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Latest meta-analysis of HCQ studies shows increased mortality

This a the largest meta-analysis so far, and come out of France.

Conclusion

Hydroxychloroquine alone was not associated with reduced mortality in hospitalized COVID-19 patients but the combination of hydroxychloroquine and azithromycin significantly increased mortality.

https://www.clinicalmicrobiologyandinfection.com/article/S1198-743X(20)30505-X/fulltext

Of course the devil will be in the details of which studies were included in the meta-analysis and which were excluded. However it’s an important new data point in the endless controversy, and one I expect will get a lot of airtime as it enforces the default position.

Cheers

Just have time for a quick look
Hospitalized patients - not early treatment then.

All studies - mortality odds ration 0.83 ie 17% reduction.in mortality, non-significant (statistically)
Non-randomized smaller.
Randomized studies (with high fiddle factors) higher than one.
Need to see what’s been excluded.

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I honestly don’t care what the supposed credentials of this study are, because if this is its result it is quite clearly “just another” in a long line of set ups intended to destroy HCQ’s role and potential role in ending the CV epidemic.
I just finished another article mostly on HCQ, and immunity and disinformation, with some useful links, including those I posted earlier.
https://ahtribune.com/world/covid-19/4372-viral-pandemics.html and to back it up today there was this:

https://www.smh.com.au/politics/federal/craig-kelly-accused-of-pushing-dangerous-covid-19-conspiracy-theory-20200827-p55pw4.html

Craig Kelly is a climate change denier, so his absolutely reasonable statements on HCQ will be rejected by the left, and the right and middle! WE are the “dangerous conspiracy theorists” of course.

Hi David

Quite possibly. Although it’s always reading through just in case they have really discovered some real effect.

In this case, as it’s a meta-analysis, everything will depend on the studies they chose to include/exclude. I’ll take a closer look soon.

Thanks for the links - I’ll take a look!

Very interesting bit on the Indian experience with HCQ, David. Also very interesting results on the seroprevalence results in India.

What’s a good reliable source to read up on those studies? In particular the result that >50% of people in some poor areas have been infected?

I’m asking as there is some debate as to what level of infected (and hopefully recovered) people is required to start to see a slow down in new transmissions.

If the number really is >50% then we can expect a resurgence of cases in cities like London, Madrid and NYC, which would probably be bad news…

Cheers
pp

Bloody hell, David, that POS from the SMH is as arrant a piece of crass mediawhoring as I’ve seen in a while. I can see why you fulminate if this is the typical level of bovinely stupid, obviously corrupt discourse in your media there. Years ago, when I used to meet the public as part of my job in Stratford-on-Avon, I learned to categorise USAmerican tourists as brash, but with a certain amount of knowledge of the whole Shaksper complex; but it was noticeable then - 60s and 70s - that the Ozzies and Kiwis were - well, simply innocent; like cheery children. Literally, the contrast was remarkable. Things seem to have changed only in a more cancerising direction since then.

This from Paul Craig Roberts says it plainly about the anti-HCQ+ scam (thanks to Rich, who posted it on TLN, for the headsup):

https://www.paulcraigroberts.org/2020/08/28/medical-authorities-continue-to-block-effective-covid-treatment/

This quote in particular stands out:

'Dr. Marcia Angell, former editor of the new England Journal of Medicine says that “it is simply no longer possible to believe much of the clinical research that is published.” ’ Nice to see so august a member of the Western medico-Pharma establishment call it out in stark truth. She mirrors my thesis exactly. Trust absolutely nothing coming into your attention from the Western medical sphere. ALL of it has to be approached with a bucket of salt.

Here’s a 30 min. vid of a Didier Raoult interview - in English - from May, but still highly apropos. The voice of principled honesty versus the whores and chisellers of the parasite class…

This is really wierd: I keep copying the YT address onto my clip board, but it won’t post here. What gives? You can find the vid by putting the line below in a YT search box:

EXCLUSIVE: Dr. Oz Discusses The Hydroxychloroquine Study Outcome With Dr.Didier Raoult

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That’s really strange RG. Not sure what’s happening. Ping me if you get the problem again

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It’s good that the meta-analysis by Fiolet et al wasn’t announced in a press release from the rooftops. Despite that, I think the ‘body language’, or framing, of the study isn’t good.

