The ivermectin crazies are now recommending hydroxychloroquine too.
Their “protocol” includes a dangerously high dose of diuretics & recommends high dose steroids in people not on supplemental O2.
This has crossed the line from (mostly) harmless nonsense to actual harm.
Supporting Evidence:
A 2021 Cochrane meta-analysis (the 🥇standard) concluded that HCQ “has little or no effect on the risk of death and probably no effect on progression to mechanical ventilation. Adverse events are tripled compared to placebo…”
A more recent meta-analysis in @NatureComms that included unpublished studies went further, concluding “that treatment with hydroxychloroquine is associated with increased mortality in COVID-19 patients”
Regarding steroids:
The UK RECOVERY trial found that among hospitalized inpatients w/ COVID, dexamethasone 6 mg PO/IV reduced mortality
They also found a HARM signal among people NOT on supplemental Oxygen. That’s why we ONLY use Dex in inpatients on O2! nejm.org/doi/full/10.10…
A Cochrane MA concluded “there is no evidence for [steroids in] asymptomatic or mild disease (non-hospitalised participants)” pubmed.ncbi.nlm.nih.gov/34396514/
Another MA examined steroids in people not on O2 & found INCREASED duration of fever, DELAYED time to viral clearance, & LONGER hospital length of stay, concluding “steroids in non-O2 requiring COVID-19 patients can be more detrimental than beneficial.” pubmed.ncbi.nlm.nih.gov/34347106/
The spironolactone label shows a big potential harm: hyperkalemia
The recommended starting dose is lower & checking serum K+ levels is advised.
Caution is advised in people taking ACEi, NSAIDS, & other meds.
Bottom line: several aspects of FLCCC’s new I-MASK+ protocol are potentially very dangerous.
This is way worse than just presenting ivermectin as a “vaccine alternative.”
Based on the evidence & clinical practice guidelines, these recommendations are likely to cause real harm.
To put it another way:
If a person died while being treated with these meds (especially if they died from an arrhythmia), I would list the “I-MASK” protocol as a contributing factor.
It is truly malpractice to encourage this. Medical boards take notice. @ABIMFoundation@TheFSMB
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Just 3️⃣simple acts of compassion can go a long way
Important RCT just published in @TheLancet shows that a family support strategy consisting of 3 extra family meetings can substantially reduce family grief 6mo after the death of a loved one in the ICU thelancet.com/journals/lance…
1/
Pre-pandemic, ICU mortality was often ~20%
In the US, 30-60% of ICU deaths were preceded by a decision to withdraw life support
We are experts at providing comfort focused care for patients but in many cases, families feel grief months afterwards
What can we do about this? 2/
The COSMIC RCT studied this.
The intervention was 3 family meetings held following a decision to withdraw life support:
1️⃣family conference to prepare relatives for the imminent death
2️⃣ICU-room visit to provide support
3️⃣meeting after death to offer condolences & closure
To those who are unvaccinated because of worries about “unproven mRNA technology” you know you can get:
- the J&J vaccine (🇺🇸)
- the Oxford-AZ vaccine (🇬🇧&🇪🇺)
Both can prevent hospitalization or death from COVID. Neither are mRNA vaccines. So why not get vaxxed today?
To those worried about blood clots after J&J, as of April 2021:
-there were 15 cases of TTS
-out of 8 million J&J doses
The vaccine efficacy (VE) of the J&J vaccine *is* slightly less than the mRNA alternatives: 68-71% VE to prevent hospitalization (compared to ~90% for mRNA vaccines). That’s still much much better than being Unvaxxed.
Remdesivir (RDV) is in the “We suggest no remdesivir” category.
At some level, this isn’t too surprising & is old news.
Despite initial hype, RDV never moved the needle much on patient centered outcomes (risk of mortality or requiring IMV) & many of us had stopped using it. 2/
In #ACTT1 RDV did improve outcomes on an ordinal scale, but the effect was modest. It shortened time to clinical improvement but not hospital LOS (patients stayed in the hospital longer to receive it).
RDV did NOT improve mortality or risk of IMV. ncbi.nlm.nih.gov/pubmed/32445440 3/
It’s not that it’s a spiral - one of my favorite types of graphs is the Condegram spiral. (Named after Mark Conde)
It’s used in astronomy/meteorology to show changes the Earths magnetic fields (Kp index) & is used to visualize space weather.
2/
Another awesome spiral graph - and one of the best examples of #dataviz ever IMO - is the Rose plots by Florence Nightingale.
These 1858 plots show the causes of mortality in Crimean war & make a compelling case that for improving conditions (particularly shelter in winter). 3/