You are currently browsing the tag archive for the ‘Prof Didier Raoult’ tag.

They might be small in number right now, but a growing number of doctors involved in the coronavirus outbreak are wondering about the wisdom of nationwide lockdowns.

In some countries, lockdown did not make much difference to the number of deaths.

On May 14, France’s Prof Didier Raoult posted a study from Spain which showed that those who kept working outside the home were less at risk of falling victim to COVID-19. Replies follow:

Why we were told the world over to stay indoors, I do not understand. It runs counter to everything we’ve been taught over 120 years with regard to fighting epidemics:

This chart comes from another source and has more testimony about New York’s lockdown:

A doctor from Paris can corroborate that households staying indoors did get COVID-19 more often than those who did not. People were already infected before lockdown and did not show symptoms until later on.

On Tuesday, May 26, RMC — France’s talk radio station — interviewed Dr Robert Sebbag, a specialist in infectious diseases, who works at the famous Pitié-Salpêtrière hospital in Paris. The interview is a little over 19 minutes long.

Sebbag worked on the COVID-19 ward and said that if one family member was admitted to hospital with coronavirus, others from the same households were also infected days later.

He said that this led him and his colleagues to believe that general lockdowns are a bad idea. He explained that politicians were afraid of the number of deaths from this novel (new) coronavirus and decided to impose blanket lockdowns:

He said that the hospital, in the early days of the outbreak, was very gloomy indeed, with a seemingly endless number of COVID-19 patients being admitted. He, his colleagues and hospital staff were worried that they would be completely overwhelmed:

He thinks that an assessment needs to be done of how COVID-19 was handled in the first half of this year. While he personally thinks masks are a good idea, he objects to the restriction on nursing and care home visits, which he says are essential for patient well being, especially among the elderly:

Presumably, care home administrators can work out a system for visiting, perhaps requiring that healthy family members and friends make an appointment before visiting.

The greater question there surrounds infected patients being discharged from hospitals into care homes. This happened in the US, the UK, France and Germany. The very real pressure on the hospitals meant that they had to discharge elderly patients before they were fully recovered to make room for new COVID-19 patients. As such, care homes were overwhelmed with infection in some cases.

People rightly wonder if we will get a second wave. Some medical experts say no. Some say yes. Others say that we have to find a way of treating patients effectively so that coronavirus is no longer a fatal disease. The honest answer at this point is that we do not know whether there will be a second wave of infections.

As lockdowns are fully lifted in the coming weeks, we will all have to take greater responsibility for our own behaviour in a COVID-19 world. I dislike referring readers to the BBC, but they did have a good article on Sunday, May 24: Health Correspondent Nick Triggle’s ‘Coronavirus: How scared should we be?’ It is well worth reading.

For a start, we do not live in a risk-free world:

Prof Devi Sridhar, chair of global public health at Edinburgh University, says the question we should be asking is whether we are “safe enough”.

“There will never be no risk. In a world where Covid-19 remains present in the community it’s about how we reduce that risk, just as we do with other kinds of daily dangers, like driving and cycling.”

We might become more dependent on our ‘least worst’ options in managing that risk:

Statistician Prof Sir David Spiegelhalter, an expert in risk from Cambridge University and government adviser, says it has, in effect, become a game of “risk management” – and because of that we need to get a handle on the magnitude of risk we face.

There are two factors that influence the risk we face from coronavirus – our risk of becoming infected and, once infected, our risk of dying or becoming seriously ill.

We should also keep in mind that, for most people, coronavirus is relatively mild:

… only one in 20 people who shows symptoms is believed to need hospital treatment …

Think of it this way:

If your risk of dying was very low in the first place, it still remains very low.

As for children, the risk of dying from other things – cancer and accidents are the biggest cause of fatalities – is greater than their chance of dying if they are infected with coronavirus.

During the pandemic so far three under 15s have died. That compares to around 50 killed in road accidents every year.

In the months to come, there will likely be tests and tools, such as this one from University College London, that can help us assess our individual risk of catching this unpredictable and sometimes fatal disease.

The most important aspect, even more than the dreaded mask, is hand hygiene. Wash hands regularly and thoroughly with soap or soap gel, then dry them well. Damp or wet hands create a good atmosphere for viruses and bacteria.

Also keep hands away from the face, the best receptor for infections.

On Monday, May 25, 2020, the WHO dropped its hydroxychloroquine trials as a possible treatment for coronavirus.

The drug is one of a selection of anti-malarials which have been used successfully, under the right protocols.

In Europe, Prof Didier Raoult is the champion of this type of treatment. He has successfully used a protocol involving Plaquenil and azithromycin on his patients in Marseille. Raoult is the director of the regional institute for research on infections, the IHU Méditerranée Infection.

The medical establishment worldwide is attempting to discredit the renegade physician. The latest is the Lancet, Britain’s renowned medical journal. The results of their studies with the drug prompted the WHO to halt their trials.

The BBC reports:

The Lancet study involved 96,000 coronavirus patients, nearly 15,000 of whom were given hydroxychloroquine – or a related form chloroquine – either alone or with an antibiotic.

The study found that the patients were more likely to die in hospital and develop heart rhythm complications than other Covid patients in a comparison group.

