough to declare a success of any drug used treat COVID-19 in people with any specific pre existing condition including this treatment which is among those being investigated by the World Health Organisation. This is not a recommended treatment anywhere.
> 
> I haven’t read either of the studies you mention, the New Jersey or ’other doctor‘ but the numbers in both are very small for a start without knowing any further detail.
> ...


my doctor gave me steroids and antibiotics to use if i get infected surely with live and anecdotal evidence it would better to give hqr doc said if allowed it would be prescribed for me as diabetics are a high risk of death group if getting covid


----------



## Jaydee70 (Apr 10, 2020)

the world health organisation also said the virus could not be passed human to human was not as dangerous as the flu ,the chinese govt was on top off the infection. refused to help tawain on chinese sayso you still have faith in the w h o


----------



## mikeyB (Apr 11, 2020)

Covid 19 doesn’t kill most of the people it infects, diabetic or not. The treatment with HCQ produces results which are no better than chance. It is not an antiviral. It is not used in any other viral illness. COVID 19 is a coronavirus, whose family causes colds, SARS and MERS. It isn’t unique by any stretch.

HCQ has been around a long time, used across all malarial areas. It would have been noticed, if only by chance, that it had an effect on viral illnesses. It hasn’t.

The only drugs being tested in formal double blind trials are antivirals, like the HIV treatments. The tests which you insist on quoting weren’t double blind, so we don’t know what would have happened if the patients didn’t take HCQ, and neither do the doctors. Or you. They are useless.

By the way, there were clinical trials with tetanus vaccine, as there are with all vaccines. To become accepted, vaccines have to proved safe and effective in preventing the condition.

Like most folk, you haven’t had a medical or scientific education, so leave it to the experts to pass opinions. I don’t care if HCQ is being used on millions in India, it’s a panacea. And it just happens to be cheap.


----------



## trophywench (Apr 11, 2020)

…. the first diabetic patients injected with insulin died of sepsis too - until a bloke called Eli Lilly purified it to prevent that happening.  But it's the ONLY thing that keeps me alive day to day, every second of every day …...

There would have to be one helluva lot more trialling of any drug on insulin treated diabetics before I'd be happy with it - we can die of DKA, we can die of hypoglycaemia, we can die from whatever we happen to catch that can be deadly!  How many sliding scales do they even have in your average hospital anyway?  I'd object very strongly if a T2 in the next bed was put on one in favour of me!


----------



## Drummer (Apr 12, 2020)

The hydroxychloroquine apparently prevents the virus taking the iron out of the red blood cells and destroying their ability to carry oxygen. It is thinking outside the box, but when the final stages of the C-19 virus are like those of mountain sickness, for those who are dying, no amount of extra oxygen will help if there is no transport system.


----------



## Robin (Apr 12, 2020)

The problem seems to be that Covid 19 can cause cardiac arrest, and Hyrdoxycholroquine can also cause cardiac arrest. Tests are ongoing to try and find out which patients will benefit, and which won’t.








						Heart Damage in COVID-19 Patients Puzzles Doctors
					

Up to one in five hospitalized patients have signs of heart injury. Cardiologists are trying to learn whether the virus attacks the organ




					www.scientificamerican.com
				











						French Hospital Stops Hydroxychloroquine Treatment for COVID-19 Patient
					

The head of cardiology said they are now monitoring the ECG recordings of patients in the trial.




					www.newsweek.com


----------



## ianf0ster (Apr 12, 2020)

I agree with Robin, it isn't that straightforward. There appears to be quite a bit of anecdotal evidence that HQC may reduce recovery time, but there is also anecdotal evidence that it may cause harm in some patients. 

Personally I would never take an unproven drug for prevention of a disease with the know risk of side effects, which is why since I became uncertain that they are proven I stopped taking the Statins which I was prescribed. I have also stopped taking the BP drug Ramipril since my BP was never actually high and it was just prescribed as part of a cocktail for CV patients.
Note that Statins ARE proved to lower Cholesterol and Low Cholesterol can lead to a poorly functioning immune response; and that ACE2 inhibitors may make it easier for the Covid-19 virus to gain entry into cells. 
So I have valid but not uncontested reasons for my decisions.

