The Coronavirus, not the beer

[nsacpi]

There has been a bit of a back and forth between Dr. Harvey Risch and a French doctor named Vincent Fleury about HDQ.

Anyhow, I will link and cut and paste a couple paragraphs from the exchange:

From Dr. Fleury

A major error is found in the article : Early Outpatient Treatment of Symptomatic, High_Risk Covid-19
Patients that Should be Ramped-Up Immediately as Key to the Pandemic Crisis, by Harvey Risch,
which highlights how the work by Prof. Raoult should be read and considered.

Dr. Harvey Risch (1) advocated the use of hydroxychloroquine and azithromycin for the outpatient
treatment of patients with coronavirus 19 (COVID-19). To support his case, he cited the mortality
calculations from 2 cohorts, one presumably treated by Dr. Zelenko (2) in New York, and the other
treated by Million et al.(3) in France. In his article, Dr. Risch made an error in the calculation of the
estimated mortality among at-risk patients who were treated with a combination of
hydroxychloroquine and azithromycin (and possibly also zinc). Indeed, in order to prove the
supposed superiority of this bitherapy over standard care, Risch posited that based on the observed
number of fatalities among at-risk patients in other studies, one would expect 20% of the 1,466
patients in these 2 cohorts to have died (i.e., approximately 293 patients rather than 7), and
therefore the bitherapy of hydroxychloroquine plus azithromycin is 41 times more efficacious than
standard of care.

After the initial online publication of Dr. Risch’s article, it came to light that 405 of these 1,466
patients were the at-risk patients in Dr Zelenko’s cohort; the remaining 1,061 comprised the whole
sample in the study by Million et al. (3). However, as shown in their Table 2, not all of the 1,061
patients had at least 1 comorbid condition that was a risk factor. Adding the numbers of patients
with each chronic condition reveals that less than 45% of the total treated sample had such a
condition. In addition, because patients often have more than 1 comorbid condition (e.g., obesity
and diabetes or obesity and hypertension), the number of patients who were really at risk is
presumably far lower. 56 patients are even mere asymptomatic contacts of documented cases.
Furthermore, the cohort has a striking demographic distribution: The mean age was 43.6 (standard
deviation, 15.6) years, and the group included teenagers as young as 14 years of age. All of this is to
say that the cohort in the study by Million et al. is in no way comparable to a typical cohort of
hospital patients, who are generally older and in worse health. Moreover, a mean age of 44 years in a
group with no children younger than 14 years of age indicates a very young cohort, much younger
than average. When comparing the cohorts, even patients with similar comorbid conditions do not
have a similar magnitude of the risk. To be really at risk, you must be older.

Risch then multiplied 1,466 by 20% to get the expected number of deaths: 293. Here is where the
error is manifest. It is indeed true that the fatality rate in hospitalized patients may be somewhere
between 10% and 20%, as cited by Risch (1); however, there is no reason to expect a similar fatality
rate in a cohort such as the one in the study by Million et al., even if it does contain elderly people
and patients at risk. That cohort comprised patients who came on foot to queue up at the hospital,Fr
whereas in other hospitals, patients are generally admitted to the emergency department.

https://watermark.silverchair.com/kw...Qa0qwUoc4QnXXQ

And Dr. Harvey Risch's response:

I thank Dr. Fleury (1) for clarifying various details of one of the studies that I discussed in my
review of efficacy and safety of outpatient medication treatment for COVID-19 patients (2). Dr.
Raoult, the senior investigator of that study (3), has been carrying out a medically aggressive
COVID-19 testing and treatment program in Marseille, France. From this distance, it can be
difficult to glean all of the relevant details of the program and I appreciate Dr. Fleury’s more
local information and extended discussion.

In my analysis, I assumed that the patients described by Dr. Raoult as hospital patients were
high-risk. In fact, it seems that Dr. Raoult’s hospital base was used more as a clinic facility
where outpatient testing and treatment were done, and for a fraction of the patients, full hospital
admission occurred. Thus, Dr. Fleury is indeed correct that the 1,061 patients I discussed were
not all high-risk.

https://watermark.silverchair.com/kw...xoSyyNZtpwcmwg

bumping for those interested in learning why Risch's conclusions about outpatient use of HDQ may not be correct

[nsacpi]

I dont think anyone suggested that this should be administrred at all phases of the virus life.