The death rates of the treated groups were: hydroxychloroquine 18%; chloroquine 16.4%; control group 9%. Those treated with hydroxychloroquine or chloroquine in combination with antibiotics had an even higher death rate.

The researchers warned that hydroxychloroquine should not be used outside of clinical trials.

President Trump is currently taking hydroxychloroquine as a preventive measure. He receives it via prescription.

The WHO advises people not to self-medicate with these drugs.

Indeed, Prof Raoult uses them only on people who test positive for COVID-19. He also runs a battery of tests on potential patients before administering the tablets. Anti-malarials can worsen pre-existing heart conditions.

His and his team’s paper was published in May:

He was delighted to see that another study using the same two drugs was equally successful. Beneath it are the results of the less successful Lancet study, which used hydroxychloroquine and macrolide, instead of azithromycin:

He is aware that the medical establishment, including France’s two most recent health ministers, Agnès Buzyn and Olivier Véran, want him out of the picture:

That’s unfortunate, because I listen to RMC during the week and the callers from Marseille and the rest of the region of Provence-Alpes Maritimes-Côte d’Azur (PACA) consider him a hero.

However, RMC’s morning show hosts dismiss Raoult and hydroxychloroquine. Now I know why. One of the station’s main shareholders also is a major shareholder in Gilead, which is working on Remdesivir, a drug used to treat Ebola. So far, Remdesivir trials on COVID-19 have not been that successful but the marketing is good, and it would be a money maker:

Last Tuesday on RMC, the WHO/Lancet news was a topic for discussion on the mid-morning show. They took a poll of Raoult’s popularity. Three-quarters of their listeners voting during the show love the man. The poll was open for another day:

One of the show’s guests said that Didier Raoult was achieving success, not talking about hypotheticals. He found it strange that few of the other studies manage to reproduce his success:

A nurse from Marseille who used to work the the professor, who is a physician, said that the others are not following his protocol to the letter. She said that, if they were, they would get the same results.

Raoult points out in the next tweet that the other studies are not using the drugs on people who actually have the disease. Therefore, results will differ:

Back to RMC. One of the panellists compared Raoult to Trump: a renegade one loves or loathes. She said that, like Trump, Raoult is trending in popularity:

Needless to say, the conversation about Raoult got heated. The first panellist said he was annoyed that his GP wouldn’t prescribe him hydroxychloroquine and azithromycin. The show’s hosts, on either side of him, thought the GP was right not to do so:

A third panellist said that Raoult is resisting all the discrediting of his work — ‘He’s extremely courageous’:

Criticised though Raoult might be, America’s National Institutes of Health (NIH) will be doing a study on hydroxychloroquine and azithromycin:

Although Raoult gives Dr Anthony Fauci the credit, I think it actually belongs to President Trump.

——————————————————————————

MAJOR UPDATE — JUNE 4: The Guardian has investigated the Lancet paper and reports that it had to be withdrawn. The WHO is now resuming its hydroxychoroquine trials.

This never should have happened to a respected medical journal.

Emphases mine below:

The Lancet paper that halted global trials of hydroxychloroquine for Covid-19 because of fears of increased deaths has been retracted after a Guardian investigation found inconsistencies in the data.

The lead author, Prof Mandeep Mehra, from the Brigham and Women’s hospital in Boston, Massachusetts decided to ask the Lancet for the retraction because he could no longer vouch for the data’s accuracy.

The journal’s editor, Richard Horton, said he was appalled by developments. “This is a shocking example of research misconduct in the middle of a global health emergency,” he told the Guardian.

A Guardian investigation had revealed errors in the data that was provided for the research by US company Surgisphere. These were later explained by the company as some patients being wrongly allocated to Australia instead of Asia. But more anomalies were then picked up. A further Guardian investigation found that there were serious questions to be asked about the company itself.

An independent audit company was asked to examine a database provided by Surgisphere to ensure it had the data from more than 96,000 Covid-19 patients in 671 hospitals worldwide, that it was obtained properly and was accurate.

Surgisphere’s CEO, Sapan Desai, had said he would cooperate with the independent audit, but it is understood he refused to give the investigators access to all the data they asked for.

In a statement on Thursday, Mehra said: “Our independent peer reviewers informed us that Surgisphere would not transfer the full dataset, client contracts, and the full ISO audit report to their servers for analysis as such transfer would violate client agreements and confidentiality requirements. As such, our reviewers were not able to conduct an independent and private peer review and therefore notified us of their withdrawal from the peer-review process”…

The World Health Organization and several countries suspended randomised controlled trials that were set up to find an answer. Those trials have now been restarted. Many scientists were angry that they had been stopped on the basis of a trial that was observational and not a “gold standard” RCT.

Mehra had commissioned an independent audit of the data after scientists questioned it …

The Guardian wrote about Surgisphere on June 3. This is shocking.

Excerpts follow, emphases mine:

The World Health Organization and a number of national governments have changed their Covid-19 policies and treatments on the basis of flawed data from a little-known US healthcare analytics company, also calling into question the integrity of key studies published in some of the world’s most prestigious medical journals.

