My Dad's recent #COVID19. Not an academic document-just sharing a human experience of outrage & triumph.
My Dad is almost 90, frail as can be, in a nursing home. I went to visit him 3 months ago & wore a mask before it was fashionable to protect him just in case I had it.
I sent an email to 5 people at the nursing home the next day saying that I was shocked that none of the staff or visitors were wearing PPE. I warned them that the now infamous Seattle nursing home which had massive deaths early on in the #COVID pandemic was a sentinel event.
I warned them that they needed to "act now" to prevent a "major tragedy," but not a single one of the recipients responded to my email, silence. I reached out to my Dad's doctor to discuss the situation. She felt that he was a sitting duck and that prophylaxis was appropriate.
For those who don't know, my Dad had severe heart failure from #Lyme 20+ years ago. Top NYC cardiologists could only recommend heart transplant & said he'd be dead in 6-12 months without it. Long story short, antibiotics saved his life. The heart transplant was avoided.
He took several regimens for #Lyme back then, of which az/hcq was one & it was very effective. Before #COVID brought az/hcq to public consciousness, it had been previously published as a regimen for chronic #Lyme. Countless patients have taken it safely. pubmed.ncbi.nlm.nih.gov/14586290/
Since my Dad had taken az/hcq safely in the past, his doctor recommended re-treating him with it, both for his persistent Lyme symptoms 20 years later (although his heart is still strong) as well as for prophylaxis against #COVID19. My brothers and I agreed.
He's been on it for 3 months without side effects. EKG has been unchanged. He was put on zinc to enhance its good effects & magnesium to reduce its cardiac toxicity.
As I had warned, in the time since I sent my email to the nursing home, they've had a massive #COVID death toll.
My Dad has been subjected to overwhelming #COVID exposure and never developed a single symptom. He remains, to this day, unscathed. But 3 weeks ago, when all nursing home residents were tested for #COVID, his PCR swab was positive.
When his PCR returned positive, his doctor also started him on ivermectin. Now 3 weeks later, his PCR is negative. Due to his age and many co-morbidities, my Dad is high risk to have done quite poorly from #COVID, yet he sailed through it without a scratch.
People ask, "Hey Steve, why are you pro #HCQ?" I'm not pro HCQ, I'm pro truth. I think HCQ is an imperfect treatment, & doesn't work well as single agent when used late into #COVID. But I also think that when it's used early & optimally, with safety monitoring, it can have value.
And I think that ivermectin may work, or it may not, I'm not sure. The data isn't high quality at this point, but there is some. The very good news is that it's been historically an extremely safe drug.
So that's what our family has endured. Apathy on the part of the nursing home & decisive action on the part of our doctor.
Like all tweets, this doesn't contain medical advice. Just sharing a human experience, & what's medical science for, if not to enhance our human experience?
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I'm disappointed that there are no RCT's of the old, cheap, safe, supplements rutin & procyanidin for #COVID.
They're active in so many in-silico models, including a prescient study from the start of the pandemic which found activity for ivermectin. Little 5 tweet thread.👇
This article from March accurately predicted antiviral activity of such notables as ivermectin, which hit 2 of the 3 #SARSCoV2 targets evaluated.
Both rutin and procyanidin each hit 2 targets as well.
Designing valid retrospective reviews is like putting lipstick on a pig. But RCT's have no porcine roots. They start out with racehorse potential, which made it even more sad when the major design flaws in this study rendered this horse lame. Analysis:👇 acpjournals.org/doi/10.7326/M2…
To test whether #HCQ works for #COVID19, subjects must have had proof that they actually had it, not just clinical suspicion. Without this evidence, we can't draw reliable conclusions. But only 1/3 had positive COVID tests. And maybe that's why the following didn't add up:👇
Case fatality rate (CFR) for the placebo group was about 0.5%, but the observed US COVID19 CFR at the time of study enrollment was 5.58%. Could this discrepancy have been in part due to many in the study never having had COVID19 in the first place?👇cebm.net/covid-19/globa…
I think the authors put forth a good effort, but there are significant issues with this study, which was intended to evaluate #COVIDー19 post-exposure prophylaxis with #HCQ. My two cents:👇nejm.org/doi/full/10.10…
Planned enrollment threshold was within 3 days of exposure due to the average incubation period of 5.5 days. But then the threshold was changed to 4 days. Cutting it close. One can argue that the study nearly misses its basic premise of being a PEP trial. And then this: 👇
Authors wrote that the "vast majority of the participants" couldn't get diagnostic testing for #Covid. Instead, they looked at symptoms and labeled some cases as "probable," about which they admit, "predictive power of this case definition is unknown." Is this OK?👇
Subconscious biases are ubiquitous and powerful. We all have them, so what are going to do about it? "Confirmation bias—probably the most pervasive and damaging bias of them all—leads us to look for evidence that confirms what we already think." theatlantic.com/magazine/archi…
Physicians are vulnerable to bias just like other humans and it can lead to diagnostic errors. "The culture of medicine has never been one that encourages discussion of physician vulnerability." beckershospitalreview.com/hospital-physi…
This article details how researchers are blind to their own bias but can easily point it out in others, including when it comes to how receiving gifts from pharmaceutical companies affects decision making. cmu.edu/news/stories/a…
This study implies that it's an early treatment study because hospitalized patients were treated within 48 hours of diagnosis. It's a late treatment study, and here's why: 👇
About 2/3 of patients were from N. America. Unlike Asia and Europe, we haven't had access to early #C19 testing & quick turn around times. By the time patients get to the hospital, 5-7 days have typically gone by, results have been taking about 4 days, & add 48 hours to that. 👇