Thats the whole point why these other studies were garbage and most likely funded by Gilead!

Which phase do you think it has demonstrated efficacy?

[thethe]

Which phase do you think it has demonstrated efficacy?

When oxygen levels are above a certain threshold.

[nsacpi]

Symptomatic patients presenting to Dr. Zelenko were treated with five days of HCQ+AZ+zinc
sulfate if they were considered high-risk, as evidenced by one or more of: age 60 years or older;
high-risk comorbidities; body-mass index>30; mild shortness of breath at presentation.

The above is from Risch's paper. I think this last criterion "mild shortness of breath at presentation" means we should be careful about how the Zelenko results should be interpreted. It means that some of his sample is NOT old, NOT suffering from high-risk morbidities and NOT having a body-mass index greater than 30. They have "mild shortness of breath." Some additional information would be needed to understand how this affected his sample before comparing his outcomes with high risk people.

Also note that Zelenko's sample consists of people treated as outpatients. Not the same animal as a sample of very sick old people in the hospital. It wouldn't be correct to say only 1% of Zelenko's sample died versus 20% of very old people who were hospitalized. Therefore, his treatment reduces deaths by 95%. But that seems to be what Risch is claiming!

That's all I got.

[thethe]

Symptomatic patients presenting to Dr. Zelenko were treated with five days of HCQ+AZ+zinc
sulfate if they were considered high-risk, as evidenced by one or more of: age 60 years or older;
high-risk comorbidities; body-mass index>30; mild shortness of breath at presentation.

The above is from Risch's paper. I think this last criterion "mild shortness of breath presentation" means we should be careful about how the Zelenko results should be interpreted. It means that some of his sample is NOT old, NOT suffering from high-risk morbidities and NOT having a body-mass index greater than 30. They have "mild shortness of breath." Some additional information would be needed to understand how this affected his sample before comparing his outcomes with high risk people.

Also note that Zelenko's sample consists of people treated as outpatients. Not the same animal as a sample of very sick people in the hospital.

That's all I got.

Yes...before they get very sick is when HCQ should be administered.

[sturg33]

The attack on churches during this has been unbelievably transparent

[nsacpi]

When oxygen levels are above a certain threshold.

Do ANY of the studies give information on oxygen levels for people receiving the treatment?

[thethe]

Do ANY of the studies give information on oxygen levels for people receiving the treatment?

Fairly certain they all do

[thethe]

The attack on churches during this has been unbelievably transparent

Christianity has been under siege for a long time.

Powers that be still want us to believe the fire infrance wasn't arson.

[nsacpi]

Fairly certain they all do

They use oxygen level to control for inclusion in their samples?

I don't think Zelenko used this. He used age, presence of co-morbidities, obesity and "mild shortness of breath." You have to fit one of those four criteria to be included. And for the Marseille study, it was a group of walk-ins at a clinic. A self-selected sample. It included some people who were completely asymptomatic and some teenagers. For the Brazil study, the sample was a group of people treated by telemedicine. Don't think they had the oxygen level info for that group.

[sturg33]

Christianity has been under siege for a long time.

Powers that be still want us to believe the fire infrance wasn't arson.

I notice nsacpi had no problem with the government attacking 1st amendment rights when it came to churches.

silence and complicity has free speech continues to be destroyed

[nsacpi]

Religious leaders in this country have been stalwart in their response to covid-19, something for which we should all be grateful.

https://www.weforum.org/agenda/2020/...collaboration/

As some individuals may be wary of following the preventative messages pertaining to COVID-19 by government and international organizations, faith actors should utilize religious teachings to reiterate the importance of these measures for the safety of the community. The Abrahamic faiths all have teachings that profess the importance of taking action to assist others and save lives.

• The Bible encourages followers to “show me your faith apart from your works, and I will show you my faith by my works”.

• The Quran tells us: “If anyone saved a life it would be as if he saved the life of the whole humanity.”