A Guardian investigation can reveal the US-based company Surgisphere, whose handful of employees appear to include a science fiction writer and an adult-content model, has provided data for multiple studies on Covid-19 co-authored by its chief executive, but has so far failed to adequately explain its data or methodology

The Guardian’s investigation has found:

    • A search of publicly available material suggests several of Surgisphere’s employees have little or no data or scientific background. An employee listed as a science editor appears to be a science fiction author and fantasy artist. Another employee listed as a marketing executive is an adult model and events hostess.
    • The company’s LinkedIn page has fewer than 100 followers and last week listed just six employees. This was changed to three employees as of Wednesday.
    • While Surgisphere claims to run one of the largest and fastest hospital databases in the world, it has almost no online presence. Its Twitter handle has fewer than 170 followers, with no posts between October 2017 and March 2020.
    • Until Monday, the get in touch” link on Surgisphere’s homepage redirected to a WordPress template for a cryptocurrency website, raising questions about how hospitals could easily contact the company to join its database.
    • Desai has been named in three medical malpractice suits, unrelated to the Surgisphere database. In an interview with the Scientist, Desai previously described the allegations as “unfounded

You could not make this up.

Still, it’s a happy ending. Hydroxychloroquine and chloroquine trials will resume, including at the WHO.

Many thanks to my reader formerdem, who alerted me to this welcome change of events in the comment section below.

On Saturday, May 16, I tuned into France’s news channel BFMTV to see how the nation’s partial reopening went.

President Emmanuel Macron got an earful from medical professionals at La Pitié-Salpêtrière, the Paris hospital he visited on Friday, May 15. Late last week, he announced that, at this year’s Bastille Day ceremonies, health professionals and first responders would be honoured with medals commemorating their work during the coronavirus crisis. On Friday, as Macron was leaving, a health professional told him that he didn’t want any medal. Macron snapped back:

If you don’t want it, don’t take it.

It was a rough visit. A group of nurses listened to what he had to say, then one spoke up, bluntly demanding more pay and more recognition. Macron said that he was giving them a bonus for their work over the past two months, but she retorted that was not enough. She demanded a pay rise for all nurses, which is fair enough. They are on relatively low pay, not far from minimum wage.

Going back a few years when the erstwhile Conservative prime minister François Fillon (serving under Nicolas Sarkozy from 2007-2012) visited a care home during his tenure, he was able to hold a calm, considered conversation with the workers there, who were all CGT union members:

Allow me a small digression from Macron. François Fillon should have been France’s president after François Hollande. Unfortunately, the media put the boot into him for corruption, just as he was at a massive height in the popularity polls in January 2017, the year Macron was elected president.

In March 2020, Fillon was sentenced to two years in prison, with an additional three years suspended sentence. His wife was given a suspended three-year prison term and a fine of €375,000. (Source: Le Point.) Trumped up (no pun intended) or what? Something stinks there. The Fillons are a dignified couple who have kept to themselves over the years. They are low-profile people and devout Catholics.

This was François Fillon’s agenda for France in 2017: ending bureaucracy, sorting out France’s problems and restoring the pride in being French. In short: make France great again. Does that sound familiar?

How sad that it didn’t happen and might never happen. Who will accomplish this now?

I agree with the tweet below that the framing of François Fillon is truly a shame for France.

The video is from 2017:

These replies say that Fillon’s three-year plan, summarised above, was simply swept — balayé– under the carpet (by left-wing media, which started with one outlet and spread rapidly to the others):

Returning to the present day, a Parisian MP from France Insoumise (Unbowed France) says that it is urgent for Macron to say how soon the pay increase will be delivered and how much it will be. The second tweet includes one from health minister Olivier Véran, commenting on the ‘passionate’ feedback from the nurses:

Macron has been the latest French president to further shrink the nation’s health system, following Nicolas Sarkozy (Conservative) and François Hollande (Socialist), both in terms of hospital beds and other measures. Hospital masks were in short supply during the height of the coronavirus crisis. French housewives banded together from their homes to sew fabric masks for nurses. While those were technically useless, nonetheless, nurses were grateful for any protection whilst awaiting proper face coverings.

Early Saturday afternoon, BFMTV reported on the mask shortage, discovered in January 2020. However, it was too late, even with Macron’s government’s requisitioning every surgical mask in France. They were the wrong type of masks, but they would have to do. Hospital and care workers were desperate.

One physician working on the front line in Lyon died because he did not have the right type of mask. He caught coronavirus and, despite treatment in Marseille, never recovered. His widow and two daughters are suing the hospital where he worked. I can’t see how that will work, because every hospital experienced the same mask shortage.

Currently, there are enough masks for people living in France, who have been strongly encouraged to wear one outdoors. These are not proper coronavirus masks, but they will have to do.

