Research Misinfo/Disinfo: It’s a Scam
[Check the byline, thanks! /~Rayne]
When certain folks all push the same angle — Trump, Giuliani, Solomon, et al — one may think immediately it’s a scam.
Like the Ukraine quid pro quo scam on which the very same players worked together, singing from the same hymnal.
The scam is more obvious because two of the people involved are promoting a pharmaceutical and they’re not medical doctors — they may be practicing medicine without a license by encouraging the use of a medication which isn’t approved for the use they advocate.
The drug is hydroxychloroquine, an antimalarial drug which has also been approved for a small number of autoimmune disorders like lupus.
Something is clearly not right when so many of the same players are pushing a drug using the power of the presidency to do so.
~ ~ ~
Interregnum: I’ve had to put this post up now, out of order. I had originally intended to write two posts about misinfo/disinfo about research related to COVID-19 and the underlying virus, but push has come to shove with Trump pushing hydroxychloroquine again today, admitting the U.S. has not purchased ventilators or personal protection equipment on a timely basis but instead bought and stockpiled 29 million doses of hydroxychloroquine.
Trump just said that the FDA approved hydroxychloroquine for use against Covid-19.
That is medical misinformation:
The FDA gave an emergency use authorization, with a fact sheet that explicitly says there is no approved product to treat Covid-19. https://t.co/PptuczxVn7 pic.twitter.com/vVv55eP8mr
— Adam Klasfeld (@KlasfeldReports) April 5, 2020
Something is really wrong and it must be addressed immediately, before more people get hurt.
My post about the problematic background of research behind hydroxychloroquine will have to come next. Right now we need to talk about the scam in progress.
~ ~ ~
It took me a while to figure out what the angle might be on a drug which is old and cheap but I think this is the way this works.
Of course you all know Trump wants and NEEDS to stay in office or he’s up the creek without a paddle. This scam isn’t about making money but instead about serving his need not to be investigated and prosecuted for all manner of tax, bank, wire fraud and more beginning ten months from now.
So…Team Trump picks a drug which when administered in safe dose, doesn’t do much constructively for anybody except people they don’t give a shit about like patients with lupus and autoimmune disorders.
Weak sauce studies on hydroxychloroquine to date suggest it’s a 50/50 crap shoot that the critically-ill patients qualifying for compassionate use and receiving this drug will recover. Somebody external to the White House, possibly external to the U.S., maybe even the drug company/ies which makes this, may have made have chosen this drug because they did this math. They have just enough iffy research by iffy researchers to encourage its use.
They end up with just enough people who’ll recover and claim it’s a miracle drug that saved their lives, and the other half are dead or disabled so they won’t appear on camera to say otherwise. Handpicked survivors become testimonials to Trump’s ‘Wile E. Coyote super genius‘ and his prospective worth as our two-term conman-in-chief.
Even Dr. Fauci has said there’s no proof this drug cocktail works; he’s been clearly frustrated with Trump’s handling of COVID-19.
Trump cut off attempts to ask Dr. Fauci more questions about this drug today.
But Team Trump counters Fauci’s doubts by launching a character assassination attack in social media, calling Fauci part of the “deep state” out to get Trump.
At the same time there’s a continuous social media swarm pushing the drug.
Team Trump haven’t fired Fauci because they still need him to save Trump from making bigger mistakes and Fauci has much higher credibility ratings than any of the rest of Team Trump appearing before cameras.
But Trump’s current pandemic response failures are already projected to cost at least 100-240,000 American lives which Team Trump are now calling a goal, or success.
All this to boost his approval rating so he can use it for his re-election campaign. That’s the scam.
Just like the quid pro quo for which Trump was impeached — manipulate the situation so that false information boosts Trump’s approval with voters, abusing his power for his own personal gain.
~ ~ ~
What gave me pause wasn’t just the crappy research. Or the problematic French research with which this all began.
It was the fact that Rudy Giuliani, John Solomon, Charlie Kirk and a bunch of other right-wing support players were also doing their bit repeatedly to push this drug cocktail as well as a Russian doctor.
This is the Ukraine scam all over again, only this time the players are going to push a crappy drug and assassinate Dr. Fauci’s character, instead of pushing a false meme about Hunter Biden and assassinating Marie Yovanovitch’s character while she was ambassador to Ukraine.
Dr. Fauci has received death threats now because of this nonsense and his security detail has been increased because of it.
Michigan’s Governor Gretchen Whitmer has also been criticized by right-wingers about hydroxychloroquine. The state’s Department of Licensing and Regulatory Affairs throttled off-label prescriptions of the antimalarial drug because doctors and pharmacists were abusing their licenses by writing scripts for themselves and their families, hoarding the drug while depleting inventories.
But Dr. Fauci and Gov. Whitmer aren’t the only ones affected by this. There are so many stories about lupus and other autoimmune disorder patients who haven’t been able to fill their prescriptions because of a run on hydroxychloroquine because of Team Trump’s unlicensed practice of medicine at the podium — or unregistered lobbying for pharmaceutical company or companies.
Not to mention the strong possibility that although the Food and Drug Administration caved under pressure from Team Trump and now allows “compassionate use” of the drug for COVID-19, the drug could easily kill patients who are already under stress from SARS-CoV-2’s attack on their systems.
Hydroxychloroquine requires additional caution when used on females, geriatric patients, patients with diabetes — this describes a considerable number of COVID-19 patients in critical care! — thyroid disease, malnutrition, liver impairment, or those who drink alcohol to excess — for starters. The drug must be used with caution in persons with cardiac arrhythmias, congenital long QT syndrome, heart failure, bradycardia, myocardial infarction, hypertension, coronary artery disease, hypomagnesemia, hypokalemia, hypocalcemia, or in patients receiving medications known to prolong the QT interval or cause electrolyte imbalances.
This is only part a portion of the contraindications and precautions for hydroxychloroquine.
It may also cause permanent eye damage.
Imagine monitoring the patients receiving hydroxychloroquine even more closely when hospitals are overwhelmed and understaffed.
None of the research so far has been performed in vivo in a large, randomized trial. We really do not know what it will do except for what it has done for malaria patients and for autoimmune disorders — hardly the same things as patients in extremis from COVID-19.
Trump’s pushing drugs from the presidential podium must stop because Americans are being hurt for the sake of whatever scam Team Trump is pulling off this time.
We can see part of the potential reasoning Team Trump has used, but who else is benefiting from this? How do pharmaceutical companies fit into this, particularly Novartis which may be the sole source for the stockpile of hydroxychloroquine the federal government acquired. We don’t know the total amount the U.S. holds, how much might have been donated, and how much has been bought.
We don’t know whether this was part of conversations which may have happened at Davos around January 22, when pharmaceutical companies like Novartis were present and when business leaders were already concerned about COVID-19 outbreak in China.
We just don’t have all the facts yet to know every angle of this particular artless deal.
~ ~ ~
Part 3 will address the research behind hydroxychloroquine in relation to COVID-19.
Hypertension and diabetes covers probably half the people in the US, especially in the areas where most of the GOP-T voters live. It’s almost like they want to kill their own supporters.
A link on the alleged evidence:
https://www.skepticalraptor.com/skepticalraptorblog.php/chloroquine-for-coronavirus-i-mean-the-trumpvirus-evidence-is-weak/
We know it won’t effect any Republican’s vision because they are already blind.
Saw this on twitter: Copy/pasted
Nick Jack Pappas@Pappiness@realDonaldTrump
Trump continues to push hydroxychloroquine, an unproven drug.
A subtle reminder that Novartis, the maker of the drug, paid Michael Cohen $1.2 million for access to Trump.
Always money over people.
11:54 AM · Apr 6, 2020·Twitter Web App
Trump will be swept into office by a surge in the Republican youth vote. They will see him as facilitating the greatest transfer of wealth to the younger generations ever in US history.
Wow. You could at least offer everybody a bit of that edible you’re munching on this morning.
One more thing: the weird manner in which he pushed this drug yesterday reminded me of guys who try to wheedle sex out of a woman after she’s said no. Just so fucking creepy. It’s the next step before non-consensual demand, though, and I think he did that with stockpiling hydroxychloroquine. I’m sure he asked no credible medical or public health official about that.
He’s certainly trying to block reputable medical experts from talking about how dangerous it is and how little evidence there is (like, none) for treating the virus.
Follow that money!
That video clip is just plain creepy. What’s the lyric? “If I were the president of this nation….I’d declare total war on the pusher man”.
You just grab them by their fear of death. They’ll totally let you do it when you’re the president.
A+ :-)
I watched him peddle that stuff. He was relentless.
He was unhinged.
And Rudy bought $2,000,000 of Novartis stock.
Get those people out if the Whitehouse.
Rayne, stick this in your notes for the next post on this stuff:
https://twitter.com/schneiderleonid/status/1242889208651448322
Already have it, thanks anyhow.
You’re welcome.
This too, I had posted my comments on this article channeling Newsweek two threads back, but dig into this as well.
Follow the money will never fail with these grifters.
https://www.dailykos.com/stories/2020/4/5/1934708/-Trump-Is-Buying-Up-the-Hydroxychloroquine-Supply
I am always willing to believe the worst about the Cheetos-greased-face guy running the country & I know that there is online smearing of Fauci, but is there any actual proof that he or close allies of his are organizing that?
It’s going to be even harder to find out now with the IG fired, and the rest of the IGs getting undermined. I think huge coverup #2 is well under way.
I wonder if Cheetos-grease face uses clandestine former intelligence types to after people in his own government. I.E. online trolling of political opponents.
Today Trump paused and repeated the drug’s name slowly and phonetically. Quite helpful I’m sure for those at home trying to write it down so they can call their docs tomorrow.
Speaking of doctors, this medicine still requires a prescription. I would assume drug salespeople would be banned from doctors offices because of the virus?
I would be curious to see how this is being pitched to medical professionals.
It seems like a no-win situation.
Doctor’s have to choose between taking the “what do you have to lose” approach as outlined by the guy center stage with zero medical expertise at today’s Covid- 19 rally, or the “first do no harm” approach that they are probably more familiar with.
The word non-maleficence is used to described “first do no harm” or (one ought not inflict evil or harm)
Another word I came across in medical ethics discussions was “beneficence” (One ought to PREVENT evil or harm.)
Granted it was a quick search, but nowhere did I see any wiggle room at all for an argument of writing scripts for this stuff as a loyalty test.
