Is anyone at all concerned that the leader of the free world...against all recommendations...is taking hydroxychloroquine as a preventative measure...despite having high cholesterol?
Or that a doctor felt OK prescribing such to the leader of the free world despite said concerns? I mean HOLY COW!?!?!? How many will be banging down doors now to follow suit???
Quote
Several doctors questioned the wisdom of taking the unproven drug, given the possible risks.
“I think it’s a very bad idea to be taking hydroxychloroquine as a preventive medication,” said Dr. Eric Topol, a cardiologist and the director of the Scripps Research Translational Institute in La Jolla, Calif. “There are no data to support that, there’s no evidence, and in fact there is no compelling evidence to support its use at all at this point.”
Dr. Topol said that the risk of developing a potentially fatal arrhythmia because of hydroxychloroquine could come without warning and did not happen only in people with heart conditions. “We can’t predict that; in fact, it can happen in people who are healthy,” he said. “It could happen in anyone.”
Dr. David Maron, a cardiologist and the chief of the Stanford Prevention Research Center, said in an interview that in his opinion “the risk-benefit ratio doesn’t make sense.”
Are there NO repercussions for this kind of insanity??? Sorry...but WOW!!. Am good and would get the hell out of this field if I could for sooo many reasons right now...but opening a restaurant right now is out and that's what I'd wanna do...rofl.
Specializes in NICU, PICU, Transport, L&D, Hospice.
3 hours ago, FullGlass said:
1. So why don't you ignore my comments and practice what you preach?
2. What's Kaepernick got to do with this?
3. Again, you ask for evidence, yet fail to provide any of your own to support your own positions. Do you know how to do research?
However, I will humor you and provide both logic and evidence.
Logic: The mainstream media and much of the medical establishment was very incensed that Trump touted Plaquenil and were very quick to condemn use of this medication for COVID, before there was enough time to conduct conclusive research. This is going to discourage a lot of prescribers from writing for this. And it was pretty obvious that this condemnation was politically motivated, so it is reasonable to conclude a lot of providers did not use Plaquenil when it might have been helpful.
Evidently, people on this thread think that providers are incapable of making their own decisions and rely on the opinion of politicians as to medication effectiveness, so by that standard, providers are going to go along with what the mainstream media and much of the medical establishment says. Can't have it both ways.
Evidence: It is common for medications to be prescribed for off-label use. Plaquenil for COVID is such a case.
1. The FDA revoked emergency authorization for Plaquenil for COVID, before any conclusive research.
Based on the above, it is reasonable to conclude that some patients may not have received Plaquenil when they could have benefited from it.
1. Why would I ignore your comments, they aren't a source of irritation or other obnoxious emotion. You commented about how the thread made you feel sick, etc.
2. Kaepernick is an example of an American being held personally and professionally accountable for his free speech. Trump himself makes him an example. Why can't Trump be held to the same standard?
Your humor and logic are interesting but irrelevant to the Holy Crap concern that this thread is discussing relative to the president's habit of saying untrue, reckless, inflammatory, divisive, and dangerous things. You are welcome to start a thread to discuss the merits of one pharmaceutical treatment regime over another.
As for thinking that providers can't make decisions, you still haven't said why it is that you think that providers are deciding to withhold treatment options because they hate Trump. That is what you implied. No amount of projection changes that.
Specializes in Psychiatric and Mental Health NP (PMHNP).
3 hours ago, ladycody said:
Ooooh. Ouch....rofl.
My point exactly. It's still available for "off label" use (which I'm well aware of...thanks)....so there's really no problem....RIGHT? Which means it's on the providers to determine if useful...and if they screw up by rushing things...it's on them...which with a new and unproven med...is reasonable. Find another venue.
1. The FDA revoked emergency authorization for Plaquenil for COVID, before any conclusive research.
Based on the above, it is reasonable to conclude that some patients may not have received Plaquenil when they could have benefited from it.
3. Noticed you backed off on this is too dangerous, etc.
4. Finally, since you are not a provider, and do not have any experience or training as such, then it is you who are making potentially dangerous statements regarding various treatments.
Personally, I think it is pretty outrageous that you condemn Trump's opinion as "dangerous and divisive" and started this thread just because you disagree with him on Plaquenil. So no one can say anything you disagree with without being dangerous?