It appears that Macron now has to get on with his promised reform — improvement — of a beleaguered health system. Here’s an inside look at his control room:

The replies to this tweet featuring an LREM MP are interesting. The MP says that a centralised health system doesn’t work, but the replies say that the system has been sclerotic for some time, Macron has ignored calls for improvement and there are too many hospital administrators and/or politicians involved rather than medical professionals. The response I’ve included below says that Germany spends far less money than France and has better performing hospitals, with four times more intensive care beds:

However, another BFMTV journalist reported that Macron is facing a crisis in other aspects of French society, including the gilets jaunes (yellow jackets). They are still protesting in some cities on Saturdays, although not in as great a number as before the coronavirus crisis:

Making matters worse, Macron’s political party, LREM, no longer has an absolute majority in parliament:

Ten of his MPs have left to form their own party with ten other MPs — Ecologie, démocratie, solidarité:

It is unclear whether that will have any impact on the second round of local elections, rescheduled for June 28:

However, one commentator said that Macron’s success as president will largely depend on how he and his government handle the coronavirus crisis this year. He has a few years left in his first term, which ends in 2022.

Meanwhile, during the first weekend of partial reopening, BFMTV reminded viewers that they are not allowed to travel further than 100km from home. They also cannot not leave the house to visit anyone, including relatives, unless they are going to drop something off. Visiting second homes is also forbidden. The French are allowed to travel to work, to school, to a child minder, for a funeral, for a medical appointment, for recreational purposes (limited at this point) or to shops that are open:

Late last week, some beaches in France opened so that people could have a new way of exercising. For now, reopening beaches is up to individual mayors. As the virus is still active, the beaches are ‘dynamic’, meaning that sitting or sunning oneself is strictly forbidden. Fishing is also forbidden. Beachgoers can walk, swim and surf. A one-way system is in place with an entrance and an exit:

The second tweet says, ‘This increasing surveillance is seriously getting on my nerves’:

Interior minister Christophe Castaner visited a beach in Normandy that was preparing to reopen. He said that everyone visiting beaches had to respect the rules in place, otherwise they will be closed. He hopes that beaches will reopen fully during the summer:

For those who miss culture, small museums, with hygiene restrictions in place, may reopen:

Driving schools can also open. There is no social distancing in the car, so the car windows must be open at all times during the lesson. Those taking virtual instruction are socially distanced. Driving tests can begin in June, provided there is no second wave of coronavirus:

Those worried about the impact of more drivers on the environment need not be too concerned. During lockdown, there was only a 7% decrease in particulates. That is surprising:

At 2 p.m. on Saturday afternoon, Lourdes reopened, even if there are no dine-in restaurants. It will attract locals until travel restrictions are lifted:

Speaking of health and healing, coronavirus testing continues. In Brittany, a new cluster of infections was discovered at an abattoir:

Elsewhere in France, new infections were found in schools that reopened last week. Those schools are now closed:

One Frenchman might have a future solution to school closures. He is developing a fabric that kills coronavirus. This video shows his chair and desk covers:

Where schools remained open, this is what the scene looked like outdoors. Recess must have been fun (not). This is so SAD, beyond belief:

France’s medical agency has found that 500 medications are harmful in treating coronavirus. Incredibly, hydroxychloroquine is among them. This has to be the establishment’s figurative poke in the eye at Prof Didier Raoult, Marseille’s champion in treating patients with the drug combined with azithromycin:

The article says, in part:

Hydroxychloroquine (Plaquenil) represents the majority of adverse cardiac reactions, in 141 out of 159 cases. Cardiac reactions comprise 69% of those reported, versus 44% where Kaletra (an antiretroviral combining lopinavir and ritonavir) is used …

The number of deaths linked to hydroxychloroquine in hospital remains at four. In view of these risks, the health agency advises that these drugs, when used against Covid-19, must be used as a priority only in the context of ongoing clinical trials.

In general, provided there is no sizeable second wave of infections, more businesses will be able to open at the beginning of June.

Philippe Etchebest, who is a chef, restaurateur, television celebrity and MOF (maître ouvrier de France), says that restaurants must reopen as soon as possible, because the government cannot afford to keep them closed. The subsidies are ‘colossal’:

Last month, Etchebest said that partial reopening will not work. Social distancing — e.g. halving the number of tables — will not bring in enough revenue. Perhaps he will be employing one of these social distancing methods:

Recently, the loathsome globalist Jacques Attali said that restaurateurs must change their business model.

Etchebest took strong objection to that, saying that he is neither a grocer nor a wine merchant. Those replying to this tweet also criticised Attali, saying he should shut up for once or retire to a nursing home. The quote from Attali on the internet is interesting:

The internet represents a danger to those in the know and those who decide things, because it gives access to information outside of received knowledge.

Bravo, Philippe:

Attali was one of Emmanuel Macron’s early mentors. Go figure.

No wonder the French are angry.

We have been told that our coronavirus lockdowns will not end until a vaccine has been successfully developed.

Meanwhile, in France, Professor Didier Raoult has been successfully using chloroquine, where suitable, on his COVID-19 patients at the IHU Méditerranée Infection facility, where he is the Director.

Professor Raoult is also a physician. A number of his fellow doctors oppose his use of an anti-malarial drug, which is cheap as chips, to treat this novel (new) coronavirus, said to have no known remedy, much less cure, at this time.

Raoult describes himself as a ‘renegade’ physician. Other doctors in France certainly agree. They doubt his claims. Now they want to suspend him from France’s national medical association, l’Ordre des Médecins (The Order of Physicians).