However if I were in the situation of having a bad case of Covid and had a real prospect of being intubated on a ventilator, I would be only too pleased to take either the HQC combo or one of the retroviral ones - none of which have been proved to work for Covid-19, because I calculate the odds of any of them doing me harm would be outweighed by the chances of them improving my otherwise approximately  30% chance of survival!


----------



## Drummer (Apr 12, 2020)

Mountain sickness can cause damage to the heart as it struggles to pump ever more blood around the body to provide the oxygen it doesn't carry - it is a very dangerous situation to be in.


----------



## ypauly (Apr 12, 2020)

I don't think chloroquine is the problem from what I have read, it's using it, it's combination with other drugs, I do believe the combination you speak of would require such things as ECG monitoring due to the high risk of blood clots.

I am not a doctor but have read an awful lot during lockdown


----------



## ypauly (Apr 12, 2020)

Our understanding is evolving day by day 
This is from another website I frequent




First one (called Don):

I saw a few things about treatment and wanted to pass them along just in case you can possibly find some benefit. They came from the Denver area. I asked, "Have these protocols produced measurably better outcomes so far? He responded, "What I’m seeing with my own eyes the answer is a definitive yes. Things are happening so fast and this shift all happened in the last week so no data published yet.

#1
COVID-19 UPDATE - GOOD NEWS AND BAD NEWS
Bad news:
As you see on the news constantly, death toll and new cases are still increasing exponentially on a national level.

The next two weeks are likely to be the worst two weeks of the crisis.

I’m seeing firsthand, tragedy after tragedy in the hospital, of people dying way before their time, not being able to say goodbye to their loved ones. I did two years of critical care many years ago and dealt with a lot of death, but I’ve never seen anything close to this. It’s been truly humbling for all of us in the medical profession.

Good news:

The medical community has been making incredible advances in learning just how the virus attacks the body. Being a novel virus, we need to be able to adjust on the fly and be open to all possibilities. Initially we thought that this was predominately a viral pneumonia causing a syndrome called ARDS (acute respiratory distress syndrome) that we see in other pneumonias. Typically the treatment for ARDS is having the patient placed on a ventilator and treating the underlying cause of the disease. We now believe that this is not a classic ARDS, and we are seeing more successful outcomes for patients treated with oxygen rather than intubation. Patients appear to do better if they can breathe on their own; having air forced into their lungs may eventually cause severe damage to the lung tissue. For the subset of patients who do require a ventilator, however, it appears that using significantly lower pressures will improve the mortality (this is different from what we do with classic ARDS). As a result of this new, exciting information, I am working with hospitals in Denver to initiate new protocols in the treatment of COVID-19 that I believe will change the mortality significantly.

Thanks to the cooperation of the citizens of Colorado, it appears the curve here is flattening. So far we have been able to provide a hospital bed (ICU or regular) for everyone that needs it, and we are hopeful that this will continue to be the case if everyone continues to do their part. Keep up the good work; every time you decide to not interact with someone outside your household, you are literally saving lives. This type of diligence needs to continue, likely until we have rapid and widely available testing. Hopefully, this will come soon, and we can resume a more normal way of life.

We are also making progress with various pharmacologic treatments and antibody treatments. These likely won’t help significantly in this wave of the illness, but hopefully they will for any additional waves that may come prior to an approved and available vaccine.

#2
COVID-19 Update – Hospital Treatment Protocol for Critically Ill Patients

My urgent focus this week has been developing a treatment protocol for hospitalized COVID-19 patients that can be adopted nationwide. I’ve corroborated with colleagues around the world including Spain and Iran. After countless conversations with pulmonologists and hematologists, here are my conclusions:

1. This is primarily a hematologic disease. People are dying from excessive clotting, not pneumonia or ARDS like we initially thought. This has important implications because treatment needs to be directed towards thinning the blood with the help of our hematologists. Hematologists should be on the front lines and are essential in combating this disease.