Although “All studies except one were conducted on hospitalized patients”, this is not obvious if you don’t delve into the paper. The absence of ‘hospitalized’ in the title appears to invite inevitably misleading application of the study’s findings to early HCQ treatment (which has had the most promising results).

This is especially likely given that the study calls for an end to further HCQ research:

“Our results suggest that there is no need for further studies evaluating these molecules, and the European DisCoveRy clinical trial or the WHO international Solidarity clinical trial have already discontinued treatment arms using hydroxychloroquine [81,85].”

Authors often say their results warrant further research. It is premature to call for no more research, as it tells the medical world to accept their conclusions as final, and shut the book on HCQ. Not to mention this hasty action would also shut the book on early treatment, which the meta-analysis does not address.

Moreover, as there is no mention of zinc in the Fiolet study, calling for the HCQ book to be closed is saying forget hydroxychloroquine in combination with anything, including zinc - yet without analyzing any studies with this combination, like the study of Zelenko’s protocol (Zinc Plus Low Dose Hydroxychloroquine and Azithromycin) which is not mentioned.

Also - as this is a meta analysis - this call also implies the medical world should simply agree with their judgements regarding what studies should be included. This amounts to self-endorsement within the study, before it has been subject to wider review. And these judgements (choices is probably a better word) are buried among the text of the paper, and rendered less accessible by statistical software which assigns things like ‘risk of bias’ to studies.

Based just on these handles (this is a meta-analysis - why are they there, why isn’t the wording more careful?), the framing of this study readily lends it to be used as propaganda to diminish HCQ as a treatment - irrespective of what drug combination it is part of. Aiming wider than the range of the scientific parameters doesn’t inspire confidence. Need to wait for the dust to settle on the details, but other studies that provided such propagandistic handles have not stood up to inspection.

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Great thoughts W. I was planning on taking a look at the actual studies that were used in this meta analysis and tabulating things like at what point did the treatment start etc, but didn’t get to it today. I think that would be a useful exercise. Perhaps if we did that we could reach out to Fiolet, and ask a couple questions.

That could be quite enlightening. I’ll let you know when I’ve put some data together

Cheers

PP

thanks for finding this RG, as I’ve been trying to find English translations or subtitled interviews with Raoult for the last four months! I asked a French girlfriend of a friend if she could listen/watch Raoult’s interview at the French National Assembly and give me a better idea of the context of what happened - where the support was etc - which she did, but there is nothing to beat subtitled interviews IMO.
This was the most critical submission, at which he made the accusation that the negligence and corrupt influence of those being paid by GILEAD to promote Remdesevir had cost thousands of lives in France - as demonstrated by his far lower death rate around Marseilles. That this area is now being targeted by Paris as a “hot-spot” with perhaps further restrictions, must be setting the place on fire, as Raoult has a huge following and support in the south.
But his most recent interviews are very interesting, along the same lines as the French epi interviewed in the OffGuardian article. Raoult has made the same point about the change in behaviour of the virus, and the fact that it appears no longer to be causing the same problems in the LRT with blood coagulation as seen early on. The big rise in cases is an indication that it’s perhaps a little more infectious, while less dangerous, but this is something that the Powers simply will not and cannot admit, or the whole dirty enterprise will crash down. Oh that it would !

Our media is hopeless, and this morning pushing the idea that the virus is now being transmitted “aerially” - and so the importance of everyone masking and being frightened of groups of people is emphasised. Only it’s not! If the virus is “like smoke in the air”, then nothing less than a respirator will prevent you from breathing it in. But never mind, science is boring, and people won’t notice the cognitive disjunction!

Have a look at this if you think that’s bad:

It says that anyone else found on social media or daring to turn up to the protest next Saturday will face the same $20,000 fine etc, while the 76 year old who “incited” the protests, and had his laptop etc seized after police raided his home without a warrant, has been bailed to appear in court next February.

Words totally fail me.

This was a really interesting conversation between Oz and Raoult - thanks for digging this out Rhis!

You’re right PP, what studies were excluded, and when did the treatment start - these are key questions, and they are also related - because in the end, only one study survived to the final count that was not hospitalized patients!

The main study by the Raoult group (Million et al) and Zelenko’s results with the Zelenko protocol (later incorporated into the Scholz et al study) played key roles in shaping world reaction to early HCQ treatment, not to mention in seemingly treating large numbers of patients, with great success.