What Trump is doing is like every other drug commercial you see on television. He’s not pitching it to doctors, but to possible patients. “If you have [condition X], ask your doctor if you are a good candidate for our prescription.”
That, exactly. “What do you have to lose?” isn’t a question one poses to a physician who has a license and malpractice insurance on the line. It’s what you say to terrified suckers.
Trump may not be talking to the doctors, but he has “pressed” [instructed? ordered?] the CDC to “talk” to them:
Exclusive: Pressed by Trump, U.S. pushed unproven coronavirus treatment guidance
https://www.reuters.com/article/us-health-coronavirus-usa-guidance-exclu/exclusive-pressed-by-trump-u-s-pushed-unproven-coronavirus-treatment-guidance-idUSKBN21M0R2
APRIL 4, 2020 / 1:52 PM
We talked about that Reuters article here:
https://www.emptywheel.net/2020/04/04/like-all-else-trumps-inspector-general-turnover-is-about-pandemic/#comment-836549
SO MUCH DEEP SWAMPINESS
How the f can a politician “press” federal health officials to push an unproven drug?
Seriously?
If this what it takes for the party previously know as “republicans” to get their guy re-elected, perhaps it’s time the rest of us grab some mirrors and force these “party of Trump” a-holes to look into them and explain why the hell they are still defending him?
Their 401k’s are gone, they will soon be sponging off the tax-payer dime, and company paid health care is looking like a pretty stupid idea right about now.
All that they have left is rallying around Trump’s hate, and at least in my neck of the words the energy for that is fading fast.
If that where DJT stopped he might be unethical and smarmy but not yet liable (but we should have the lawyers weigh in). There is a reason all of those commercials spend several seconds of air time covering the warnings and contraindications, it’s to cover their legal butts. However, DJT is not only barreling ahead without the warnings, but also shouting down Dr. Fauci when he tried to keep DJT out of legal jeopardy.
We have the couple that took the fish tank stuff (one died) citing DJT as their inspiration. I doubt that their possible litigation could get traction because HCQ wasn’t in its therapeutic form, but…
If there are victims of HCQ side effects incurred due to the drumbeat of advocacy for off-label use by DJT and Peter Navarro and Dr Oz (I think doctors and pharmacists are now covered by the “compassionate use” exemption) without the warnings I would suspect the suits to come will have more traction.
It might be time for a rational legal input on what it would take to litigate something like this, noting how the talcum powder and Roundup litigation have progressed (IIRC large jury awards overturned on appeal). A primer would help us sort out options.
I’m not a lawyer but I know there are different (higher) standards for politicians and that you would have to prove anything Trump said was done with an intent to harm.
I think Trump has the art of avoiding responsibility down to a science. He just winds people up and let’s them go.
I don’t think it’s an accident that in one sitting Trump will repeat multiple versions of whatever trash he is pushing. He plants his evil idea, covers it with horseshit (“I’m just saying” “everyone says”, “I get lots of calls”, “she’s lying, you know it and I know it”) for his trump-splainers to use when they go out and give him cover, and then he just stands back to watch it grow.
“I heard” and “they/people say”. It’s always anonymous, always someone else telling him.
There is an interesting parallel with the 1918 pandemic – at the time, a common drug (aspirin) was widely recommended as a treatment, though in very high doses. Plausible arguments have been made that aspirin poisoning added to the harm done by the pandemic.
https://www.smithsonianmag.com/history/ten-myths-about-1918-flu-pandemic-180967810/
chastened by the failure of Trump Vodka, he retools to sell hardware store denatured ethanol as premium apirits in its place.
he’ll make it up on volume, i guess.
David Gorski from science based medicine digs into the flaws of the French study on hydroxychloroquine here:
https://sciencebasedmedicine.org/are-hydroxychloroquine-and-azithromycin-an-effective-treatment-for-covid-19/
TLDR, No control, removed patients that got worse/died from the study, sloppy technique even if everything goes correctly…
And another followup on the ensuing grift.
https://sciencebasedmedicine.org/hydroxychloroquine-and-azithromycin-versus-covid-19/
And used the same image at least twice with different description.
It’s almost like that “researcher” was going to gain financially from sales, somehow.
I wonder why Novartis gave 1.2 million dollars to Michael Cohen.
You have to spend money to make money right?
Old News FWIW:
https://www.latimes.com/business/hiltzik/la-fi-hiltzik-novartis-cohen-20180716-story.html
Jul 16, 2018 … A report by Senate Democrats indicates Novartis lied about its deal with Trump lawyer Michael Cohen.
The main takeaway from the article linked above is that Novartis wanted drug prices to remain high and that the Trump administration has not been serious about lowering drug prices.
I have no idea how that ties into what’s happening now.
I think the U.S. Senate report that you referred to is “White House Access for Sale: Michael Cohen, Novartis and the bid to sell access to the Trump Administration,” a staff report prepared by the Senate Committee on Finance…, July 12, 2018. Other players include Columbus Nova, Yamo Pharmaceuticals, and Victor Vekselberg.
I read somewhere a few weeks ago that doctors in China tried hydroxychloroquine on critically ill COVID-19 patients but had to back off because it was causing too many severe side effects, including organ damage and death. Sorry, I have no citation or link to offer.
Hunt down the citation. We’re in territory now where this really, REALLY matters or you can’t simply leave comments like this. It amounts to more misinfo/disinfo when not substantiated.
Perhaps Alan referred to this? https://fortune.com/2020/03/20/malaria-drug-coronavirus-treatment-chloroquine-trump-musk-deadly-china/
Perhaps, but it’s really up to Alan to address this.
(For the record, Alan, if you’re reading this, you still have a problem with your username’s lack of uniqueness because we have several Alans here.)
I found this one – it’s a better-documented trial, but not good enough to recommend its usage:
https://www.contagionlive.com/news/results-from-a-controlled-trial-of-hydroxychloroquine-for-covid19
and this one:
https://www.statnews.com/2020/03/27/we-dont-know-hydroxychloroquine/
Laurie Garrett cited a Chinese study on Hydroxychloroquine vs. Placebo for COVID-19 from Fudan University; no significant difference but a small sample size (30 patients). Link:
http://subject.med.wanfangdata.com.cn/UpLoad/Files/202003/43f8625d4dc74e42bbcf24795de1c77c.pdf
Thanks for sharing that, SV. Marcy mentioned you’d tried to share this earlier; this is one of the studies I can’t pull down through wanfangdata[.]com[.]cn. Suspect my security features are blocking it.
I think this is the same study, also from Fudan U, has 30 participants: http://www.zjujournals.com/med/CN/10.3785/j.issn.1008-9292.2020.03.03
The size of the study is troubling considering how many potential participants there were.
Right there, bottom line: “Larger sample size study are needed to investigate the effects of HCQ in the treatment of COVID-19.”
EDIT: I want to point something out which is incredibly important, even from this small study. This bit right here in the results is key:
This tells us the body clears the virus on its own, without hydroxychloroquine, in the same amount of time — roughly seven days after conventional therapy began.
These studies seem to be about promotion rather than fact-finding. That is a problem.
Yes, I believe that’s the point – 30 patients, randomized, did not find HCQ any better than a placebo. Which is why you need randomized trials.
And to be brave enough to publish a non-result.
If there is an HCQ effect, it would need a large study to tease it out, therefore NOT a magical wonder cure.
This is one of many HCQ trials I’ve seen or herd of, and none have shown anything close to something warranting promoting HCQ as a solution to this problem.
This is “Trump Drugs”, like Trump Steaks or Trump Vodka.
The consistency of the not-quite-a-success across these small trials is a benefit to this scam. If they had large, randomized, clinical trials they couldn’t play this dicey crap shoot because there’d be a lot of visibility. I have a suspicion somebody already knows this drug won’t produce anything more at scale, which is why it was suggested to the administration.
And yes, Trump Products™ — a bunch of shiny gold paint with nothing beneath it.
Is this hydroxy stuff curative, that is, kills the virus, or is it a very powerful anti-pyretic, an adjunct to reduce fever of other symptoms while the patient can recover?
In addition to its use as an anti-malarial drug, hydroxychloroquine is used as an anti-inflammatory, prescribed for persons with autoimmune disorders in which inflammation a feature.
It has NOT shown strong antiviral activity in the small studies to date. As some patients in at least one crappy study — Gautret et al (2020) — didn’t even have fevers, it’s difficult to say that it even provides anti-inflammatory activity for COVID-19 patients when an anti-inflammatory may help the most.
It’s also not clear based on the small study size and the condition of COVID-19 patients studied whether the drug did anything at all for them.
Those interested in a fine piece of detective work are urged to read Gerald Posner’s “Pharma: Greed, Lies, and the Poisoning of America.”
Hydroxychloroquine’s side effects are standard in an industry that may end up killing as many people as it saves.
Anecdotes are not data.
Trump’s mouth is like a bottomless well of slime, or a late-medieval image of the anus of the devil. It continues to amaze, the stream of dreck that pours out. There, got that off my chest.
I believe that among other things what he is doing with this touting of hydroxychloroquine is exactly to differentiate himself from science and knowledge, Dr. Fauci, and rationality itself. Notice how he ridiculed “test tubes” and “studies”. What he is doing is saying to his base that the experts and knowledge ARE the problem. This anti-intellectual, anti-science riff is one of the key pillars of his cult. When he pushed Fauci aside last night he was communicating this with his body. The entire purpose of the WH briefing, for Trump, is to razzle his base. Fauci, Birx, and perhaps even Azar have another agenda, that is to mitigate. But not Trump. Hydroxychloroquine is just a prop in this drama. He could have picked any one of the possible treatments under study.
No. Somebody encouraged this specific medication. Not any medication or there’d have been more effort to push an anti-inflammatory or a better antiviral, or any of them combined. He AND his wrecking crew are focused on just one drug cocktail.
And Trump’s goal is maintaining his grasp on power long enough to avoid prosecution and pay off whoever owns his ass.
I agree with you. People are pushing it. I was struck by his comment day before yesterday ridiculing test-tubes and studies. That was not “necessary”; it would be “enough” to just say “give it a try, what do you have to lose”, but by adding the generic anti-science comment I believe he is reinforcing that sentiment in his base.
