1/ Dr. Fauci is misleading the American people when he says that randomized controlled trials have shown hydroxychloroquine to be ineffective.

Here’s why.
2/ There's only one double-blind RCT on HCQ in early treatment of COVID-19.

All of the other RCTs (SOLIDARITY, RECOVERY, etc) were in very sick patients and are borderline worthless because they just support what we've been saying since March—HCQ is for early disease, not late.
3/ The "randomized controlled trial" for EARLY treatment of COVID-19 that Dr. Fauci is too embarrassed to even mention by name is the one done by the University of Minnesota, “Hydroxychloroquine in Nonhospitalized Adults With Early COVID-19” (Jul 2020)

https://www.acpjournals.org/doi/10.7326/M20-4207
4/ The Minnesota study is honestly an embarrassment to the term “randomized controlled trial” and should actually be called an “anonymous online survey” instead.
5/ Only 34% of participants had a positive PCR test. The remaining 66% either did not have a PCR test or actually tested negative.

This means that a positive diagnosis was made based on only SYMPTOMS for the vast majority of participants.

This isn’t great, but it gets worse.
6/ The participants were evaluated via a static online survey and not actually seen by physicians or medical personnel.

So the quality of the diagnosis was essentially equivalent to someone typing symptoms into WebMD.
7/ What happens if a large percent of the participants didn’t actually have COVID-19?

It would diminish the observed therapeutic effect of hydroxychloroquine (HCQ probably isn’t going to help allergies or the common cold).
8/ Next point.

If the researchers had kept their original end point (hospitalization/death), the study would've actually shown a strong trend toward benefit for HCQ.

Instead, the researchers changed the end point mid-study from hospitalizations/death to symptoms at 14 days.
9/ The conclusion of the study is actually a ~40% reduction in hospitalizations/deaths in patients treated with HCQ vs placebo (2.5% vs 4.1%).

This did not reach significance, but would have been strong encouragement to proceed with additional higher powered RCTs.
10/ The good news is that Dr. Fauci & the NIH started a trial in May doing just this.

The bad news is they cancelled the trial after enrolling only 20 subjects in order to focus on a new trial evaluating remdesivir plus baricitinib (another “novel” patented drug).
11/ In conclusion, it's been >4 mos since HCQ was proposed for early stage COVID-19.

Yet, with their vast resources, neither the WHO nor NIH conducted a trial on this.

Instead Dr. Fauci's evidence for the inefficacy of HCQ comes from an online survey under the guise of an RCT.
You can follow @JamesTodaroMD.
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