On Saturday, April 25, Geopolintel (French language, translated below) reported that the ANSM (French National Agency for Medicines and Health Products Safety), INSERM (French National Institute of Health and Medical Research) and the biopharmaceutical drug company Gilead are out to get Raoult.

The article is an open letter to Raoult’s critics:

The Covid-19 crisis shows the destructive ideology of your policies as well as that of the health institutions of our country.

Given the sums of money involved, it takes any and all costs to transfer the professor from Marseille for the generalized vaccination agreement between Macron and Bill Gates to be realized.

Censors, you have lost public opinion and you cannot regain it by threatening Professor Raoult with suspension by the Order of Physicians.

He makes fun of your stories of cash and corruption, unlike you, he treats and does not bear responsibility for death by organized shortage.

What displeases you in him is his indifference to lobbies and sirens of glory and as a professor, researcher and doctor; he cares while you polish your the seats of your trousers on the leather armchairs of the circles of initiates who have done nothing in their lives other than lying and earning dirty money.

There have been major pharmaceutical scandals in France in recent years, yet the establishment is going after Raoult, who has provided patient relief in an inexpensive prescription anti-malarial drug available at pharmacies. The medical establishment has accused the professor of employing ‘illegal medical research protocols’:

Regarding the “illegal clinical research protocols” which are attributed to Didier Raoult, what about the scandals of the Pick (Médiator), Depakin and other drugs approved in the so-called respect for randomized trial protocols?

As for his possible suspension by the Order of Physicians:

The Council of the Order of Physicians threatens Professor Raoult with immediate suspension of activity, because his clinical trials “do not comply with official procedures”, and he risks up to a year in prison and 15,000 euros in fines.

Yet, President Macron visited Raoult in Marseille recently to find out more about the doctor’s success with his COVID-19 patients. About this, the article says:

As a reminder, Professor Raoult presented Emmanuel Macron with the results of his work on 1,061 patients.

Almost 92% of patients cured in ten days,
Nearly 5% of patients cured “late”
Less than 5% of “patients with complications”.
Or 31 patients hospitalized for more than ten days,
10 transferred to intensive care,
and 5 deaths. On 1061: do your accounts and compare to the rest of France…

The abstract and summary table of the data in our article on the treatment of 1061 patients are online!
The abstract and the summary table of our paper on the treatment of 1061 patients are online! https: //t.co/mTWj6aGpTk https: //t.co … pic.twitter.com/PLdygNolxG
– Didier Raoult (@raoult_didier) April 10, 2020

These are the full results of Raoult’s study:

The article concludes:

The first reaction of the simple man that I am, in the delusional French context that I observe from afar, is this: Raoult heals while the profession flounders. It has no response, no treatment, adding the humiliation of the mandarins to the resentment of the rascals. In short, Raoult must be suspended. It is urgent: he risks treating even more people.

Now, it must be said that chloroquine doesn’t work on everyone. Nor does a similar drug, hydroxychloroquine, often combined with azithromycin (which contains zinc), in COVID-19 treatment. The latter is the treatment that President Trump has been championing for weeks.

Both should be used with caution and under medical supervision. They can harm patients with certain types of heart ailments. Never self-medicate!

As is true in France, the American medical establishment is eager to pour cold water on Trump’s claims.

On April 16, 2020, MedRxiv published an abstract of one such study: ‘Outcomes of hydroxychloroquine usage in United States veterans hospitalized with Covid-19’, which ends as follows:

CONCLUSIONS: In this study, we found no evidence that use of hydroxychloroquine, either with or without azithromycin, reduced the risk of mechanical ventilation in patients hospitalized with Covid-19. An association of increased overall mortality was identified in patients treated with hydroxychloroquine alone. These findings highlight the importance of awaiting the results of ongoing prospective, randomized, controlled studies before widespread adoption of these drugs.

Yet, nearly half of America’s 50 states are stockpiling the drug, as Axios reported on April 25 (emphases in the original):

At least 22 states and Washington, D.C., are building up stores of the anti-malarial drug President Trump previously touted as a possible solution for the novel coronavirus, AP reports.

Why it matters: The Food and Drug Administration advised doctors Friday against prescribing hydroxychloroquine or the related drug chloroquine to coronavirus patients as it appears to be causing some serious and potentially life-threatening side effects.

    • ‘The warning comes as doctors at a New York hospital published a report that heart rhythm abnormalities developed in most of 84 coronavirus patients treated with hydroxychloroquine and the antibiotic azithromycin, a combo Trump has promoted,” AP notes.

What they’re saying: “While clinical trials are ongoing to determine the safety and effectiveness of these drugs for COVID-19, there are known side effects of these medications that should be considered,” FDA Commissioner Stephen Hahn said.

The state of play: Some health experts worry the public could misuse the drug if it is made more widely available.

The FDA has authorised use of hydroxychloroquine under the following conditions, summarised on page 4 of their guidelines:

The hydroxychloroquine sulfate may only be used to treat adult and adolescent patients who weigh 50 kg or more hospitalized with COVID-19 for whom a clinical trial is not available, or participation is not feasible.9

South Dakota is the first state to participate in a trial of the drug:

Kudos to their governor, Kristi Noem, who ignored calls for lockdown. South Dakotans rewarded her with a parade:

But I digress.

