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Controversy over Hydroxychloroquine Exposes Emptiness of LIEbralism

May 22, 2020 14 comments

Let me begin by saying that I would have preferred to write about the actual science behind the potential usefulness of Hydroxychloroquine (and other 4-aminoquinolines such as Chloroquine, Amodiaquine etc) for treating COVID-19 infections. In fact, I might still do that in the near future. But the debate around their use, has for reasons we shall soon explore, now entered the realm of ideology aka secular religious beliefs. While we can certainly argue over who is to blame more for the politicization of what should have been a scientific debate, one thing is very clear- the debate around use of Hydroxychloroquine to treat COVID-19 has exposed the incredible vacuousness of LIEbralism, specifically its american variant.

I won’t bore you with the history of how anti-malarial drugs were developed almost 70-80 years ago in this post, other than saying that it is a very interesting story- provided you are interested in how drug development actually worked during the golden age of drug discovery. The only relevant part of that story for the purpose of this post concerns their subsequent re-purposing for treating auto-immune diseases. To make another long and interesting story short, by the 1970s, it became obvious through a bunch of serendipitous observations that these drugs could be used to treat autoimmune diseases such as Systemic Lupus Erythematosus (SLE) and Rheumatoid Arthritis (RA). Nowadays in western countries these drugs, specifically Hydroxychloroquine, are almost exclusively used for the treatment of autoimmune diseases.

The anti-viral effects of these drugs were accidentally discovered sometime in the 1970s during experiments aimed at determining the mechanisms of viral entry into cells. Some of the first published reports about their anti-viral activity can be found as far back as 1980. Without going into further detail in this post, the ability of CQ and HCQ to block infection and spread of infection of a number of viruses from diverse families at concentrations achievable in body tissues with normal therapeutic doses is established science- not a matter of controversy. Some of you might ask.. why haven’t these drugs been used for treatment of viral diseases till now. Well.. there are two main reasons.

Firstly, by 1980, we had already developed very effective vaccines for every major acute viral disease affecting humans. So.. we already had vaccines for everything from rabies and yellow fever to measles and mumps by the time this particular effect of CQ and HCQ was discovered. Effective vaccines are just way cheaper and far more effective at controlling infectious diseases whenever they are available. Secondly, while these drugs do have some effect against chronic viral diseases such as HIV and Hepatitis C, we quickly found far more effective and specific drugs to treat those illnesses. In other words, we never needed drugs such as CQ and HCQ to treat acute viral infections on any large scale until now.

As far as coronaviruses are concerned, we have known that both drugs inhibit the SARS virus in cell cultures at very reasonable concentrations since 2004 and 2005. In fact, the first instance of a paper describing this effect for a species of bovine (cattle) coronavirus can be found as early as 1990. We also have data showing the efficacy of CQ for treating certain coronavirus infections in animal models as early as 2009. So the idea that CQ and HCQ can treat coronaviral infections, especially if given early on in the course of illness, is perfectly sound and based in experimental data. The real question, then, is whether they work in humans suffering from coronaviral diseases. And this brings us to the issue of when such drugs should be started..

The thing with acute viral infections is that, unlike most bacterial or fungal infections, peak viral replication occurs before the peak clinical symptoms. This has a lot to do with the ability of one virus (infecting a cell) to generate several hundred daughter viruses in contrast to one bacteria multiplying into two every thirty or so minutes. Long story short, drugs for treating acute viral infections work best (or at all) only if given early on in the course of illness. That is why drugs like Oseltamivir (Tamiflu) and Valaciclovir (Valtrex) have to be started within 48 hours of first definitive symptoms, of Flu and Herpes Simplex (or Zoster) respectively, for maximal efficacy.

As far as COVID-19 is concerned, there are two phases of the illness: predominantly viral (first 4-5 days) and predominantly inflammatory (6-7 days onward). Note that serious respiratory issues occur in the inflammatory phase, not the earlier viral phase. For any anti-viral drug for this illness would have to be administered within first 4-5 days of symptoms to have any worthwhile effect. That is why even a direct anti-viral such as Remdesivir which works pretty well in many animal models of various coronaviruses has such poor efficacy in hospitalized patients on ventilators. If the patient has reached the stage where peak viral replication has already occurred, you are far better off giving supportive care than any anti-viral drug.

