Brazil halted a trial of the drug cocktail that Trump and Giuliani have endorsed:
A small study in Brazil was halted early for safety reasons after coronavirus patients taking a higher dose of chloroquine developed irregular heart rates that increased their risk of a potentially fatal heart arrhythmia.
Chloroquine is closely related to the more widely used drug hydroxychloroquine. President Trump has enthusiastically promoted them as a potential treatment for the novel coronavirus despite little evidence that they work, and despite concerns from some of his top health officials. Last month, the Food and Drug Administration granted emergency approval to allow hospitals to use chloroquine and hydroxychloroquine from the national stockpile if clinical trials were not feasible. Companies that manufacture both drugs are ramping up production.
The Brazilian study involved 81 hospitalized patients in the city of Manaus and was sponsored by the Brazilian state of Amazonas. It was posted on Saturday at medRxiv, an online server for medical articles, before undergoing peer review by other researchers. Because Brazil’s national guidelines recommend the use of chloroquine in coronavirus patients, the researchers said including a placebo in their trial — considered the best way to evaluate a drug — was an “impossibility.”
Despite its limitations, infectious disease doctors and drug safety experts said the study provided further evidence that chloroquine and hydroxychloroquine, which are both used to treat malaria, can pose significant harm to some patients, specifically the risk of a fatal heart arrhythmia. Patients in the trial were also given the antibiotic azithromycin, which carries the same heart risk. Hospitals in the United States are also using azithromycin to treat coronavirus patients, often in combination with hydroxychloroquine.
Diane Ravitch's blog 
Diane,
I am no Trump fan at all. Here, though he may have been on to something. Please read this article https://news.yahoo.com/emergency-room-doctor-near-death-054816082.html and from my own experience – my wife had the virus – deathly ill. I can not say for sure it helped, but I had heard about Artemisinin, a Chinese herb – grabbed the last bottle at Willner Chemists in NYC and she started taking it and improving quite dramatically. She was home.. Hydroxychloroquine, Artemisinin, and the drug mentioned in the link above, Actemra, all have something in common – they calm the immune system. They calm the Cytokine War inside the body. So please – yes Trump is done more harm and damage to our Earth and needs to be voted out. But here he has a point and a morsel of common sense.
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Without clinical trials and studies, you have no way of know if any of those drugs or the combination. What you describe about the herb could be the placebo effect, which is real in some people. Your experience is nothing but anecdotal and adds absolutely nothing to the body of medical knowledge.
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…combination were effective…
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BULLSHIT!
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…I heard about…sounds a whole lot “a lot of people say.” I have no doubt your wife is better and that you are relieved. But you have absolutely no way of knowing if your drug cocktails worked. As you well know, in the vast majority of cases, the virus runs its course and people recover. Your wife was likely one of those, but you have no way of verifying your assumptions. Scientific method and all that.
My other comment is in moderation, but perhaps it might provide a little lesson for you.
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“The president may be on to something” Ouch
If you had said, “The president, after hearing from a room full of scientists, doctors, research institutions, the FDA and other professionals immersed in science, not hearsay, has advised that clinical trials begin…” that would be different.
This president doesn’t make recommendations – he throws out sound bites and hunches and hearsay and what a friend of his said or some corporate cronie profiteer slips under the table – then declares he’s going to cure cancer and go to the moon.
The only thing this president is “on to” is what makes him a hero and is demeaning anyone with an ounce of expertise.
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Lass Dich umarmen!
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Today Trump held a press event in the Oval office with people who claimed to have been cured by the Trumpster’s recommended regimen of hydroxychloroquine and perhaps azithromycin. Trump pulled out all of the stops to make a show of his deep concern for these people and his absolute certainty that this combination of drugs should be widely available. I am confident that videoclips from this event will be shown today at the 5 pm Trump show, and as an explicit challenge to Dr. Fauci and others who have raised red flags about Trump’s cavalier “what have you got to loose” pushing of this combo. Trump is saying, in effect, “You can lose your life…so what? Lot’s of people die from heart problems.”
