Posted on 04/12/2020 8:05:52 AM PDT by Fido969
It’s an opinion shared by President Donald Trump and a growing cadre of physicians and some infectious diseases experts who believe that an effective way to control the spiraling pandemic is to prescribe the anti-malarial at the first sign of symptoms even though it has not gone through the requisite number of clinical trials.
(Excerpt) Read more at nypost.com ...
They seek out a few usual suspects who will provide sound bite quotes for a few seconds in the spotlight.
But, in reality, almost all doctors are prescribing it, patients are demanding it, and governors are loosening regulations regarding its use.
The media are in an alternate universe regarding this matter. It's just bizarre.
“It’s just bizarre.”
Orange Man Not Allowed To Win.
Even if you die.
.
The CDC is doing a phony study without the zinc to squash it.
Anecdotally of course, many doctors and other health workers who can get their hands on it are using it successfully as a prophylactic.
So how many people that are on it for other reasons have caught CV19? It's over 1,400/MM in the population, so their rate should give some indication of effectiveness.
I live in nyc. If I get it or someone in my family does, I plan on going to my nj beach house so that I can get the treatment. It’s crazy that I’d have to do that.
Coronavirus patients on NHS wards have started receiving a controversial anti-malarial drug - despite debate over its effectiveness. Hydroxychloroquine is being used at Barts in London and the Royal Devon and Exeter to keep critically ill coronavirus patients alive. President Trump described the drug as a 'game changer' and it has been added to the Chinese guidance for tackling the disease, but up until now the NHS has strongly discouraged its use.
No cognition, no cognitive dissonance.Bring Out Your DeadOrange Man Bad!
Post to me or FReep mail to be on/off the Bring Out Your Dead ping list.
The purpose of the “Bring Out Your Dead” ping list (formerly the “Ebola” ping list) is very early warning of emerging pandemics, as such it has a high false positive rate.
The false positive rate was 100%.
At some point we may well have a high mortality pandemic, and likely as not the “Bring Out Your Dead” threads will miss the beginning entirely.
*sigh* Such is life, and death...
If a quarantine saves just one child's or one old fart’s life, it's worth it.
What’s CNN’s Cuomo taking?
It was also inevitable that politicians would make common cause with those who create this virtual reality in order to gain the advantage in the struggle for power over people.
Thus you have the useful idiots of the White House press corps reacting with shock and dismay when President Trump answers one of their questions by simply saying "because it came from China, Chi-na."
When you think about it, the childhood fable called The Emperor's New Clothes is really a parable about the creation of a virtual reality by crowd-sourcing, and the manner in which the majority of people will make themselves into useful idiots of their own free will, and will fight those who try to give them "the red pill."
The US Military should all be treated first with HCQ and Zinc immediately. All of our Camps and Ships are infected with this Virus and we are very vulnerable. On a Carrier, if the Combat Pilots are down with the Virus, they are dead in the water.
bkmk
While the trifecta pill treatment (hc, antibiotic, zinc for 3 days) reportedly has a very high/successful cure rate for patients seriously ill with The Virus, whether to prescribe it prophylactically to well people is not as clearly indicated. But since the pills are plentiful and cheap with usually minor or no side effects, it can be done. I would leave this decision to the consultation between individual and doctor.
“What’s CNN’s Cuomo taking?”
Hydroxyfredoquone.
Easy for you to say.....