Based on my knowledge of medical microbiology and pharmacology, here is what I think about the potential efficacy of HCQ in treatment of COVID-19. The drug will very likely reduce the extent of viral multiplication and size of peak if given within first 3-4 days of symptoms. Such a substantial reduction in viral load will likely result in a far more benign course for the illness. Furthermore the strong immunomodulatory effects of HCQ will also reduce the amounts of various pro-inflammatory cytokines released by the body in response to the virus. Long story short, HCQ if given within first 3-4 days of symptoms (fever, malaise, cough etc) will very likely result in a substantial reduction in number of people who go onto become ill enough to require hospitalization and mechanical ventilation.

My point is that HCQ is not a wonder drug, but used early enough in the infection it should reduce the risk of clinical deterioration often seen in later phase of disease process. So.. it is not going to miraculously prevent infection or milder forms of the disease- just stop people from getting ill enough to require hospitalization and intubation. In that respect, it is very similar to Oseltamivir and other neuraminidase inhibitors used to treat Influenza. And guess what.. more than a few preprints of publications from China say the exact same thing. According to them and emerging reports from Italian doctors, using it to treat patients within first few days of illness or when they have just arrived in hospital with mild respiratory failure reduces the risk of hospitalization and intubation respectively by about 3-4 times compared to historical controls. Also, people on that drug who are not in serious respiratory failure seem to recover faster than otherwise.

While a reduction of 3-4 fold reduction in rates of hospitalization and intubation is not in the same class as using antibiotics to treat bacterial pneumonia, it is definitely better than nothing. More importantly, and relevant to rest of this post, the drug has little to no efficacy in people who are already far into the second phase of illness. So giving it to people with severe respiratory failure and those on ventilators is close to useless. This is why I find the corporate media obsession with “studies” by LIEbral american doctors in certain states who purposely bias their test population with patients who are very ill and in second phase of illness to be both sad and darkly comic. Who are these dumbfucks trying to convince? Then again, LIEbrals have never been known for their intelligence, otherwise the orange man would have never won the presidency in 2016- but he did.

But why are these pathetic attempts to pretend that HCQ has no efficacy so incredibly stupid and likely to backfire very badly? Well.. because the world is bigger than coastal states.

As we speak, doctors from Turkey and Russia to India and Italy are prescribing HCQ quite freely to patients within first few days of illness. From the look of things thus far, it seems that the strategy of prescribing that drug to anybody with even mild or suspected COVID-19 is certainly reducing the rate of hospitalization and death. While Italy started a bit later than others down that path, their death rate is now going down much faster than countries such as UK and USA at an equivalent stage of the pandemic. You can bet that these results will be written up and published in medical journals within next few months. Even in this country, some states are using HCQ far more freely to treat even milder cases or those in first stage of illness. These results too will be written up and published soon. And guess what will happen next..

As I have said in many previous posts, LIEbrals are too stupid to pick the right fight- in addition to be quite incompetent, despite their “credentials”. The fight these dumbfucks chose this time was always a losing proposition. Let me explain. See.. there are only two possible outcomes to the HCQ controversy: 1] It works to a limited extent and reduces need for hospitalization and intubation or 2] It has zero therapeutic effect. Notice that I said nothing about adverse effects.. here is why.. HCQ, when taken in normal therapeutic doses, is a remarkably safe drug in real life. This is especially so if you are taking it for less than two weeks. The smart thing to do was ignore the HCQ controversy and insist on the drug being tried under a variety of circumstances.

That way, you can win regardless of outcome. If it turns out be effective, that is great news. If it fails, you can claim to have tried all possible options- and let other people blame Trump. But the LIEbral mind is too petty and stupid to gasp such solid reasoning. Instead these fucking dimwits converted the HCQ controversy into political football, a game they will lose either way. Confused? Let me explain, again. See.. if it turns out that HCQ reduces hospitalization and intubation, LIEbrals look like petty murderers. But even if turns out to have zero therapeutic effect, almost nobody outside their clique will believe it because these morons have lied about everything connected to Trump for past four years. The boy who cried wolf!

The sad reality is that even if HCQ was ineffective, too many voters will connect the LIEbral attempts to smear that drug with their futile attempts to get rid of Trump via the Russia-Gate, Ukraine-Gate and other stupid conspiracies. It does not help that democratic politicians seem very enthusiastic about prolonging the lockdown resulting in far more unemployment and human suffering than would otherwise occur. Also, if it eventually turns out that HCQ reduces risk of hospitalization and death when given early, the orange man will end up looking like a genius.

What do you think? Comments?