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The death of a Trump associate and campaign donor ($400,000) was announced today- his demographics fit the Fox audience- he was a NYC real estate developer.
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complications from corona virus.
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I read a funny-ish story in a German paper today. Upon learning this, it was the first time that the Idiot has shown any emotion or empathy for a COVID victim.
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He should have tried the “Trump Cure”.
Not to be flippant, these deaths are no laughing matter and my heart goes out to all those families who have experienced loss from this pandemic.
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Every drug has an inherent risk. For example, a handful of people die every year because of adverse reactions to aspirin. But this snake oil salesman (actually that’s an insult to real snake oil salesmen) should get a special place in Hell for this alone. There are, according to a report today there are 161 drug and vaccine candidates being studied right now, which is remarkable considering most were launched within the past two months. https://www.genengnews.com/a-lists/vanquishing-the-virus-160-covid-19-drug-and-vaccine-candidates-in-development/
The risk of long term injury is great if drugs are not studied systematically with peer review so that we don’t make guinea pigs out of the general population. In fact, the modern Food & Drug Administration was born because of the tragic side effects of thalidomide, ostensibly a sleeping aid for pregnant women. It caused a process that constricted development of blood vessels in the extremities and caused severe birth defects. It was considered for approval here, but the process set in motion to review it meant it never reached an American audience (until it was proven to be an effective drug for certain cancer in the late 90s).
Some widely-used vaccines also have catastrophic consequences (but NOT autism) in an infinitesimal portion of the population. In response to this, there is a federal vaccine injury fund (https://www.hrsa.gov/vaccine-compensation/index.html) to compensate and pay for lifelong care. One of the stories that should be getting a lot of play, but is not, is that this administration is trying to defund and gut the program by implementing limits on spending and funding the program. So, on the one hand, the Idiot is potentially putting more lives at risk both by promoting this drug, either by people who shouldn’t be taking it or distracting them from meaningful treatments and protocols. On the other, he wants to make sure that people who might be catastrophically injured will never get the compensation and support they will need for the rest of their lives.
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Please read my post above and keep an open mind. Yes clinical trials are important and have their place. In an emergency you do not have time. Further, say back in time – if a person were on the street bleeding to death – and you had heard that a tourniquet might be able to stop the flow of blood – but you would not use the tourniquet because it did not go through clinical trials – that would be pretty darned stupid. So let us not be stupid with people’s lives. I have had first hand experience – others too. If someone God forbid was dying of cancer and heard about something like an herb could help – it would be stupidity not to try. One must be very careful about how they can be dismissive-
Being dismissive is not educationally sound and can be hurtful – look at the way Trump was dismissive concerning this virus – do we all have that tendency to be dismissive? – I do – but I am increasingly aware of it and try to be careful super careful about it. As educators we all need to be careful about dismissiveness.
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I apologize if my comments above may have been too clinical, or dismissive, as you characterize them. I realize you’ve been through an emotional, scary time. My perspective comes as a non-scientist working in advocacy and patient education who has collaborated with researchers, physicians, and patients of a relatively rare cancer for more than 22 years. When I started, it was a sure death sentence for virtually everyone who was diagnosed with it. No one understood why a few, very few, had long term survival rates.
Over the years, I have seen patients tout spices, boiled sea cucumber, green tea, and all sorts of other things as potential cures. I have also seen the approval of more drugs for this type of cancer than any other. Today the vast majority of patients will live good long lives. A disease that once had a 20-ish percent five year survival rate now has rates approaching 95 percent at some of the top clinics in the world.
I still see the desperation and fear in the eyes of newly diagnosed patients, I see how they completely buy the wartime analogy you use above. But they do not have the long term experience of grizzled veterans like me and the people with whom I work. So I again, forgive me if I sound crass. But like everything else related to this pandemic, I believe strongly that we must trust in the scientific method and the many, many professionals who are engaged in using it in their work. When you write, “If someone God forbid was dying of cancer and heard about something like an herb could help – it would be stupidity not to try.”, my response is: if that were true, don’t you think physicians all over the world would be doing so? People who literally devote their lives to finding cures and treating patients? We cannot base important medical decision-making on emotion or anecdotal experiences. Never.