2. What is causing the excessive clotting is an exaggerated immune response to the virus. As one colleague put it, it’s a wimpy virus, with a devastating, hyper-exaggerated immune response. It’s the immune response that’s killing us by causing the excessive clotting mentioned above, not the virus. It’s the clotting in the blood vessels going to the lungs that is causing breathing difficulties, not pneumonia/ARDS as previously believed. This is important because I believe we can stop this disproportionate immune response in critically ill patients with the use of steroids.

3. As mentioned in my previous post, much of the ARDS we are seeing is likely being caused by positive pressure ventilation. This is important because we can stop this by changing our threshold to intubate. We need to tolerate patients having low oxygen levels as long as they are not in respiratory distress and show no signs of organ damage as a result of low oxygen levels. In other words, only intubate patients if they are showing signs of respiratory distress or organ damage. Amazingly, for reasons that remain somewhat unclear to me, patients seem to tolerate low levels of oxygen with this specific disease.

4. As discussed above, the majority of critically ill COVID-19 patients do not have classic ARDS, and standard ARDS protocols should not be used in these patients whose lungs are not behaving like ARDS. In my opinion, this will reduce the amount of ARDS caused by ventilators.

If the above measures are adopted broadly, I believe that the course of this disease will change dramatically, and we will see a huge reduction in the death rate.

I don’t claim to be an expert, but I’ve spent a great deal of time these past two weeks learning from people way smarter than me, and this what I’ve compiled. The above protocols are being used in a piecemeal approach, and I’m sure some institutions are doing all of the above, but it is not accepted standard of care yet. Many people in the healthcare field would like to wait for randomized control trials. In the meantime, people are dying at an alarming rate. It’s not the time to wait for trials; we need to act immediately on our solid understanding of physiology, our observations, and our intuition, and continue to adjust protocols as we continue to learn more.

I do want to make one thing abundantly clear. Most people with COVID-19 do not need to be hospitalized. If you have relatively mild disease and are well enough to not be hospitalized, steroids and blood thinners are not indicated. These drugs are not benign and can have serious side effects. Steroids should not be used prophylactically or in the first phase of the disease (note that most patients do not progress to a second phase of the disease). It is up to hospital specialists to decide when the benefits of these drugs outweigh the risks, and how much of each can be safely administered. At this point, it is estimated that roughly 20% of people with COVID-19 require hospitalization, and it's my strong advice to stay home and manage the symptoms unless you have signs of respiratory distress, or an oxygen saturation of less than 90, or other severe symptoms that cannot be managed at home.


Second one, in response:

Don, thanks for posting this. I just finished my ICU shift and I spent half the day trying to wean down those pressures the doctor is referring to. I'm no pulmonologist but I largely disagree with the way we're managing COVID in our unit, which is essentially to intubate patients when they can't maintain 90% spo2 via noninvasive means, then use high PEEP pressures initially to oxygenate once intubated. I sent several articles and anecdotal reports to our medical director that reinforce these concepts detailed in the protocol you posted. The pathophysiology really is nothing like ARDS or typical pneumonias; it resembles pulmonary infarcts (and running a close second, acute kidney failure almost certainly from the same clotting cascade that's attacking the pulmonary vasculature). Our sickest patients are coming in with d-dimer levels through the roof: normal levels 1-250, our patients having levels in the 16,000+ stratosphere. It's an indication of clotting activity, something you'd be tested for if you were suspected of a pulmonary embolism (though not a specific or definitive test for PE). So we're getting caught up on anticoagulation when relatively safe and appropriate, but I'm afraid we're going to see a mortality rate higher than more progressive institutions as a result of our reticence to allow persistent hypoxemia without invasive intervention. It's frustrating to not only not know the right approach to treatment, but also to be hamstrung by protocols that appear to be at best ineffective and at worst harmful.