Science is NEVER settled. It is open to constant inquiry. That is the fundamental nature of science, and by extension, medicine. Your comments are designed to shut down further discussion and debate of a potential treatment because you dislike the speaker, not by a sincere desire to help evolve "science."
I read a recent article, actually, this has been around for awhile. Many modern people dismiss ancient and folk remedies as the products of ignorance and superstition. In medieval times, a concoction of onion, garlic, wine, and cow's bile was used as an eye salve. That sounds pretty bizarre, doesn't it? Most of you probably have a mental picture of some ignorant medieval person brewing this up, and would dismiss this as a potential medicine. Well, it works, and it works even against MRSA. So, instead of just dismissing something without proper investigation, keep an open mind and be open to new findings.
Specializes in Psychiatric and Mental Health NP (PMHNP).
1 hour ago, toomuchbaloney said:
Your humor and logic are interesting but irrelevant to the Holy Crap concern that this thread is discussing relative to the president's habit of saying untrue, reckless, inflammatory, divisive, and dangerous things. You are welcome to start a thread to discuss the merits of one pharmaceutical treatment regime over another.
As for thinking that providers can't make decisions, you still haven't said why it is that you think that providers are deciding to withhold treatment options because they hate Trump. That is what you implied. No amount of projection changes that.
This has been a long thread, so as a refresher, here is the original post:
"Is anyone at all concerned that the leader of the free world...against all recommendations...is taking hydroxychloroquine as a preventative measure...despite having high cholesterol?
Or that a doctor felt OK prescribing such to the leader of the free world despite said concerns? I mean HOLY COW!?!?!? How many will be banging down doors now to follow suit???"
BTW, that was written by an RN, not a provider. The OP also is not privy to Trump's medical history in its entirety, so is in no position to have an informed opinion on the President's medical care.
I fail to see how Trump's comments were dangerous or divisive. He stated his opinion. So what? For your information, MDs don't always agree on the efficacy and merits of various treatments. They are debating the merits of Plaquenil.
Kaepernick is irrelevant. And as for consequences, that is what elections are for.
Specializes in NICU, PICU, Transport, L&D, Hospice.
1 hour ago, FullGlass said:
This has been a long thread, so as a refresher, here is the original post:
"Is anyone at all concerned that the leader of the free world...against all recommendations...is taking hydroxychloroquine as a preventative measure...despite having high cholesterol?
Or that a doctor felt OK prescribing such to the leader of the free world despite said concerns? I mean HOLY COW!?!?!? How many will be banging down doors now to follow suit???"
BTW, that was written by an RN, not a provider. The OP also is not privy to Trump's medical history in its entirety, so is in no position to have an informed opinion on the President's medical care.
I fail to see how Trump's comments were dangerous or divisive. He stated his opinion. So what? For your information, MDs don't always agree on the efficacy and merits of various treatments. They are debating the merits of Plaquenil.
Kaepernick is irrelevant. And as for consequences, that is what elections are for.
And just keep ignoring evidence and logic.
Sure, like ignoring the evidence that the president barks out dangerous nonsense and gut feelings with absolutely no expertise in any of the facts, data, science or details? Kaepernick is irrelevant because you don't see that it's relevant. You also apparently believe that providers are withholding treatment options for patients because they hate Trump. Apparently Trump's words as president aren't influential unless the person hates him...then those haters use his words about treatment to mistreat their patients...is that about right?
Specializes in Psychiatric and Mental Health NP (PMHNP).
20 hours ago, toomuchbaloney said:
Sure, like ignoring the evidence that the president barks out dangerous nonsense and gut feelings with absolutely no expertise in any of the facts, data, science or details?
Again, let's look at the original post that started this thread:
Is anyone at all concerned that the leader of the free world...against all recommendations...is taking hydroxychloroquine as a preventative measure...despite having high cholesterol?
Or that a doctor felt OK prescribing such to the leader of the free world despite said concerns? I mean HOLY COW!?!?!? How many will be banging down doors now to follow suit???
The whole premise of this thread is that Trump was divisive and dangerous for touting Plaquenil.
I disagree with this premise. We don't know enough about COVID at this point to say that HCQ is or is not effective. We need more studies on this, as well as on other proposed treatments for COVID. Does anyone dispute this?