But neither are included in the final tally of Fiolet, which produces these eye-catching final numbers on which conclusions depend.

Zelenko/Scholz is not considered at all , and the Million/Raoult study drops off in the controlled basket-shaking (otherwise known as meta-analysis).

Lets see what happened to them.

Zelenko’s data probably didn’t make the cut because of the requirement for confirmed Covid-19 diagnosis. This seems reasonable - but it’s essential to keep your eye on the ball for later, when people make pronouncements about the picture forgetting what was left out.

If you watch the Zelenko video you will see that in his protocol the patient was treated right away. He explains (my emphasis):

" Extremely important - based on clinical suspicion, Treated within 1st 5 days of symptoms…I noticed most patients come day 4 or 5. They wait a day or 2 to see, then wait to see a Dr.

On about 6 the viral load explodes.

The testing took 3 days to get back. By then the infections is worse. Not a reason not to treat.

1/3 of negative tests are wrong. Took clinical decision."

Hence, early treatment is necessary according to Zelenko who spelled out the reasons why diagnosis might be the wrong route.

This raises an additional doubt about the meta-analysis. It essentially throws together three disease states 1) the early stages of a viral infection, 2) cytokine storms 3) pneumonia, acute respiratory failure, etc, as if they were one disease.
Imagine they gave everyone the corticosteroid dexamethasone even mild suffrerers, then analyzed it all as one disease

Zelenko and co can hardly be pleased to see that a meta-analysis comes along and starts counting studies that only intervened ‘after the viral load has exploded’ - thereby stepping over his evidence at the outset - and then claims to be the final word on his drug combination.

The Raoult study (Million et al) was excluded due to ‘critical risk of bias’. This seems to stem from the notion that in comparing overall effects of a treatment in a controlled trial, one should take into account any main health differences between the treatment and control populations, and adjust the calculated final treatment effect accordingly. Not to do this might indeed suggest ‘bias’.

Again, this may sound reasonable - but Million/Raoult was not a controlled trial. They retrospectively noted that the mortality rate from their HCQ+AZ treatment was less than 1%. This was when the virus in the early stages of the pandemic was on the up and up; the case fatality rate in the rest of France (not using HCQ), was running at over 10% - as it was and is in the UK, Spain and Italy. So although the reported results were impressive, there was no ‘effect size’ to adjust. Indeed Fiolet say they dealt with this situation when it occurred in three studies:

“When studies did not report an effect size for mortality risk [17,23,24],we used the number of deaths per group to calculate an unadjusted relative risk using metabin function in meta package in R Software [25]”,

ie they initially processed the studies. The issue with the Million/Raoult therefore does not seem to be ‘bias’ but the rules by which bias was determined, which ruled out the study by default. And indeed, the rules of the meta-analysis also drew a line through the Scholz/Zelenko data.
These rules might be justifiable in isolation, but then you need to be awfully careful afterwards about the range of applicability of your conclusion. One would expect ‘academia’ to know that… :astonished: :wink:

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Excellent analysis W. Perhaps this would be a good first blog post between us (hint hint).

Lots of material to analyse, and a textbook application of the 5-filters to Covid. Has that even been done somewhere? Think of the fame and fortune that might follow!! (/s)

:star_struck: :upside_down_face:

What bothers me about Drs. Raoult and Zelenko is their seeming uncritical acceptance of the purported reality of COVID-19. Unless I have completely misunderstood other sources of information, they and we have absolutely NO RELIABLE TEST of the presence and amount of this supposed “virus” in the body, blood or tissue. The multi-layered dialectic [if offended, please forgive my deployment of this word in its Marxist sense] of COVID-19 long ago left the launch pad of COVID Real | COVID Not Real, passing through (very, very quickly, a matter of days if not hours) COVID Real Natural (Wuhan wet market) | COVID Real Man-Made (bioweapon).

The next level(s) of COVID dialectics deal(s) with (1) rates of mortality and morbidity and, especially, (2) different TREATMENTS, their efficacy, and their relative life-saving potential(s). Here’s where we have “America’s Frontline Doctors” coming forth out of nowhere with uncertain backing yet remarkable publicity. Here too we find Dr. Raoult – whose appearance alone who disaffect most who watch him (thus “blackwashing” HCG?) – and also Dr. Zelenko. The dialectic concerning HCQ first featured great polarization due to POTUS Trump’s mention, if not endorsement, followed by rumors that world leaders were taking HCQ as a prophylactic. Then we had Dr. Fauci and US State governors intervene and prohibit or preclude treatment of COVID-19 with HCQ. All of which served to keep this boat (COVID-19) afloat in public consciousness as REAL, riding on the waves of HOW TO TREAT.

