wattsupwiththat--2020-05-01--EPA COV-19 Environmental Justice Grant Funding

The mission of the United States Environmental Protection Agency ( EPA ) is to protect human health and the environment .
I think most people would agree with me that the intent is to protect human health from air , water , and land environmental risks .
In that light it was disconcerting to me to see the following announcement from for $ 1 million in grants to states to “ help local environmental justice communities address COVID-19 concerns faced by low-income and minority communities ” .
EPA defines environmental justice as “ the fair treatment and meaningful involvement of @ @ @ @ @ @ @ , national origin , or income , with respect to the development , implementation , and enforcement of environmental laws , regulations , and policies .
This goal will be achieved when everyone enjoys : the same degree of protection from environmental and health hazards , and equal access to the decision-making process to have a healthy environment in which to live , learn , and work.
” The request for applications states that applications must address the impacts of COVID-19 through public education , planning , and training activities related to COVID-19 @ @ @ @ @ @ @ 1 ) sharing information related to EPA approved disinfectants to combat COVID-19 , 2 ) addressing underserved residents ’ increased exposure to in-home pollutants and healthy housing issues as an unintended consequence of local stay-at-home orders , and 3 ) training of community health workers as community educators for environmental justice communities .
While there is no disputing low-income and minority communities have historically been disproportionately impacted by air , water , and land environmental risks the question is whether COVID-19 grants are an appropriate way to address those risks .
EPA plans @ @ @ @ @ @ @ approximate amount of $ 200,000 each .
Given what the release says about what the money is to be used for , wouldn ’ t this be a more appropriate thing for the Department of Health or Center for Disease Control to do ?
Finally , grants are due at the end of June , grants start October 1 and the grants can run for two years , what will there be to do in that timeframe for the education , planning and training activities ?
EPA Provides Grant Funding to Support Environmental @ @ @ @ @ @ @ York , New Jersey , Puerto Rico and U.S. Virgin Islands Impacted NEW YORK ( April 30 , 2020 ) The U.S. Environmental Protection Agency ( EPA ) is working to improve the environment and public health conditions of low-income and minority communities through our daily efforts to ensure all Americans have clean air , safe water , and access to information to make decisions to protect personal and public health .
In response to the COVID-19 public health emergency , EPA is making $ 1 million in grant funding available to states @ @ @ @ @ @ @ COVID-19 concerns faced by low-income and minority communities .
Through the State Environmental Justice Cooperative Agreement Program , EPA will provide funds to states , local governments , tribes and U.S. territories to work collaboratively with environmental justice communities to understand , promote and integrate approaches to provide meaningful and measurable improvements to public health and the environment .
“ Environmental justice grants aim to support public education , training , and emergency planning for communities across the country impacted by COVID-19 , regardless of their zip code , ” said EPA Administrator @ @ @ @ @ @ @ part of EPA ’ s effort to actively fight the COVID-19 pandemic that is having a disproportionate impact on low-income and minority communities.
” The grant funding will be used to support public education , training , and emergency planning for communities impacted by COVID-19 .
Projects could include sharing information related to EPA-approved disinfectants to combat COVID-19 ; addressing increased exposure of residents to in-home pollutants and healthy housing issues ; and training community health workers .
EPA anticipates awarding five grants of approximately $ 200,000 each for up to a two-year @ @ @ @ @ @ @ to develop innovative plans and processes to conduct effective outreach to underserved communities , especially in places where Internet access may not be readily available to all residents .
Interested applicants must submit proposal packages on or before June 30 , 2020 to be considered for the available funding .
Roger Caiazza blogs on New York energy and environmental issues at Pragmatic Environmentalist of New York .
This represents his opinion and not the opinion of any of his previous employers or any other company he has been associated with .

Guest post by Roger Caiazza
The mission of the United States Environmental Protection Agency (EPA) is to protect human health and the environment. I think most people would agree with me that the intent is to protect human health from air, water, and land environmental risks. In that light it was disconcerting to me to see the following announcement from for $1 million in grants to states to “help local environmental justice communities address COVID-19 concerns faced by low-income and minority communities”.
EPA defines environmental justice as “the fair treatment and meaningful involvement of all people regardless of race, color, national origin, or income, with respect to the development, implementation, and enforcement of environmental laws, regulations, and policies. This goal will be achieved when everyone enjoys: the same degree of protection from environmental and health hazards, and
equal access to the decision-making process to have a healthy environment in which to live, learn, and work.”
The request for applications states that applications must address the impacts of COVID-19 through public education, planning, and training activities related to COVID-19 including but not limited to: “1) sharing information related to EPA approved disinfectants to combat COVID-19, 2) addressing underserved residents’ increased exposure to in-home pollutants and healthy housing issues as an unintended consequence of local stay-at-home orders, and 3) training of community health workers as community educators for environmental justice communities.
While there is no disputing low-income and minority communities have historically been disproportionately impacted by air, water, and land environmental risks the question is whether COVID-19 grants are an appropriate way to address those risks. EPA plans to award five cooperative agreements in the approximate amount of $200,000 each. Given what the release says about what the money is to be used for, wouldn’t this be a more appropriate thing for the Department of Health or Center for Disease Control to do? Finally, grants are due at the end of June, grants start October 1 and the grants can run for two years, what will there be to do in that timeframe for the education, planning and training activities?
EPA Provides Grant Funding to Support Environmental Justice Communities Impacted by COVID-19; New York, New Jersey, Puerto Rico and U.S. Virgin Islands Impacted Contact: Elias Rodriguez, (212) 637-3664, rodriguez.elias@epa.gov NEW YORK (April 30, 2020) The U.S. Environmental Protection Agency (EPA) is working to improve the environment and public health conditions of low-income and minority communities through our daily efforts to ensure all Americans have clean air, safe water, and access to information to make decisions to protect personal and public health. In response to the COVID-19 public health emergency, EPA is making $1 million in grant funding available to states to help local environmental justice communities address COVID-19 concerns faced by low-income and minority communities. Through the State Environmental Justice Cooperative Agreement Program, EPA will provide funds to states, local governments, tribes and U.S. territories to work collaboratively with environmental justice communities to understand, promote and integrate approaches to provide meaningful and measurable improvements to public health and the environment. “Environmental justice grants aim to support public education, training, and emergency planning for communities across the country impacted by COVID-19, regardless of their zip code,” said EPA Administrator Andrew Wheeler. “These grants are part of EPA’s effort to actively fight the COVID-19 pandemic that is having a disproportionate impact on low-income and minority communities.” The grant funding will be used to support public education, training, and emergency planning for communities impacted by COVID-19. Projects could include sharing information related to EPA-approved disinfectants to combat COVID-19; addressing increased exposure of residents to in-home pollutants and healthy housing issues; and training community health workers. EPA anticipates awarding five grants of approximately $200,000 each for up to a two-year funding period. The agency encourages applicants to develop innovative plans and processes to conduct effective outreach to underserved communities, especially in places where Internet access may not be readily available to all residents. Interested applicants must submit proposal packages on or before June 30, 2020 to be considered for the available funding. To apply for funding: https://www.epa.gov/environmentaljustice/state-environmental-justice-cooperative-agreement-program
Roger Caiazza blogs on New York energy and environmental issues at Pragmatic Environmentalist of New York. This represents his opinion and not the opinion of any of his previous employers or any other company he has been associated with.
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wattsupwiththat--2020-05-02--Pseudo-Science behind the Assault on Hydroxychloroquine

This is a research article published as information for health care professionals and public officials , and for an open peer review .
It is not medical advice .
I reviewed the scientific literature on hydroxychloroquine ( HCQ ) , azithromycin ( AZ ) , and their use for COVID-19 .
My conclusions : • HCQ-based treatments are effective in treating COVID-19 , unless started too late .
• Studies , cited in opposition , have been misinterpreted , invalid , or worse .
• HCQ and AZ are some of the most tested and safest prescription drugs .
• @ @ @ @ @ @ @ including heart arrhythmia .
QTc prolonging drugs might amplify this tendency .
Millions of people regularly take drugs having strong QTc prolongation effect , and neither FDA nor CDC bother to warn them .
HCQ+AZ combination , probably has a mild QTc prolongation effect .
Concerns over its negative effects , however minor , can be addressed by respecting contra-indications .
• Effectiveness of HCQ-based treatment for COVID-19 is hampered by conditions that are presented as precautions , delaying the onset of treatment .
For examples , some states require that COVID-19 patients @ @ @ @ @ @ @ settings .
• The COVID-19 Treatment Panel of NIH evaded disclosure of the massive financial links of its members to Gilead Sciences , the manufacturer of a competing drug remdesivir .