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David, this comment appeared in the NYT last week; this physician corroborates your personal experiences.
Michael Rose
Brooklyn11h ago
I’m an Infectious Disease doctor in Brooklyn, and while it doesn’t make me happy to defend Trump here, we are using hydroxychloroquine (HCQ) on almost all of our patients with COVID, and I think it’s the right move. While it’s obviously unnerving to be prescribing a medication with such limited clinical evidence so liberally, we simply don’t have the luxury to wait for a well-powered RCT to give us clearer guidance. We’ve got hundreds of patients in the hospital RIGHT NOW, many of whom are dying. So we use the best evidence available to guide our judgment, which- it should be noted- is not as limited as some are suggesting. After all, there IS good vitro data to suggest the benefits of HCQ against COVID, along with a proposed mechanism. (it stops viral entry by blocking the ACE2 receptor). There’s also some decent mouse data, and some limited, yet promising early studies using HCQ against COVID in human subjects. (the less-than-stellar, non-randomized French study is currently getting some support from a larger RCT from China that will be coming out soon). Additionally, it’s a fairly well-known drug, with a well-known side effect profile, so it seems unfair to act like we’re completely winging it in terms of its safety.
Ultimately, as physicians, we have to make decisions using the best data available, even if that data is not the kind of well-powered RCTs we’ve come to depend on. While I’m leaving myself open to being proven wrong about HCQ, for now I am using it.
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Keeping an open mind based on anecdotes and hypotheticals when there are sound medical reasons for this President NOT to be promoting any drug, is not being dismissive. Trump has not only promoted these drugs but has claimed to have the authority to decide everything. His conduct is dangerous and that judgment does not entail being dismissive of your experience.
There is not yet scientific evidence of the efficacy of the drug or combination of drugs for COVID-19. Trump’s promotion ignores the first principal of medical practice: Do no harm.
A typical course of “treatment” for Covid-19 with hydroxychloroquine takes 12 to 14 tablets. If I was given these pills without my MD’s approval, especially by an emergency room doctor, I would probably die because there are life-threatening interactions with other drugs I am taking.
This is not quite the same for azithromycin. It has some value in treating bacterial infections but not those from a virus. According to the Mayo clinic “Azithromycin belongs to the class of drugs known as macrolide antibiotics. It works by killing bacteria or preventing their growth. However, this medicine WILL NOT WORK FOR COLDS, FLU, OR OTHER VIRUS INFECTIONS. Same for other drugs of this kind: Biaxin (Clarithromycin), Zithromax (Azithromycin), Dificid (Fidoximycin), and Erythromycin.
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If we did not pay any mind to “Keeping an open mind based on anecdotes and hypotheticals” we would still be in the dark ages. Found this: https://thevaccinereaction.org/2017/08/anecdotal-evidence-has-long-guided-medical-research/ I rest my case! And thank you John Webster!
What have we educators arrogantly dismissed in education because of our arrogance of anecdotal evidence? If an idea makes good sense the data can come later!!
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David, you’re welcome. For the record, I’m not a scientist or a medical expert, and I hold Trump in low regard; his track record of uninformed and/or deceitful statements means that he doesn’t deserve the benefit of the doubt when he speaks about complex subjects. But hundreds of physicians around the world have been using this drug mixture with a high record of success, albeit not perfect. And the important fact that pertains to this thread: those successes have been disclosed in many news outlets – this is not a matter of people blindly supporting Trump. Good advice for all of us: read a diverse number of news reports and opinions, and don’t be satisfied with only the news sources that tell you what you’re already disposed to believe.
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I don’t think that Trump’s recommended drug cocktail has been verified by reputable laboratories. He is not a doctor, nor is Rudy Giuliani or Jared Kushner or Sean Hannity.