We're two weeks in and have yet to successfully extubate a COVID patient. The patients who do best are the ones who never get intubated. I don't think the obvious conclusion holds anymore, that they do poorly on the vent because they were sicker than those who didn't require it in the first place. High flow oxygen, a higher threshold for intubation, mucolytics, bronchodilators, steroids, chest physiotherapy, and staying off the vent until pending respiratory failure might be the best chance for survival.


The second has previously posted that the autopsies they’ve been conducting have shown small levels of clotting throughout the body. This exchange also seems to explain the previously discussed Hugh mortality rate for patients who go onto a vent.


----------



## mikeyB (Apr 13, 2020)

Neither doctor appears to have heard of the cytokine storm which is often the cause of death in younger patients. And it’s nothing to do with clotting. Nor do they address the cause in older patients, a secondary bacterial infection. 

I’m not sure two junior doctors chatting adds anything to our knowledge.


----------



## Eddy Edson (Apr 13, 2020)

mikeyB said:


> Neither doctor appears to have heard of the cytokine storm which is often the cause of death in younger patients. And it’s nothing to do with clotting. Nor do they address the cause in older patients, a secondary bacterial infection.
> 
> I’m not sure two junior doctors chatting adds anything to our knowledge.



There are a fantastic array of actual expert virologists and epidemioligsts communicating regularly on Twitter. There's no reason to listen to any of the less-than-top-expert chatter.

Twitter has really become a great platform for quick insight into what experts are thinking, if you use it properly. Some of the people I follow:






						Allen Cheng (@peripatetical) on Twitter
					

The latest Tweets from Allen Cheng (@peripatetical). ID physician, epidemiologist/statistician, Dad/villager. Opinions my own. RT ≠ endorsement. Australia




					twitter.com
				








						Carl T. Bergstrom (@CT_Bergstrom) on Twitter
					

The latest Tweets from Carl T. Bergstrom (@CT_Bergstrom). Prof. Biol. @UW. Information flow in biology, society, & science. I love crows and ravens. he/him  Book *Calling Bullshit* coming Aug 4th: https://t.co/37LBNmiuyI. Duwamish Lands (Seattle)




					twitter.com
				








						Marc Lipsitch (@mlipsitch) on Twitter
					

The latest Tweets from Marc Lipsitch (@mlipsitch). Infectious disease epidemiologist and microbiologist, aspirational barista.      mlipsitc@hsph.harvard.edu Director @CCDD_HSPH. Boston, MA




					twitter.com
				








						Eric Topol (@EricTopol) on Twitter
					

The latest Tweets from Eric Topol (@EricTopol). physician-scientist, author, editor   https://t.co/AWqrOxpoZP. La Jolla, CA




					twitter.com
				








						Trevor Bedford (@trvrb) on Twitter
					

The latest Tweets from Trevor Bedford (@trvrb). Scientist @fredhutch, studying viruses, evolution and immunity. Collection of #COVID19 threads here: https://t.co/Yc4fun5rcp. Seattle, WA




					twitter.com
				








						Scott Gottlieb, MD (@ScottGottliebMD) on Twitter
					

The latest Tweets from Scott Gottlieb, MD (@ScottGottliebMD). Resident Fellow @AEI. Partner @NEA. Contributor @CNBC. 23rd Commissioner of the @US_FDA 2017 to 2019. Boards: @Pfizer @Illumina @AetionInc @TempusLabs. Washington, DC




					twitter.com
				








						ɪᴀɴ ᴍ. ᴍᴀᴄᴋᴀʏ, ᴘʜᴅ  (@MackayIM) on Twitter
					

The latest Tweets from ɪᴀɴ ᴍ. ᴍᴀᴄᴋᴀʏ, ᴘʜᴅ  (@MackayIM). virologist. scientist. husband. dad. reader. writer. fixer. bad typist. in no order. facts referenced. opinions mine alone. not medical advice or endorsement. Brisbane, Australia




					twitter.com
				








						Florian Krammer (@florian_krammer) on Twitter
					

The latest Tweets from Florian Krammer (@florian_krammer). Viruses, viruses, viruses and vaccines  Professor at the Department of Microbiology Icahn School of Medicine at Mount Sinai. New York, NY




					twitter.com


----------



## ianf0ster (Apr 13, 2020)

mikeyB said:


> Neither doctor appears to have heard of the cytokine storm which is often the cause of death in younger patients. And it’s nothing to do with clotting. Nor do they address the cause in older patients, a secondary bacterial infection.
> 
> I’m not sure two junior doctors chatting adds anything to our knowledge.


I disagree, they have 'front line' experience and are supported by a new study out in non-peer reviewed form today. It suggests that there are 2 different states of lung issues L and H and that the treatment for the L stage (which may or may not progress to the H stage) is with extra Oxygen and perhaps CPAP rather then going in heavy and intubating. 

Other people might want the theory of all of this before changing their perceptions. I.e. from people with credentials but who are far from the front line in dealing with this new virus. But precisely because it is a new virus of which we still know very little, I personally would rather be treated by a doctor who has actual curiosity and the guts to go with what works in their own considerable experience.


----------



## Eddy Edson (Apr 13, 2020)

__ https://twitter.com/i/web/status/1249614017233969152


----------



## ianf0ster (Apr 14, 2020)

Eddy Edson said:


> __ https://twitter.com/i/web/status/1249614017233969152


Why did this trial decide to use double the safe usual dose of HQC ? That there is a  dangerous Overdose level was already well known!
I just saw this, about a different novel treatment based upon IV Vitamin C (Ascorbic Acid) in combination with Corticosteroids. The problem with it is that it is done as an early stage treatment - so high numbers needed to test it efficacy.

__ https://twitter.com/i/web/status/1249814830027960320


----------



## mikeyB (Apr 14, 2020)

Drummer said:


> The hydroxychloroquine apparently prevents the virus taking the iron out of the red blood cells and destroying their ability to carry oxygen. It is thinking outside the box, but when the final stages of the C-19 virus are like those of mountain sickness, for those who are dying, no amount of extra oxygen will help if there is no transport system.


HCL is an anti malarial. C-19 doesn’t ‘live’ in red blood cells, because it is a virus. A virus needs a cell nucleus containing DNA to replicate. Red blood cells don’t have a nucleus. A virus can no more appropriate iron than a brick. It is an inert bit of RNA enclosed by a shell. That’s why HCL can have no effect on it.

Don't forget that malaria is not caused by a virus or a bacterium. It is a single celled organism, like an amoeba. And in most parts of the world, it is now resistant to HCL. What you are describing was how it works in malaria.


----------



## ianf0ster (Apr 15, 2020)

@mikeyB Though what you say is true I feel you are missing the point. HQC for Covid-19 is administered with Zinc and an anti-pneumonia drug. The action required of the HQC is to help get the Zinc into the Cells which do have a DNA nucleus.  The zinc suppresses the Virus from replicating and the anti-pneumonia drug is to deal with the collateral damage from the initial viral load.

You give the impression that this combination can't be effective for Covid-19. Which appears contrary to many of the studies done using low/medium doses (i.e. non-toxic ones): 
https://docs.google.com/document/d/1O6Cls-Oz2ZAgJuyDbnICEGjMvQPEyM-aaXARUomR9Ww/edit


----------



## Jaydee70 (Apr 15, 2020)

mikeyB said:


> Covid 19 doesn’t kill most of the people it infects, diabetic or not. The treatment with HCQ produces results which are no better than chance. It is not an antiviral. It is not used in any other viral illness. COVID 19 is a coronavirus, whose family causes colds, SARS and MERS. It isn’t unique by any stretch.
> 
> HCQ has been around a long time, used across all malarial areas. It would have been noticed, if only by chance, that it had an effect on viral illnesses. It hasn’t.
> 
> ...