Among those who failed to disclose such links are 2 out of 3 of its co-chairs .
• Despite all the attempts by certain authorities to prevent COVID-19 treatment with HCQ and HCQ+AZ , both components are approved by FDA , and doctors can prescribe them for COVID-19 .
Hydroxychloroquine ( HCQ ) was accepted as a COVID-19 treatment by the medical @ @ @ @ @ @ @ early April .
67 % of the US physicians said they would prescribe HCQ or chloroquine CQ for COVID-19 to a family member ( Town Hall , 2020-04-08 ) .
An international poll of doctors rated HCQ the most effective coronavirus treatment ( NY Post , 2020-04-02 ) .
On April 6 , Peter Navarro told CNN that “ Virtually Every COVID-19 Patient In New York Is Given Hydroxychloroquine.
” This might explain decrease in COVID-19 deaths in the New York state after April 15 .
The time lag is because COVID-19 deaths @ @ @ @ @ @ @ symptoms .
But on April 21 , several perfectly coordinated events took place , attacking HCQ ’ s use for COVID-19 patients .
• The COVID-19 Treatment Guidelines Panel of the National Institute of Health issued recommendations with negative-ambivalent stance regarding the use of HCQ as a COVID-19 treatment .
This surprising stance was taken contrary to the ample evidence of the efficacy and safety of HCQ and despite absence evidence of its harm .
The panel also strongly recommended against the use of hydroxychloroquine with azithromycin ( AZ ) , the combination @ @ @ @ @ @ @ the same day , a paper ( Magagnoli , 2020 ) was posted on a pre-print server medRxiv , insinuating that HCQ is not only ineffective , but even harmful .
This not-yet peer reviewed paper , by unqualified authors with conflicts of interest , received wall-to-wall media coverage , as it if were a cancer cure .
It used data from Veterans Administration hospitals , spicing its effects .
The paper has shown to be somewhere between junk science and fraud .
• Rick Bright , a government official who was probably @ @ @ @ @ @ @ preparedness to the epidemic than most others , and had been re-assigned to a lower position earlier , emerged as a “ whistleblower.
” He claimed he had been demoted for opposing hydroxychloroquine , the claim to be soon debunked by documents bearing his signature .
The media also gave him a wall-to-wall coverage .
On April 24 , the FDA struck its own blow , issuing a stern warning against use of HCQ for COVID-19 treatment .
While these warnings are not binding to doctors , they do produce a chilling effect @ @ @ @ @ @ @ receive necessary treatment , or they receive it with a delay , sharper decreasing its effect .
This allows detractors to question HCQ efficacy even more aggressively .
Below , I review problems in the NIH COVID-19 Treatment Guidelines and other sources , used to wage anti-HCQ propaganda .
The relevant section of ( COVID-19 Treatment Guidelines Panel , 2020 ) is Potential Antiviral Drugs .
The antiviral treatment recommendations ( more accurately , failure to provide recommendations ) include : Notice that CQ and HCQ are addressed together , although these are @ @ @ @ @ @ @ clearly superior to CQ both in efficiency and safety .
Also notice that the basic recommendation of “ insufficient clinical data to recommend either for or against ” is given to both HCQ and Remdesivir .
However , the recommendation for HCQ goes further to state that when using HCQ , “ clinicians should monitor the patient for adverse effects ( AEs ) , especially prolonged QTc interval ” .
Practically , this means that HCQ should be used only in hospital settings .
No such restrictions are set for Remdesivir , for @ @ @ @ @ @ @ .
It goes against all logic .
The demand to use HCQ only in hospital settings means : • HCQ treatment will be delayed until a patient decides to be admitted to a hospital , thus lowering HCQ ’ s efficiency • Hospitals will quickly become overwhelmed with COVID-19 patients This drug combination is the most effective and widely used treatment for COVID-19 , and the Panel recommends against it !
The Panel criticizes some studies of patients ’ treatment with HCQ+AZ for the absence of a control group .
Stephen McIntyre tweeted @ @ @ @ @ @ @ used it : “ there ’ s a very large control group of COVID19 patients not receiving this drug combination : hospitals and morgues are full of them.
” There are only two studies , quoted by the Panel against HCQ+AZ , ( Molina , 2020 ) and ( Chorin , 2020 ) .
Both are misinterpreted by the Panel .
Despite ( Molina , 2020 ) ’ s angry tone and aggressiveness , it reports no results contradicting efficiency of HCQ or HCQ+AZ .
The paper describes treatment of 11 hospitalized COVID-19 @ @ @ @ @ @ @ , one had AIDS , and almost all were in a bad shape : “ at the time of treatment initiation , 10 of the 11 patients had a fever and received nasal oxygen therapy.
” Using HCQ+AZ , 10 of the patients ’ lives were saved .
The article ’ s point of contention is that when they tested these patients , 5-6 days after the treatment initiation , they still found CoV2 RNA in 8 out of 10 .
Virus RNA is a molecule .
Some viral RNA remains in patients @ @ @ @ @ @ @ it is neither harmful nor infectious .
Detecting viral RNA depends on the sensitivity of the testing equipment .
The study ’ s title is No evidence of rapid antiviral clearance or clinical benefit with the combination of hydroxychloroquine and azithromycin in patients with severe COVID-19 infection seems to be lost on the Panel .
The Panel also quotes ( Chorin , 2020 ) as evidence that HCQ+AZ therapy causes QTc prolongation .
QTc prolongation is not a health condition itself , but a warning sign that a person is at higher risk @ @ @ @ @ @ @ , heart arrhythmia , or tachycardia , which might lead to cardiac arrest and death ( Simpson , 2020 ) .
Nevertheless , none of the patients , treated with HCQ+AZ , suffered TdP or arrhythmia .
Four patients died , but none of them had an arrhythmia .
Other studies , in which COVID-19 patients are treated with HCQ+AZ , reported taking patients off this medicine after QTc exceeds 500ms .
But the treatment may have already had its effect at that time or later , while HCQ remained in the bloodstream @ @ @ @ @ @ @ .
It provides no information on whether QTc prolongation was caused by the disease or the therapy .
( FDA WARNING , 2020 ) , issued on April 24 , piggybacks on the COVID-19 Panel Guidelines .
It says This statement is confused , and probably not true about hydroxychloroquine .
See below .
I think that HCQ+AZ is a proven treatment for COVID-19 .
There is a difference between proven treatment and approved treatment .
HCQ+AZ is not approved but proven , because many patients have been treated with this combination and @ @ @ @ @ @ @ COVID-19 !
See ( Bansal , 2020 ) and ( Wang , et al.
, 2020 ) .
The media hysteria played its role , too .
The articles about the supposed dangers of HCQ , with detailed description of the symptoms , triggered complaints even before the April 24 warning .
And there are people who tried to self-medicate – in the situation when authorities make it difficult to obtain prescription for HCQ – and took the wrong drug or overdosed .
Also , QT interval prolongation is not an event , @ @ @ @ @ @ @ urging and advertisement guarantee that the FDA will receive mountains of complaints .
HCQ & CQ are two different drugs .
HCQ is clearly superior to CQ .
HCQ has already been selected over CQ .
Discussing these two drugs as if they were co-equal in COVID-19 treatment is misleading and a sign of bad faith .
HCQ and AZ are some of the most widely prescribed drugs and have been prescribed for decades .
HCQ is as safe as a prescription drug can be .
AZ is an antibiotic , and it @ @ @ @ @ @ @ be .
Because these drugs have been prescribed so widely , their adverse effects have been studied .
A few adverse events associated with them have been reported .
Combining these few anecdotal cases , some medical researchers have raised some concern , as a precaution .
Doctors understand this .
Statisticians understand this .
But unscrupulous media uses this information to mislead the naïve public and even public figures Remdisivir is the opposite .
It has been developed very recently and has been scarcely used .
There is little information about its @ @ @ @ @ @ @ present this lack of evidence of adverse effects as evidence of the absence of adverse effects .
The leading objection against HCQ / HCQ+AZ is possible QTc prolongation .
Most professionals refer to ( CredibleMeds.org , 2020 ) which puts both HCQ and AZ in the category of Known Risk of TdP ( KR ) .
I think that HCQ was listed in that category by mistake .
A review of the literature reveals only few anecdotal cases .
Some of them are poisoning by large overdoses of HCQ .
Then there are @ @ @ @ @ @ @ , suddenly got sick and recovered when HCQ was withdrawn .
While there are millions of people continuously taking HCQ , only a few cases of cardiac events have been reported .
Even if HCQ was the cause of these rare cases , which is usually unknown , it is still statistically insignificant .
It is much safer than driving .