It is difficult to fathom the mass psychology underpinning such creatures. We read our Arendt, our Wilhelm Reich, and yes our Emptywheel, all the history and psychology we can, to try to get it.
Well, at least the President has prompted some serious research on HCQ’s effect upon the infected.
https://www.thedp.com/article/2020/04/penn-med-coronavirus-clinical-trial-hydroxylchloroquine
When were the 29 million doses acquired? I can’t find anything. I understand the desire to say this drug was pursued instead of going after ventilators in a timely fashion, but were they doing it when they should have been buying ventilators a month ago? Or did they start doing going after the drug fairly recently, when they have also been buying ventilators?
I suspect Trump realizes he is in a pickle now as deaths rise. Hence the spin on going from the expected 2 million deaths to 200k deaths as a great victory that he as the War President presided over. But that isn’t enough for the supreme narcissist. Re-election and playing to his psychological and financial needs are the underpinnings of his actions. I think he knows the testing game is lost (and has tried to pin that on the Chinese, the CDC, anyone else, etc.) and the medical equipment game he is trying to rig for grift (again, pointing to his own genius, via Kushner’s, knowing more about this than anyone) to keep support amongst the rest of the grifting business community (also via the no oversight bailouts) and also to try to pump the stock market back up.
But I think the difference here with HCQ is that he wants to be seen as the savior. It’s sort of the Hail Mary play at this point. And it ties back to the 2mil vs 200k death “mission accomplished” scenario, because the drug saved all those people. The thing with the ventilators (another way to save the people) is that clearly, there wasn’t a way to get enough for everyone, and he had to prioritize his base, holding them back most likely to give to red states. To be cynical, he may have also held them back because, he only cares that the total death rate is lower, and doesn’t care which areas have the most deaths, as long as they are blue states. Imagine the red states resist shutdowns, their economies fair better briefly, he touts this, and then saves a lot of people via much better access to ventilators? Obviously, this is just a guess, but I try to think of his actions in the most cynical and self serving ways and usually that works best for understanding his motives. This is also why he needs to get rid of the IG, so it can never come out how he was rigging the system to try to save his political and financial prospects.
Trump wants to put himself in a situation where he can go on the attack down the road and claim that hundreds of thousands of Americans died needlessly because the Deep State Medical Establishment refused to advocate for the use of his Miracle Cure, HCQ, rather than have to remain on the defensive trying to explain the lack of adequate numbers of ventilators, PPE, and other medical supplies needed for this public health crisis.
Imagine if warfarin was just being used now in experimental test trials as a blood thinner for humans and Trump began touting its use. Some people would likely start self-medicating on rat poison.
This. It’s really pretty simple.
Trump isn’t a complicated person.
Yesterday, Keith A. Spencer put out an interview in Salon (which is summarized at Raw Story). A Dr. Jonathan Raskin tells what it is like enduring his own cytokine storm — the out of control immune response some patients may develop in the course of a Covid 19 attack. In the interview, he mentions the desperate measures his physicians executed and says HCQ was used among several other things the tried to calm the storm. Since it is a drug typically used to address auto-immune disorders, it makes sense they tried it, but they tried other things in mix and all under supervised emergency care. How often these cytokine storms occur in relation to a Covid 19 infection is one of the many questions that needs answering. Anyway, the doctor’s story in quite harrowing.
https://www.rawstory.com/2020/04/what-it-feels-like-to-survive-covid-19s-dreaded-cytokine-storm/
We don’t know that 29 million is the real number. But there are reliable reports – meaning not from the WH – that 3 million doses were sent by the manufacturer.
Trump frequently lies about having done things he hasn’t. His staff scramble to do them, issue more lies having been done them, or walk back why something had to be put on hold (when it hadn’t been started). Having “ordered 29 million,” also says nothing about delivery dates. He uses the same game when he claims to have ordered supplies that are critical.
When valuing things, Trump front loads everything except debt. When he calculates his “net” worth, for example, he uses inflated values for his real estate, but refuses to discount it owing to the debt on it. He might have 10% equity in a building, but claims the full market value as his net worth. His lies know no bounds.
For those of you who don’t know about this, you can search for clinical trials at clinicaltrials.gov. If you type in COVID and hydroxychloroquine in the search fields, you can see how many clinical trials are being done with this drug, and what the criteria are for that particular study.
Lol. What are the results? I perused the French study. It established absolutely nothing, is there anything else?
The French study reminds me of the paid “studies” that were done back in the days when the tobacco industry was under assault. All it takes is a PhD. and a willingness to accept payment to support an ideology, and Bingo!, an expert opinion has been created for Twitter.
Or it takes a compromised researcher who can’t get funding because of their past practices, willing to do a study as requested with funding attached.
@bmaz
Sorry for not being clearer. clinicaltrials.gov is the website to go to if you want to see a snapshot of what clinical trials are being done right now for ANY disease. For COVID-19, some of these trials (not many) are complete, but most are either gearing up to recruit subjects or currently enrolling them. Trials being done with COVID-19 and hydroxychloroquine are listed in the database just like trials for any other disease would be.
My point was to illustrate that there are a LOT of ongoing studies about COVID-19 and hydroxychloroquine, and you can review the study designs on the website. We should start seeing the the first set of results from these studies in the next few weeks.
clinicaltrials.gov is also a good resource for people who are interested in volunteering to be study subjects. For example, if you’ve already had COVID-19, and you want to volunteer to donate plasma, you can search for research trials that are being done in your area. (If you want to search for some other disease that you’re interested in, you can do that, too.)
Frank, I join Rayne in saying thanks. Pretty sure you know I was not harshing on you at all (the “French study”, which had nothing to do with you, absolutely). And thank you for the update.
The nesting throws me off sometimes. I just wanted to make sure everyone knew that the not-really-a-link was legit. (There’s actually a similar site with a similar name that I don’t trust as much, believe it or not, so I like to make sure people don’t get pointed to the wrong one.)
Oops, I meant to say thanks, Frank. The number of new, not-yet-recruiting studies is very scary. Good that there will be more eyeballs but bad in that there could be more opportunities to fuzz overall consensus about this drug.
A lot of people will take these drugs. 95% of them will never develop a severe Covid/19 disease. The drug will get the credit, among non scientific people. And they will vote for Trump. Its just a placebo. But it certainly will kill a few people who take it, if they persist in self medicating.
That is why it is critical for Trump to denigrate science. It is the Thaumaturgical king.
https://en.wikipedia.org/wiki/Royal_touch
I would caution against assumptions about how this plays out. These are not the same times as 2016-19.
I think there is a greater chance than in the past that Trump gets pushed out by the GOP, and it may be the case that the people who fall for scams are the ones most likely to jump to the next guy promising a miracle cure.
Yes! Now is the time for the GOP to use the 25th amendment. The man is clearly incompetent and crazy. They could shuffle him out the door with (probably) no consequences by saying he’s gone beyond the bend. Once he’s not president he can’t get any revenge on them, unless there are tapes or other evidence provided by Putin that would be disastrous for them.
The 25th Amendment will not happen, but it is conceivable to me that they will buy him off with the promise of a buyer for his distressed properties and a pardon, and convince him to let Pence take over.
That leaves him at risk for state charges, but he may decide that it’s better to take a deal before the GOP convention than take his chances on November if the polling gets bad enough. If we are looking at a major growth in cases,a long period of restrictions and high unemployment, the polling may well get that bad.
I don’t think Trump’s ego could survive his departure from office. I don’t think he would entertain the idea, let alone negotiate a deal for it. He would also be the first to tell you that any promise not already fulfilled is worthless.
The one thing that I think would make it happen is the risk to his businesses,
I don’t know the combination of tax and loan obligations that he is facing, but I can believe he is in the same boat as a lot of others in the hospitality business.
I think that would make a buyout tempting if the spring and summer are bad for business, although it would obviously have challenges on a number of fronts to pull off.
Particularly since Trump’s real financing may be off the books, in that Russian oligarchs may be guarantors-in-fact for his biggest loans from DB. Then there’s the unexplained cash he found to acquire and improve his Scottish properties.
Now, a normal real estate magnate might be able to hide behind a major economic downturn. Trump, though, is president. His guarantors will expect him to use his power to keep paying the vig. Plus, it appears they intend him to disrupt the US as much as possible. His doing that might be one of his few successes.
Some of his creditors may be insisting that he stay. They may have even more leverage over him that just staying profitable.
That could be true. I certainly won’t stick my neck out on this, but I think people should be prepared for higher odds for the unexpected before November than a regular election year. Seven months is going to seem like an eternity.
That fits with Trump’s behavior pattern. He greedily takes credit for anything that works out, and feverishly denies responsibility for anything that doesn’t. And he wouldn’t give a shite for anyone who died along the way. As for liability, causation would be a legal hurdle and the political hurdles coming from the “criminalizing policy differences” crowd would be enormous, leading to the usual freedom from liability.
Well. I for one am very glad to see that he has decided not to use a mask. Or practice social distancing. Or wear gloves. Maybe his recklessness will take him out of our misery for us. [sly grin]
His behavior says he’s not a germaphobe. If he were, he’d be masked and gloved all the time, and not standing next to anyone who isn’t also wearing a mask and gloves.
Social distancing and best health practices are working. Social distancing by itself, reduces the viral load and gives each person’s immune system a fighting chance.
We’d all be better off if we conducted ourselves in public like we all had that tragic affliction of the elderly, I.F.D. (Involuntary Farting Disorder).
Is there a pill for IFD? Asking for a friend.
No. Just Beano.
Watchit!
Modi has halted hydoxycloroquine export. In US , Mylan and Novartis have been ramping up production. Mylan has been accused of price gouging in the past. In 2019, Novartis set aside $700 million dollars for US bribery settlement. Grift and graft opportunities?
Hmmm. Trump has been pushing hard to rescind the Foreign Corrupt Practices Act (the FCPA). I wonder if that’s a link in the chain.
He’s been hammering on that since 2017. Was very obvious when regulation related to tracing extracted (mined or drilled) materials was killed.
Bribery is why the US is trying to extradite Firtash from Austria.
I think it’s more likely that they’re keeping it for their own population. I haven’t seen much about the spread of COVID-19 in India recently, but it was looking like they were going to take a big hit. If hydroxychloroquine turns out to be the miracle drug Trump thinks it is (It won’t.), then they may want to save their own people first. Modi would be practically deified if he could give his people a miracle cure. After all, what does he have to lose?
