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Anyone who looks to this charlatan as a source of medical expertise or even as someone with anything resembling scruples is undertaking a fools errand. This is a textbook example of his dishonesty (thread). https://twitter.com/zev_dr/status/1290306190530850816
People who read this article and support it have really zeroed in on the quote that says that HCQ can act as both a vaccine and a therapy. First of all, nowhere in the article is it described as such.
The article is an in vitro study of HCQ in Vero cells.
The article is an in vitro study of HCQ in Vero cells.
What is actually said is that it MAY have some therapeutic and prophylactic efficacy. In no way can this behave like a vaccine because that is fundamentally antithetical to the function of HCQ as it's immunosuppressive. But that's really the tip of the iceberg.
The article claims that Virology Journal is somehow a publication of the NIH. This is absolutely false. Virology Journal is indexed on Pubmed, which I am guessing is what they were trying to suggest.
Pubmed is a database. Just like a library has garbage books...
Pubmed is a database. Just like a library has garbage books...
a paper on pubmed is not automatically good because it's on pubmed.
The publication authors aren't even affiliated with the NIAID or NIH. They're from the Special Pathogens Brach, Division of Viral and Rickettsial Diseases, CDC, and ...
The publication authors aren't even affiliated with the NIAID or NIH. They're from the Special Pathogens Brach, Division of Viral and Rickettsial Diseases, CDC, and ...
Laboratory of Biochemical Neuroendocrinology, Clinical Research Institute of Montreal.
Note that none of that is the NIAID... the organization Fauci actually heads.
Note that none of that is the NIAID... the organization Fauci actually heads.
Furthermore, this study was performed in 2005. SARS-CoV-2 didn't exist (at least in a form that could infect humans) until 2019. There is absolutely no way you can directly translate the results of this study to suggest it works for COVID-19. The condition didn't exist yet.
On top of that: IT'S AN IN VITRO STUDY. There is a reason in vitro studies are at the bottom of the hierarchy of evidence: just because something works in vitro is not proof it works in vivo. End of story.
Even if we accepted this as a promising lead on drug candidates, it would need a ton of follow up investigation. And you know what? We have done those studies. We have prospective randomized studies on HCQ for prophylaxis and therapy of COVID-19. What do they find?
Negative: https://www.nejm.org/doi/full/10.1056/NEJMoa2016638
Negative: https://www.nejm.org/doi/full/10.1056/NEJMoa2019014
NIH press release to discontinue use of HCQ after no observed benefit: https://www.nih.gov/news-events/news-releases/nih-halts-clinical-trial-hydroxychloroquine?fbclid=IwAR0plLmNZw3610LD0dK8cuzo8ycWoaXjWkFBCwXYtED92pCmExolfvGjp9M
Negative: https://www.nejm.org/doi/full/10.1056/NEJMoa2019014
NIH press release to discontinue use of HCQ after no observed benefit: https://www.nih.gov/news-events/news-releases/nih-halts-clinical-trial-hydroxychloroquine?fbclid=IwAR0plLmNZw3610LD0dK8cuzo8ycWoaXjWkFBCwXYtED92pCmExolfvGjp9M
Also, in something that should (at this point) surprise no one, Vero cells aren't a good in vitro model for COVID-19 infection! If you use human respiratory epithelial cells a funny thing happens when you try to use (H)CQ: nothing!
https://www.nature.com/articles/s41586-020-2575-3_reference.pdf
https://www.nature.com/articles/s41586-020-2575-3_reference.pdf
Also based on the prior studies on HCQ given its huge volume of distribution and measured EC50 values you would need an absolutely untenable dose for it to demonstrate any reasonable efficacy as an antiviral (discussed that here: https://medium.com/@edwardnirenberg/hydroxychloroquine-and-covid-19-e7d8f14a583d)
Furthermore from purely mechanistic reasoning in vivo SARS-CoV-2 entry overwhelmingly occurs through the plasma membrane, not the endocytic pathway which renders it inured to HCQ's MoA. https://www.cell.com/cell/fulltext/S0092-8674(20)30229-4?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0092867420302294%3Fshowall%3Dtrue
So to recapitulate: there wasn't an iota of honesty in the screenshot posted by Zelenko and multiple lines of evidence show HCQ to be an inviable therapy.
But there's another piece to this that's worth mentioning.
But there's another piece to this that's worth mentioning.
Spreading this kind of misinformation has direct harms. As it is, the fiduciary relationship between clinician and patient can be difficult to establish. How does it look when the patient thinks that the clinician is withholding effective therapy from them?
The insinuation that the body of scientists, public health professionals, and clinicians working to find a way out of this pandemic are actively withholding effective treatment is so beyond the pale for appropriate in its tacit insinuations
utterly defies basic human decency. These people are actively risking their lives to care for those we care about and arm us with resources to return to normalcy. Instead, here, a man tries to fill his purse with no regard for the corpses that will pave the path to remuneration.
It's despicable.
And it's a transparent attempt to shift the blame for our current crisis on the people working to undo it and away from the actors who made it possible.
And it's a transparent attempt to shift the blame for our current crisis on the people working to undo it and away from the actors who made it possible.