Other antivirals are known to cause QTc prolongation too but are not being pulled from practice .
In the case of HCQ , it seems that a precaution principle has prevailed over @ @ @ @ @ @ @ is in the KR category , just like many other antibiotics , including Erythromycin .
I have never heard of patients requiring QTc monitoring , when taking Erythromycin .
Attention of the Trump Derangement Syndrome crowd : many widely used psycho-active drugs are also listed in the KR category .
That includes anti-psychotic Haloperidol , anti-depressants Escitalopram ( Cipralex , Lexapro ) and Citalopram ( Celexa ) .
The most reliable source of information about arrhythmia risks is the American College of Cardiology .
( Simpson , 2020 ) in the Cardiology Magazine @ @ @ @ @ @ @ .
In other words , after over 50 years of effective use , HCQ and AZ have proven their safety and efficacy .
There is no reason for fear , except the fear itself .
But some people might be vulnerable , so the article explains how to calculate an individual Risk Score for QTc prolongers .
Individuals with higher Risk Score might need QTc monitoring .
Also , the authors suggest avoiding other QTc prolonging medications in the time of HCQ+AZ treatment .
The cardiologists who wrote this article did not dismiss @ @ @ @ @ @ @ pertaining to it and suggest proper mitigation measures .
Other literature also suggests low risk of HCQ and AZ .
( Prutkin , 2020 ) : HCQ and AZ have other known contra-indications , but they are out of the scope here .
Many studies show that COVID-19 causes heart arrhythmia .
Cardiac arrest , not directly caused by respiratory damage , is one of the leading direct causes of COVID-19 deaths .
( Bansal , 2020 ) is a review .
It finds that It also notes that CoV2 virus might cause @ @ @ @ @ @ @ possibility of a treatment impact is mentioned as a less likely one .
( Wang , et al.
, 2020 ) finds that 44 % of the patients transferred to ICU developed arrhythmia .
None of them received HCQ or CQ .
Most of the patients received an unrelated anti-viral and an antibiotic .
Only in 18 % of the patients the antibiotic was AZ .
At least some of the patients developed an arrhythmia before the treatment .
Thus , the hypothesis that CVOID-19 patients experience QTc prolongation and arrhythmia because of @ @ @ @ @ @ @ HCQ+AZ treatment , is well founded .
AZ may increase the odds of QTc prolongation in COVID-19 patients , who would otherwise die from cardiac arrest or multiple organs failure .
The media and professional publications report a sharp increase of mortality from cardiac arrest at home in the last few weeks .
Some of these cases are known to be COVID-19 , but most of them are not tested .
Could many of them be happening due to the cardiac damage caused by COVID-19 ?
Can the cardiac impact of COVID-19 be @ @ @ @ @ @ @ people take regularly ?
There are countless variables confounding this statistic .
There is an especially sharp increase in home cardiac arrests in New York , which is usually explained by people ’ s reluctance to call an ambulance or ER .
( Kochi , 2020 ) provides in-depth explanation of the cardiac effects of respiratory infections and interaction with QTc prolongation medications .
Gone unmentioned are HCQ ’ s positive cardiac effects .
They were widely reported before HCQ had misfortune of being mentioned by President Trump .
For example , Taking @ @ @ @ @ @ @ Heart Risk by 17 % The article is based on ( Jorge , 2019 ) .
These findings might be applicable only to long term taking of HCQ , not a 5-day course for COVID-19 , but the same can be said about the alleged negative cardiac effects .
Listed here are several other papers , influential in the media , but not in the science .
These papers span the range from erroneous to … non-existent .
( Magagnoli , 2020 ) is a not peer-reviewed pre-print .
It makes a retrospective @ @ @ @ @ @ @ patients , who received HCQ or HCQ+AZ treatment prior to April 11 , in Veterans Affairs hospitals .
In the Abstract , it claims that a larger percentage of HCQ treated patients died compared to untreated patients .
This ignores the fact that HCQ or HCQ+AZ treatment was given only in the most desperate cases , frequently as compassionate care .
Deep inside of the manuscript , it does acknowledge that initial conditions of the HCQ and HCQ+AZ groups was much worse than those of the untreated group , but then ignores it @ @ @ @ @ @ @ the “ study ” was published on April 21 .
It received crushing criticism in the comments and was replaced with another one on April 23 , hiding those comments .
Casting even further doubt on the credibility of this study , one of the authors disclosed Gilead funding for another research .
This work was funded by a NIH grant .
Despite its multiple flaws , lack of peer review , and obscurity of the authors , this pre-print immediately received wall-to-wall media coverage .
Given these circumstances , this work looks @ @ @ @ @ @ @ a scientific one .
( Tang , 2020 ) is a not peer-reviewed pre-print .
It reports results of a clinical trial in China , in which HCQ was given to patients 16-17 days after onset of the disease .
This is too late for an anti-viral to work .
Thus , this study describes the incorrect use of HCQ , rather than efficacy or safety of the drug .
From the comments : Once again , despite its obvious errors , the study was widely covered , including the New York Times @ @ @ @ @ @ @ article addresses the obvious lateness of the drug ’ s application .
( Mahevas , 2020 ) is another not peer-reviewed pre-print .
Didier Raoult and his colleagues replied to it with a bluntness , rare in scientific journals : Scientific fraud to demonstrate the lack of efficacy of hydroxychloroquine compared to placebo in a non-randomized retrospective cohort of patients with Covid : Response to MAHEVAS et al .
, MedRxiv , 2020 .
( Brouqui , et al.
, 2020 ) .
( Mahevas , 2020 ) also gathered many negative comments @ @ @ @ @ @ @ patients at 22 hospitals in New York is being conducted by the University at Albany School of Public Health under the management of dean David Holtgrave .
Although the study was not finished , Mr. Holtgrave already announced that the results are negative : “ We don ’ t see a statistically significant difference between patients who took the drugs [ HCQ , HCQ+AZ ] and those who did not , ” according to CNN .
New York Governor Andrew Cuomo referred to the results as neither positive nor negative , per CNN @ @ @ @ @ @ @ even pre-print , reporting these results , has been published , as of April 29 ( searches on Google Scholar , PubMed , and medRxiv were conducted for Holtgrave hydroxychloroquine ; Holtgrave COVID-19 ) .
New York and other “ resistance ” states make patients jump through hoops to obtain HCQ .
As an anti-viral , it should be taken as soon as possible .
Dr. Vladimir Zelenko explained that in his letter , which is worth reading in its entirety : He refers to patients in the high-risk category – older than @ @ @ @ @ @ @ or shortness of breath .
The resistance states established onerous requirements that delay HCQ treatment for days .
This sharply lowers the efficiency of the treatment , and possibly increases TdP risks .
The mixed results , promised by Mr. Holtgrave , might be caused by this delay .
On March 28 , Russia announced a COVID-19 treatment based on Mefloquine .
Mefloquine , invented in the US in 1970s , is another anti-malaria drug , similar to HCQ .
In the West , Mefloquine was withdrawn from use after a controversy about @ @ @ @ @ @ @ use HCQ .
From a Russian brochure ( Nikiforov , 2020 ) : The mechanisms of HCQ and HCQ+AZ action are explained ( Hache & Raoult , 2020 ) .
On March 27 , WHO erected another roadblock to treating COVID-19 patients with HCQ .
WHO stated that HCQ was not only insufficiently tested ( which was true at that time ) , but that it was considered for COVID-19 at much higher doses than for malaria .
This is dangerous misinformation .
HCQ dosage for COVID-19 is the same or lower than @ @ @ @ @ @ @ .
WHO was aware of this , because it was already conducting clinical trials including HCQ and a number of other Big Pharma drugs .
Yet , as of April 29 , this paragraph still appears there .
This act alone justifies not only defunding but ignoring WHO .
Google and Facebook adhered to WHO on everything related to COVID-19 .
Together with Twitter , they purged information favorable to HCQ .
These is outrageous behavior for telecommunications and computational services providers .
• It seems that the main contra-indication for HCQ treatment @ @ @ @ @ @ @ needed for healthy individuals below age 50 .
• Persons in the President ’ s circle were claiming that HCQ / HCQ+AZ are unproven treatments .
That might have been true a month ago , but not now .
These drugs are proven by practice and by failure of its opponents to disprove their efficacy and relative safety .
• The Guidelines are accompanied by a financial disclosure of the panel members .
Weirdly , this disclosure covers a period of 11 months : May 1 , 2019 to March 31 , 2020 @ @ @ @ @ @ @ for some reason .
Nevertheless , 9 out of 50 members of the panel disclosed financial ties to Gilead .