I agree that the administration’s hyping of HCQ is political ass-covering.
But on the other hand, there’s reason to believe that HCQ could be of value to a subset of patients.
The patients who die of CoVID-19 are mostly those with severe pulmonary involvement. This is similar to SARS-1.
There’s data from SARS-1 patients indicating that the pulmonary flares were associated with anti-virus antibodies (IgG). (See Liu et al., https://doi.org/10.1172/jci.insight.123158 . This is a macaque study, which demonstrates the phenomenon.)
If CoVID-19 (aka SARS-2) acts in the same fashion, that could explain the disparity in frequency of severe reactions between younger and older patients.
There are several other coronaviruses which have circulated in human populations (see, e.g. Fung and Liu, Ann Rev Microbiol 73:529 (2019).) Those who have been infected and recovered would have developed immune responses to clear the virus; as part of that response, they would also develop a reserve of ‘memory’ B cells. If infected again by the same virus, the memory cells will mount a much more rapid response the second time around. (That, of course, is the basic principle of vaccination–to prime the immune system.)
If we presume that there’s some antibodies generated against the antigens on a particular CoV will display cross-reactivity with comparable antigens on other CoVs (a fair presumption);
and if we further presume that older patients are more likely to have been exposed to one or more CoVs in their lifetime (also fair);
and if we presume that SARS-2 acts like SARS-1 (fair again);
and if the reports of anti-virus-IgG-mediated enhancement of disease are true (?);
then we’d expect to see relatively little severe disease among younger patients, and rates increasing with age.
Lupus is an autoimmune disease. Many of the symptoms are the result of auto-antibodies — antibodies which bind to self antigens. (Normally, the immune system is ‘tolerant’ of self; autoimmune diseases arise when this tolerance is faulty.) HCQ helps lupus patients because it inhibits the function of B cells, the cells which produce antibodies.
If HCQ inhibits B cells, then it might be of value in preventing the antibody-mediated enhancement of disease in older patients.
Might.
I’d be in favor of some well-designed studies.
Even if HCQ is of use, it will take study to figure out how to best deploy it. (Timing of HCQ delivery vis-a-vis time of infection is clearly critical. One might envision it working prophylactically, but not therapeutically.)
All that said, the President and others who are pointing to HCQ as a silver bullet are criminally misleading the public, and have totally fucked the HCQ supply chain.
Is that TL;DR for nobody knows yet, the “French Study” is shit, and the President and his toads like Rudy and Navarro should not be pushing on this without actual research?
TL;DR:
Published studies are questionable and/or inconclusive;
Public officials should shut up about HCQ;
Allocation of some resources for further testing is justifiable
“If CoVID-19 (aka SARS-2) acts in the same fashion” <<-- NO. Just stop the fuck right there. That's a HUGE assumption. I mean you literally make that statement after talking about SARS in MACAQUE MONKEYS. You should have stuck with this: "…the President and others who are pointing to HCQ as a silver bullet are criminally misleading the public, and have totally fucked the HCQ supply chain.“
I’m quite aware of the limitations of macaque studies, having conducted a few myself.
And it’s perfectly reasonable to look for parallels between SARS-1 and CoVID-19 (while understanding that there are differences).
The point I’m trying to make with all this is simply that there’s reason to consider HCQ as a possible therapeutic.
But until there’s solid data on this, or any other potential agents being tested, the president, his supporters, the political press should just leave it be.
I propose a clinical trial, 60 day period. Trump, his cabinet, his immediate family, Fox News Hannity and Morning Joe anchors, Rush Limbaugh, the Senate Republican caucus, and Trumps re-election campaign senior staff. Double blind: all other medications and recreational drugs, topically applied compounds, alcohol and caffeine withheld. Half the sample set receives a placebo, other half receives HCQ in recommended dosage. Doctor supervised (if you can find one willing to risk malpractice). Gross results to be immediately published, not subject to classification. Back your brand with all you’ve got, mr. salesman!
Great idea!
And sequestered in shielded facilities where no signals can be transmitted or received. Sixty blissful days while those cretins play a game of “Lord Of The Flies” and our airwaves are free of the trumpkins.
Can I suggest every (r)epuglicon governor and congress critter be added to that viral mix?
At the very least, McCarthy, Nunes, Massie, and Gohmert.
any word on Rand Paul’s prognosis?
For getting his head unwedged? Unlikely.
Yes, this scam must be about more than pushing an off-patent (low price) drug – which was mostly taking up shelf space in a large pharmaceutical company’s warehouse – for an unapproved and unproven use. Price gouging might help a drug company, but revenue from this drug would ordinarily be a nit in a mega-company’s sales figures.
It does not explain why an American president and his entire propaganda machine are pushing this in the middle of a pandemic. A drowning president might grab at anything that floats, but it does not explain the full court press from his propaganda and vilification machine. Why does Trump even know he ordered 29 million pills? Did he agree on the deal or sign the order? I’d love to see the terms: parties, quantity, delivery, price and payment terms, hold harmless and exceptions from liability clauses. They would make interesting reading.
On the other hand, Trump is not pushing companies to produce more PPE and ventilators, or promoting social separation and wearing of masks, which are necessary or have proven effective. He’s denying they’re important or that his government has a role in providing more of them. Instead, he’s pushing a fake cure. How does it terrorize his enemies, and keep him in office and out of prison? Like Bela Okmyx, Trump never does anything without a piece of the action.
While we’re looking, Trump’s incompetence and malfeasance are killing people. Maybe he thinks his war on his own people and to remain in office and out of prison makes him a wartime president.
Also, did he really get 29 million doses, or did he (as usual) pull a number out of his @ss because it sounds good?
The 29 million was evidently an underestimate and when Trump said he “purchased” the lot, he should have said “received donations” of the drug.
https://www.statnews.com/2020/04/06/trump-hydroxychloroquine-fact-check/
I suspect that people have filed patent applications on the use of almost any drug you can think of for treating CoVID-19. Apparently it is possible to get patent protection on an old drug if it is for a new use. Then, a successful PR campaign could make an otherwise cheap drug very expensive (and profitable).
That said, Trump is probably trying to position himself to cite his advocacy for HCQ in support of future claims that, no matter what has happened, things would have been worse if not for him.
If you want to get more angry read this on propublica: https://www.propublica.org/article/early-data-shows-african-americans-have-contracted-and-died-of-coronavirus-at-an-alarming-rate
Racial/ethnic cleansing by disease?
Marginalized groups who are more likely not to have adequate health insurance will certainly be affected in ways that privileged groups are not. The concentration of marginalized persons will also make them a target for neglect under a highly-partisan government.
But I want to caution people about the assumptions regarding race, and I say this as a person of mixed race heritage. Look carefully at the locations of hot spot cities; each one is home to an international airport. Who works at those airports?
Now look at a city like Milwaukee; the outbreak isn’t right next to the airport, but in a location with the highest density of secondary schools. Many more young people are there, likely to be asymptomatic carriers who may have been traveling.
How does race fit into these situations? The racism here is much older and deeper — who lives near airports and why? Who lives in college towns and why?
Plus, the homeless in various states of disrepair and addiction aren’t aware of this. KCBS here in the Bay Area ran a story today of a formerly homeless filmmaker doing a documentary about COVID-19 and the homeless and observed half did not know anything about it at all. Also observing that their deaths would in many cases not be attended or blamed on something else it would seem that the official COVID-19 count is going to be a very low estimate.
Very perceptive, Rayne. Thank you.
Housing is so f—-d up in this country. There is no housing policy. Title VIII was the best effort we had, and it’s in shreds. Like Jesse Jackson says: the only definitive housing policy this country has is prison.
Milwaukee in particular was hit hard by the foreclosure crisis. What we are seeing reflects the long tail of the parasitic nature of subprime mortgages.
Dr. Dangerous states, “I’m not a doctor. But I have common sense.” He is promoting hydroxychloroquine because he is a “stable genius.”
And a stable is where you’re likely to find a horse’s ass.
Ha Ha Ha. Good one.
Trump is playing the penny slots. He does this all the time. He makes a grand claim with a petite hedge, like “maybe, maybe not, but what do we have to lose?” If it hits he scores yuuuuuuuugely as the most stable, world-saving genius of all time. If it doesn’t, well he only raised the issue and said “maybe.” Penny slots. He’s got nothing to lose but a penny.
The early medical information coming out of China talked about the cytokine storm associated with Covid.
Gout flare ups can result in cytokine storms causing muscle skeletal inflammation at the flare site to spread uncontrollably. The cytokines involved with Covid and Uric Acid Arthritis (Gout) have some common occurrences.
Colchicine is one drug they give to STOP the storm occurrence with Gout. Before pandemic days, my MD and pharmacist stated Colchicine is an immunosuppressant. There are two basic protocols in administration for Gout. Preventative and Intervention. It will not remove the inflammation, just stop the uncontrollable spread. One has to take anti inflammatories to eliminate the resultant inflammation. This treats only symptoms not causation. Due to symptom and causation medicine, I have to have comprehensive metabolic panels at least monthly to monitor for organ damage.
Thanksgiving 19, I was in the worst flare up of my life. Started in right knee. A few hours passed. Then storm hit and the inflammation spread up, down, and all around encompassing toes through to hips and was spreading down the other leg and climbing up my back. Massive swelling which locked up joints and caused stretch marks.
It is approaching 5 months and I am still taking 800mg ibuprofen 3x a day. When mobility returned, I had lost about 30% of tissue from the right leg.
I have no idea whether or not taking Colchicine as a preventative for gout is a positive, neutral, or negative regarding Covid. Regardless, the price has skyrocketed and availability has shrunk in this area.
The orange mafia boss is pushing a drug as treatment based some motivation other than addressing the crisis of this pandemic and or the welfare of individual or group. Whatever the motivation is/was almost makes no difference. The results will be more Americans will die when they could have survived, democracy will be further degraded, and the orange mafia will profit as well as use the contrived controversy to attack our society.
Staying out of the hospital and in isolation at home is the only measure so many have to mitigate this crisis. Just wish there was affective medical protocols to eliminate the disease in the Oval Office.
Am curious as to why you recommend “staying out of the hospital”. Have been thinking about pros and cons of ventilators and ICU beds as “treatments”.
The sentence was not a recommendation.
Simply put, any person needing hospitalization for any reason adds more burden to the system. Given the situation we are in the treatment options are becoming fewer in number and higher in risk.
https://www.politico.com/news/magazine/2020/04/06/i-dont-have-coronavirus-it-might-kill-me-anyway-163101
The link above points to an article describing one example.
Staying home has its own risks. Avoiding injury is always better than having to get patched up.
Hospitals all over are going to be like the one shown in the video from BBC.
https://mobile.twitter.com/existentialfish/status/1247309761131012096
Swedish hospitals stop using chloroquine says this story. I will assume it is the same thing as hydroxychloroquine. The story does not say the government has demanded its use stopped.
https://www.newsweek.com/swedish-hospitals-chloroquine-covid-19-side-effects-1496368
Hydroxychloroquine is a derivative.
Story in Swedish press doesn’t say government intervened, either. More like the hospitals have strong ethical guidelines about performance expected from drugs administered under compassionate use.
These are two short reviews looking at antiviral properties of cloroquine from contrasting angles; neither should hit a paywall. Bottom line, it’s not a new idea, the promise stems largely from cultured cell studies, and as yet there is no large scale study demonstrating successful use of chloroquine to treat viral infection in any animal model. In terms of Trump’s “what do you have to lose”, a key point from the second link is “the margin between the therapeutic and toxic dose is narrow and chloroquine poisoning has been associated with cardiovascular disorders that can be life-threatening”.
This link summarizes the biology of cloroquine on viral replication, effects on the immune system and cell to cell attachment points in epithelial cells called tight junctions. The figures are very useful I think.
https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(03)00806-5/fulltext
This link summarizes chloroquine as an anti-viral treatment from a historical “been there done that” viewpoint.
https://www.sciencedirect.com/science/article/pii/S0166354220301145?via%3Dihub
The bigger thing to dumps: “what do you have to lose”
is that many people will use his non-evidence-based opinion to try and self-heal.
This is the standard model for all quacks.
(Not casting aspersions on homeopaths, chiropratics, woo artists, etc.)
Quack sounds too harmless to describe this IMO. I think of him as being a pusher-somebody squeezing financial gain from inducing people to abuse biologically active compounds. The question is, what’s his angle?
o/t via Kate Brannen:
Acting Navy Secretary blasts USS Roosevelt captain as ‘too naive or too stupid’ in leaked speech to ship’s crew
https://taskandpurpose.com/news/navy-secretary-blasts-fired-aircraft-carrier-captain
APR 6, 2020 12:15 PM EDT
[Task and Purpose have posted about 15 minutes of the audio]
I understand the crew wasn’t happy at all. They know and trust Crozier.
At one point in the audio, you can hear someone yell “What the f*ck?”
And remember that Modly is ACTING Secretary because the previous secretary, Richard Spencer was fired when he did not support Trump’s position on convicted war criminal Eddie Gallagher’s SEAL credential.
Modly must have a deep desire to learn how to swim. Pissing on a ship captain to the crew he tried to take care of, in the face of deep criticism. Even the Navy brass disagreed with Trump about dismissing Crozier from his command, so Trump screamed at Modly to do the job they refused.
Stand up guys like Crozier are hard to find: He’s good at his work – carrier commanders are among the most accomplished officers in the Navy – he does the right thing, and he won’t be bribed or bullied. That’s exactly what would scare the shit out of Donald Trump.
So, Trump pissed on Modly, who flew all the way out to the Teddy Roosevelt to piss on its former captain, and to encourage everyone else in the Navy to STFU. Were Modly qualified for his job, he would know that was exactly the wrong thing to do. But he’s a Trump man, which means he’s a glaring example of the Peter Principle and willing to suck up to anyone in order to keep his job. It’s the only kind of guy Trump hires.
I’m sure it really stuck in Trump’s craw that Crozier’s crew posted all that obviously genuinely felt applause and cheering on social media.
Did Modly somehow miss all of “Star Trek” while growing up? Even though it wasn’t “real life”, it was pretty damned clear that there was loyalty going up and down the line, at the ship/station level, anyway.
Not only does it require the most accomplished officers, but being assigned to a carrier command is a sure sign of being on the fast track to flag rank. He had the choice of being a careerist or doing the right thing. He knew the minute he wrote those words his career was over. He chose the one that let him sleep at night. In this administration he has some good company as small as it is.
Indeed. I think being a carrier commander, along with commanding a ballistic missile submarine, are the most demanding jobs in the fleet. Carrier command, though, is more public. Success at every earlier command and a high level social skills are among the prerequisites, as is graduating well from nuke school.
Unless you run your ship aground or have some unexpected huge failure, flag rank usually follows. The cost of having Donald Trump as president is becoming more visibly expensive.
It normally does as I had noted earlier. Acting SecNav Modly is a graduate of Canoe U (as we ROTC guys called it) and spent seven years in active duty (probably still a LT
then but maybe had a selection board to LCDR, I do not know what community he was in, line or staff) so I’m surprised he wouldn’t understand it. I listened to the speech and what he claimed (and allegedly why he was not amused) was that his chief of staff reached out and was told assistance would not be necessary, and no other communications occurred until the SF Chronicle broke the story.
However, CAPT Crozier will be able to demand the GCM (and it will be a general CM because of the topic and attention) to clear his record and find the true timeline here. Modly still has to explain why he did not act when he would have been notified via 7th Fleet of COVID-19 infections on the TR, even if Crozier said nothing (which I doubt).
Bottom line, IF what Modly says is true (he reached out, was rebuffed and read about it later) then I’m not surprised CAPT Crozier was let go for bypassing the chain of command. The GCM will tell us either way, and if the fellow captains agree with him they will see to it that the evidence is public and includes embarrassing details even if they don’t fully exonerate him. Look for how the board is made up, whether line (i.e. surface warfare, submariners and aviators) or staff officers (i.e. supply chain, JAGs or docs) are named.
I think Navy Corps of Engineers – the officers for the CBs – should be line. (Mother’s cousin is retired from that group; he served in Korea and in Nam, during the shooting period. Got to RAdm.)
Crozier’s past suggests he would have fully communicated up the chain of command on the arrival and progression of Covid-19 cases on board his ship, and accurately communicated what, if any, assistance he required. It was a task foreseen by every ship commander in the fleet and around the world. It says nothing about how the Navy responded.
The odds of what Modly says of being true would appear to be on par with what Donald Trump says. Wiki says he was a helo pilot, but says nothing about his final rank. Post-graduate degrees from G’town and, of course, HBS. That he rose to be managing director of PWC government and public services business says he’s highly ambitious and a skilled lobbyist. That he taught political science at the AF Academy, suggests that his beliefs are fundamentalist. That he chose to work for Trump, after his predecessor (to whom he reported as Navy Undersecretary) was fired for doing his job, reinforces all that.
I don’t imagine the Navy would want to convene a GCM while Modly and Trump are still in office. But given his experience as a Navy helo pilot, Modly knew aircraft carrier culture and its command structure. He knew how what he said would be received and said it anyway. Once a government contractor, always a government contractor. Fuck him.
You know the top boss is lying to you when he explains – after firing your boss – how much of a victim that decision makes him.
In Modly’s rant to the Roosevelt’s crew, he whined that he and his family have received undescribed “threats” because of his decision, and that he had nothing to gain by it. Contra, see below.
Modly claimed in a late-night phone call to the WaPo’s David Ignatius – long time friend of the IC and DOD – that he fired Crozier before Trump could tell him to do it. He wanted to preempt Trump from getting mad at him for not doing it.
In TrumpWorld, the claim to Ignatius is the sort of lie a minion trots out to relieve Trump from liability for what he had already demanded. It also suggests that had Modly served in Vietnam, he would have stuffed the space under his bunk so fully, no one could roll anything under it and ruin his sleep.
The part about firing before Trump ordering it was a tell for me too, and I also note that there are those officers who are ambitious pricks who would lick any boots that can help their career. I’d be interested to see what caused him to leave the USN.
even his biography at defense.gov doesn’t say much about his career:
Sounds like he wasn’t good enough to get promoted past junior officer.
And I used to think the commander, the Captain of an aircraft carrier was, you know, somebody.
For a summary of the various paths to possible treatments, I saw a reference to this Science Magazine article.
The graphic “Lines of Attack” on the progress of SARS-CoV-2 and the various interventions being considered is excellent at aiding understanding.
And, clearly, a century+ of medical experience says that the only thing to believe are blinded clinical trials, done with all the long established protocols to make sure you aren’t fooling yourself.
Which takes time.
https://fcld.ly/n2w29hj
https://www.sciencemag.org/news/2020/03/who-launches-global-megatrial-four-most-promising-coronavirus-treatments
[FYI, URL edited to remove tracking. Thanks! /~Rayne]
Thanks for that link. The “crowdsourcing” idea behind SOLIDARITY is interesting. In addition to the caveat of not being double blind, another worry I’d have is that there is unlikely to be any standardization of methods and assessment across groups. This can really confound interpretation. On the other hand, if there is feedback within the study, things that show promise could be rapidly disseminated and attempts made to repeat.
Howdy SV! Thanks for the link.
Note that your posted link that has tracking info embedded ( the stuff after the “?”). We try to refrain from that around here. Folks are rightly concerned about anonymity.
Long time reader, but first time posting – so I’m learning. Not so savvy yet on link grammar.
In Michael Cohen’s criming days, Novartis (HCQ manufacturer) was paying Cohen something like 100k a month to influence Trumpasaurus administration. And somewhen between then and now Novartis had offered to pony up 130 million doses of HCQ gratis, I believe.
As is often the case, Trump’s minions double down when they screw up, the better to imitate and impress the boss. Take Peter Navarro, for example (please). The Harvard PhD economist claims that he’ll take Trump’s intuition over science any day in crafting a response to Covid-19. You might think a Harvard PhD could only get away with that absurd statement on Faux Noise, and you’d be right.
https://crooksandliars.com/2020/04/peter-navarro-i-be-trumps-intutition-over
Take HCQ with a heaping of salt.
Besides all of the excellent comments above (especially the info about the French PI’s past regarding academic misconduct, and questionable photoshopping of the data presented), there is a MAJOR theoretical basic science reason why it might not work.
RRAR
For those of you who have read at length about SARS-CoV-2 basic biology, you may recognize this as a sequence of amino acids found in the Spike protein (the “key” for cellular entry, whose “lock” is ACE2 on the cell surface) at a cleavage site that separates the Spike protein into 2 subunits.