Doctors and epidemiologists are debating the utility of HCQ. It is far from settled whether or not it is effective. Recent evidence indicates it can indeed be effective for some patients when given early in disease course. There are plenty of reputable experts that defend the use of HCQ.
Yet, due to hatred of Trump by much of the media, and by many on this forum, HCQ was roundly condemned by much of the media and medical establishment, before we had much information! I provided evidence that in NY prescribing HCQ off-label was made illegal, and the FDA rescinded approval as well.
Furthermore, Trump didn't pull HCQ out of his behind - he has advisors and that is where he got the info. You may disagree with them and think HCQ is a bad idea, but don't delude yourself that this is a unanimous opinion and "settled" science (which doesn't even exist).
There is nothing divisive about voicing an opinion over a medication. It's called debate, people.
How about this doctor? He is both an MD and a PhD and is at the Yale Univ Dept of Epidemiology. Sounds pretty reputable to me. Harvey A. Risch, MD, PhD:
"As professor of epidemiology at Yale School of Public Health, I have authored over 300 peer-reviewed publications and currently hold senior positions on the editorial boards of several leading journals. I am usually accustomed to advocating for positions within the mainstream of medicine, so have been flummoxed to find that, in the midst of a crisis, I am fighting for a treatment that the data fully support but which, for reasons having nothing to do with a correct understanding of the science, has been pushed to the sidelines. As a result, tens of thousands of patients with COVID-19 are dying unnecessarily. Fortunately, the situation can be reversed easily and quickly.
I am referring, of course, to the medication hydroxychloroquine. When this inexpensive oral medication is given very early in the course of illness, before the virus has had time to multiply beyond control, it has shown to be highly effective, especially when given in combination with the antibiotics azithromycin or doxycycline and the nutritional supplement zinc.
On May 27, I published an article in the American Journal of Epidemiology (AJE) entitled, "Early Outpatient Treatment of Symptomatic, High-Risk COVID-19 Patients that Should be Ramped-Up Immediately as Key to the Pandemic Crisis." That article, published in the world's leading epidemiology journal, analyzed five studies, demonstrating clear-cut and significant benefits to treated patients, plus other very large studies that showed the medication safety . . . Since publication of my May 27 article, seven more studies have demonstrated similar benefit . . .
Beyond these studies of individual patients, we have seen what happens in large populations when these drugs are used. These have been "natural experiments." In the northern Brazil state of Pará, COVID-19 deaths were increasing exponentially. On April 6, the public hospital network purchased 75,000 doses of azithromycin and 90,000 doses of hydroxychloroquine. Over the next few weeks, authorities began distributing these medications to infected individuals. Even though new cases continued to occur, on May 22 the death rate started to plummet and is now about one-eighth what it was at the peak.
A reverse natural experiment happened in Switzerland. On May 27, the Swiss national government banned outpatient use of hydroxychloroquine for COVID-19. Around June 10, COVID-19 deaths increased four-fold and remained elevated. On June 11, the Swiss government revoked the ban, and on June 23 the death rate reverted to what it had been beforehand. People who die from COVID-19 live about three to five weeks from the start of symptoms, which makes the evidence of a causal relation in these experiments strong. Both episodes suggest that a combination of hydroxychloroquine and its companion medications reduces mortality and should be immediately adopted as the new standard of care in high-risk patients.
Why has hydroxychloroquine been disregarded?
First, as all know, the medication has become highly politicized. For many, it is viewed as a marker of political identity, on both sides of the political spectrum. Nobody needs me to remind them that this is not how medicine should proceed. We must judge this medication strictly on the science. When doctors graduate from medical school, they formally promise to make the health and life of the patient their first consideration, without biases of race, religion, nationality, social standing—or political affiliation. Lives must come first.
Second, the drug has not been used properly in many studies. Hydroxychloroquine has shown major success when used early in high-risk people but, as one would expect for an antiviral, much less success when used late in the disease course. Even so, it has demonstrated significant benefit in large hospital studies in Michigan and New York City when started within the first 24 to 48 hours after admission . . .
In fact, as inexpensive, oral and widely available medications, and a nutritional supplement, the combination of hydroxychloroquine, azithromycin or doxycycline, and zinc are well-suited for early treatment in the outpatient setting. The combination should be prescribed in high-risk patients immediately upon clinical suspicion of COVID-19 disease, without waiting for results of testing. Delays in waiting before starting the medications can reduce their efficacy.