Does anyone else have something to dissuade this inveterate DOOM & GLOOMER that “all of the above” is NOT part and parcel of this massive, global psy-op?

Your use of scare quotes around the word “virus” suggests that you think that SARS-CoV-2 does not exist! If that is indeed what you meant, do you have any references (or arguments and evidence that can be brlefly summarised here) to justify your statement?

If that is not what you meant, do you have any references or arguments or evidence to justify your statement that the presence of SARS-CoV-2 in the human body “absolutely” - and in big shouty capital letters, to boot - cannot be detected “RELIABLY”?

I know far less about the subject than some others here, but even I can probably dig up some references to convince you that SARS-CoV-2 exists, and is worth worrying about, if you can convince me that you are open to evidence and argument. Perhaps you’ll even sting me into thinking a bit harder about the subject.

On a meta-level, it’ll also be interesting to see if the subject can be debated civilly in this forum, unlike another forum I could mention. :wink:

TWIRLIP, in my baliwick, we call that use of quotation marks “snark marks”. Same idea when you subtract from “scare quotes” the component of fear. More along the dimension of sarcasm.

The CDC publication “CDC 2019-Novel Coronavirus (2019-nCoV) Real-Time RT-PCR Diagnostic Panel” [these are straightforward quotation marks!] [https://www.fda.gov/media/134922/download] makes it clear that the PCR test, as confirmed and re-emphasized by its inventor, is NOT appropriate for identifying much less classifying people as “COVID patients”. Another scientist has pointed out that a primary indicator [a genetic sequence] of positive for the PCR test as disseminated is common to all human beings. What have you left in such a situation??

One thing sure: You stop talking about DEATHS and you start talking about CASES! The more you test, the more “positives”. BUT, you then increase the denominator in population rates far quicker than you can “manufacture COVID deaths” as numerator. So death rates everywhere fall to or below “average flu season totals”. Hence, the absolute necessity of talking up CASES. The fear of death is gone; the social, political, and especially ECONOMIC consequences of “testing positive for COVID” remain!!

You can retreat to the level of dialectic promoted heavily by Jon Rappoport (No More Fake News), whose investigative and journalistic efforts date as far back as to the HIV scam. He also dealt with SARS, Swine Flu, Ebola, Zika, and other such. If you do not follow accepted scientific protocols to isolate and identify the entity you think CAUSES disease, what then do you have?? A scientific purist would answer, “Nothing.”

Hey, it’s not as if US, Inc., and its collaborators – other countries, multi-national corporations – lack for Level-4 biosafety (bioweapons) laboratories to do the work required! THEY HAVE NOT DONE THE WORK FOR COVID-19 TO DATE! Does, therefore, COVID-19 actually exist as such? If a tree falls in the forest…

Other scientists speak of the inherent mutability of coronaviruses. Even assuming a Level 4 (bioweapons) Lab in the US or China (or elsewhere) concocted a viable bioweapon, they had no guarantee it would detonate in a population with anything near the force required for a genuinely impressive “live exercise” (per US SoS Pompeo).

If real, then, by all reasonably reliable statistics, COVID-19 proved a DUD. Analysts other than Jon Rappoport pick up from there with little difference in subsequent layers of assessment of the dialectics of COVID-19 (legitimacy, motivation of governmental and corporate [Big Pharma] response, efficacy of various treatment protocols [e.;g., HCQ, other], etc.)

Hope the above satisfies your request if not fully satiates your curiosity! Don’t take my word for all this. Do the research you need to do to satisfy yourself as to the truth of this matter!

Another handy interview with Didier Raoult. From April, but still highly relevant, particularly his firm distinction between doctors actually practicing at treating patients with whatever might work, and observing outcomes directly, in clinical practice, on the one hand (a huge number worldwide using HCQ+ with excellent results even then, and many more by now), and on the other hand theorisers setting policy with politicians, theorisers who often have no such hands-on, face-to-face experience; or none current and relevant, at best. English subtitles: