hydroxychloroquine remains the key for Covid-19 cure
As professor of epidemiology at Yale School of Public Health, I have authored over 300 peer-reviewed publications and currently hold senior positions on the editorial boards of several leading journals. I am usually accustomed to advocating for positions within the mainstream of medicine, so have been flummoxed to find that, in the midst of a crisis, I am fighting for a treatment that the data fully support but which, for reasons having nothing to do with a correct understanding of the science, has been pushed to the sidelines. As a result, tens of thousands of patients with COVID-19 are dying unnecessarily. Fortunately, the situation can be reversed easily and quickly.
I am referring, of course, to the medication hydroxychloroquine. When this inexpensive oral medication is given very early in the course of illness, before the virus has had time to multiply beyond control, it has shown to be highly effective, especially when given in combination with the antibiotics azithromycin or doxycycline and the nutritional supplement zinc.
On May 27, I published an article in the American Journal of Epidemiology (AJE) entitled, "Early Outpatient Treatment of Symptomatic, High-Risk COVID-19 Patients that Should be Ramped-Up Immediately as Key to the Pandemic Crisis." That article, published in the world's leading epidemiology journal, analyzed five studies, demonstrating clear-cut and significant benefits to treated patients, plus other very large studies that showed the medication safety.
Physicians who have been using these medications in the face of widespread skepticism have been truly heroic. They have done what the science shows is best for their patients, often at great personal risk. I myself know of two doctors who have saved the lives of hundreds of patients with these medications, but are now fighting state medical boards to save their licenses and reputations. The cases against them are completely without scientific merit.
Since publication of my May 27 article, seven more studies have demonstrated similar benefit. In a lengthy follow-up letter, also published by AJE, I discuss these seven studies and renew my call for the immediate early use of hydroxychloroquine in high-risk patients. These seven studies include: an additional 400 high-risk patients treated by Dr. Vladimir Zelenko, with zero deaths; four studies totaling almost 500 high-risk patients treated in nursing homes and clinics across the U.S., with no deaths; a controlled trial of more than 700 high-risk patients in Brazil, with significantly reduced risk of hospitalization and two deaths among 334 patients treated with hydroxychloroquine; and another study of 398 matched patients in France, also with significantly reduced hospitalization risk. Since my letter was published, even more doctors have reported to me their completely successful use.
My original article in the AJE is available free online, and I encourage readers—especially physicians, nurses, physician assistants and associates, and respiratory therapists—to search the title and read it. My follow-up letter is linked there to the original paper.
Beyond these studies of individual patients, we have seen what happens in large populations when these drugs are used. These have been "natural experiments." In the northern Brazil state of Pará, COVID-19 deaths were increasing exponentially. On April 6, the public hospital network purchased 75,000 doses of azithromycin and 90,000 doses of hydroxychloroquine. Over the next few weeks, authorities began distributing these medications to infected individuals. Even though new cases continued to occur, on May 22 the death rate started to plummet and is now about one-eighth what it was at the peak.
A reverse natural experiment happened in Switzerland. On May 27, the Swiss national government banned outpatient use of hydroxychloroquine for COVID-19. Around June 10, COVID-19 deaths increased four-fold and remained elevated. On June 11, the Swiss government revoked the ban, and on June 23 the death rate reverted to what it had been beforehand. People who die from COVID-19 live about three to five weeks from the start of symptoms, which makes the evidence of a causal relation in these experiments strong. Both episodes suggest that a combination of hydroxychloroquine and its companion medications reduces mortality and should be immediately adopted as the new standard of care in high-risk patients.
Why has hydroxychloroquine been disregarded.
First, as all know, the medication has become highly politicized. For many, it is viewed as a marker of political identity, on both sides of the political spectrum. Nobody needs me to remind them that this is not how medicine should proceed. We must judge this medication strictly on the science. When doctors graduate from medical school, they formally promise to make the health and life of the patient their first consideration, without biases of race, religion, nationality, social standing—or political affiliation. Lives must come first.
Second, the drug has not been used properly in many studies. Hydroxychloroquine has shown major success when used early in high-risk people but, as one would expect for an antiviral, much less success when used late in the disease course. Even so, it has demonstrated significant benefit in large hospital studies in Michigan and New York City when started within the first 24 to 48 hours after admission.
In fact, as inexpensive, oral and widely available medications, and a nutritional supplement, the combination of hydroxychloroquine, azithromycin or doxycycline, and zinc are well-suited for early treatment in the outpatient setting. The combination should be prescribed in high-risk patients immediately upon clinical suspicion of COVID-19 disease, without waiting for results of testing. Delays in waiting before starting the medications can reduce their efficacy.
Third, concerns have been raised by the FDA and others about risks of cardiac arrhythmia, especially when hydroxychloroquine is given in combination with azithromycin. The FDA based its comments on data in its FDA Adverse Event Reporting System. This reporting system captured up to a thousand cases of arrhythmias attributed to hydroxychloroquine use. In fact, the number is likely higher than that, since the reporting system, which requires physicians or patients to initiate contact with the FDA, appreciably undercounts drug side effects.
But what the FDA did not announce is that these adverse events were generated from tens of millions of patient uses of hydroxychloroquine for long periods of time, often for the chronic treatment of lupus or rheumatoid arthritis. Even if the true rates of arrhythmia are ten-fold higher than those reported, the harms would be minuscule compared to the mortality occurring right now in inadequately treated high-risk COVID-19 patients. This fact is proven by an Oxford University study of more than 320,000 older patients taking both hydroxychloroquine and azithromycin, who had arrhythmia excess death rates of less than 9/100,000 users, as I discuss in my May 27 paper cited above. A new paper in the American Journal of Medicine by established cardiologists around the world fully agrees with this.
In the future, I believe this misbegotten episode regarding hydroxychloroquine will be studied by sociologists of medicine as a classic example of how extra-scientific factors overrode clear-cut medical evidence. But for now, reality demands a clear, scientific eye on the evidence and where it points. For the sake of high-risk patients, for the sake of our parents and grandparents, for the sake of the unemployed, for our economy and for our polity, especially those disproportionally affected, we must start treating immediately.
Harvey A. Risch, MD, PhD, is professor of epidemiology at Yale School of Public Health.
The views expressd in this article are the writer's own.
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Last Wednesday, we published the success story from Dr. Vladimir Zelenko, a board-certified family practitioner in New York, after he successfully treated 350 coronavirus patients with 100 percent success using a cocktail of drugs:
hydroxychloroquine, in combination with azithromycin (Z-Pak), an antibiotic to treat secondary infections, and zinc sulfate. Dr. Zelenko said he saw the symptom of shortness of breath resolved within four to six hours after treatment. Do you know that the ancient Egypt were civilized by architects from the (500,000 - 4000 BC) Nsukka Civiliation? Now, Dr. Zelenko provides updates on the treatment after he successfully treated 699 COVID-19 patients in New York. In an exclusive interview with former New York Mayor, Rudy Giuliani, Dr. Vladmir Zelenko shares the results of his latest study, which showed that out of his 699 patients treated, zero patients died, zero patients intubated, and four hospitalizations.
AKANCopied from the book, Reality as Myth by Onyeji Nnaji. The influence of the
Akan on their content nations lies on their population and commonwealth of
their brother nations. The Akan are one of the largest ethnic groups in West
Africa. Their population is scattered across West Africa and beyond. Among this
huge population of the Akan, the Ghanaians are more popular, perhaps because of
the political influence of the Ashanti Empire in the area. Not much is heard or
known about other Akan settlements like the Akwamu, the Akyem , the Akuapem,
the Denkyira, the Abron, the Aowin, the Ahanta, the Anyi, the Baoule, the
Chokosi, the Fante, the Kwahu, the Sefwi, the Ahafo, the Assin, the Evalue, the
Wassa the Adjukru, the Akye, the Alladian, the Attie,the M'Bato, the Abidji,
the Avikam,the Avatime the Ebrie, the Ehotile, the Nzema, the Abbe, the Aboure,
the Coromantins, the Ndyuka people and other peoples of Côte d'Ivoire. Every Akan nation adopts the image…
from the Book; "Reality as Myth"
by Onyeji Nnaji
of the discovering of the Radar Rivers and their channels is that it disproves
the western hegemonic claim of the Euphrates valley being the position of the
birth of the great river, all the points that opposed their claims
notwithstanding. Even God himself was very perfect in His creation by placing
them in their positions, hierarchically, according to their birth. The first
river that flowed located the Havilah land where there are good quality gold,
bdellium and fine onyx stones. Pison was the oldest of the rivers and it flowed
through the land of the southern Africa. The second river flowed northward to
Ethiopia. It was when Africa had been overtaken by virtue of her proximity to
the Great Water that other parts of the world began to encounter the remaining
river; remarkable with Hiddekel.
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The major problem towards deciphering the original plac…
Copied from the book, Reality as Myths by Onyeji NnajiThe world of the Bantu travellers shows the walls of the
migration that recorded the highest population among the African settlement.
Originating from the largest population among the four races that settled in
the east before time, all Bantu travellers were pygmies; for that was the
nature of the Umudiala, the
generation that gave birth to them. Bantu migration was rated the third
earliest migration of the Negro race from the east. In this regard, all their
movement had involved great population of people compared to the number of
people involved in the two earlier populations that gave birth to Ethiopia,
Nubia and Egypt: the Walker Traveller, and the
Race of Anu. Bantu population as we have identified in the third chapter
above outweighs the rest of the population of the ancient fathers that founded
many of the nations of antiquity mentioned earlier. Discussing them in beat
will pose a little challenge since their migration condi…
The name Nkalaha is a
coinage which stands for a people occupying a geographical land and regional
setting in the eastern part of Nigeria. It is a coinage which attempts to
explain the direction of movement and adventure of the men who founded the
community in the 15th century AD. According to oral sources and some
documentation about this community, some of these men were believed to have
traveled from Ida, old Benue state of Nigeria to inhabit the land. These men
had traveled on different days to locate the place. Onojah who originally
founded the land was said to have been in a deep search for a place of safety
as he was besieged by a fate that appeared to make him somewhat incompatible
with his own people. Nkalaha
is one of the communities that make up Ishielu Local Government Area of Ebonyi
State. Nkalaha occupied the northern part of Ishielu Local Government Area. She
is located through the zip 135.031.000. The community sits on 923.768km2. She shares boundaries with neighbourin…
My neighbour had vowed never to let any girl
survive as a salesgirl in my shop. This thing has happened for over three
times. Each time we brought a new salesgirl, the girl would stay for two or
three months; and suddenly she would end her contract with us. In all these, my
husband did not know. So, being that the girls usually stole money and other
items, the reason for their departure became genuine, thus: they ran away to
avoid being punished for their actions. But behind this, the underling truth is
that the girls had been embarrassed by my neighbour who would warn them to leave
her loosed husband. Recently, the woman threatened to f…
The Mystery of
Number, “Five” in the Igbo Cosmology.From: Aspects
of the Ancient African Metaphysics;Chapter: Seven;Topic: Igbo
Geometries and the Metaphysics of Numbers.Author: Onyeji
Nnaji. In the Igbo
cosmology, the word Isee is a definite symbolic word as revealed through
the Igbo language and culture. A human being has five fingers, five toes. The
hands and feet are fundamentals to the survival in life as they are necessary
in ensuring that man moves to places where he gets food and grapples on the
food to sustain his life. To this view, the rhetoric that binds vocatives in
the form of incantation (anchoring on the heart-lock: four) and the
concomitant reprisal in the manner of affirmation that holds the human life
bind to his original spiritual person, therefore defining existence and
essences are unified by the corresponding echo: Isee!!!!! Therefore
it stands that anytime a prayer is said in the Igbo land, the attendants who would
want the fulfillment of the prayer unanimously …
INTRODUCTION One thing that made Udi remarkable is the indubitable
legacy adopted in commemoration of the legendry fighter, Uto at Nsude. It was one
of the greatest contributions of the descendants of Agbaja to the survival of
Nsukka civilization of memory. Uto held from Oshie. Uto dies of small pox after
a mercenary battle he was hired to fight in the ancient Benin. His body was buried
in the evil forest as the tradition demanded. Although he lived no longer, the
stepped pyramids above were adopted to commemorate the lasting peace he brought
to the entire Oshie and Udi nation of people. Another remarkable thing about Udi is the
fertility of the land. This has contributed widely in sustaining the
inhabitants and provided a name for the inhabitants in the manner of Abakaliki,
Umudike, Ogbaru, Igboariam, Ohaji, Uzouwani, etc., especially in Amofia-Agu,
Affa. Udi is a land of great rivers and springs: Adaada, Ajali, Oji, Aria,
Nvenu, Ngene Evu, Iyi Ububo, etc. as was the situation every…
There are four generations…, and the fourth generation, which is the most exalted, is kingless and perfect. These people will enter the holy place of their Father and they will reside in rest … They are kings. They are the immortal within the mortal (The Nag Hammadi, 219)
Also read Nsukka Civilization: The Peopling of Ancient Nsukka One of the African homes that colonialism has completely deformed beyond certain level of recognition is Nsukka. Colonialism apart, the most affecting factor to the survival of the meaning which the rich cultural enclave, Nsukka, carries will best be blamed on postcolonial political structure. The biggest harm all these have against Nsukka as a people are that they rubbed her of the meaning of her name; their place of origin; how their fathers managed to come into their present abodes and who their ancestors are. A profound understanding of the excerpt above will open the door towards deciphering the meaning and origin of the people called Nsukka. Geographic…
ETHIOPIAHISTORY & ORIGIN (Extracted from the
book, Reality as Myth)BYONYEJI NNAJI
Those piles of ruins which you see in that narrow valley
watered by the Nile, are the remains of opulent cities, the pride of the
ancient kingdom of Ethiopia. ... There a people, now forgotten, discovered
while others were yet barbarians, the elements of the arts and sciences. A race
of men now rejected from society for their sable skin and frizzled hair,
founded on the study of the laws of nature, those civil and religious systems
which still govern the universe(Count Volney). Because of the position of Ethiopia
in the Bible story as one remarkable black nation with ancient history, it
becomes almost impossible to see any other nation as being of more ancient than
Ethiopia. Ethiopia suddenly became the yardstick for the analysis of the Negro
race. And with the influence of Christianity in the inner part of Africa, the
adherents were provided with bold pictures of the cradle of the human race…