thank you for reply i would recommend dr didier raoult recently published report on 100061 patients treated with hcq and azithromycin which president macron personally travelled to his clinic to get and held up publication for 24 hrs .i have personal knowledge of three people treated within 7 days of sypmtoms and all doing well. the last one was so ill the paramedics along with his wife ,a retired gp agreed not to transfer him to hospital but he told her he had saw a post about hcr and z pak within 6hrs of the loading dose his breathing had got a lot better and 12 hrs later most symptoms were improving  and apart from some fatique hes doing fine


----------



## Jaydee70 (Apr 15, 2020)

Jaydee70 said:


> my doctor gave me steroids and antibiotics to use if i get infected surely with live and anecdotal evidence it would better to give hqr doc said if allowed it would be prescribed for me as diabetics are a high risk of death group if getting covid


i would recommend you read dr didier raoult recently published report on treatment of 100061 patients with covid and his conclusion that early treatment saves life and keeps people out of hospitals.as i said earlier the self isolating for people with diabetes is about stopping the spread not treating patients


Jaydee70 said:


> my doctor gave me steroids and antibiotics to use if i get infected surely with live and anecdotal evidence it would better to give hqr doc said if allowed it would be prescribed for me as diabetics are a high risk of death group if getting covid


----------



## mikeyB (Apr 16, 2020)

That is all anecdotal evidence, I’m afraid. There is no way of telling whether all those patients were following their natural course. That’s the nature of anecdotal evidence. Scientifically worthless.


----------



## Jaydee70 (May 1, 2020)

LucyDUK said:


> Hi @Jaydee70
> Welcome to the forum. There have been no studies robust enough to declare a success of any drug used treat COVID-19 in people with any specific pre existing condition including this treatment which is among those being investigated by the World Health Organisation. This is not a recommended treatment anywhere.
> 
> I haven’t read either of the studies you mention, the New Jersey or ’other doctor‘ but the numbers in both are very small for a start without knowing any further detail.
> ...


northwell health system studied 5700 covid patients and discovered that diabetic patients who receieved the hqr therapy within 48 hrs of symptoms or before respiratory systems did not need ventilators as did the patients  with lung disease  and can you tell me why people with late stage disease caused by cytokine storm syndrome are now given an anti viral drug instead of immune suppressant therapy as its being used successfuly at cedar sinai  hospitals


----------



## Jaydee70 (May 1, 2020)

the top virus hunter doctor ian lipkin was treated with hqr  therapy within 24 hrs of being diagnosed why if its a treatment for him is it not suitable for anyone else


----------



## Jaydee70 (Jul 4, 2020)

everydayupsanddowns said:


> But if it’s a positive treatment for covid-19, and if those results are repeated widely, I would say it should be made available to people with covid-19, rather than offered to all people with diabetes (the vast majority of whom don’t have covid-19 and who would only have it mildly if they did get it).
> 
> Just my opinion.


having just finished treating 4 th covid19 diabetic patients  with hcq and zpak +zinc in 2 cases ,all over 70 and all are doing fine .it is refreshing to see the seventh major study into the use of hcq therapy within 24-36 hrs of symtoms of covid is a massive  benefit to patients with diabetes and staying isolated with no treatment is a death sentence to many diabetics .


----------



## everydayupsanddowns (Jul 4, 2020)

This still isn’t officially supported as a treatment for covid-19 as far as I can make out. I’m not sure what studies you are referring to? But the US seems to have switched to focussing on securing the global supply of remdesevir - presumably because the data was more robust (though it seems less convincing than the significantly cheaper dexamethasone to my simple mind).

What is it that leads you to post exclusively about hcq on the forum? Do you have a personal interest in the product?


----------



## Bruce Stephens (Jul 4, 2020)

everydayupsanddowns said:


> What is it that leads you to post exclusively about hcq on the forum? Do you have a personal interest in the product?