• In Judaism, the preservation of human life takes precedence over all other commandments, as emphasized in the Talmud.

In understanding how these teachings emphasize the importance of taking action, communities can be encouraged to follow government-implemented measures and practice social distancing in order to protect themselves.

[nsacpi]

"Love the Lord your God with all your heart and all your soul and with all your mind and with all your strength. The second is this: 'Love your neighbor as yourself.' there is no commandment greater than these." Mark 12:30-31

Loving your neighbor as yourself is found eight times in the Bible.

[sturg33]

Just so were clear your cool with governments shutting down church by of scary virus right?

But protests are A OK

[thethe]

Religious leaders in this country have been stalwart in their response to covid-19, something for which we should all be grateful.

https://www.weforum.org/agenda/2020/...collaboration/

As some individuals may be wary of following the preventative messages pertaining to COVID-19 by government and international organizations, faith actors should utilize religious teachings to reiterate the importance of these measures for the safety of the community. The Abrahamic faiths all have teachings that profess the importance of taking action to assist others and save lives.

• The Bible encourages followers to “show me your faith apart from your works, and I will show you my faith by my works”.

• The Quran tells us: “If anyone saved a life it would be as if he saved the life of the whole humanity.”

• In Judaism, the preservation of human life takes precedence over all other commandments, as emphasized in the Talmud.

In understanding how these teachings emphasize the importance of taking action, communities can be encouraged to follow government-implemented measures and practice social distancing in order to protect themselves.

lots of things we can do to save lives.

I recommend we all stay in because of the seasonal flu.

If we could just save one life...

[nsacpi]

Just so were clear your cool with governments shutting down church by of scary virus right?

But protests are A OK

The church I go to has not just complied but endorsed the governor's measures. Most churches have an understanding that during a pandemic some adjustment will be needed even for cherished rights and liberties.

[thethe]

The church I go to has not just complied but endorsed the governor's measures. Most churches have an understanding that during a pandemic some adjustment will be needed even for cherished rights and liberties.

But not protestors which you joined hand and hand.

[sturg33]

The church I go to has not just complied but endorsed the governor's measures. Most churches have an understanding that during a pandemic some adjustment will be needed even for cherished rights and liberties.

Good for them.

Kentucky church goers had their license plates reported to the dept of health for attending and Easter drive in service.

Your complicity and support for that is clearly noted

[nsacpi]

Muslim clerics have emphasized regulations issued by governments by creating fatwas calling for a halt in organized religious gatherings and encourage communities to adhere to government calls of social distancing and self-isolating. Prominent Muslim scholar Shaykh Bin Abdullah Bin Bayyah, Chairman of the United Arab Emirates Council for Fatwa and President of the Forum for Promoting Peace in Muslim Societies, issued a fatwa calling on the community to obey the directives and instruction of governments in order, “to cooperate to combat the disease and halt its dissemination”.

Russell Moore, of the Ethics and Religious Liberty Commission of the Southern Baptist Convention, responding to ignoring the plight of the elderly in the pandemic, said in the New York Times: “Each human life is more significant than a trillion-dollar gross national product. Stocks and bonds are important, yes, but human beings are created in the image of God.”

"We need to take our time because we have a high moral responsibility here," said Cardinal Dolan, while visiting two Catholic charities food programs on Staten Island. The Cardinal also said he will follow Gov. Cuomo’s directive limiting faith services to 10 people or fewer and follow the CDC guidelines that masks and hand sanitizer must be used:

"We need to be attentive to health care of our people and reopen in a gradual layered way."

[nsacpi]

But not protestors which you joined hand and hand.

I managed to find a way to join the protest in my town while social distancing. I'm pleased to have been able to do that. Fortunately, it does not seem to have had any impact on local infection rates.

I might add that people in my town have been protesting both sides while social distancing. I often see a lady near the train station with a blue lives matter sign. And an elderly couple on a street corner supporting black lives matter. I think its great people are making themselves heard in this way. Speaking out is as important as ever. But we have to take care how we do it. Practicing our faith is as important. And here too some adjustments have to be made. I know some people who have been going to pray at church during the middle of the week. When the church is empty.