Gilead ’ s Remdesivir is an inferior competitor to HCQ – more expensive , almost untested , and less efficient ( as far as the little testing with it has shown ) .
HCQ is a generic drug with low profit margin .
Gilead Sciences directly participates in WHO trials of Remdesivir as a COVID-19 treatment .
• HCQ / HCQ+AZ are prescribed by a doctor .
They are not OTC and should @ @ @ @ @ @ @ HCQ+AZ is the most common treatment .
HCQ acts on its own but is much more effective with Zinc ; AZ is an antibiotic and a source of Zinc .
See Dr. Zelenko ’ s regimen is HCQ+AZ+Zinc .
• There is a live document by Michael J .
A. Robb , M.D.
, tracking effectiveness of HCQ-based treatments https : //drive.google.com/file/d/1w6p_HqRXCrW0_wYNK7m_zpQLbBVYcvVU/view Brouqui , P. , Million , M. & Raoult , D. , 2020 .
Scientific fraud to demonstrate the lack of efficacy of hydroxychloroquine compared to placebo in a non-randomized retrospective @ @ @ @ @ @ @ to MAHEVAS et al .
, MedRxiv , 2020 .
Mediterranee Infection , 24 04 .
Chorin , E. e. a. , 2020 .
The QT Interval in Patients with SARS-CoV-2 Infection Treated with Hydroxychloroquine/Azithromycin .
medRxiv , 3 April .
CredibleMeds.org , 2020 .
COMBINED LIST OF DRUGS THAT PROLONG QT AND/OR CAUSE TORSADES DE POINTES ( TDP ) .
[ Online ] Available at : https : //crediblemeds.org/pdftemp/pdf/CombinedList.pdf FDA WARNING , 2020 .
FDA cautions against use of hydroxychloroquine or chloroquine for COVID-19 outside of the hospital … .
[ Online @ @ @ @ @ @ @ Gautret , P. & Raoult , D. e. a. , 2020 .
Clinical and microbiological effect of a combination of hydroxychloroquine and azithromycin in 80 COVID-19 patients with at least a six-day follow up : A pilot observational study .
Travel Medicine and Infectious Disease , 4 April .
Hache , G. & Raoult , D. e. a. , 2020 .
Combination of hydroxychloroquine plus azithromycin as potential treatment for COVID 19 patients : pharmacology , safety profile , drug interactions and management of toxicity.. Mediterranee Infection , 22 April .
Jorge , @ @ @ @ @ @ @ Use and Cardiovascular Events Among Patients with Systemic Lupus Erythematosus and Rheumatoid Arthritis .
American College of Rheumatology .
Kochi , A. e. a. , 2020 .
Cardiac and arrhythmic complications in patients with COVID-19.. Journal of Cardiovascular Electrophysiology , 08 April .
Magagnoli , J. e. a. , 2020 .
Outcomes of hydroxychloroquine usage in United States veterans hospitalized with Covid-19 .
medRxiv , 23 April .
Mahevas , M. e. a. , 2020 .
No evidence of clinical efficacy of hydroxychloroquine in patients hospitalized for COVID-19 infection with oxygen requirement : @ @ @ @ @ @ @ data to emulate a target trial .
medRxiv , 14 April .
Molina , J. M. e. a. , 2020 .
No evidence of rapid antiviral clearance or clinical benefit with the combination of hydroxychloroquine and azithromycin in patients with severe COVID-19 infection .
Médecine et Maladies Infectieuses , 28 March .
Simpson , T. e. a. , 2020 .
Ventricular Arrhythmia Risk Due to Hydroxychloroquine-Azithromycin Treatment For COVID-19 .
[ Online ] Available at : https : //www.acc.org/latest-in-cardiology/articles/2020/03/27/14/00/ventricular-arrhythmia-risk-due-to-hydroxychloroquine-azithromycin-treatment-for-covid-19 Tang , W. e. a. , 2020 .
Hydroxychloroquine in patients with COVID-19 : @ @ @ @ @ @ @ .
medRxiv , 14 April .
Wang , D. , Hu , B .
& Hu , C. , 2020 .
Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan , China .
JAMA Network , 7 February .

This is a research article published as information for health care professionals and public officials, and for an open peer review. It is not medical advice.
Summary
I reviewed the scientific literature on hydroxychloroquine (HCQ), azithromycin (AZ), and their use for COVID-19. My conclusions:
HCQ-based treatments are effective in treating COVID-19, unless started too late.
Studies, cited in opposition, have been misinterpreted, invalid, or worse.
HCQ and AZ are some of the most tested and safest prescription drugs.
Severe COVID-19 frequently causes cardiac effects, including heart arrhythmia. QTc prolonging drugs might amplify this tendency. Millions of people regularly take drugs having strong QTc prolongation effect, and neither FDA nor CDC bother to warn them. HCQ+AZ combination, probably has a mild QTc prolongation effect. Concerns over its negative effects, however minor, can be addressed by respecting contra-indications.
Effectiveness of HCQ-based treatment for COVID-19 is hampered by conditions that are presented as precautions, delaying the onset of treatment. For examples, some states require that COVID-19 patients be treated with HCQ exclusively in hospital settings.
The COVID-19 Treatment Panel of NIH evaded disclosure of the massive financial links of its members to Gilead Sciences, the manufacturer of a competing drug remdesivir. Among those who failed to disclose such links are 2 out of 3 of its co-chairs.
Despite all the attempts by certain authorities to prevent COVID-19 treatment with HCQ and HCQ+AZ, both components are approved by FDA, and doctors can prescribe them for COVID-19.
Intro
Hydroxychloroquine (HCQ) was accepted as a COVID-19 treatment by the medical community in the US and worldwide by early April. 67% of the US physicians said they would prescribe HCQ or chloroquine CQ for COVID-19 to a family member (Town Hall, 2020-04-08). An international poll of doctors rated HCQ the most effective coronavirus treatment (NY Post, 2020-04-02). On April 6, Peter Navarro told CNN that “Virtually Every COVID-19 Patient In New York Is Given Hydroxychloroquine.” This might explain decrease in COVID-19 deaths in the New York state after April 15. The time lag is because COVID-19 deaths happen on average 14 days after showing symptoms.
But on April 21, several perfectly coordinated events took place, attacking HCQ’s use for COVID-19 patients.
The COVID-19 Treatment Guidelines Panel of the National Institute of Health issued recommendations with negative-ambivalent stance regarding the use of HCQ as a COVID-19 treatment. This surprising stance was taken contrary to the ample evidence of the efficacy and safety of HCQ and despite absence evidence of its harm. The panel also strongly recommended against the use of hydroxychloroquine with azithromycin (AZ), the combination of choice among practitioners. On the same day, a paper (Magagnoli, 2020) was posted on a pre-print server medRxiv, insinuating that HCQ is not only ineffective, but even harmful. This not-yet peer reviewed paper, by unqualified authors with conflicts of interest, received wall-to-wall media coverage, as it if were a cancer cure. It used data from Veterans Administration hospitals, spicing its effects. The paper has shown to be somewhere between junk science and fraud. Rick Bright, a government official who was probably more responsible for the low level of preparedness to the epidemic than most others, and had been re-assigned to a lower position earlier, emerged as a “whistleblower.” He claimed he had been demoted for opposing hydroxychloroquine, the claim to be soon debunked by documents bearing his signature. The media also gave him a wall-to-wall coverage.
On April 24, the FDA struck its own blow, issuing a stern warning against use of HCQ for COVID-19 treatment.
While these warnings are not binding to doctors, they do produce a chilling effect. Consequently, either patients do not receive necessary treatment, or they receive it with a delay, sharper decreasing its effect. This allows detractors to question HCQ efficacy even more aggressively. Below, I review problems in the NIH COVID-19 Treatment Guidelines and other sources, used to wage anti-HCQ propaganda.
NIH Panel Guidelines
The relevant section of (COVID-19 Treatment Guidelines Panel, 2020) is Potential Antiviral Drugs. The antiviral treatment recommendations (more accurately, failure to provide recommendations) include:
“Remdesivir There are insufficient clinical data to recommend either for or against the use of the investigational antiviral agent remdesivir for the treatment of COVID-19 (AIII). Clinical Data to Date: Only anecdotal data are available.“ “AIII” means a strong position based on expert opinion rather than on evidence. “Chloroquine or Hydroxychloroquine There are insufficient clinical data to recommend either for or against using chloroquine or hydroxychloroquine for the treatment of COVID-19 (AIII) . When chloroquine or hydroxychloroquine is used, clinicians should monitor the patient for adverse effects (AEs), especially prolonged QTc interval (AIII) .
or for the treatment of COVID-19 . Clinical Data in COVID-19 The clinical data available to date on the use of chloroquine and hydroxychloroquine to treat COVID-19 have been mostly from use in patients with mild, and in some cases, moderate disease; data on use of the drugs in patients with severe and critical COVID-19 are very limited. [Follows is a description of some studies]“
Notice that CQ and HCQ are addressed together, although these are two different drugs, and HCQ is clearly superior to CQ both in efficiency and safety.
Also notice that the basic recommendation of “insufficient clinical data to recommend either for or against” is given to both HCQ and Remdesivir. However, the recommendation for HCQ goes further to state that when using HCQ, “clinicians should monitor the patient for adverse effects (AEs), especially prolonged QTc interval”. Practically, this means that HCQ should be used only in hospital settings. No such restrictions are set for Remdesivir, for which there is no clinical data available. It goes against all logic.
The demand to use HCQ only in hospital settings means:
HCQ treatment will be delayed until a patient decides to be admitted to a hospital, thus lowering HCQ’s efficiency Hospitals will quickly become overwhelmed with COVID-19 patients
Then the Panel nixes HCQ+AZ:
“Hydroxychloroquine plus Azithromycin The COVID-19 Treatment Guidelines Panel recommends against the use of hydroxychloroquine plus azithromycin for the treatment of COVID-19, except in the context of a clinical trial (AIII).“
This drug combination is the most effective and widely used treatment for COVID-19, and the Panel recommends against it!
The Panel criticizes some studies of patients’ treatment with HCQ+AZ for the absence of a control group. Stephen McIntyre tweeted about this argument long before the Panel used it: “there’s a very large control group of COVID19 patients not receiving this drug combination: hospitals and morgues are full of them.”
There are only two studies, quoted by the Panel against HCQ+AZ, (Molina, 2020) and (Chorin, 2020). Both are misinterpreted by the Panel.
Molina et al.
Despite (Molina, 2020)’s angry tone and aggressiveness, it reports no results contradicting efficiency of HCQ or HCQ+AZ. The paper describes treatment of 11 hospitalized COVID-19 patients, five of which had cancer, one had AIDS, and almost all were in a bad shape: “at the time of treatment initiation, 10 of the 11 patients had a fever and received nasal oxygen therapy.” Using HCQ+AZ, 10 of the patients’ lives were saved. The article’s point of contention is that when they tested these patients, 5-6 days after the treatment initiation, they still found CoV2 RNA in 8 out of 10. Virus RNA is a molecule. Some viral RNA remains in patients for weeks after full recovery, but it is neither harmful nor infectious. Detecting viral RNA depends on the sensitivity of the testing equipment. The study’s title is No evidence of rapid antiviral clearance or clinical benefit with the combination of hydroxychloroquine and azithromycin in patients with severe COVID-19 infection seems to be lost on the Panel.
Chorin et al.
The Panel also quotes (Chorin, 2020) as evidence that HCQ+AZ therapy causes QTc prolongation. QTc prolongation is not a health condition itself, but a warning sign that a person is at higher risk of torsades de pointes (TdP), heart arrhythmia, or tachycardia, which might lead to cardiac arrest and death (Simpson, 2020).
Nevertheless, none of the patients, treated with HCQ+AZ, suffered TdP or arrhythmia. Four patients died, but none of them had an arrhythmia. Other studies, in which COVID-19 patients are treated with HCQ+AZ, reported taking patients off this medicine after QTc exceeds 500ms. But the treatment may have already had its effect at that time or later, while HCQ remained in the bloodstream.
This study has no control group. It provides no information on whether QTc prolongation was caused by the disease or the therapy.
FDA Warning
(FDA WARNING, 2020), issued on April 24, piggybacks on the COVID-19 Panel Guidelines. It says
Hydroxychloroquine and chloroquine can cause abnormal heart rhythms such as QT interval prolongation and a dangerously rapid heart rate called ventricular tachycardia.
This statement is confused, and probably not true about hydroxychloroquine. See below.
Be aware that there are no proven treatments for COVID-19 …
I think that HCQ+AZ is a proven treatment for COVID-19. There is a difference between proven treatment and approved treatment. HCQ+AZ is not approved but proven, because many patients have been treated with this combination and have recovered.
We have reviewed case reports … concerning serious heart-related adverse events and death in patients with COVID-19 receiving hydroxychloroquine and chloroquine, either alone or combined with azithromycin or other QT prolonging medicines. These adverse events were reported from the hospital and outpatient settings for treating or preventing COVID-19, and included QT interval prolongation, ventricular tachycardia and ventricular fibrillation, and in some cases death.
These are manifestations of COVID-19! See (Bansal, 2020) and (Wang, et al., 2020). The media hysteria played its role, too. The articles about the supposed dangers of HCQ, with detailed description of the symptoms, triggered complaints even before the April 24 warning. And there are people who tried to self-medicate – in the situation when authorities make it difficult to obtain prescription for HCQ – and took the wrong drug or overdosed. Also, QT interval prolongation is not an event, but an early warning.
To help FDA track safety issues with medicines, we urge patients and health care professionals to report side effects involving hydroxychloroquine and chloroquine or other medicines to the FDA MedWatch program, using the information in the “Contact FDA” box at the bottom of the page.
Such an urging and advertisement guarantee that the FDA will receive mountains of complaints.
HCQ and AZ Safety
HCQ, CQ, and AZ
HCQ & CQ are two different drugs. HCQ is clearly superior to CQ. HCQ has already been selected over CQ. Discussing these two drugs as if they were co-equal in COVID-19 treatment is misleading and a sign of bad faith.
HCQ and AZ are some of the most widely prescribed drugs and have been prescribed for decades. HCQ is as safe as a prescription drug can be. AZ is an antibiotic, and it is as safe as an antibiotic can be.
Because these drugs have been prescribed so widely, their adverse effects have been studied. A few adverse events associated with them have been reported. Combining these few anecdotal cases, some medical researchers have raised some concern, as a precaution. Doctors understand this. Statisticians understand this. But unscrupulous media uses this information to mislead the naïve public and even public figures
Remdisivir is the opposite. It has been developed very recently and has been scarcely used. There is little information about its adverse effects. The corrupt news networks present this lack of evidence of adverse effects as evidence of the absence of adverse effects.
CredibleMeds
The leading objection against HCQ / HCQ+AZ is possible QTc prolongation. Most professionals refer to (CredibleMeds.org, 2020) which puts both HCQ and AZ in the category of Known Risk of TdP (KR).
I think that HCQ was listed in that category by mistake. A review of the literature reveals only few anecdotal cases. Some of them are poisoning by large overdoses of HCQ. Then there are patients who were on HCQ for years, suddenly got sick and recovered when HCQ was withdrawn. While there are millions of people continuously taking HCQ, only a few cases of cardiac events have been reported. Even if HCQ was the cause of these rare cases, which is usually unknown, it is still statistically insignificant. It is much safer than driving. Other antivirals are known to cause QTc prolongation too but are not being pulled from practice. In the case of HCQ, it seems that a precaution principle has prevailed over statistical reasoning and common sense.
AZ is in the KR category, just like many other antibiotics, including Erythromycin. I have never heard of patients requiring QTc monitoring, when taking Erythromycin.
Attention of the Trump Derangement Syndrome crowd: many widely used psycho-active drugs are also listed in the KR category. That includes anti-psychotic Haloperidol, anti-depressants Escitalopram (Cipralex, Lexapro) and Citalopram (Celexa).
American College of Cardiology
The most reliable source of information about arrhythmia risks is the American College of Cardiology. (Simpson, 2020) in the Cardiology Magazine:
Chloroquine, and its more contemporary derivative hydroxychloroquine, have remained in clinical use for more than a half-century as an effective therapy for treatment of some malarias, lupus, and rheumatoid arthritis. … Despite these suggestive findings, several hundred million courses of chloroquine have been used worldwide making it one of the most widely used drugs in history, without reports of arrhythmic death under World Health Organization surveillance.
HCQ is even milder than CQ.
Azithromycin, a frequently used macrolide antibiotics lacks strong pharmacodynamic evidence of iKr inhibition [associated with QT prolongation]. Epidemiologic studies have estimated an excess of 47 cardiovascular deaths which are presumed arrhythmic per 1 million completed courses, although recent studies suggest this may be overestimated.
In other words, after over 50 years of effective use, HCQ and AZ have proven their safety and efficacy. There is no reason for fear, except the fear itself. But some people might be vulnerable, so the article explains how to calculate an individual Risk Score for QTc prolongers. Individuals with higher Risk Score might need QTc monitoring. Also, the authors suggest avoiding other QTc prolonging medications in the time of HCQ+AZ treatment.
