The Mining Play

Global Health Effects on Markets and Mining Stock

*Maybe a simple tally. From Boots on the ground.
#1. Know anybody that has had the virus?
#2. If yes
A. did they survive it?
or
B. Died from it?
Feel free to add any notes on either A. or B. They will be kindly read.
Such as; If they survived, how? Hospitalized? Or at Home? And how are the fairing now? Fully recovered?
Or if died;
Was it from the virus alone? … or had been immune compromised before coming down with the virus.

** I know of one victim so far. Male: 68
#1. Came down with it in Thailand. Mid Nov. 2019
A. Survived. Quarantined and recovered in place. Hotel room.
. Two weeks of flue like symptoms. Recovered to what he considers his normal health.
Side note Also has Parkinson’s disease.

                                          Thank You   C.s.
 ....   global-health-effects-on-markets-and-mining-stock    .....

     **“In the midst of chaos, there is also opportunity.” –  **Sun Tzu**

Who ever, among the large nations, comes out of this virus problem the fastest,
will be top dog.
If they hold little debt, are flush with gold, and hold others debt, will help …
…Or hold the patent on this virus (which is patented). you might hold the vaccination to it. $$

May you stay healthy, and wise.
C.S.

Early modeling has been shown time and again to inaccurately be a good predictive model. The health risks of this virus are truly devastating, but are increasingly being shown to be in the eldest part of our country’s population, especially those with multiple health problems. This is the area that should receive the most attention in containment, preventative measures, early monitoring and treatment. Disappointedly, there was one other ER doctor that had information removed by Youtube and it was not because of presenting non-factual information.

A quote from the write-up of Dr. Yealy, chair of UPMC ER who gave an interview Thursday on Ingraham follows below. It was a well done interview! The Youtube showing the interview has now been removed. A link to the article follows, which was a fairly accurate write-up. Dr. Yealy had a lot to say. Is Youtube removing newsworthy items to protect the public from “unapproved” news outlets? Smacks a bit of selected censorship:

A UPMC doctor on Thursday made a case the death rate for people infected with the new coronavirus may be as low as 0.25% — far lower than the mortality rates of 2-4% or even higher cited in the early days of the pandemic.

As of last Friday in the US, there were 11 deaths reported for the under 4 age group, and 18 deaths in the 5-17 age group. You have to scroll down to see the statistics. Risks are not proportional to a full science based re-assessment balanced with a host of other considerations. The overreaction and permanent damage being caused to the healthcare system and overall economy does not have a one-size-fits-all solution. Here’s the link to the demographic by age. There is much more info of interest presented as you scroll down the page:

Covid-19 Mortality by age

One last link to share; Again check the link because there is a great amount of detailed information by state as you scroll down:

https://www.cdc.gov/nchs/nvss/vsrr/covid19/index.htm

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*Morning: *

  • By now, I dare to say, all that read this form, have probably heard about a rush by the powers, to come up with a vaccine for this C.C.P produced Virus.*
  • To if it has merit, is up to your individual belief.*
  • When it comes to vaccinations, its safe to say, very few people follow the research and history of them. It’s a complicated science that bores most.*
  • We humans are more concerned of, what type of food to feed our pets, what tires to put on our auto, what fashion is in vogue. *
    Just give me the “shot” and let me get on with my life, is a freedom of our choice. … What if …it becomes mandatory ?
    It’s not just for you then, BUT ALL in your family tree. Grand parents, Spouses, teens,…(and think hard about this)… your grade school age, and infants?

Your choice. : What follows is a vaccine story. Https. Link is at the end.
This is just one story. I hope you don’t find it boring. C.s
_____*

APRIL 23, 2020

The Dengvaxia Disaster Was Twenty Years in the Making—What Will Happen With a Rushed COVID-19 Vaccine?

Print

Editorial by Lyn Redwood, President, Children’s Health Defense

Article that follows by the Children’s Health Defense Team

Vaccine development is a topic that is on the minds of everyone as the world grapples with ways to protect our health and the health of our loved ones from coronavirus. The team at Children’s Health Defense decided to write an article about Dengue Fever because an important part of medicine’s body of knowledge comes from the opportunity to learn from past mistakes.

Dengue fever is a common disease in more that 120 countries and, like Coronavirus, has been the target for a vaccine for many years. The development and licensure of Dengvaxia® vaccine by Sanofi spanned more than 20 years and cost more than 1.5 billion U.S. dollars. But the development of the vaccine turned out to be tricky. Dengue vaccine antibodies can also make the infection worse, especially in infants and children who have never been exposed to the virus. The virus may actually use the antibodies created by the vaccine to spread the virus throughout the body. So an infection with dengue — when your blood already has antibodies in it — can actually enhance the disease resulting in deadly complications.

Despite the fact that Sanofi tested Dengvaxia in several large clinical trials with more than 30,000 kids globally and published the results in the prestigious New England Journal of Medicine , there were serious problems. According to epidemiologists who reviewed the data, the trials were riddled with “small inaccur­acies, missing data, and uncalculated risks.” Buried in those clinical trials was a disease enhancement safety signal, but industry and the World Health Organization (WHO) turned a blind eye to the problem, calling it a “theoretical possibility.” Dengvaxia was subsequently admini­ster­ed to thousands of children in the Philippines. It was reported last year that the deaths of approximately 600 children who received the vaccine are under investigation by the Public Attorney’s Office. The vaccine has been permanently banned in the country.

What is also very concerning is that even after Dengvaxia led to tragic injuries and deaths in the Philippines, the FDA moved forward and licensed the vaccine in the U.S. According to a May 1, 2019 press release, the agency granted the application Priority Review under a program intended to encourage development of new drugs and biologics for the prevention and treatment of certain tropical diseases. Such actions by the FDA raise serious questions about safety, not only for the Dengue vaccine, but for future vaccines in development.

Questions about vaccine safety are critically important since past research has documented the same concerns with disease enhancement with coronavirus vaccines. Peter Hotez, MD, PhD, Dean of the National School of Tropical Medicine at Baylor College of Medicine worked on a vaccine for coronavirus in 2016 that stopped just short of commercial development. Despite having “tried like heck” to obtain funding to move his vaccine into clinical trials, Hotez told a U.S. Congressional Committee (on March 5) that coronavirus vaccines are scientifically challenging and have a unique potential safety problem—the same problem with immune enhancement that caused the deaths of children who received the dengue vaccine. When Hotez observed this immune pathology in his coronavirus laboratory animals, he thought, “Oh my God, this is going to be problematic.”

How can we be sure the rush to create a coronavirus vaccine will not produce another disaster like the dengue vaccine? Sadly, at least as of the time being, there is little assurance that it will not happen again. One of the issues that must be addressed are the conflicts of interest inherent to a system that allows vaccine patent royalties to flow to the same government agencies (HHS, NIH, FDA and CDC) that are responsible for research, approval, recommendations to use vaccines, safety surveillance and compensation for injuries.

When automobiles were found to have preventable and fatal defects, consumer advocate Ralph Nader’s book, Unsafe at Any Speed , led to congressional hearings and ultimately the creation of an independent watchdog safety agency. To assure that vaccine safety becomes a priority, we must step back and review each step of the development, review, approval, safety surveillance and compensation process. It is time for President Trump to renew his plan to create a vaccine safety commission to make sure that the process has a review conducted by a multidisciplinary, independent watch dog team before the approval of a coronavirus vaccine.

The Dengvaxia Disaster Was Twenty Years in the Making—What Will Happen With a Rushed COVID-19 Vaccine?

By the Children’s Health Defense Team

For several weeks, Dr. Anthony Fauci and Bill Gates have been beating the drum about a COVID-19 vaccine, seeking to keep the world’s coronavirus optics focused on a medical intervention that Gates acknowledges to be risky enough to require indemnification against lawsuits. The two are casting a COVID-19 vaccine—which they speculate could be ready in as little as 18 months—as the passport for a return to “normalcy.” The two opinion leaders’ gambit seems to be backfiring among people savvy enough to understand that Fauci’s and Gates’ organizations, pocketbooks and agendas are driving the rush for an indemnified vaccine. Other Americans may be too distracted by the historically unprecedented lockdown, however, to think through the safety issues raised by a potential COVID-19 vaccine.

… the Philippines’ mass dengue vaccination program—implemented with undue haste—not only killed children but provoked protests, criminal investigations, indictments, revocation of the vaccine’s license in that country and a plummeting of parental confidence in vaccine safety from 82% to 21%.

Americans would be well advised to revisit a virus-and-vaccine cautionary tale that briefly captured front-page attention a year ago. In April 2019, the U.S. Food and Drug Administration (FDA) approved Sanofi Pasteur’s Dengvaxia vaccine, joining 19 other countries in granting regulatory approval to the world’s first dengue vaccine. The FDA gave its green light not long after the Philippines—the first country to roll out the vaccine widely—witnessed hundreds of distressing hospitalizations and deaths in 9-16 year-olds, representing a clear safety signal.

Dengvaxia’s fallout was so dramatic that it even overrode the U.S. media’s customary whiteout of vaccine safety problems. As summarized by National Public Radio (NPR), the Philippines’ mass dengue vaccination program—implemented with “undue haste”—not only killed children but provoked protests, criminal investigations, indictments, revocation of the vaccine’s license in that country and a plummeting of parental confidence in vaccine safety from 82% to 21%.

… in some individuals, subsequent infection with a different dengue virus can increase the risk of severe outcomes—a phenomenon known as “disease enhancement.”

Viral vaccines and “disease enhancement”

Given that an estimated 40% of the world’s population is at risk of mosquito-borne dengue infection, it is not surprising that the vaccine industry has had a dengue vaccine on its list for decades. There are four types of dengue virus that can trigger infection, albeit with a highly variable trajectory that ranges from asymptomatic infection or “mild and non-specific febrile illness” (together representing about 75% of cases) to “classic dengue fever” and, in an “occasional” subset, more severe outcomes such as plasma leakage, bleeding, shock or death. In children, experts believe the majority of dengue infections are subclinical. Researchers note that environmental and host immune factors play a significant role in shaping both susceptibility and outcomes.

Natural infection with one type of dengue virus provides long-lasting protection against the same type but only short-term protection against the other three varieties. The vexing result is that, in some individuals, subsequent infection with a different dengue virus can increase the risk of severe outcomes—a phenomenon known as “disease enhancement.” In a 2018 review, researchers listed reports of “enhanced illness” resulting from influenza, respiratory syncytial virus (RSV), Zika, West Nile virus, dengue and coronavirus—and emphasized that either infection or vaccination could produce this response.

In 2018, the WHO’s Global Advisory Committee on Vaccine Safety reviewed some of the deaths associated with Dengvaxia but stated that it could not determine whether the vaccine was causally related to the “vaccine-related immune enhancement.” This disingenuous conclusion flies in the face of decades of evidence showing some viral vaccines to be capable of “subverting” the immune system and provoking “exacerbated illness.” It is doubtful that WHO or Sanofi are unaware of this phenomenon, which numerous publications acknowledge as a “major obstacle” for the development of safe dengue and other viral vaccines. After the problems in the Philippines, however, Sanofi’s global medical director asserted that “In hindsight . . . Sanofi wouldn’t do anything differently.”

A dengue expert who develops vaccines for the U.S. military issued warnings about Dengvaxia’s risks ahead of time—vainly cautioning that vaccinating 9-16 year-olds who were “seronegative” or “dengue-naive” at baseline (that is, had never before been exposed to dengue) was likely to significantly augment their lifetime risk of severe disease when later exposed to dengue. (About 21% of vaccinees were seronegative.) Why did this industry insider—who has been a paid dengue vaccine consultant to Takeda, Merck, Sanofi Pasteur and SmithKlineBeecham—voice these concerns and condemn international health institutions for unethical, unscientific and “contorted explanations” that “fail[ed] to identify breakthrough dengue disease in vaccinated subjects as serious adverse events”? As he pointed out in numerous letters and articles, the potential for vaccine-enhanced dengue disease was readily apparent in Dengvaxia’s clinical trials, but both Sanofi and WHO chose to ignore the evidence.

Belatedly—a year and a half after the launch of the Philippines’ disastrous vaccination campaign—Sanofi announced that “new information” was prompting the company to declare that “vaccination should not be recommended” for seronegative individuals of any age. Repackaging Dengvaxia as a vaccine solely for individuals who have had at least one laboratory-confirmed bout of dengue is easier said than done, however, because many mild dengue infections go undiagnosed and undocumented.

The dengue vaccine pipeline

Sanofi reluctantly revised its recommendation to provide Dengvaxia only to individuals with evidence of past infection, which “leaves a substantial unmet need” that other dengue vaccine developers appear only too eager to exploit. Although Sanofi’s formulation—which took two decades and two billion dollars to develop—is the first dengue vaccine ever to make it out of the pipeline and into the marketplace, two other vaccines (TAK-003 and Butantan-DV) are currently undergoing late-stage clinical trials in Asia/Latin America and Brazil, respectively.

Dengue vaccine development has been marked by strong for-profit industry involvement. In addition, there has been “wide participation and co-ownership” by U.S. government institutions in dengue vaccine research and development, even though dengue disease poses little threat on the U.S. mainland. With dengue-endemic areas limited to Puerto Rico and a few offshore territories and protectorates, HHS—the umbrella agency for the National Institutes of Health (NIH), Fauci’s National Institute of Allergy and Infectious Diseases (NIAID), the CDC and the FDA—owns 65 dengue-vaccine-related patents, dwarfing the 19 owned by Sanofi and the 12 and 4 owned by GlaxoSmithKline and Merck, respectively. All of the private companies involved in dengue vaccine development share patents with U.S. government agencies; meanwhile, very few patent applications have been filed in developing countries.

CDC scientists designed and constructed the TAK-003 vaccine and then licensed it to Japan’s Takeda Pharmaceutical Company, Asia’s largest pharmaceutical conglomerate. However, preliminary analyses of the clinical trial results suggest that TAK-003 may suffer from similar problems as Dengvaxia, providing “unbalanced protection among the four types of dengue” that could “increase the risk of severe disease after exposure to a second type of the virus.” Takeda plans to apply for approval in dengue-endemic countries anyway.

Some experts are placing their bets on the third finalist, Butantan-DV, developed by none other than NIAID. NIAID has sponsored Butantan-DV clinical trials in Brazil since 2013, licensing its vaccine technology to Brazil’s Butantan Institute and launching the most recent trials in 2016. Not content to lurk in the background, NIH and NIAID have taken pains to call attention to their role in the vaccine’s development; publications presenting clinical trial results have titles referring to the “National Institute of Allergy and Infectious Diseases tetravalent dengue vaccine” and the “National Institutes of Health dengue vaccine.” In studies published to date, investigators only monitored adverse reactions for 21 days.

Mosquito versus needle

The Dengvaxia experience—involving a skewed immune response and enhanced risks—raises questions “applicable to all dengue vaccine candidates” and a number of other viral vaccines. One not-often-discussed consideration pertains to the “considerable differences between a wild-type [dengue virus] delivered by a mosquito versus needle administration of a vaccine,” which have the potential to elicit different immune responses. Instead of acknowledging these vaccines’ potentially unconquerable risks, why not focus on training health care workers in the provision of the supportive care known to be “very effective when delivered by experienced practitioners”? Even in severe cases of dengue characterized by vascular permeability and fluid loss, practitioners who “accurately and rapidly” replace fluids can stabilize patients’ condition—“and rather quickly”—with the result that “the vascular permeability phenomenon abruptly disappears.” In addition, fruitful avenues of research could include studying the environmental and immune system factors associated with the minority of cases that involve more severe dengue outcomes.

With vaccine damage occurring in association with many different vaccines, it is unclear why so many individuals and organizations jumped on the anti-Dengvaxia bandwagon last year, but—with a rushed COVID-19 vaccine in the works—their words of warning are worth heeding. As NPR noted, “the debacle in the Philippines offers a key lesson for governments and manufacturers when it comes to approving and selling new vaccines: Slow down.” The dengue expert who presciently warned about Dengvaxia’s dangers put it this way:

*Dengvaxia-enhanced disease has created a major ethical dilemma for the vaccine community, an enduring public health management crisis, and legal nightmare. Vaccines should not harm recipients, directly or indirectly. WHO and the manufacturer owe the customer a safe product.
From. …*https://childrenshealthdefense.org/news/government-corruption/the-dengvaxia-disaster-was-twenty-years-in-the-making-what-will-happen-with-a-rushed-covid-19-vaccine/

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Mike G.
Very informed posting and statistics. Mike.

The second article “Coronavirus Desease 2019 (COVID-19)
Had a honest paragraph along the bottom of the page:
; Among 2,028 hospitalized adults with information on underlying medical conditions, (( “90.6%)) “had” at least one reported underlying medical condition!!!
the most reported were hypertension”” , obesity, chronic metabolic disease, and cardiovascular disease.
(Now do you think" being quarantined at home! , is helping any of those symptoms). Do yourself and your loved ones a favor, get out in nature,
smile at her, eat good food, enjoy your people, and remember worry is optional.
… And be kind… C.s.

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So far just ! case??? And he is still alive.

From a earlier posting: **
*Maybe a simple tally. From Boots on the ground.
#1. Know anybody that has had the virus?
#2. If yes
A. did they survive it?
or
B. Died from it?
Feel free to add any notes on either A. or B. They will be kindly read.
Such as; If they survived, how? Hospitalized? Or at Home? And how are the fairing now? Fully recovered?
Or if died;
Was it from the virus alone? … or had been immune compromised before coming down with the virus.

** I know of one victim so far. Male: 68
#1. Came down with it in Thailand. Mid Nov. 2019
A. Survived. Quarantined and recovered in place. Hotel room.
. Two weeks of flue like symptoms. Recovered to what he considers his normal health.
Side note Also has Parkinson’s disease.

I can add 1# more victim to the Virus tally.
A 47 year old single healthy male. (bikes 6miles to and from work when weather permits) Caught C.C.P. V. after a Company meeting in Arizona.
He does not know the source? Before he left? Meetings? or on the flights there or on way back?
He said he came down with fever, fatigue, headache, about 3rd day home.
He was down and out for almost 2 weeks. Was not hospitalized, did talk
to his doctor. He was not tested. Took same precautions as the flue.
He is now back at work doing well. He did say ; " It was a ass kicker"!!

 ......C.s.....

Appears to finally be a cheap drug that actually reduces mortality for COVID. The randomized trial research paper hasn’t been released/no peer review yet however so some caution is advised. (This is probably the real deal since nobody will be making money from using this drug.)

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This thread has been underutilized lately.
Let’s start discussing the collateral damage the mismanaged reopening of the economy has caused.
Domestically, many family owned enterprises will not reopen. The effects of the FED and Treasury’s efforts to rescue the economy are widely beneficial for the PM mining stock sector, however. Will much of the remaining stockmarket be as predictable?

Feb 9 mdmnwonk said, “There is a serious case of denial going on”. That same day MikeGold pointed out: “CCP is doing everything they can to silence things at the moment so indeed hard to figure out what is happening. All the numbers provided so far have been debunked; basically fiction. “ Feb 29 TDK posted this link and few people responded: https://www.bloomberg.com/news/articles/2020-02-28/gold-prices-plunge-by-the-most-intraday-since-june-2013

March 1 MikeGold noted, “Could be a really ugly week in the markets again. Perhaps the worst will be over for Gold?” It was quite evident that this discussion needed a new thread other than the “Other Mining Stocks” thread on which all this started and Cabezon broke the discussion off to a new thread titled Global Health Effects on Markets and Mining Stock .

It was March 1 that 1st posted,“The risks to individuals having their health adversely affected in the US are actually very low. Much of the media are creating panic by sensationalizing the perception of the health risk to individuals living in the US. The global economic risks are much greater and likely to persist.

…Covid19 is definitely impacting a growing list of global concerns. The one immediately greatest impact was witnessed this past week. Between margin calls, the widespread positions in ETFs and Funds and the use of options. It is no wonder the algorithms took over the trades. Puts on the $SPX and other Indexes put the final knife in the majority of positions being held by individual investors.

Again I would recommend reviewing the repost of “Crikey” subtitled “Things That Make You go Hmmm…” for a better understanding of what has been happening.
https://www.gowebcasting.com/events/precious-metals-summit-conferences-llc/2019/11/12/crikey-what-s-going-on-with-gold-by-grant-williams/play/stream/28893
Looking back on history puts things in a different perspective. The psychology moving the markets is much the same, even though the differences in particular forces are different. At least that’s my perspective of where things are at with PMs and what investors may be in for short and longer term.”

Again, MikeGold warned, “It is going to get a lot uglier before it gets better.” I agreed and added, “This will be quite alarming given the level of global economic news coverage blamed on COVID-19 which is only the catalyst initiating the event. Do not underestimate how this will effect world economy.“

And so it goes. There is so much data, data mismanagement and misreporting, and progress made that is truly having an effect global health policy decisions. It is appropriate putting the health and well-being of community and public as a priority.

That was one focus of this tread. The other focus is the effect this CCP Coronovirus is having on Markets. We still have a forum thread focusing on on Mining Stocks, so some of this discussion may tend to drift a bit between the two threads, Genuinely interested in hearing everyone’s perspective on what they are seeing and experiencing, but would like to steer away from political points of view as much as possible, China has changed that goal, as have many other events driving narratives in the news. Let’s try to stay focused on what the effect the virus and lockdowns have done, progress made, and the best path forward.

There is an undeniable rise in covid cases … is it important? There have been 25 million tests performed. One would expect more “case” as a result of more tests. Now that tests are available, one does not have to be so sick that a trip to the ER is needed in order to receive a test. Anyone feeling sick may be tested, even if it is a less severe case that can likely be treated conservatively at home. Not all new cases are requiring hospitalization or resulting in death.
Is reporting a percentage rise valid to report after mitigation results in a sharp decline of “cases”, or should one look at raw numbers?


https://www.cdc.gov/nchs/nvss/vsrr/covid19/index.htm

I would argue that the only important stats to follow are hospitalizations and deaths. It is unlikely there will be an elimination of all risk. The reason for the lockdown was to assure hospitals would not be overrun all at once with severely ill patients needing acute care in a hospital setting. That scenario has passed in many areas. It is true the CCP coronavirus has limited treatment options and no vaccines. No one is denying this is a very dangerous virus with far reaching detrimental effects to global health and the global economies. There are always risks to be mitigated, but zero risk is an unattainable goal. Thankfully we live in a country where so much new information is available for individuals to take responsibility for minimizing risks suitable to the individual.

Lately there are the two extremes in the MSM. The press either overly sensationalizes the percentage rise of cases or overlooks the prudent and reasonable precautions to take from a public health policy perspective. I would not expect someone with young children and/or elderly relatives living in the same household to adhere to the same precautions as an 18-40 year old just returning to the workforce. Someone living in an area of known outbreak spikes would naturally feel compelled to use extra care in protecting themselves and not spreading the virus. The effects of this virus will be long lasting and devastating for far to many people. Officials should avoid making the indirect and direct harm on health and well-being from the economic destruction that appears to be unfolding greater than the direct harm from the virus. Much of the economic destruction is preventable.

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Just some follow up on using the steroid Dexamethasone for COVID.

The pre-print non peer review paper is out: https://www.medrxiv.org/content/10.1101/2020.06.22.20137273v1.full.pdf

I guess I’m not impressed at all. As is usually the case, press releases over state the benefits.

It is in a nutshell: Overall, 454 (21.6%) patients allocated
dexamethasone and 1065 (24.6%) patients allocated usual care died within 28 days .

21.6% vs 24.6%. Should we be impressed? No…not even sure that is statistically significant but they say it is.

It appears there is some benefit if taken right at the correct time in the course of the disease with the right dosage. It is very likely harmful(excess deaths recorded) if taken too soon. Almost all the benefit was shown for patients on ventilators which is odd/suspect. The death rate on ventilators in the U.K. following the usual treatment is very high compared to other countries so seeing improvement using the steroid may simply be helping when bad protocols are being followed to begin with. Note that no benefit was found in other studies done on the steroid in China and it also had no effect on MERS and SARS patients.

Back to waiting for the vaccine.

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A lot of new information being compiled all the time regarding the CCP Coronavirus:

Assessment of Evidence for COVID-19-Related Treatments: Updated 6/25/2020

The information contained in this evidence table is emerging and rapidly evolving because of ongoing research and is subject to the professional judgment and interpretation of the practi- tioner due to the uniqueness of each medical facility’s approach to the care of patients with COVID-19 and the needs of individual patients. ASHP provides this evidence table to help practi- tioners better understand current approaches related to treatment and care. ASHP has made reasonable efforts to ensure the accuracy and appropriateness of the information presented. However, any reader of this information is advised ASHP is not responsible for the continued currency of the information, for any errors or omissions, and/or for any consequences arising from the use of the information in the evidence table in any and all practice settings. Any reader of this document is cautioned that ASHP makes no representation, guarantee, or warranty, express or implied, as to the accuracy and appropriateness of the information contained in this evidence table and will bear no responsibility or liability for the results or consequences of its use.

AHFS Clinical Drug Information® is now available for a 90-day trial period. Take a survey (https://bit.ly/ahfscdi) to get access. ASHP’s patient medication information is available at http://www.safemedication.com/.

Visit our website for the latest information on current drug shortages.
Select entries were updated on 6/25/2020; these can be identified by the date that appears in the Drug(s) column.

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COVID-19 COULD CAUSE A DIFFERENT DISEASE IN PREVIOUSLY HEALTHY PEOPLE

The coronaviruses responsible for the current and previous outbreaks share a similar way of getting into cells. The now-familiar protein spikes on the surface of the virus attach to ACE2 receptors are abundant in lung, kidney and islet cells in the pancreas. It is proposed that once in islets, Covid-19 disrupts normal cell function leading to abnormalities in the pathways that maintain blood glucose through insulin secretion. It is also possible that cell invasion leads to acute inflammation that kills islet cells.
https://www.inverse.com/mind-body/covid-19-diabetes

GUT REACTION
Children and young adults are less likely to develop symptomatic Covid-19, although infection readily occurs in young people with equally high viral loads in the airway, suggesting that they can certainly infect others. In contrast, people of older age and those with pre-existing chronic conditions are highly at risk and very likely develop symptomatic, severe disease.

If we consider the gradient of the severity of the disease, children are at one end, and the elderly and patients with chronic conditions are at the other end.

HOW YOUR INTESTINES MAY AFFECT THE SEVERITY OF COVID-19

I found the above linked site intriguing and full of information. It has much more information than the other link in my previous post with the same title on many aspects of COVID-19. Well worth exploring. Sorry for having to edit this post to catch the correct link. The website has much on it.
WHO IS PREDISPOSED TO SERIOUS COVID-19?

WHAT CONDITIONS ARE LINKED TO SEVERE COVID-19?

HOW DOES THE BODY FIGHT COVID-19 INFECTION?

A BASIC HUMAN BEHAVIOR HAS BEEN UPENDED BY COVID-19

THE ORIGINAL SARS VIRUS DISAPPEARED. HERE’S WHY COVID-19 WON’T DO THE SAME.
EZ

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This about sums it where we are at now:

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You know, if you Americans wanted to build a wall between US and Canada, not too many Canadians would object. Just saying :wink:

Things that make you go “Hmmm” …

Treatment with Hydroxychloroquine Cut Death Rate Significantly in COVID-19 Patients, Henry Ford Health System Study Shows

July 02, 2020

DETROIT – Treatment with hydroxychloroquine cut the death rate significantly in sick patients hospitalized with COVID-19 – and without heart-related side-effects, according to a new study published by Henry Ford Health System.