If the effects were _that_ strong I'd have thought they'd be easy to spot in trials and so far the trials don't seem to have shown  that.

And if it were effective I'd have expected people to be delighted since it's an old drug and presumably not too expensive. (And nowadays the UK and US have lots of supplies of it slowly going out of date, just in case.)

(The only downsides I can see is that it would require conceding that President Trump was right, and that the various other crazy people (some of whom also believe that the virus is a hoax, that it's a Chinese military weapon, that it's a Democrat conspiracy, that it's part of a plot by Bill Gates to inject everyone with mind control chips, etc.) were right too.

Even so, if it worked I think doctors would use it, though those downsides are quite significant.)


----------



## Robin (Jul 4, 2020)

Bruce Stephens said:


> If the effects were _that_ strong I'd have thought they'd be easy to spot in trials and so far the trials don't seem to have shown  that.
> 
> And if it were effective I'd have expected people to be delighted since it's an old drug and presumably not too expensive. (And nowadays the UK and US have lots of supplies of it slowly going out of date, just in case.)
> 
> ...


Another downside is the side effects, which can be severe, and even fatal.
WHO have reported today that they are suspending the trial of hcq in hospital use as it has been found not to alleviate mortality rates. Trials in non-hospital settings, and as a prophylactic continue.








						WHO discontinues hydroxychloroquine and lopinavir/ritonavir treatment arms for COVID-19
					

WHO today accepted the recommendation from the Solidarity Trial’s International Steering Committee to discontinue the trial’s hydroxychloroquine and lopinavir/ritonavir arms. The Solidarity Trial was established by WHO to find an effective COVID-19 treatment for hospitalized patients.  The...




					www.who.int


----------



## Jaydee70 (Jul 5, 2020)

everydayupsanddowns said:


> This still isn’t officially supported as a treatment for covid-19 as far as I can make out. I’m not sure what studies you are referring to? But the US seems to have switched to focussing on securing the global supply of remdesevir - presumably because the data was more robust (though it seems less convincing than the significantly cheaper dexamethasone to my simple mind).
> 
> What is it that leads you to post exclusively about hcq on the forum? Do you have a personal interest in the product?


latest study is from henry ford health system ,michigan usa as for  remdesevir the us purchased approx 80 millions tablets  and 70 million tablets of hcq remdesevir may have some benefit for patients with lung problems in hospital but some immuno-suppressant drugs  have shown some promise too.the only therapy that has shown to help patients with diabetes is hcq and zpak if given before respiratory problems start the stay home with no treatment is a death sentence for many diabetics who have covid.


----------



## Jaydee70 (Jul 5, 2020)

would a treatment that could help people stay off of ventilators be worth trying as studies show the hcq therapy can cut death rate by up to 50%.my interest in hcq was using it ,under medical supervision for a friend of mine who was showing signs of covid and getting  the stay at home and wait to it gets worse .after 48 hrs of symptoms i started the treatment and even his gp was amazed he didnt have to go to hospital he is now ok


----------



## Bruce Stephens (Jul 5, 2020)

Jaydee70 said:


> latest study is from henry ford health system



It's not an uncontroversial study. Critics say it wasn't randomised, and patients given HCQ were twice as likely to also be receiving steroids. And they excluded 10% of patients (who were still in hospital when the study ended).


----------



## mikeyB (Jul 7, 2020)

Jaydee70 said:


> would a treatment that could help people stay off of ventilators be worth trying as studies show the hcq therapy can cut death rate by up to 50%.my interest in hcq was using it ,under medical supervision for a friend of mine who was showing signs of covid and getting  the stay at home and wait to it gets worse .after 48 hrs of symptoms i started the treatment and even his gp was amazed he didnt have to go to hospital he is now ok


What you describe appears to be the normal course of the disease. When you say you started the treatment, was that because you had symptoms or you gave him HCL? Didn't realise you were a doctor.


----------