The cardiologists who wrote this article did not dismiss the concern. They explained the science pertaining to it and suggest proper mitigation measures.
Other literature also suggests low risk of HCQ and AZ. (Prutkin, 2020):
Limited data on hydroxychloroquine suggest it has a low risk of causing TdP, based on its use for rheumatoid arthritis, systemic lupus erythematosus, and antimalarial therapy. … For these medications [HCQ and AZ], their time window of use is short duration, which is another reason the risk of TdP may be lower
HCQ and AZ have other known contra-indications, but they are out of the scope here.
COVID-19 caused Arrhythmia
Many studies show that COVID-19 causes heart arrhythmia. Cardiac arrest, not directly caused by respiratory damage, is one of the leading direct causes of COVID-19 deaths.
(Bansal, 2020) is a review. It finds that
COVID-19 is primarily a respiratory illness but cardiovascular involvement can occur through several mechanisms.
Acute cardiac injury is the most reported cardiovascular abnormality in COVID-19, with average incidence 8-12%
Both tachy- and brady-arrhythmias are known to occur in COVID-19. A study describing clinical profile and outcomes in 138 Chinese patients with COVID-19 reported 16.7% incidence of arrhythmia. The incidence was much higher (44.4%) in those requiring ICU admission …
It also notes that CoV2 virus might cause cardiac injury directly or indirectly. The possibility of a treatment impact is mentioned as a less likely one.
(Wang, et al., 2020) finds that 44% of the patients transferred to ICU developed arrhythmia. None of them received HCQ or CQ. Most of the patients received an unrelated anti-viral and an antibiotic. Only in 18% of the patients the antibiotic was AZ. At least some of the patients developed an arrhythmia before the treatment.
(Hawryluk, 2020):
Doctors have found that the infection can mimic a heart attack. They have taken patients to the cardiac catheterization lab to clear a suspected blockage, only to find the patient wasn’t really experiencing a heart attack but had COVID-19.
Thus, the hypothesis that CVOID-19 patients experience QTc prolongation and arrhythmia because of the disease, rather than due to HCQ+AZ treatment, is well founded. AZ may increase the odds of QTc prolongation in COVID-19 patients, who would otherwise die from cardiac arrest or multiple organs failure.
The media and professional publications report a sharp increase of mortality from cardiac arrest at home in the last few weeks. Some of these cases are known to be COVID-19, but most of them are not tested. Could many of them be happening due to the cardiac damage caused by COVID-19? Can the cardiac impact of COVID-19 be aggravated by strong QTc prolongers that many people take regularly? There are countless variables confounding this statistic. There is an especially sharp increase in home cardiac arrests in New York, which is usually explained by people’s reluctance to call an ambulance or ER.
(Kochi, 2020) provides in-depth explanation of the cardiac effects of respiratory infections and interaction with QTc prolongation medications.
Positive Cardiac Effects of HCQ
Gone unmentioned are HCQ’s positive cardiac effects. They were widely reported before HCQ had misfortune of being mentioned by President Trump. For example, Taking Hydroxychloroquine for RA or Lupus Can Reduce Heart Risk by 17%
If you take the anti-malarial drug hydroxychloroquine (Plaquenil) as part of your treatment for lupus or rheumatoid arthritis (RA), you may be getting cardiovascular protection as an added bonus.
The article is based on (Jorge, 2019). These findings might be applicable only to long term taking of HCQ, not a 5-day course for COVID-19, but the same can be said about the alleged negative cardiac effects.
Articles/Studies criticizing HCQ
Listed here are several other papers, influential in the media, but not in the science. These papers span the range from erroneous to … non-existent.
Magagnoli et al.
(Magagnoli, 2020) is a not peer-reviewed pre-print. It makes a retrospective statistical comparison of the outcome in COVID-19 patients, who received HCQ or HCQ+AZ treatment prior to April 11, in Veterans Affairs hospitals. In the Abstract, it claims that a larger percentage of HCQ treated patients died compared to untreated patients. This ignores the fact that HCQ or HCQ+AZ treatment was given only in the most desperate cases, frequently as compassionate care. Deep inside of the manuscript, it does acknowledge that initial conditions of the HCQ and HCQ+AZ groups was much worse than those of the untreated group, but then ignores it
The original version (archived) of the “study” was published on April 21. It received crushing criticism in the comments and was replaced with another one on April 23, hiding those comments. Casting even further doubt on the credibility of this study, one of the authors disclosed Gilead funding for another research. This work was funded by a NIH grant.
Despite its multiple flaws, lack of peer review, and obscurity of the authors, this pre-print immediately received wall-to-wall media coverage. Given these circumstances, this work looks like a criminal fraud, rather than a scientific one.
Tang et al.
(Tang, 2020) is a not peer-reviewed pre-print. It reports results of a clinical trial in China, in which HCQ was given to patients 16-17 days after onset of the disease. This is too late for an anti-viral to work. Thus, this study describes the incorrect use of HCQ, rather than efficacy or safety of the drug. From the comments:
With an average delay of 16 days from symptom onset to enrollment and treatment in this trial, those patients are pretty much past the viral phase of the disease, where an antiviral treatment would have the most value, and are well on their way to pneumonia and a cytokine storm problem, which is ultimately what kills.
Once again, despite its obvious errors, the study was widely covered, including the New York Times and LA Times. Neither headline nor article addresses the obvious lateness of the drug’s application.
Mahevas et al.
(Mahevas, 2020) is another not peer-reviewed pre-print. Didier Raoult and his colleagues replied to it with a bluntness, rare in scientific journals: Scientific fraud to demonstrate the lack of efficacy of hydroxychloroquine compared to placebo in a non-randomized retrospective cohort of patients with Covid: Response to MAHEVAS et al. , MedRxiv, 2020. (Brouqui, et al., 2020). (Mahevas, 2020) also gathered many negative comments on MedRxiv.
Oral Statements of Holtgrave & Cuomo
A study of 600 patients at 22 hospitals in New York is being conducted by the University at Albany School of Public Health under the management of dean David Holtgrave. Although the study was not finished, Mr. Holtgrave already announced that the results are negative: “We don’t see a statistically significant difference between patients who took the drugs [HCQ, HCQ+AZ] and those who did not,” according to CNN. New York Governor Andrew Cuomo referred to the results as neither positive nor negative, per CNN and ABC.
No paper, or even pre-print, reporting these results, has been published, as of April 29 (searches on Google Scholar, PubMed, and medRxiv were conducted for Holtgrave hydroxychloroquine; Holtgrave COVID-19).
New York and other “resistance” states make patients jump through hoops to obtain HCQ. As an anti-viral, it should be taken as soon as possible. Dr. Vladimir Zelenko explained that in his letter, which is worth reading in its entirety:
It is essential to start treatment against Covid-19 immediately upon clinical suspicion of infection and not to wait for confirmatory testing. There is a very narrow window of opportunity to eliminate the virus before pulmonary complications begin. The waiting to treat is the essence of the problem.
He refers to patients in the high-risk category – older than 60, having certain health conditions, or shortness of breath. The resistance states established onerous requirements that delay HCQ treatment for days. This sharply lowers the efficiency of the treatment, and possibly increases TdP risks. The mixed results, promised by Mr. Holtgrave, might be caused by this delay.
Russia
On March 28, Russia announced a COVID-19 treatment based on Mefloquine. Mefloquine, invented in the US in 1970s, is another anti-malaria drug, similar to HCQ. In the West, Mefloquine was withdrawn from use after a controversy about its long-term effects. Russia might also use HCQ. From a Russian brochure (Nikiforov, 2020):
These drugs have a comprehensive negative effect on the coronavirus. It may take years of scientific experimentation to understand how and what exactly they affect. Now the fact of a positive effect has been established, and the drugs should and will be used.
The mechanisms of HCQ and HCQ+AZ action are explained (Hache & Raoult, 2020).
WHO
On March 27, WHO erected another roadblock to treating COVID-19 patients with HCQ. WHO stated that HCQ was not only insufficiently tested (which was true at that time), but that it was considered for COVID-19 at much higher doses than for malaria.
In the context of the COVID-19 response, the dosage and treatment schedules for chloroquine and hydroxychloroquine that are currently under consideration do not reflect those used for treating patients with malaria. The ingestion of high doses of these medicines may be associated with adverse or seriously adverse health outcomes.
This is dangerous misinformation. HCQ dosage for COVID-19 is the same or lower than for malaria (Drugs.com, 2019). WHO was aware of this, because it was already conducting clinical trials including HCQ and a number of other Big Pharma drugs. Yet, as of April 29, this paragraph still appears there. This act alone justifies not only defunding but ignoring WHO.