I prefer to hear from Dr. Fauci, who is an expert.
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I believe they are using the drug as a “Hail Mary” trying to keep those dying patients alive despite the nasty side effects (like a heart attack).
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This is truly sad and a reflection of how people are prone to accept anything if it confirms their biases (something that happens far too often on this blog). You cite an anti-vaxxer site to confirm your opinions (not knowledge). It is not reputable and is agenda-driven. A paranoid agenda at that. It is the equivalent of citing a “deep state” conspiracy blog.
And John Webster cites a comment on a newspaper blog which allows one to “rest his case.” Very sad, especially from people who purport to care about education.
I know sources akin to this would never even be considered by any scholar or moderately informed citizen. I take back my apologies from above. You have become hysterical.
Panic is not a constructive plan.
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Thank you, Laura. It amazes me in this day and age that people still do not understand (most especially the Idiot) that antibiotics do not treat viruses.
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Just to confirm I am not trying to be insulting, “the Idiot” is the most benign way I know of to describe the current occupant in the White House, it is not directed at anyone who reads this.
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I’m not sure if I’m amused or horrified by reading “those successes have been disclosed in many news outlets.” Here’s the thing: when it come to medical information, I don’t, won’t, and never have relied on “many news outlets.” FOX, OAN, and the WSJ are “news outlets,” interesting, provocative, and criminally ignorant for the most part. Now when the consensus includes the likes of the New England Journal of Medicine, the American Society of Clinical Oncology, Mayo Proceedings, the American Society of Hematology, Lancet, the Journal of the American Medical Association, et al, proves my views to be wrong, please feel free to call me whatever slur you want. But, please, don’t cite some wacko anti-vaxxer site, because it only confirms desperate fantasy. I can take it.
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WordPress arbitrarily puts comments in moderation, although I also have a number of people that I put into moderation because they insulted me or the blog or the teaching profession.
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Diane – I would never insult you! I might very rarely disagree – I think what you have done and continue to do is truly amazing and I have the highest respect for you and your important work!!
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David Di Gregorio: Everyone who posts regularly here will have comments that go into moderation. There is ABSOLUTELY no reason. It just happens.
Diane will look and see these moderated comments and post them, if she likes what has been written.
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And with W.H.O. I hate to say it – look at Taiwan- it was ignored by them. So I think I do agree with Trump – They should have let Taiwan in, Taiwan handled this and they were smart very early – and USA might have benefitted from their wisdom.
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Curious. What are your scientific bona fides?
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What would be your purpose in asking?
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You seem to think you are more knowledgeable about drug approvals than anyone I’ve ever met. I was thinking of putting you in touch with the most celebrated cancer researcher I know—who insists that a randomized clinical trial is the only way to test the efficacy of drug treatments. You could set him straight.
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Science doesn’t work by anecdote. It runs by trial and error and produces results that are replicable.
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In my experience, the only thing that works by anecdote, but only if you trust the one who spreads them, are restaurant recommendations. And even those have their pitfalls.
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Diane,
I agree science does not work by anecdote – but it can begin by anecdote. An anecdote can be a form of observation. If it can be verified, and the reasons behind it revealed, does it not become scientific? So as time goes on and these therapies are researched and it is found that they in fact help through various facts . . or not . ..what is true will rise to the top. Time will tell. Meanwhile I have re-ordered Artemisinin – and will keep it handy. My doctor agrees – perhaps the vitamin C drip he gave me helped me avoid catching it (or minimized my symptoms) from my wife? Hey! One more anecdote for you all!! I wish you all good health, including GregB!
DD
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And I wish you and your family, most especially your wife (you? still thinking about it 😎), the best of health. We have fundamental disagreements that may not be resolved, but mutual hopes that we will all get through this a stronger people, nation, and humanity. While it may seem I ridicule your opinions (OK, I admit it, I do), I will never question your motives or sincerity.
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