Health Feedback is a site that debunks current coronavirus remedies or possible cures. Another is Poynter. Both must be busy.

There has been much talk of using ventilators on ICU patients with COVID-19. However, in some cases, ventilators do not always work and, in some instances, have worsened patients’ outcomes.

On March 20, Cleveland Clinic published an explanation of the damage that COVID-19 can do to the lungs, leading to the need for intensive care and, likely, a ventilator. Excerpts follow (emphases mine):

Although many people with COVID-19 have no symptoms or only mild symptoms, a subset of patients develop severe respiratory illness and may need to be admitted for intensive care.

In a new video, lung pathologist Sanjay Mukhopadhyay, MD, lays out in detail how the lungs are affected in these severe cases. The 15-minute video walks through how COVID-19 causes a “dangerous and potentially fatal” condition known as acute respiratory distress syndrome (ARDS) while providing stark images that underscore the severity of the damage that condition can cause to your lungs.

As Dr. Mukhopadhyay explains, Chinese researchers have linked COVID-19 to ARDS. Their study examined risk factors for 191 confirmed coronavirus patients who died while being treated in two hospitals in Wuhan, China.

The researchers found 50 of the 54 patients who died had developed ARDS while only nine of the 137 survivors had ARDS

If you have ARDS, you’ll have symptoms like sudden breathlessness, rapid breathing, dizziness, rapid heart rate and excessive sweating.

But the four main things doctors will look for are:

    • If you have an acute condition, symptoms that started within one week of what they call a “known clinical insult,” or new or worsening symptoms.
    • If your shortness of breath isn’t explained by heart failure or fluid overload.
    • Having low oxygen levels in your blood (severe hypoxia).
    • Both lungs appearing white and opaque (versus black) on chest X-rays (called bilateral lung opacities on chest imaging) …

There might have been other articles like this circulating recently, ones that mention hypoxia.

Hypoxia has been mentioned often in online discourse and in some online articles, such as one from April 5, posted on Medium, ‘Covid-19 had us all fooled, but now we might have finally found its secret’, written by a non-medic whose Medium account has since been deleted.

That article has appeared all over various fora over the past few weeks.

It does sound really plausible, even though Poynter and Health Feedback have both debunked it, which I’ll get to below.

Not being a medic or have anyone in the family who is, I’m just going to throw these excerpts out there.

As such, I wonder if this is accurate, i.e. something that front line physicians will mention a year from now. Anyone with a medical background reading this should feel free to leave a comment below.

The author explains why ventilators don’t always work on COVID-19 patients. This is what caught my eye:

There is no ‘pneumonia’ nor ARDS. At least not the ARDS with established treatment protocols and procedures we’re familiar with. Ventilators are not only the wrong solution, but high pressure intubation can actually wind up causing more damage than without, not to mention complications from tracheal scarring and ulcers given the duration of intubation often required… They may still have a use in the immediate future for patients too far to bring back with this newfound knowledge, but moving forward a new treatment protocol needs to be established so we stop treating patients for the wrong disease.

Then the author quotes someone in the medical profession who published a paper that seems to have gone nowhere (see below). Unfortunately, there is no reference to what or whom he quotes, which is this:

The past 48 hours or so have seen a huge revelation: COVID-19 causes prolonged and progressive hypoxia (starving your body of oxygen) by binding to the heme groups in hemoglobin in your red blood cells. People are simply desaturating (losing o2 in their blood), and that’s what eventually leads to organ failures that kill them, not any form of ARDS or pneumonia. All the damage to the lungs you see in CT scans are from the release of oxidative iron from the hemes, this overwhelms the natural defenses against pulmonary oxidative stress and causes that nice, always-bilateral ground glass opacity in the lungs. Patients returning for re-hospitalization days or weeks after recovery suffering from apparent delayed post-hypoxic leukoencephalopathy strengthen the notion COVID-19 patients are suffering from hypoxia despite no signs of respiratory ‘tire out’ or fatigue.

I only found the Medium article last week, but I have many COVID-19 links bookmarked, including this one from April 10:

The article is behind a paywall, but you can read it here in its entirety. The doctors the Telegraph interviewed seem to be saying the same as the Medium author does: no ARDS, no pneumonia, therefore, no ventilator, which can do more harm than good:

British and American intensive care doctors at the front line of the coronavirus crisis are starting to question the aggressive use of ventilators for the treatment of patients.

In many cases they say the machines, which are highly invasive and require the patient to be rendered unconscious, are being used too early and may cause more harm than good. Instead they are finding that less invasive forms of oxygen treatment through face masks or nasal cannulas work better for patients, even those with very low blood oxygen readings.

Dr Ron Daniels, a consultant in critical care at University Hospitals Birmingham NHS Foundation Trust, on Thursday confirmed reports from US medics that he and other NHS doctors were revising their view of when ventilators should be used.

At the heart of the issue was the “bizarre” and “frankly baffling” phenomenon of Covid-19 patients presenting with catastrophically low blood oxygen levels but few other ill effects.