Google and Facebook adhered to WHO on everything related to COVID-19. Together with Twitter, they purged information favorable to HCQ. These is outrageous behavior for telecommunications and computational services providers.
Remarks
It seems that the main contra-indication for HCQ treatment of COVID-19 is that no treatment is needed for healthy individuals below age 50.
Persons in the President’s circle were claiming that HCQ / HCQ+AZ are unproven treatments. That might have been true a month ago, but not now. These drugs are proven by practice and by failure of its opponents to disprove their efficacy and relative safety.
The Guidelines are accompanied by a financial disclosure of the panel members. Weirdly, this disclosure covers a period of 11 months: May 1, 2019 to March 31, 2020. The latest three weeks were excluded for some reason. Nevertheless, 9 out of 50 members of the panel disclosed financial ties to Gilead. Gilead’s Remdesivir is an inferior competitor to HCQ – more expensive, almost untested, and less efficient (as far as the little testing with it has shown). HCQ is a generic drug with low profit margin. Gilead Sciences directly participates in WHO trials of Remdesivir as a COVID-19 treatment.
HCQ / HCQ+AZ are prescribed by a doctor. They are not OTC and should not be used for self-medication.
HCQ+AZ is the most common treatment. HCQ acts on its own but is much more effective with Zinc; AZ is an antibiotic and a source of Zinc. See Dr. Zelenko’s regimen is HCQ+AZ+Zinc.
There is a live document by Michael J. A. Robb, M.D., tracking effectiveness of HCQ-based treatments https://drive.google.com/file/d/1w6p_HqRXCrW0_wYNK7m_zpQLbBVYcvVU/view
References
Bansal, M., 2020. Cardiovascular disease and COVID-19. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 25 March.
Brouqui, P., Million, M. & Raoult, D., 2020. Scientific fraud to demonstrate the lack of efficacy of hydroxychloroquine compared to placebo in a non-randomized retrospective cohort of patients with Covid: Response to MAHEVAS et al. , MedRxiv, 2020. Mediterranee Infection, 24 04.
Chorin, E. e. a., 2020. The QT Interval in Patients with SARS-CoV-2 Infection Treated with Hydroxychloroquine/Azithromycin. medRxiv, 3 April.
COVID-19 Treatment Guidelines Panel, 2020. COVID-19 Treatement Guildelines, s.l.: s.n.
CredibleMeds.org, 2020. COMBINED LIST OF DRUGS THAT PROLONG QT AND/OR CAUSE TORSADES DE POINTES (TDP). [Online]
Available at: https://crediblemeds.org/pdftemp/pdf/CombinedList.pdf
Drugs.com, 2019. Hydroxychloroquine Dosage. [Online]
Available at: https://www.drugs.com/dosage/hydroxychloroquine.html
FDA WARNING, 2020. FDA cautions against use of hydroxychloroquine or chloroquine for COVID-19 outside of the hospital …. [Online]
Available at: https://www.fda.gov/drugs/drug-safety-and-availability/fda-cautions-against-use-hydroxychloroquine-or-chloroquine-covid-19-outside-hospital-setting-or
Gautret, P. & Raoult, D. e. a., 2020. Clinical and microbiological effect of a combination of hydroxychloroquine and azithromycin in 80 COVID-19 patients with at least a six-day follow up: A pilot observational study. Travel Medicine and Infectious Disease, 4 April.
Hache, G. & Raoult, D. e. a., 2020. Combination of hydroxychloroquine plus azithromycin as potential treatment for COVID 19 patients: pharmacology, safety profile, drug interactions and management of toxicity.. Mediterranee Infection, 22 April.
Hawryluk, M., 2020. Mysterious Heart Damage Hitting COVID-19 Patients. WebMD, 06 April.
Jorge, A. e. a., 2019. Hydroxychloroquine Use and Cardiovascular Events Among Patients with Systemic Lupus Erythematosus and Rheumatoid Arthritis. American College of Rheumatology.
Kochi, A. e. a., 2020. Cardiac and arrhythmic complications in patients with COVID-19.. Journal of Cardiovascular Electrophysiology, 08 April.
Magagnoli, J. e. a., 2020. Outcomes of hydroxychloroquine usage in United States veterans hospitalized with Covid-19. medRxiv, 23 April.
Mahevas, M. e. a., 2020. No evidence of clinical efficacy of hydroxychloroquine in patients hospitalized for COVID-19 infection with oxygen requirement: results of a study using routinely collected data to emulate a target trial. medRxiv, 14 April.
Molina, J. M. e. a., 2020. No evidence of rapid antiviral clearance or clinical benefit with the combination of hydroxychloroquine and azithromycin in patients with severe COVID-19 infection. Médecine et Maladies Infectieuses, 28 March.
Nikiforov, B. B., 2020. Modern Approaches to COVID-19 Therapy. [Online]
Available at: http://fmbaros.ru/upload/medialibrary/53f/Nikiforov-_-Sovremennye-podkhody-etiotr.-i-patogeneticheskoy-terapii-_2_.pptx
Prutkin, J. M., 2020. Coronavirus disease 2019 (COVID-19): Arrhythmias and conduction system disease. UpToDate, 24 April.
Simpson, T. e. a., 2020. Ventricular Arrhythmia Risk Due to Hydroxychloroquine-Azithromycin Treatment For COVID-19. [Online]
Available at: https://www.acc.org/latest-in-cardiology/articles/2020/03/27/14/00/ventricular-arrhythmia-risk-due-to-hydroxychloroquine-azithromycin-treatment-for-covid-19
Tang, W. e. a., 2020. Hydroxychloroquine in patients with COVID-19: an open-label, randomized, controlled trial. medRxiv, 14 April.
Wang, D., Hu, B. & Hu, C., 2020. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China. JAMA Network, 7 February.
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wattsupwiththat--2020-05-02--Study: High End Model Climate Sensitivities Not Supported by Paleo Evidence

University of Michigan researchers have done the unthinkable , and checked climate model predictions against available paleo-climate data to see if the predictions are plausible .
Some of the latest climate models provide unrealistically high projections of future warming Date : April 30 , 2020Source : University of MichiganSummary : A new study from climate researchers concludes that some of the latest-generation climate models may be overly sensitive to carbon dioxide increases and therefore project future warming that is unrealistically high .
A new study from University of Michigan climate researchers concludes that some of the latest-generation climate models may @ @ @ @ @ @ @ and therefore project future warming that is unrealistically high .
In a letter scheduled for publication April 30 in the journal Nature Climate Change , the researchers say that projections from one of the leading models , known as CESM2 , are not supported by geological evidence from a previous warming period roughly 50 million years ago .
The researchers used the CESM2 model to simulate temperatures during the Early Eocene , a time when rainforests thrived in the tropics of the New World , according to fossil evidence .
But the CESM2 @ @ @ @ @ @ @ 55 degrees Celsius ( 131 F ) in the tropics , which is much higher than the temperature tolerance of plant photosynthesis — conflicting with the fossil evidence .
On average across the globe , the model projected surface temperatures at least 6 C ( 11 F ) warmer than estimates based on geological evidence .
“ Some of the newest models used to make future predictions may be too sensitive to increases in atmospheric carbon dioxide and thus predict too much warming , ” said U-M ’ s Chris Poulsen , a @ @ @ @ @ @ @ and Environmental Sciences and one of the study ’ s three authors .
“ Our study implies that CESM2 ’ s climate sensitivity of 5.3 C is likely too high .
This means that its prediction of future warming under a high-CO2 scenario would be too high as well , ” said Zhu , first author of the Nature Climate Change letter .

Guest essay by Eric Worrall
University of Michigan researchers have done the unthinkable, and checked climate model predictions against available paleo-climate data to see if the predictions are plausible.
Some of the latest climate models provide unrealistically high projections of future warming
Date:April 30, 2020Source:University of MichiganSummary:A new study from climate researchers concludes that some of the latest-generation climate models may be overly sensitive to carbon dioxide increases and therefore project future warming that is unrealistically high.
A new study from University of Michigan climate researchers concludes that some of the latest-generation climate models may be overly sensitive to carbon dioxide increases and therefore project future warming that is unrealistically high.
In a letter scheduled for publication April 30 in the journal Nature Climate Change, the researchers say that projections from one of the leading models, known as CESM2, are not supported by geological evidence from a previous warming period roughly 50 million years ago.
The researchers used the CESM2 model to simulate temperatures during the Early Eocene, a time when rainforests thrived in the tropics of the New World, according to fossil evidence.