The …RRAR… sequence (Arginine-Arginine-Alanine-Arganine, for those who care) is found in SARS-CoV-2 Spike, but NOT in SARS-CoV-1 Spike, and it’s a major reason why COVID-19 is much more transmissible than is SARS.
RRAR is recognized by an enzyme, called furin, which is found in the late Golgi apparatus, where newly assembled SARS-CoV-2 virions wait for the green light to be released by the infected cells. Thus, on their way out, their Spike proteins are all cleaved by furin and essentially, molecularly “cocked” to be primed for cellular entry upon binding a susceptible cell’s ACE2 proteins.
Again, SARS-CoV-1 does not have this cleavage site, so its Spike protein is not “cocked” in this way. Thus it must undergo 2 cleavage events when infecting a new cell, as opposed to just the one event that SARS-CoV-2 has to undergo.
Why does this matter? Because there is data that shows SARS-CoV-1 Spike is cleaved at the same location by a different enzyme, cathepsin L.
Cathepsin L is a LYSOSOMAL enzyme that is activated by low pH in the lysosome. And, you may have guessed, HCQ and chlorquine derivatives work by inhibiting lysosomal maturation, and preventing the acidification of the compartment. Thus, cathepsin L will not work under these conditions, so the spike protein cannot be cleaved.
And as such, chloroquine seems to be very promising as a SARS drug, as it effectively prevents infection.
But SARS-CoV-2 Spike, while seeming to require cathepsin L for entry in vitro, at least in this highly lab contrived model system, can also fuse with the cellular membrane at the cell surface using a non-lysosomal enzyme, TMPRSS2 (which is not expressed by 293 cells used in the paper I cited). In addition, the cleaved spike protein can also induce cell-cell fusion and basically horizontally infect neighboring cells that way, even if those cells were not originally targeted by the virus.
So the TL;DR here is that HCQ and its chloroquine derivatives likely WILL NOT prevent continued infection by SARS-CoV-2, especially late in the game, although it may slow it down a bit. There are other non-lysosomal pathways of entry for this virus that will be insensitive to HCQ.
I’d read that the spike in Sars-2 is easier to split, and about furin, but this is a nice explanation of what happens.
That is interesting. It is also possible that there is more than one pH dependent step. Differences in the pH dependency of the proteases that liberate the fusion peptide from S, like you are pointing out, could be one type of pH dependent event that appears to differ between coronaviruses.
However, given the rather non-specific ability of agents that prevent endosomal maturation (ie pH drop) to block cell entry (cultured cell models) from a number of distantly related viruses, it has also been argued that there is a more general pH dependency. Endosomal maturation is driven through acidification, and is associated with changes in lipid bilayer composition that may it easier for the fusiogenic reaction to occur. Thus, the virus can take advantage of a normal pH dependent transport pathway to get arrive into a compartment where it can fuse more easily. Can dig out a citation if interested.
Sure, I’d love to see a citation for the neutral pH fusion reactions. As you point out, most of the enveloped viruses seem to need the drop in pH to promote a conformational change that allows for fusion, yet I think SARS-CoV-2 is different, and that may explain why it’s so infectious. If the virus can infect cells with having to “wait” for a relatively rare endocytosis event (i.e. just fuse at the cell membrane surface, or “horizontally infect” neighboring cells via syncytium formation from cell-cell fusion events), that is in its evolutionary interest.
The syncytia to me seem very key for SARS-CoV-2, and it’s reported that the cleaved S1/S2 boundary product from furin is a major reason why this happens so easily. Great way to allow one virus to infect one cell, but give it the power to churn out 7-10 x the output of virions due to all the syncytial hijacked cell organelles acquired from cell-cell fusion. Such a strategy probably explains why viral loads are so high early in the infectious period.
Sorry for all the technical talk, folks. Basically, it’s again pointing out that HCQ may not be the savior some people want you to believe it is.
Horizontal infection would imply that type I alveolar epithelial cells (that don’t express ACE2) are being lysed as well as type II (that do express ACE2), would it not? This would be bad news for any particular alveolar sac in terms of recovery, I would think.
No, thank you for posting what you have. It is very helpful. This is what makes this forum great. Also why we try to encourage smart commentary and, well, discourage bullshit. Thank you for smart commentary.
“The syncytia to me seem very key for SARS-CoV-2, and it’s reported that the cleaved S1/S2 boundary product from furin is a major reason why this happens so easily. ”
Maybe especially if the activated fusion protein ended up being routed to the baso-lateral surface of the cells some fraction of the time.
Thanks for your comments. If you had something you’d be willing to say on possible basis for dysregulated coagulation that you mention in your comment below that sounds potentially important. Associated with B and T cells getting involved?
I promised a citation re a general requirement for pH drop for membrane fusion in viruses utilizing an endosomal pathway for cell entry. Memory was stretched some but see ref below, last para discussion.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2772765/
Also, given the direction of the conversation and per your original post, note that SARS CoV-1 (if I am employing correct terminology) is also able to exploit a TMPRSS2 cell surface pathway for viral entry, and is therefore not solely dependent on endocytotic cathepsin cleavage.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3004351/
THAT. Thank you, thank you. This is why I was SO upset earlier when the comparison was made in comment here to SARS-CoV-1.
This became a pandemic because SARS-CoV-2 is *NOT* like SARS-CoV-1. That enzyme mechanism is what makes it so much more infectious.
See: http://virological.org/t/the-proximal-origin-of-sars-cov-2/398 and https://www.biorxiv.org/content/10.1101/2020.02.10.942185v1.full.pdf (pre-print)
I have been wondering whether that cell-cell fusion is what makes the inflammatory response so rapid and dramatic, and if the reason why men are more likely to become severe/critical is because of androgen regulation of TMPRSS2.
Also bothers me that we haven’t seen any indications that persons who had been prescribed HCQ for autoimmune disorders were less likely to be affected by COVID-19. And while there are some mumblings about the African continent not having as many reported cases because they must be more widely treated for malaria, it’s *reported* cases (which we know is a political issue), and the continent is far more used to dealing preemptively with transmissible disease outbreaks like Ebola.
Also, % of population that travels frequently and population density matter a lot here. As we’re seeing in a number of more rural states that have major population centers, it will still take a long time to see overall state peaks, due to relative lack of travel to the cities from the rural areas. We will likely see, for instance, peaks in St. Louis and KC, long before the entire state peaks for this reason. Same could be said of upstate NY.
Good point about TMPRSS2, I hadn’t realized it was androgen regulated.
I suspect though, the male factor may be more related to HTN incidence and propensity for microthrombotic events given increased Hct, iron loads and higher ferritin levels.
I and several other colleagues are really starting to look at the role dysregulated coagulation is playing as a common pathway for mortality, rather than “just” respiratory failure. There’s a lot of anecdotal case reports of patients getting better on the vent, only to die a day or 2 later from sudden cardiac collapse, and with clean coronary arteries. Microthromboses (i.e. clots in small vessels) in the heart, pulmonary vasculature and possibly even kidneys could explain these sudden multi-organ failure states.
It’s also worth noting that the patients who died on the vent at autopsy with COVID tend to have more lymphocytes (T and B cells) in their lungs, rather than neutrophils, which are the predominant form of inflammation seen in garden variety acute respiratory distress syndrome. There is also a lot more scarring and fibrosis seen in those (the typical ARDS) cases, and people usually take weeks to die, not days. I’ve also heard some critical care colleagues saying the vent settings are nowhere near as complex as for your typical ARDS case, meaning the lung is much easier to aerate overall (and has less fluid buildup), yet the patients are still dying.
“Also, % of population that travels frequently and population density matter a lot here. As we’re seeing in a number of more rural states that have major population centers, it will still take a long time to see overall state peaks, due to relative lack of travel to the cities from the rural areas. We will likely see, for instance, peaks in St. Louis and KC, long before the entire state peaks for this reason. Same could be said of upstate NY.”
Yep. I am worried with the hold-out red states that we’ll see small spikes everywhere throughout the summer. As soon as air travel picks back up we’ll have yet another series of small waves in every city with a major airport. I really don’t know how we’re going to be able to let kids go back to K-12 and university this fall given the likelihood they are a major vector in cryptic transmission.
I’ll have to look into the dysregulated coagulation. Could explain China’s observations of fulminant myocarditis or myocardial injury as cause of death rather than hypoxia, observed in patients w/o CVD as well as cardiac history.
With the increased lymphocytes we circle back to an anti-interleukin-6 receptor antibody and the use of tocilizumab. If I had to hazard a guess I think we’re still looking at remdesivir and tocilizumab if remdesivir can’t tamp down the virus.
Agree mostly. But there’s another drug that might be really really promising if the Chinese data are to be believed.
Dipyridamole, which is an anti-platelet drug may be a damn near magic bullet for COVID if some of this data is to be believed. I remain skeptical for now, but I do think the best strategy has to include anti-platelet or anticoagulant drugs.
Also convalescent plasma seems very promising for severe cases too.
I’ll have to look to see if clopidogrel is also being tested if they’re looking at dipyridamole.
I can’t help wondering if there is some other late trigger that patients’ lungs begin to improve and this clotting+inflammatory response then kicks in. Like the ACE2 receptors in the ileum — perhaps there’s little to no local inflammatory response but some gut-brain messaging tripping a heightened immune response elsewhere like the heart. All the more reason to look at an monoclonal antibody to throttle down ACE2 receptors.
We desperately need a cheap, fast, reliable antibody/antigen test to identify healthy, recovered potential plasma donors. I’d prefer to think of that as the ultimate Hail Mary since we’d need nearly one-for-one donor-to-patient donation. If we had the antibody tests available on widespread basis, we could already be saving many lives the White House wants to throw at hydroxychloroquine with iffy odds.
Hey viget — really need to ask you this; do you know if anyone has yet looked at carriers of thalassemia w/regard to dysregulated coagulation? I am looking at the countries which have had some of the worst experiences with COVID-19 and they happen to be countries where a sizable percentage of the population are β-thalassemias heterozygotes.
It could explain apart from structural racism why African Americans have been more adversely affected. I haven’t yet seen numbers on Jewish and Muslim populations in US who are of Middle Eastern descent. Certainly could explain why Italy and Iran have been devastated. See location of populations in https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5333734/
That said, COVID-19 is still bad for other populations; wonder, though, if the dysregulated coagulation doesn’t occur uniformly across ALL populations and non-β-thalassemia carriers may experience what we normally expect from fulminant myocarditis.