In a large-scale retrospective analysis of 2,541 patients hospitalized between March 10 and May 2, 2020 across the system’s six hospitals, the study found 13% of those treated with hydroxychloroquine alone died compared to 26.4% not treated with hydroxychloroquine. None of the patients had documented serious heart abnormalities; however, patients were monitored for a heart condition routinely pointed to as a reason to avoid the drug as a treatment for COVID-19.

The study was published today in the International Journal of Infectious Diseases, the peer-reviewed, open-access online publication of the International Society of Infectious Diseases (ISID.org).

Patients treated with hydroxychloroquine at Henry Ford met specific protocol criteria as outlined by the hospital system’s Division of Infectious Diseases. The vast majority received the drug soon after admission; 82% within 24 hours and 91% within 48 hours of admission. All patients in the study were 18 or over with a median age of 64 years; 51% were men and 56% African American.

“The findings have been highly analyzed and peer-reviewed,” said Dr. Marcus Zervos, division head of Infectious Disease for Henry Ford Health System, who co-authored the study with Henry Ford epidemiologist Dr. Samia Arshad. “We attribute our findings that differ from other studies to early treatment, and part of a combination of interventions that were done in supportive care of patients, including careful cardiac monitoring. Our dosing also differed from other studies not showing a benefit of the drug. And other studies are either not peer reviewed, have limited numbers of patients, different patient populations or other differences from our patients.”

Zervos said the potential for a surge in the fall or sooner, and infections continuing worldwide, show an urgency to identifying inexpensive and effective therapies and preventions.

“We’re glad to add to the scientific knowledge base on the role and how best to use therapies as we work around the world to provide insight,” he said. “Considered in the context of current studies on the use of hydroxychloroquine for COVID-19, our results suggest that the drug may have an important role to play in reducing COVID-19 mortality.”

The study also found those treated with azithromycin alone or a combination of hydroxychloroquine and azithromycin also fared slightly better than those not treated with the drugs, according to the Henry Ford data. The analysis found 22.4% of those treated only with azithromycin died, and 20.1% treated with a combination of azithromycin and hydroxychloroquine died, compared to 26.4% of patients dying who were not treated with either medication.

“Our analysis shows that using hydroxychloroquine helped saves lives,” said neurosurgeon Dr. Steven Kalkanis, CEO, Henry Ford Medical Group and Senior Vice President and Chief Academic Officer of Henry Ford Health System. “As doctors and scientists, we look to the data for insight. And the data here is clear that there was benefit to using the drug as a treatment for sick, hospitalized patients.”

Overall, hospital system patients in the study experienced an 18.1% in-hospital mortality rate. Regardless of treatment, mortality was highest in:

Patients older than 65,

Patients who identified as Caucasian,

Patients admitted with reduced oxygen levels,

Patients who required ICU admission.

Patients who died commonly had serious underlying diseases, including chronic kidney and lung disease, with 88% dying from respiratory failure. Globally, the overall mortality from SARS-COV-2 is estimated to be approximately 6% to 7%, with mortality in hospitalized patients ranging between 10% and 30%, according to the study. Mortality as high as 58% has been seen among patients requiring ICU care and mechanical ventilation.

According to the U.S. Centers for Disease Control & Prevention, hydroxychloroquine (also known as hydroxychloroquine sulfate) is a U.S. Food & Drug Administration (FDA)-approved arthritis medicine that also can be used to prevent or treat malaria. It is available in the United States by prescription only. The drug is sold under the brand name Plaquenil and it is also sold as a generic medicine. It is commonly used by patients with arthritis, lupus or other rheumatic conditions.

Dr. Zervos also pointed out, as does the paper, that the study results should be interpreted with some caution, should not be applied to patients treated outside of hospital settings and require further confirmation in prospective, randomized controlled trials that rigorously evaluate the safety and efficacy of hydroxychloroquine therapy for COVID-19.

“Currently, the drug should be used only in hospitalized patients with appropriate monitoring, and as part of study protocols, in accordance with all relevant federal regulations,” Dr. Zervos said.

Henry Ford Health System, as one of the region’s major academic medical centers with more than $100 million in annual research funding, is involved in numerous COVID-19 trials with national and international partners.

Henry Ford Health System is currently also involved in a prophylactic hydroxychloroquine study: “Will Hydroxychloroquine Impede or Prevent COVID-19,” or WHIP COVID-19. The study is a 3,000-person, randomized, double-blinded look at whether hydroxychloroquine prevents healthcare and frontline workers from contracting the COVID-19 virus. The WHIP COVID-19 team is working on expanding study sites while there is a lull in the number of COVID-19 cases in Southeast Michigan. This is in preparation for a potential increase of COVID-19 cases as Fall flu season approaches, with additional sites available for convenient enrollment of healthcare workers and first responders. The WHIP COVID-19 team is also taking this gift of time to reach out to other areas of the world that are seeing a blossoming of cases: Brazil and Argentina. There are currently 619 people enrolled in the study, out of a target of 3,000.

https://www.henryford.com/news/2020/07/hydro-treatment-study

Pretty sure there is nothing here. Basically all other studies show no benefit or even harm. Also, Michigan has the highest fatality rate in the nation which further suggests something odd with the results since a large percent of the deaths occurred in Henry Ford Hospitals.It appears they simply didn’t give the drug to the most sick patients which skewed the results.(i.e. they compared apples to oranges.)Since this study was not randomized, it cant be relied on to show anything. Will look to see what the experts will say about this but can already guess. (And one other thing, the time periods when the drug was used and when it wasnt dont match. In general, the sickest average patient was at the beginning of the outbreak for a number of reasons. The drug was not used till later when the less vulnerable were hospitalized.)