But the CESM2 model projected Early Eocene land temperatures exceeding 55 degrees Celsius (131 F) in the tropics, which is much higher than the temperature tolerance of plant photosynthesis — conflicting with the fossil evidence. On average across the globe, the model projected surface temperatures at least 6 C (11 F) warmer than estimates based on geological evidence.
“Some of the newest models used to make future predictions may be too sensitive to increases in atmospheric carbon dioxide and thus predict too much warming,” said U-M’s Chris Poulsen, a professor in the U-M Department of Earth and Environmental Sciences and one of the study’s three authors.
…
“Our study implies that CESM2’s climate sensitivity of 5.3 C is likely too high. This means that its prediction of future warming under a high-CO2 scenario would be too high as well,” said Zhu, first author of the Nature Climate Change letter.
…


wattsupwiththat--2020-05-04--Researchers, Lawmakers Cry Foul After Harvard Quietly Edits Study Suggesting Pollution Leads To More

Researchers, Lawmakers Cry Foul After Harvard Quietly Edits Study Suggesting Pollution Leads To More COVID Deaths

• Maryland Rep. Andy Harris wants the Environmental Protection Agency to review a Harvard University study suggesting pollution could create an 8 % increase in the United States ’ s coronavirus death rate .
• One top critic of the study told the Daily Caller News Foundation that the university ’ s research is unfounded and relies on faulty modeling and testing .
• The university ’ s researchers initially claimed that people in certain areas of the country are 15 % more likely to die of the virus , but quietly edited the study to dramatically change the nature @ @ @ @ @ @ @ Republican Rep. Andy Harris of Maryland is asking the Environmental Protection Agency ( EPA ) to conduct a rigorous review of a Harvard University study associating high pollution levels to an increase in coronavirus deaths as researchers criticize the researchers ’ findings .
EPA Administrator Andrew Wheeler should conduct an investigation into the study , which suggests a link between pollution and higher rates of coronavirus deaths , Harris wrote to Wheeler on Saturday in a letter obtained by the Daily Caller News Foundation .
Harris addressed the letter to Department of Health @ @ @ @ @ @ @ well .
Harris ’ s letter refers to a Harvard T.H .
Chan School of Public Health study , published April 4 , concluding that an increase in long-term exposure to particulate matter leads to an 8 % increase in the coronavirus death rate .
Areas with elevated levels of pollution are likely to experience higher death rates during the pandemic , the research claimed .
The study initially claimed that people in areas with high levels of pollution are 15 % more likely to die but added an April 24 clarification that @ @ @ @ @ @ @ finding as that an increase of 1 μg/m3 in PM is associated with an 8 % increase in the COVID-19 death rate.
” The revision noted that the study changed after researchers included “ confounding factors ” impacting the virus .
Harvard ’ s research received extensive media attention with The New York Times , The Washington Post , The Guardian and the Los Angeles Times publishing articles highlighting the study ’ s original claims .
The outlets have not yet updated their reporting to reflect the April 24 clarification posted on the @ @ @ @ @ @ @ : Trump ’ s EPA Makes Big Changes To Rule Banning ‘ Secret Science , ’ Obama-Era Officials Rage ) “ It is incumbent on you to accurately communicate the best available scientific understanding of the virus and the factors that may influence patient outcomes , not only to ensure American citizens are not misinformed , but also to enable proper allocation of resources , ” Harris wrote in the letter to Wheeler .
Researchers have come out of the woodwork to criticize the study .
The study , which has yet to @ @ @ @ @ @ @ “ statistical model that has not been tested and verified as yielding accurate predictions , ” Tony Cox , who chairs the EPA ’ s Clean Air Scientific Advisory Committee , told the DCNF .
He and other researchers say spikes in deaths in certain areas were more likely a reflection of where those regions were on the virus curve rather than pollution .
Cities also have higher levels of air pollution , not to mention they have higher death rates from COVID-19 for reasons unrelated to pollution .
There are other factors @ @ @ @ @ @ @ spread .
States and counties have adopted different social distancing guidelines , with states like Georgia adopting lax efforts while California adopted strict mitigation policies .
Neither the EPA , or Harvard ’ s school of public health has not responded to the DCNF ’ s request for comment about the clarification added to the study or the criticisms levelled against the research .
The study only notes an association between pollution and the virus , which originated in China , according to Stanley Young , a member of the EPA ’ s @ @ @ @ @ @ @ the proverbial butterfly in China causing a tornado in Alabama , and generally the world doesn ’ t work that way , ” Young , a statistician , told the Washington Examiner .
“ The paper is written in a way that strongly implies cause and effect , ” he said before saying the study ’ s authors “ could have been a lot more circumspect than that.
” Environmentalists believe President Donald Trump ’ s environmental rollbacks could lead to more deaths on this front .
The EPA relaxed Obama-era rules , @ @ @ @ @ @ @ for coal-fired plants , as well as to keep levels for limits on fine particle pollution .
The virus has killed nearly 24,000 in New York and more than 67,000 across the country .

From The Daily Caller
Chris White Tech Reporter May 03, 2020 2:02 PM ET
Maryland Rep. Andy Harris wants the Environmental Protection Agency to review a Harvard University study suggesting pollution could create an 8% increase in the United States’s coronavirus death rate.
One top critic of the study told the Daily Caller News Foundation that the university’s research is unfounded and relies on faulty modeling and testing.
The university’s researchers initially claimed that people in certain areas of the country are 15% more likely to die of the virus, but quietly edited the study to dramatically change the nature of the study’s findings.
Republican Rep. Andy Harris of Maryland is asking the Environmental Protection Agency (EPA) to conduct a rigorous review of a Harvard University study associating high pollution levels to an increase in coronavirus deaths as researchers criticize the researchers’ findings.
EPA Administrator Andrew Wheeler should conduct an investigation into the study, which suggests a link between pollution and higher rates of coronavirus deaths, Harris wrote to Wheeler on Saturday in a letter obtained by the Daily Caller News Foundation.
Harris addressed the letter to Department of Health and Human Services Secretary Alex Azar as well.
Harris’s letter refers to a Harvard T.H. Chan School of Public Health study, published April 4, concluding that an increase in long-term exposure to particulate matter leads to an 8% increase in the coronavirus death rate.
Areas with elevated levels of pollution are likely to experience higher death rates during the pandemic, the research claimed.
The study initially claimed that people in areas with high levels of pollution are 15% more likely to die but added an April 24 clarification that reads: “We have revised our finding as that an increase of 1 μg/m3 in PM 2.5 is associated with an 8% increase in the COVID-19 death rate.”
The revision noted that the study changed after researchers included “confounding factors” impacting the virus.
Harvard’s research received extensive media attention with The New York Times, The Washington Post, The Guardian and the Los Angeles Times publishing articles highlighting the study’s original claims.
The outlets have not yet updated their reporting to reflect the April 24 clarification posted on the school’s website. (RELATED: Trump’s EPA Makes Big Changes To Rule Banning ‘Secret Science,’ Obama-Era Officials Rage)
“It is incumbent on you to accurately communicate the best available scientific understanding of the virus and the factors that may influence patient outcomes, not only to ensure American citizens are not misinformed, but also to enable proper allocation of resources,” Harris wrote in the letter to Wheeler. Researchers have come out of the woodwork to criticize the study.
The study, which has yet to be peer reviewed, relies on a “statistical model that has not been tested and verified as yielding accurate predictions,” Tony Cox, who chairs the EPA’s Clean Air Scientific Advisory Committee, told the DCNF.
He and other researchers say spikes in deaths in certain areas were more likely a reflection of where those regions were on the virus curve rather than pollution.
Cities also have higher levels of air pollution, not to mention they have higher death rates from COVID-19 for reasons unrelated to pollution.
There are other factors that contribute to the virus’s spread. States and counties have adopted different social distancing guidelines, with states like Georgia adopting lax efforts while California adopted strict mitigation policies.
Neither the EPA, or Harvard’s school of public health has not responded to the DCNF’s request for comment about the clarification added to the study or the criticisms levelled against the research.
The study only notes an association between pollution and the virus, which originated in China, according to Stanley Young, a member of the EPA’s Science Advisory Board.
“This is the proverbial butterfly in China causing a tornado in Alabama, and generally the world doesn’t work that way,” Young, a statistician, told the Washington Examiner.
“The paper is written in a way that strongly implies cause and effect,” he said before saying the study’s authors “could have been a lot more circumspect than that.”
Environmentalists believe President Donald Trump’s environmental rollbacks could lead to more deaths on this front. The EPA relaxed Obama-era rules, reversing the legal underpinning of mercury limits for coal-fired plants, as well as proposed to keep levels for limits on fine particle pollution.
The virus has killed nearly 24,000 in New York and more than 67,000 across the country.
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