EDIT: For anyone else reading this comment, do NOT make assumptions about this if you are not a medical or public health professional (medical doctor, microbiologist, virologist, epidemiologist, etc.). SARS-CoV-2 is extremely complex and it doesn’t discriminate; it does affect different people differently, who may need different therapy. Some therapies may eventually be aimed at certain ages or sex, persons with certain genes, perhaps even location.
Rayne, I was reading something about the Plague in the last couple of days, and they said that because it had hit Europe so many times, that Europeans had made a genetic evolution that allowed them to withstand Covid 19 a bit better. But they said that it had not touch sub-Saharan Africa and that could explain why people of African decent were more impacted by Covid 19.
I cannot for the life of me remember where I read this. My apologies, but it struck me as a very interesting proposition.
I doubt that’s true. Would not explain why indigenous North and Central Americans have experienced the plague regularly and are now affected disproportionately by SARS-CoV-19. Portions of the African continent do experience plague — we just haven’t heard about it as regularly as we’ve heard about eurocentric experience.
I fully admit I have very little knowledge of South/Central America
Re the Jaimes et al pre-print, there is in a recent Cell paper on SARS-CoV-2 cell entry you might find interesting.
https://www.cell.com/cell/fulltext/S0092-8674(20)30229-4?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0092867420302294%3Fshowall%3Dtrue#secsectitle0010
If I follow both your argument and theirs, the suggestion from this data is not so much that SARS CoV-2 is mechanistically distinct from SARS CoV-1 but that SARS CoV-2 may be evolved to perform both the ACE2 binding and TMPRSS2 mediating priming steps more efficiently.
“Also bothers me that we haven’t seen any indications that persons who had been prescribed HCQ for autoimmune disorders were less likely to be affected by COVID-19.” I was wondering about this just from my layman’s POV.
“Patients with lupus, arthritis, other conditions are *already* on hydroxychloroquine. And we are diagnosing them with Covid-19 LEFT AND RIGHT.”
ht tps://www.statnews.com/2020/04/06/trump-hydroxychloroquine-fact-check/
Thank you!:
P J Evanssays:
April 6, 2020 at 11:41 am
Boris Johnson has just been moved to ICU
A site called Sludge has a post entitled “Pharma-Funded Group Tied to a Top Trump Donor Is Promoting Malaria Drug to the President” that offers one answer to the question, “Why hydroxychloroquine?”
I don’t know the site or how rigorous their reporting is: it seems a little wild-eyed to me. Google the title if you want more. But here are some lightly edited snips:
— On March 26, Job Creators Network, a conservative dark money nonprofit, launched a petition, a series of Facebook ads, and a blast text message campaign calling on Trump to “cut the red tape” and immediately make hydroxychloroquine available to treat patients. JCN was founded in 2011 by billionaire Home Depot co-founder Bernard Marcus, who spent more than $7 million through outside groups to help elect Trump in 2016. Marcus has said that he plans to spend part of his fortune to help re-elect Trump in 2020.
— JCN has been funded by Pharmaceutical Research and Manufacturers of America (PhRMA), which donated $500,000 to Job Creators Network in 2017. JCN’s hydroxychloroquine campaign has been run in partnership with a nonprofit called Physicians for Reform, which works with FreedomWorks [yes, Koch] to promote deregulatory health care policies. PhRMA gave $100,000 to Freedomworks in 2018.
So if Koch gets a win they have another arrow in their deregulation quiver, and some people make a buck.
Thanks, Bruce. I’d read that and I was still trying to figure out the angle, assuming they have all their facts right. Why would a pharma *group* work so cooperatively to push an off-patent, off-label, cheap-to-make drug?
The only thing I could think of is this is a no-holds barred assault on the FDA’s regulatory process, and that they are trying to make a point that the U.S. doesn’t need drug regulations any more than it needs environmental regulations.
I mean, Koch’s behind this, that’s the nexus between those two areas, drugs and environment.
But there must be a massive amount of money involved and we’re not seeing it. Where is it? Trump and his sidekicks must be making bank on this somehow. Where?
The $ don’t need to be Soros-level, though…
Making a couple of million by trading options (or even the underlying stock) should be easy enough w/ inside info. Teva is up about 50% since the announcement, Novartis is up about 20%, and Mylan is flat or off a little. And I’ll note that Novartis’ recent low was on 3/23, the date the campaign began (if the article is to be trusted).
Besides, there’s always fundraising off this stuff, whether it’s defending Dear Leader or blaming governmental overreach on closing beaches, churches, et al.
The Department of Veterans Affairs and the Justice Department’s Bureau of Prisons have both reported purchases of hydroxychloroquine since March 26, according to federal procurement records.
The Department of Veterans Affairs purchased $40,000 in hydroxychloroquine sulfate tablets from the pharmaceutical company McKesson, and another $168,000 from the Colorado-based generic drug distributor Golden State Medical Supply. Procurement records for both list them as “emergency” purchase orders to deal with the coronavirus outbreak.
The Bureau of Prisons’ purchase order does not mention the coronavirus. But the $60,000 purchase of hydroxychloroquine sulfate tablets from the company Premium Rx National came on March 31—in the midst of a worsening outbreak at the federal correctional facilities that the bureau oversees and days before President Trump announced that he was stockpiling millions of pills of the drug.
https://www.thedailybeast.com/the-bureau-of-prisons-just-bought-a-ton-of-hydroxychloroquine-trumps-covid-19-miracle-drug
Goddamn it. Now I’m wondering if they were planning to use inmates as test subjects — and potentially in violation of the Helsinki Declaration on human experimentation.
It could be just straight up theft of BOP funds but if Big Pharma’s aim is to ditch the FDA, they need guinea pigs.
Thanks for the link.
I’m reading that Boris Johnson, British Prime Minister who is infected with corona virus, has been admitted to ICU.
This drain on Britain’s capacity to provide adequate care for Covis-19 sufferers, by the man who delayed imposing effective social distancing measures while his Chief Science Officer blathered about “herd immunity, ” is at least (an all too rare) instance of negative personal consequence for leaders whose decisions have condemned many others to death.
I wish BJ a quick recovery so his bed in ICU is again available for the deserving ill.
Well, well… I may pray for the first time since I was about 10.
Not I. Don’t wish him death simply a slow and pain ful recovery
What goes around comes around
Trump is gobsmacked that Navy Capt. Crozier could write a letter that was five pages long!! Single-spaced!! Who reads that much? How did he have time to do it and do his job? (It was his job.) And he copied it “28” times or “a lot of times”. “He shouldn’t have done that.”
It’s almost artful how Trump totally avoids the substance of Capt. Crozier’s letter. Sensitive to feelings that must be boiling over in the Navy, especially after the Gallagher affair, Trump claims to be trying to save Crozier’s career by….spouting horseshit. JFC.
Trump, a guy who demands gold faucets in his bathrooms and went bankrupt six times, is also complaining about how much the Navy spends on a nuclear carrier. (An expense and mission that might be justly criticized, but that’s not why Trump brought it up.)
WTF covers it (that’s “Western Truck Fab” you snickerers, it’s in Hayward) but really I don’t think DJT can comprehend anything not in Sharpie or crayon.
Modly says he fired CAPT Crozier so DJT was spared the heat for now but he’s not smart enough to stay out of it.
I’m curious about why DJT thought the letter showed weakness if he hadn’t read it.
Hmmmmmmmmm……
Trump seems to regard “being weak ” – he defines it so broadly, he confuses it with being human – as the worst sin and the greatest possible weakness. That makes it impossible for him to be human or care about other humans.
Anything that involves empathy/sympathy or not being a bully is weakness, in Trmp’s broken mind.
To believe Trump’s false claim tonight – that he was concerned that Capt. Crozier’s career not be ruined “over a single slip-up” – we would have to forget that he devoted a fifty-year career to publicly humiliating people he’s fired. He relishes the power to do it without being held to account. He celebrates it with such abandon, he built a television empire and paved his way to the White House by doing it in front of the camera.
And we’ve seen that he can’t fire people in person: he always does it through someone else.
The Navy’s a big operation. It hires, retires, and fires thousands of people every year. It’s built to withstand abrupt changes in the chain of command. But what would hole it below the water line is to lose its Capt. Croziers and replace them with Tom Modlys and Eddie Gallaghers.
I see Modly had to be ordered to write an apology to the ship and to CAPT Crozier. We’ll see how the decision by SecDef Esper is evaluated by DJT after he gets over Grisham’s departure. There, that’ll do it.
Unfortunately, during peacetime is when the “ring-knockers” have their ascendancy until the next war forces competence to return.
Steve Herman on Twitter: 9:04 PM · Apr 6, 2020
An apology from @SECNAV for his comments to the crew of the USS Theodore Roosevelt.
https://twitter.com/W7VOA/status/1247329279253323776
Classic character assassination from a long-time lobbyist and government contractor: “I’m sorry I had to defame you….It was for your own good.”
The above discussions of ACE2, furin and TMPRSS2 with respect to SARS-CoV-2 virus are beyond my day-to-day experience, but this website by nephrologists looking into COVID-19 and ACE inhibitors and ARBs might be helpful to those of you who are familiar with the terms.
http://www.nephjc.com/news/covidace2
I’ve been interviewing patients with COVID-19 symptoms in respiratory illness clinics in the Boston area for the last two weeks. Several of them have subsequently been confirmed as SARS-CoV-2 virus positive and are now in the hospital. What may be reassuring, to Trump’s great consternation, not one of them has asked about trying hydroxychloroquine.
In somewhat related news. Mass General Hospital and Brigham and Women’s Hospital announced that starting today (Monday April 6, 2020) N95 masks will be decontaminated and returned to the original users (up to 20 times) using a hydrogen peroxide vapor process by Battelle.