The Telegraph says that this new protocol goes against prior received wisdom on the unknown COVID-19. Prime Minister Boris Johnson had been in intensive care that week, released back to a general ward on the evening of Maundy Thursday, April 9:

The initial recommendations from doctors in China and Italy were to ventilate Covid patients early and aggressively, with the so-called “PEEP” pressure on the machines turned up high so their lungs did not contract when they exhaled.

The initial message was treat as if you were treating for acute respiratory distress syndrome (ARDS) with a high PEEP,” said Daniels. “But now we are becoming braver. We are tolerating much lower blood oxygen levels and using lower pressures. We are learning as we go along”.

The alternative to mechanical ventilation is oxygen treatment delivered via a mask or a nasal cannula or via a non-invasive high flow device. This is the sort of treatment the Prime Minister Boris Johnson is said to be receiving in an intensive care unit at St Thomas’s hospital London. His blood oxygen levels are not known.

Increasingly doctors in the UK, America and Europe are using these less invasive measures and holding back on the use of mechanical ventilation for as long as possible

Doctors in Italy and Germany wrote to the American Journal of Respiratory and Critical Care Medicine last week making a similar point. They urged other doctors to be “patient” with Covid patients, arguing for “gentle ventilation” wherever possible

It is not known why Covid-19 allows some patients to tolerate such low blood oxygen readings without air hunger or obvious confusion. One clue may be that patients are still able to exhale carbon dioxide – a toxin – through their lungs even if they are having difficulty absorbing oxygen.

“The patients in front of me are unlike any I’ve ever seen,” one American doctor working in a Brooklyn hospital told the specialist health publication STAT this week. “They looked a lot more like they had altitude sickness than pneumonia.”

Dr Daniels agreed that there were similarities with altitude sickness, itself a potentially fatal condition. “We’ve seen a lot of headache and dizziness”, he noted …

You might have heard of Drs Dan Erickson and Artin Massihi, whose two-part press briefing in California was removed last week from YouTube. The two went against the received wisdom of the WHO. I watched both videos when they came out at the beginning of April. In the second video, they warned against the aggressive use of ventilators when treating COVID-19.

Therefore, the Medium article might not be either wrong or fake news with regard to ventilators.

It has an explanation of what might be happening whereby blood gets starved of oxygen through COVID-19, and it is this which has proven to be controversial with physicians:

Your red blood cells carry oxygen from your lungs to all your organs and the rest of your body. Red blood cells can do this thanks to hemoglobin, which is a protein consisting of four “hemes”. Hemes have a special kind of iron ion, which is normally quite toxic in its free form, locked away in its center with a porphyrin acting as it’s ‘container’. In this way, the iron ion can be ‘caged’ and carried around safely by the hemoglobin, but used to bind to oxygen when it gets to your lungs.

When the red blood cell gets to the alveoli, or the little sacs in your lungs where all the gas exchange happens, that special little iron ion can flip between FE2+ and FE3+ states with electron exchange and bond to some oxygen, then it goes off on its little merry way to deliver o2 elsewhere.

Here’s where COVID-19 comes in. Its glycoproteins bond to the heme, and in doing so that special and toxic oxidative iron ion is “disassociated” (released). It’s basically let out of the cage and now freely roaming around on its own. This is bad for two reasons:

1) Without the iron ion, hemoglobin can no longer bind to oxygen. Once all the hemoglobin is impaired, the red blood cell is essentially turned into a Freightliner truck cab with no trailer and no ability to store its cargo. It is useless and just running around with COVID-19 virus attached to its porphyrin. All these useless trucks running around not delivering oxygen is what starts to lead to desaturation, or watching the patient’s spo2 levels drop. It is INCORRECT to assume traditional ARDS and in doing so, you’re treating the WRONG DISEASE. Think of it a lot like carbon monoxide poisoning, in which CO is bound to the hemoglobin, making it unable to carry oxygen. In those cases, ventilators aren’t treating the root cause; the patient’s lungs aren’t ‘tiring out’, they’re pumping just fine. The red blood cells just can’t carry o2, end of story. Only in this case, unlike CO poisoning in which eventually the CO can break off, the affected hemoglobin is permanently stripped of its ability to carry o2 because it has lost its iron ion. The body compensates for this lack of o2 carrying capacity and deliveries by having your kidneys release hormones like erythropoietin, which tell your bone marrow factories to ramp up production on new red blood cells with freshly made and fully functioning hemoglobin. This is the reason you find elevated hemoglobin and decreased blood oxygen saturation as one of the 3 primary indicators of whether the shit is about to hit the fan for a particular patient or not.