Which is why I respectfully disagree Mike; Did you miss the point on how HCQ is useful to prevent or lessen the severe onset of Covid when used early in the treatment? The retrospective study just cited for HCQ was given to everyone entering the hospital, not just those after being sent to the ICU or already on a ventilator. This randomized study sets it apart from other published studies where no benefit was found. It was never touted as a “hail mary” treatment for patients undergoing a cytokine storm event. Early reports born out by the non-peer reviewed studies such as the inappropriately VA reported results (since retracted), and those out of Brazil that discredited HCQ, were for late stage, severely impacted patients. There’s a lot going on. Nearly impossible to keep up with all of it as it unfolds. Try keeping an open mind as studies get underway to show where HCQ may be useful before patients become severely ill. HCQ may may be proven to have use as a preventative measure.

A government study cites:

Blocks viral entry by increasing endosomal pH and inhibiting viral fusion to the cell membrane. Decreases affinity of ACE2 receptor for SARS-Cov-2 by impairing terminal glycosylation of ACE2.

Here are a few studies of interest:

Early treatment of COVID-19 patients with hydroxychloroquine and azithromycin: A retrospective analysis of 1061 cases in Marseille, France

In France, the combination hydroxychloroquine (HCQ) and azithromycin (AZ) is used in the treatment of COVID-19.

Conclusion

Administration of the HCQ+AZ combination before COVID-19 complications occur is safe and associated with a very low fatality rate in patients.

Sciencedirect.com

Current studies underway can be found here:

https://clinicaltrials.gov/ct2/results?recrs=ab&cond=Covid-19&term=hydroxychloroquine&cntry=US&state=&city=&dist=

Outcomes of 3,737 COVID-19 patients treated with hydroxychloroquine/azithromycin and other regimens in Marseille, France: A retrospective analysis

Abstract

Background

In our institute in Marseille, France, we initiated early and massive screening for coronavirus disease 2019 (COVID-19). Hospitalization and early treatment with hydroxychloroquine and azithromycin (HCQ-AZ) was proposed for the positive cases.

Methods

We retrospectively report the clinical management of 3,737 screened patients, including 3,119 (83.5%) treated with HCQ-AZ (200 mg of oral HCQ, three times daily for ten days and 500 mg of oral AZ on day 1 followed by 250 mg daily for the next four days, respectively) for at least three days and 618 (16.5%) patients treated with other regimen (“others”). Outcomes were death, transfer to the intensive care unit (ICU), ≥10 days of hospitalization and viral shedding.

Results

The patients’ mean age was 45 (sd 17) years, 45% were male, and the case fatality rate was 0.9%. We performed 2,065 low-dose computed tomography (CT) scans highlighting lung lesions in 592 of the 991 (59.7%) patients with minimal clinical symptoms (NEWS score = 0). A discrepancy between spontaneous dyspnoea, hypoxemia and lung lesions was observed. Clinical factors (age, comorbidities, NEWS-2 score), biological factors (lymphocytopenia; eosinopenia; decrease in blood zinc; and increase in D-dimers, lactate dehydrogenase, creatinine phosphokinase, and C-reactive protein) and moderate and severe lesions detected in low-dose CT scans were associated with poor clinical outcome. Treatment with HCQ-AZ was associated with a decreased risk of transfer to ICU or death (Hazard ratio (HR) 0.18 0.11–0.27), decreased risk of hospitalization ≥10 days (odds ratios 95% CI 0.38 0.27–0.54) and shorter duration of viral shedding (time to negative PCR: HR 1.29 1.17–1.42). QTc prolongation (>60 ms) was observed in 25 patients (0.67%) leading to the cessation of treatment in 12 cases including 3 cases with QTc> 500 ms. No cases of torsade de pointe or sudden death were observed.

Conclusion

Although this is a retrospective analysis, results suggest that early diagnosis, early isolation and early treatment of COVID-19 patients, with at least 3 days of HCQ-AZ lead to a significantly better clinical outcome and a faster viral load reduction than other treatments.

https://www.sciencedirect.com/science/article/pii/S1477893920302817

Study will test if hydroxychloroquine can prevent COVID-19

By Rachael Rettner - Senior Writer March 30, 2020

“Currently, there is no proven way to prevent COVID-19 after being exposed,” Anna Bershteyn, an assistant professor of population health at NYU Langone Health and co-principal investigator on the study, said in the statement. “If hydroxychloroquine provides protection, then it could be an essential tool for fighting this pandemic. If it doesn’t, then people should avoid unnecessary risks from taking the drug.”

https://www.livescience.com/hydroxychloroquine-prevent-covid-19-study.html

Study initiates hydroxychloroquine clinical trial to prevent COVID-19 in healthy people

Rush University Medical Center has opened enrollment for a new clinical trial investigating whether the drug hydroxychloroquine is better than a placebo in preventing COVID-19 infection in healthy people working in health care settings.

The Healthcare Worker Exposure Response & Outcomes of Hydroxychloroquine (HERO-HCQ) Trial will enroll 15,000 people from the HERO Registry, an online community of thousands of people working in health care, which supports this and future trials.

New trial will evaluate hydroxychloroquine to treat and prevent COVID-19

The study will evaluate therapy for current patients with the coronavirus and prophylaxis in health care workers.