Good news for our current nationwide shortage of personal protective equipment (PPE); however, my first association to the news, from being a regular emptywheel reader, was anthrax and Bruce Ivins.
https://www.battelle.org/newsroom/press-releases/press-releases-detail/battelle-develops-system-to-decontaminate-personal-protective-equipment-to-meet-growing-demand-during-covid-19-crisis
Josh Marshall on Twitter: 9:28 PM · Apr 6, 2020
Gov @GovPritzker confirms that the federal ‘Air Bridge’ flights from China, organized by the White House taskforce, are bringing PPE back from China which are then turned over to private companies. The states then have to bid against each other to purchase from those companies.
https://twitter.com/joshtpm/status/1247335425074696199
There were trillions of dollars invested in the January 2020 economic reality. The drug scam is part of their billion to one long shot chance of holding that reality. A dash to the rear deck rail of the Titanic if you will. Ten percent of the deaths in New York are 50 to 59. Are you old, have pre-existing conditions or are you poor? Then you get thrown under the bus in their scheme. Their only chance of survival is if the drug scam actually works and they “reopen” the economy. But the economy is not theirs to reopen. The shutdowns did not crash the economy. The restaurants saw killing loss of diners. Companies closed their campuses. Domestic air travel all but ceased. Social and business gatherings stopped cold or became cluster explosions. Some people thinking only of themselves are willing to take their chances. A majority would rather not be part of an infection chain.
The economy is not anyone’s to reopen until the virus is vanquished. Suggestions to the contrary should be attacked. Workers are already dying because of their employers’ incompetence.
https://www.washingtonpost.com/business/2020/04/06/supermarket-workers-deaths-coronavirus-/
Will they be able to charge any of these clowns with murder? Snake oil sales men just never seem to go out of businesses. They just find new target groups.
It also makes me think trump and these thug types have run out of money or other methods of making money. This is the new scam.
We know tabaco companies were sued. Ditto big pharma for opioids. There was some reports of Fox being sued for claims they made regarding the virus. Hopefully some one will sue Rudy and his gang. Hadn’t heard much from him in the recent past but now we know what he is up to. Too bad they can’t put him and a few others on ventilators. At least it would shut them up
I’m sure the base will be buying it. It’s just so unfortunate others won’t be able to access the medication they require
Im sure the virus can wait two years for its research, treatments, and its effects. Ill tell the virus company to put a freeze on the global account.
[Welcome to emptywheel. Please use a more differentiated username when you comment next as we have several community members named “Josh.” Thanks. /~Rayne]
First, nobody is advocating waiting for outcome of research; nobody should plunge into using a drug which on the face of it doesn’t work well enough to outweigh its manifest risks.
Second, if some asshole in the White House had acted responsibly we’d have all kinds of time and we wouldn’t be cooped up, but here we are.
Third, learn how to use punctuation.
Fourth, you don’t have the cred to be a smartass here. Earn it or leave.
Meanwhile, in not-so-merry Olde England:
https://www.telegraph.co.uk/global-health/science-and-disease/coronavirus-tests-never-heard-hold-key-exit-lockdown/
If it’s in the Torygraph, it’s favorable to the government. It is certainly favorable to the minders of Porton Down. It normally takes heat for its more than a century of work on chemical and biological weapons. I’m happy that it might be involved in something productive, all hands on deck and all that, but the story’s figures for hospitalizations, use of ICU among those admitted, and mortality seem low.
Meanwhile, in TEXAS [via Laura Rozen]:
https://twitter.com/PatrickSvitek/status/1247244505562198018
3:27 PM · Apr 6, 2020
The first question any rational journalist should ask is whether these patients consented to being used in human experimentation.
The next question is who is managing data collection on these patients so it is kept private but shareable.
Not all of Texas is cheerfully following Abbott and Patrick to their desired destination (whatever that is).
https://www.myplainview.com/news/article/Plainview-extends-stay-at-home-order-Hale-County-15179098.php
Benjamin, “I want to say one word to you. Just one word….Are you listening? Plaquenil.”
According to Ellen Hopkins, “The president’s family trusts all invest in a mutual fund whose largest holding is the drugmaker of Plaquenil, the brand-name version of hydroxychloroquine.” https://twitter.com/EllenHopkinsLit/status/1247377258597081090
OMG
It’s just too f#cking early in the morning to feel like I’m going to have a heart attack.
THE VULTURES
SENATOR DAVID PERDUE
https://twitter.com/ossoff/status/1247275032109334528
5:28 PM · Apr 6, 2020
From the linked AJC article:
Meanwhile for WISCONSIN GOP:
US SUPREME COURT VOTES TO SUPPRESS VOTING.
https://twitter.com/Hickenlooper/status/1247350633608273921 [Running for U.S. Senate. Join our team]
10:29 PM · Apr 6, 2020
#RIP GOP
UNSIGNED majority opinion.
GINSBURG writes the SIGNED By FOUR dissent.
GINSBURG:
TRUMP WEIGHS IN:
https://twitter.com/realDonaldTrump/status/1247382518376140800
12:35 AM · Apr 7, 2020
Pretty much what Kelly’s GOP colleagues on the Wisconsin Supreme Court said before they voted to prohibit a delay in an election in which Kelly’s seat on the court is at stake. As Trump admits, the GOP would not win another election if it did not cheat to suppress the vote.
Marcy retweeted this last night:
https://twitter.com/brianefallon/status/1247313226368520192
8:00 PM · Apr 6, 2020
via nycsouthpaw: https://twitter.com/mirandayaver/status/1247306262410186752
7:32 PM · Apr 6, 2020
TRUMP ON ELECTIONS:
https://twitter.com/RiegerReport/status/1247309002163314694
7:43 PM · Apr 6, 2020
WARREN ON ELECTIONS
Protecting Our Elections During the Coronavirus Pandemic
https://medium.com/@SenWarren/protecting-our-elections-during-the-coronavirus-pandemic-efd3da6dbcaf 4/7/20
BIDEN ON ELECTIONS
https://twitter.com/daveweigel/status/1247536295682830336
10:46 AM · Apr 7, 2020
[I know I’m repeating myself here]:
BLECH
In-person voting is also a social thing. I chat a bit with the pol workers, if it’s a slow time. You don’t get that with vote-by-mail. (I prefer in-person – but I refuse to use the machines until they’re properly tested and certified, and the “voting center” setup that L.A. county had for the primary makes it *harder* to vote in person.)
Very late to the party here – but thank you for posting this, Rayne! Of all the lies and misinformation that this reckless, incompetent president has spread and manufactured in his illegitimate term, this is the most pernicious and dangerous. I am curious if there is a grift here too. There must be some sort of money to be made in this hydroxychloroquine hubbub. Grandpa Guiliani must have some sort of scam going that El Trumpo is trying to get in on. Either that, or else Trump knows his hotels and resorts will be bankrupt if the lockdown goes on past April 30th and he is grasping for any straw to cling to so that his shabby “empire” doesn’t collapse before Election Day.
Meanwhile in MICHIGAN
Detroit rep says hydroxychloroquine, Trump helped save her life amid COVID-19 fight
https://www.freep.com/story/news/local/michigan/detroit/2020/04/06/democrat-karen-whitsett-coronavirus-hydroxychloroquine-trump/2955430001/
Published 2:52 p.m. ET April 6, 2020 | Updated 6:01 p.m. ET April 6, 2020
TRUMP weighs in:
https://twitter.com/realDonaldTrump/status/1247268841845141504
5:03 PM · Apr 6, 2020
A critical worker is “still awaiting results” of his Covid-19 test. Thanks, Donald.
Odd that neither Trump nor Whitsett are waiting for medical professionals to support their personal feelings regarding an unproven remedy.
Note, too that she had used/been prescribed hydroxychloroquine before [or at least that’s what this sentence sounds like to me] for Lyme disese:
…just found that interesting.
I hear Comet is a wonder, makes dirty sinks sparkling white. I’ll have to give it a try on my teeth.
So he found his first miracle testimonial for his campaign ad.
A goddamn stupid Democrat in Michigan.
Just perfect.
Navarro memos warning of mass coronavirus death circulated in January
https://www.axios.com/exclusive-navarro-deaths-coronavirus-memos-january-da3f08fb-dce1-4f69-89b5-ea048f8382a9.html
If I believed in reincarnation, I would swear that in Trump, Jim Jones and David Koresh have found a new home.
Then they knew. They let it happen on purpose. They can say Trump was reluctant but every single person who received Navarro’s memos had a duty to act appropriately.
And none of them did. No action is a decision.
I guess I’ll have to reread US v. Alstoetter and the other Subsequent Nuremberg Trials. Might come in handy whenever Trump leaves office.
January 29, 2020 Navarro memo to Trump:
February 23, 2020 Memo: Navarro to White House Task Force:
That last line has proven true, but at the time, Navarro and Trump would have had to make the case with Congress to allow it to reach the same conclusion. That several Republican Senators apparently made insider trades suggests that at least a few Congresscritters were clued in.
Sanofi, the maker of the brand name, has been charged and fined with bribery
https://www.sec.gov/news/press-release/2018-174
Also, Trump has been buying up the drug for the national stockpile. There seems to be a limited hangout story about Trump’s stock holdings, which is interestingly sourced… but the real story is the spike in sales and the bribery history
https://www.fda.gov/media/136537/download
I’m wondering if they’re buying the brand name or the generics?
From the Johns Hopkins Daily Covid 19 blast:
“The US Food and Drug Administration currently reports nationwide shortages for both chloroquine and hydroxychloroquine. A number of clinical trials for these two drugs have been registered with the National Institutes of Health; however, none of those listed have yet reported results.
In response to the shortage, President Trump called on India to relax export restrictions to allow hydroxychloroquine to be shipped to the United States, and at yesterday’s White House Coronavirus Task Force briefing, he referenced potential “retaliation” if India did not comply with the request. India reportedly acquiesced to the request and will allow hydroxychloroquine to be exported to the United States. This request follows a US government announcement that it would restrict shipments of personal protective equipment to other countries under the Defense Production Act.”
As someone who has been taking Plaquenil for over two years, this is absolutely chilling.
Can I ask what do you pay for a dose? I’m showing a 40$ per month rate. Curious, but respect your privacy if you choose not to disclose
Willis, just seeing your comment. I don’t know what to say, because I was able to get a three months supply eac time. The last refill was $60, but that was a while ago. And I have stupid good insurance through my husband’s job. [German company].
My pharmacy can get no more and they sent me to the competition because they hear dthey had some, today. They won’t fill three months and they won’t fill my prescription until early May. I will try to remember to let you know what the new batch is. My understanding is that it has really shot up.
Well, this guy seems not too convinced about the presidential pill:
https://twitter.com/jeremyfaust/status/1246801663345618944