2) That little iron ion, along with millions of its friends released from other hemes, are now floating through your blood freely. As I mentioned before, this type of iron ion is highly reactive and causes oxidative damage. It turns out that this happens to a limited extent naturally in our bodies and we have cleanup & defense mechanisms to keep the balance. The lungs, in particular, have 3 primary defenses to maintain “iron homeostasis”, 2 of which are in the alveoli, those little sacs in your lungs we talked about earlier. The first of the two are little macrophages that roam around and scavenge up any free radicals like this oxidative iron. The second is a lining on the walls (called the epithelial surface) which has a thin layer of fluid packed with high levels of antioxidant molecules… things like ascorbic acid (AKA Vitamin C) among others. Well, this is usually good enough for naturally occurring rogue iron ions but with COVID-19 running rampant your body is now basically like a progressive state letting out all the prisoners out of the prisonsit’s just too much iron and it begins to overwhelm your lungs’ countermeasures, and thus begins the process of pulmonary oxidative stress. This leads to damage and inflammation, which leads to all that nasty stuff and damage you see in CT scans of COVID-19 patient lungs. Ever noticed how it’s always bilateral? (both lungs at the same time) Pneumonia rarely ever does that, but COVID-19 does… EVERY. SINGLE. TIME.

Poynter says this is clearly wrong:

The claim that COVID-19 causes hypoxia because the causative virus binds to hemoglobin in red blood cells is unsupported. For starters, no scientific evidence demonstrates that SARS-CoV-2 can enter red blood cells. The claim that the virus binds to hemoglobin is founded on the conclusions of a single pre-print, which solely involves computational analysis, without experimental verification or peer-review. The mechanism proposed is also inconsistent with clinical evidence from COVID-19 patients.

Health Feedback posted their refutation on Wednesday, April 15. It is lengthy and thorough. Excerpts follow:

Scientists told Health Feedback that the claim was not supported by experimental and clinical evidence. “There is no direct biological evidence that SARS-CoV-2 proteins interact with hemoglobin. The claim is based on a single study performed purely in silico without proper wet lab validation,” explained Victor Tseng, pulmonologist and assistant professor of medicine at Emory University. Eva Nozik-Grayck, clinician-scientist and critical care specialist at the Children’s Hospital Colorado, stated that “without any experimental evidence, it is dangerous and misleading to make these claims.”

David Irwin, associate professor at the University of Colorado Denver, who studies hemoglobin and hypoxia, questioned the conclusions of the ChemRxiv pre-print that served as the basis for the claim. “The authors show no convincing data to suggest that the [viral] proteins of interest, such as Orf8, etc., actually bind heme other than in modeling theories. Most troubling is that there is no way that we know of to suggest that the virus accesses hemoglobin in red blood cells to attack the heme as described in the manuscript,” he said.

A Medium article authored by Matthew Amdahl, a clinician-scientist and hemoglobin researcher at the University of Pittsburgh, details the numerous problems with [Medium author] Gaiziunas’ hypothesis. Notably, he pointed out that SARS-CoV-2 is larger than the entire hemoglobin protein, but according to Gaiziunas’ hypothesis, would somehow manage to fit into “a space barely large enough for two-atom molecules like oxygen (O2)” in order to eject iron from hemoglobin and bind to porphyrin:

To put it charitably, this would be an entirely novel and seemingly impossible sort of chemistry, and there is absolutely no scientific evidence that supports such a possibility. It’s this seemingly impossible interaction that forms the foundation of the blog post’s entire argument, and so the remainder of the conclusions drawn by the blogger simply don’t carry any weight.

Furthermore, clinical evidence from COVID-19 patients contradict Gaiziunas’ hypothesis. Firstly, supposing that the virus did bind to hemoglobin and ejected iron from red blood cells, this would have produced a modified form of hemoglobin that has an altered ability to bind to oxygen, which can be detected by measuring the oxyhemoglobin dissociation constant

In summary, while scientists have not ruled out a potential link between changes in red blood cell physiology and hypoxia observed in COVID-19 patients, the mechanisms proposed by Gaiziunas are founded on little to no scientific evidence, are highly implausible given what we already know of hemoglobin and the virus, and are contradicted by clinical evidence in COVID-19 patients.

We might find out more about hypoxia in COVID-19 patients in a year’s time.

For now, I can’t help but wonder if this type of hypoxia explains why hospitals have been refusing more ventilators for COVID-19 patients.

In the meantime, returning to Prof Didier Raoult, it seems that renegades are never in vogue with the establishment.

More power to him for successfully trialling on his coronavirus patients an inexpensive, prescription anti-malarial that has been on the market for decades. Well done. Millions of us support him in his work.

© Churchmouse and Churchmouse Campanologist, 2009-2021. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Churchmouse and Churchmouse Campanologist with appropriate and specific direction to the original content.
WHAT DOES THIS MEAN? If you wish to borrow, 1) please use the link from the post, 2) give credit to Churchmouse and Churchmouse Campanologist, 3) copy only selected paragraphs from the post — not all of it.
PLAGIARISERS will be named and shamed.
First case: June 2-3, 2011 — resolved

Creative Commons License
Churchmouse Campanologist by Churchmouse is licensed under a Creative Commons Attribution 2.0 UK: England & Wales License.
Permissions beyond the scope of this license may be available at https://churchmousec.wordpress.com/.

Enter your email address to subscribe to this blog and receive notifications of new posts by email.

Join 1,533 other followers

Archive

Calendar of posts

September 2021
S M T W T F S
 1234
567891011
12131415161718
19202122232425
2627282930  

http://martinscriblerus.com/

Bloglisting.net - The internets fastest growing blog directory
Powered by WebRing.
This site is a member of WebRing.
To browse visit Here.

Blog Stats

  • 1,658,367 hits