“the Federal Drug Administration has only approved it for treatment of COVID-19 in advanced cases of the virus and by the time patients have to rely on ventilators. “
totally false; the EULA states:
“On March 28, 2020, FDA issued an EUA to allow hydroxychloroquine sulfate and chloroquine phosphate products donated to the Strategic National Stockpile (SNS) to be distributed and used for certain hospitalized patients with COVID-19. These drugs will be distributed from the SNS to states for doctors to prescribe to adolescent and adult patients hospitalized with COVID-19, as appropriate, when a clinical trial is not available or feasible. “
nonetheless, NOTHING prevents any physician from legally or ethically prescribing this drug off-label for any medical purpose ... and thus one DOES NOT HAVE TO BE HOSPITALIZED to be treated with this drug!
bkmk
Prophylactic zinc supplements, in moderate doses, would have zero negative impact. Quinine, low dosage, similarly.
i’m posting this kind of information, because personal knowledge is critical to survival when entering the medical system for treatment, and particularly in the case of C-19 infection since the only real knowledge that the medical community has about this disease is entirely clinically based and the distribution of that knowledge is highly diverse, that is, some docs are highly knowledgeable based on treating large numbers of cases, some docs are totally clueless, and the rest are somewhere in between.
the following is a case study presentation on COVID-19 on a medical site that invites other doctors to make recommendations.
in this case, it’s unfortunate the first test was a false negative; hopefully, testing is in the process of getting quicker and hopefully more accurately, because the sooner this disease is treated, the better the outcome.
the REALLY good docs who know how to treat this will start treatment based on clinical presentation and their personal clinical knowledge of this disease; timid docs wait around, and political docs (fortunately VERY VERY few) toe the fake stream enemedia party line and refuse effective treatment.
some docs believe high ferritin is a sign C-19 inflammation is breaking down hemoglobin and that’s what ultimately kills you [no oxygen being transported] (ferritin is a protein which binds excess iron in cells, which would be a sign hemoglobin is breaking down, releasing free iron,which is toxic)
in this case, the doc does start HCQ, but VERY late in the game, and has also not added azythromicin, and the most common recommendation in the commentary is to add azythromicin or doxycycline.
to wit, the case study and comments:
Dr. M M
Cardiology, General
Apr 04
COVID-19 presentation and CXR findings in a 61 yr old male
A 61-year-old male with past medical history of hypertension not on medications presented with fever for 10 days with dry cough and generalized body pains for 4 days. He denied contact with anyone sick or travel history. Examination: febrile (38), RR of 28, HR: 80 and BP: 110/70. Chest exam was clear. All labs were within normal limits except: deranged liver enzymes, CRP: 124, D-dimer: 0.5 and high ferritin. Initial CXR showed bilateral ground glass. Patient was isolated and 1st COVID PCR was negative. 2nd CXR after 3 days showed more progression of the interstitial infiltrates. 2nd PCR came back positive. Patient is vitally stable now and started on lopinavir/ritonavir and hydroxychloroquine.
Internal Medicine Critical/Intensive Care Emergency Medicine X-ray Radiology Pulmonology Infectious Diseases COVID-19 Hospital Medicine Pathology & Lab Medicine
How is the COVID-19 Pandemic Affecting You? Join the Conversation
Responses
Sort by Oldest First
Dr. P K
Apr 04
Likely COVID 19.
Have done chest CT scan ?
Intial stage the chest X ray would be normal.
Once patient free clinically and CT chest , normal patient need discharge.
T B, MD
Apr 04
Repeat nasopharyngeal swab test for COVID-19 .
Do chest CT scan .
What about CBC and differential ? Lymphopenia ?
Add Azithromycin to the drug regime .
Nowadays no need to travel to catch as it is everywhere and mode of transmission still not completely clear.
M G, MD
Apr 04
At time of presentation chest x-ray likely normal or near normal, CT are non specific they can be identical to atypical infections, check for:
- Geographic area
- Comunity transmission
-Bilateral involvenent
- Add azythromicin
- Only half of the patients have +CRP and CXR or Chest CT findings at 48 hrs
- Follow CDC guidance to discharge
Dr. S S
Apr 04
The 2nd X Ray reminded me with similar picture of a pt with covid 19 infected pt presented by one colleague some time ago at one stage.I suggest adding doxycycline to cover atypical infections to avoid the hazards of HDQ-azithromycin combination.