A new trial led by the Perelman School of Medicine will evaluate whether the drug hydroxychloroquine (HCQ) can benefit people infected with COVID-19, as well as whether taking the drug preventatively may help people avoid infection altogether. The study, called Prevention and Treatment of COVID-19 with HCQ (PATCH), is currently enrolling patients in three separate substudies.

https://penntoday.upenn.edu/news/new-trial-will-evaluate-hydroxychloroquine-treat-and-prevent-covid-19

HSS Healthcare Workers Called to Join National PCORnet® Study to Fight COVID-19 Together
Healthcare workers who interact with COVID-19 patients have a higher risk of becoming infected: Recent data shows that up to one in five are testing positive for the disease.

Hospital for Special Surgery (HSS) is now participating in a nationwide clinical trial investigating whether an oral drug called hydroxychloroquine can effectively prevent COVID-19 in healthy healthcare workers. Known as the Healthcare Worker Exposure Response and Outcomes of Hydroxychloroquine (HERO-HCQ) trial, the study was launched by the National Patient-Centered Clinical Research Network (PCORnet) and will track responses in an estimated 15,000 participants across the country to see if they test positive for COVID-19 and whether they develop antibodies to SARS-CoV-2, the virus that causes the disease.

https://news.hss.edu/hss-healthcare-workers-called-to-join-national-pcornet-study-to-fight-covid-19-together/

1 Like

Peer reviewers have indeed already debunked the results. The study was poorly designed. I suggest you draw no conclusions from it one way or another. Fyi…the treating early benefit has been attributed to simply the standard supportive care that is being followed currently. The earlier you start it, the better. Patients that received the hydroxychloroquine were given twice the dosage of a common steroid which already been linked to possible benefit. From how the study was designed, there is no way to tell what actually helped. Finally, more than 250 patients results were removed out of the study which skewed the results. Even the researchers themselves stated that their study doesn’t negate the previous better designed studies that showed no benefit.

Mike,

We’re basically on the same page so far as early studies and results go, all of which were on hospitalized patients. HCQ is not an effective treatment in severe cases of Covid-19, and may actually be dangerous for these patients, and those with pre-existing cardiac problems. The focus of all current research is to test and determine in double blind studies whether HCQ could have utility as a prophylactic, or help diminish in the early stages the progression and onset to a more severe disease. The future studies focus primarily on non-hospitalized patients. Will early use avoid catching the disease all together? If a person tests positive, but is not yet hospitalized, will early administration of a regimen of HCQ keep a person out of the hospital, or more importantly for the elderly, avoid the necessity of acute care with convalescence/maintenance on a ventilator? These questions have not yet been definitively answered, but clinical trials are underway. The search for a prophylactic to protect healthcare workers is currently where the research is being done on volunteers only. It takes a long time for results and peer-review before publication. Indications are these results will be available in December. Retrospective studies are certainly not perfect, but for a disease that has garnered so much attention in only four-five months no effort is being outright dismissed. Where there are potential indications of benefit, including anecdotal observations, all potential candidates, including HCQ, should be given thorough peer-reviewed investigation before adopting as a standard of care. There is currently no effective standard of care for the CCP coronavirus.

There is no need to look any further at use of HCQ for severe cases, especially those patients already in the ICU in which most of the early studies were conducted. Much of the research focus is on therapeutics, including those that are already FDA approved and effective for other medical indications. Unfortunately, much of all the available MSM (Main Stream Media) is filtered with bias, misinformation, skewed data, and an agenda. From the subsequent VA study that was suspended (the original pre-mature negative report was retracted - The following highlights are mine):

Detailed Description:

SARS-CoV-2 is a novel coronavirus disease (COVID-19) that presents with fever, cough, and shortness of breath, and has a mortality rate of 2-4%. Outcomes are worse among the elderly and those with cardiovascular, respiratory, cancer and other co-morbidities. Several treatments are also emerging as promising therapeutic candidates, hydroxychloroquine and azithromycin - both available as generic pills and widely used for other indications - are potential options for treatment. A small randomized controlled trial (RCT) of hospitalized patients suggests chloroquine may be superior to placebo in promoting viral elimination and shortening disease course. Hydroxychloroquine is preferred to chloroquine in the U.S. A small non-randomized trial found azithromycin had a clinical benefit. When azithromycin and hydroxychloroquine are given together, they can cause cardiac side-effects that limit use in the outpatient setting. These drugs, however, have independent potential benefits against COVID-19 that require more rigorous study before either is considered standard of care. We propose a 3-arm RCT to determine the efficacy of hydroxychloroquine or azithromycin in treating mild to moderate COVID-19 among Veterans in the outpatient setting.

One must dig deeper into source material to see much of what is not available in the MSM by reporters and “expert consultants”. There are 38 clinical trials underway in the US looking at HCQ as a prophylactic or for use in healthcare workers and/or early stage non-hospitalized patients. This is only a small fraction of the 311 clinical trials that include many aspects of mitigating/curing the disease with such clinical trial efforts looking at O2 supplementation (hyperbaric, supplemental O2, Nitric Oxide), Plasma exchange (TPE, Convalescent Plasma), Brequinar, Sarilumab, Dexamethasone, Atazanavir, Cyclosporine, AlloStim, Losartan, bacTRL-Spike, Peginterferon Lambda-1A, Opaganib,Remestemcel-L, N-acetylcysteine, Lopinavir/Ritonavir, and others. Let’s not squander the value of this forum by focusing on, or disputing, a new retrospective peer-reviewed report on a single therapeutic. Peer reviewed trials in time will reveal what does and doesn’t work and under what circumstances show efficacy. These will then become the standard of care.

When this war against CCP Coronavirus ends, I doubt anyone will be in a celebratory mood. We are only 4-5 months into looking at what is, or may become, an effective therapy. We’ll all have to live with the devastating aftereffects of what has been inflicted upon the US and the world for many years to come.