Dr. B L
Apr 05
Did the patient have a nucleic acid of COVID-19?
The second X-ray already have progressed.
V S, MD
Apr 06
first exam shows some peripheral faint opacities that had progressed in the second one, high suggestive for covid-19.
what about tocilizumab?
J T, MD
Apr 08
Can divide these CXRs/presentations into those with a primary viral pneumonitis and those with secondary bacterial infection - similar to SARS-CoV 2003 and seasonal/pandemic influenza cases - those with secondary bacterial infection are more likely to end up on ICU, it seems - though pure viral pneumonitis cases can also end up there. Probably depends on how early the empirical antibiotics are initiated - which in turn depends on how soon the patients present to hospital.
N K, MD
1h
Once patient is clinically better meaning afebrile and not hypoxic he can be discharged home after completing hydroxychloroquine course.
We do not add Lopinavir/ Ritonavir to the regimen in our institution
I W, MD
1h
Consider adding Azithromycin. If he progresses consider Remdesivir on compassionate basis
H P, MD
1h
Does the patient require oxygen? Add Azithromycin . Once patient is afebrile x 72 hours,clinically asymptomatic and has not been on oxygen,he may be discharged on CDC guidelines and advise to complete course of hydroxychloroquin and Azithromycin.
J P, MD
1h
i would not start him on hydroxychloroquine at this stage because as of now we do not have any hard evidence that it works. the French study is anecdotal at best. the Chinese study failed to confirm any beneficial effect of this drug. it has serious side effects including prolonging the QT interval.the Lopinavir/ritonavir trial is not very convincing either..if patient becomes hypoxemic, then Cpap or Bipapor ventilator therapy if necessary is in order. there seems to be some promising results with Remdisivir and convalescent plasma
I A, MD
1h
We have mentioned previously swabs will be negative at this stage. Presentation is typical for COVID 19. This is the time for patient to have 2-3 doses of IV steroids and Tocilizumab. Continue HCQ. Patient should be on LMWH as well.
S J, MD
1h
False negative test. It’s Covid-19. Add long chain Heparin...it’s anticoag and anti-inflammatory.
V T, MD
45m
Has anyone seen reports that C-19 does not progress to ARD but is a disease of Hb. The virus splits Fe from the Hb which deposits in the lung and accounts for the ground glass appearance .This explains the high Ferritin level.
Treatment should then be transfusions. Malaria affects Hb and chloroquine is the treatment. HCQ is reported to be effective on C-19
Interesting parthenogenesis.
O G, MD
34m
High ferritin is acute phase reactant and in case of inflammation is not related to iron storage/ accumulation.
Highest ferritin levels are seen in autoinflammatory disorders
O G, MD
31m
As already discussed multiple times, NP PCR has low sensitivity during late stages of Covid and negative swab does not rule out disease.
IgM antibody could be + at this time although onset of detactable level varies from person to person.
H B, MD
27m
Obtain NP, throat and sputum samples for repeat COVID-19 and include other respiratory viruses, plus serology (if available) for COVID-19 IgM and IgG. Treat with convalescent plasma.
Olga Goodman, MD
26m
And again, HCQ is not the drug to initiated with active pneumonitis and ARDS.
It should be given early.
As example:
compare with birth control pills.
They do work for pregnancy prevention.
Plan B: post exposure prophylaxis.
If late and
Early pregnancy: yes, possible to terminate early pregnancy with MTX, prostaglandins, few others.
With onset of labor:
don’t give birth control pills and make a conclusion that they are not working.
O G, MD
20m
At this stage, keep Actemra in mind, possible 1-2 doses if IV steroids and consider to start anticoagulation therapy.
I A, MD
2m
As for the early treatment I am starting to like combo of HCQ-doxycycline more than azithromycin. +/-Kaletra. For this particular patient it is somewhat late though. Agree with Dr.Olga about steroids and Actemra
Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.