Third, concerns have been raised by the FDA and others about risks of cardiac arrhythmia, especially when hydroxychloroquine is given in combination with azithromycin. . . But what the FDA did not announce is that these adverse events were generated from tens of millions of patient uses of hydroxychloroquine for long periods of time, often for the chronic treatment of lupus or rheumatoid arthritis. Even if the true rates of arrhythmia are ten-fold higher than those reported, the harms would be minuscule compared to the mortality occurring right now in inadequately treated high-risk COVID-19 patients. This fact is proven by an Oxford University study of more than 320,000 older patients taking both hydroxychloroquine and azithromycin, who had arrhythmia excess death rates of less than 9/100,000 users, as I discuss in my May 27 paper cited above. A new paper in the American Journal of Medicine by established cardiologists around the world fully agrees with this.
Physicians who have been using these medications in the face of widespread skepticism have been truly heroic. They have done what the science shows is best for their patients, often at great personal risk. I myself know of two doctors who have saved the lives of hundreds of patients with these medications, but are now fighting state medical boards to save their licenses and reputations. The cases against them are completely without scientific merit."
You may disagree with Dr. Risch, but you can hardly argue about his qualifications and expertise. He knows more about this than anyone on this forum.
Specializes in NICU, PICU, Transport, L&D, Hospice.
Trump talks nonsense during a pandemic. The consequences of that reckless language coupled with terrible leadership is plainly evident. Today he tweeted to criticize Birx, who has risked her own professional credibility to walk a political line while doing her job. That the president would actively undermine the very experts, opinions and/or recommendations during a national public health emergency is unprecedented and counter productive. These things should not be shrugged of as a matter of opinion and freedom of speech.
Of course study and research continues, at a fevered pace, to find a widely effective treatment. I certainly expect that. Since political leadership didn't embrace mitigation at the federal level and the states sometimes followed partisan political rather than scientific strategy, we must now look to pharmaceuticals and vaccines to save us. Regardless of Trump's misleadingly cheery outlook and messaging, the American people are about to suffer through the worst fall, Winter and Spring in recent memory.
Specializes in Psychiatric and Mental Health NP (PMHNP).
2 minutes ago, toomuchbaloney said:
Trump talks nonsense during a pandemic. The consequences of that reckless language coupled with terrible leadership is plainly evident. Today he tweeted to criticize Birx, who has risked her own professional credibility to walk a political line while doing her job. That the president would actively undermine the very experts, opinions and/or recommendations during a national public health emergency is unprecedented and counter productive. These things should not be shrugged of as a matter of opinion and freedom of speech.
Of course study and research continues, at a fevered pace, to find a widely effective treatment. I certainly expect that. Since political leadership didn't embrace mitigation at the federal level and the states sometimes followed partisan political rather than scientific strategy, we must now look to pharmaceuticals and vaccines to save us. Regardless of Trump's misleadingly cheery outlook and messaging, the American people are about to suffer through the worst fall, Winter and Spring in recent memory.
Yeah, I'm Holy Crap concerned.
And here we go again - you don't like Trump. Nice dodge, BTW, ignoring all evidence and logic that doesn't fit your worldview. You remind me of a puppy dog chasing its tail - around and around in circles - but never accomplishing anything.
We don't know enough about COVID at this point to say that HCQ is or is not effective. We need more studies on this, as well as on other proposed treatments for COVID.
These are YOUR words...now...in August. Trump announced his personal off label use and sang this meds praises from the rooftops in mid May. I put this side by side with his refusal to wear a mask and social distance. If you can't see the issue with how he presents to a following that takes his opinions doctrine...if you can't acknowledge how irresponsible that behavior is...how dangerous it is...then there is no need for further discussion.
Just realize that you...in your own words as quoted above ...supported my point....whether that was your intent or not. (Which is why I popped back in. Thank you for that and have a nice day. ?
Ps...I take no issue with Dr Risch...nor was this thread intended to be about the potential merits of this or any other drug.
Specializes in NICU, PICU, Transport, L&D, Hospice.
10 hours ago, FullGlass said:
And here we go again - you don't like Trump. Nice dodge, BTW, ignoring all evidence and logic that doesn't fit your worldview. You remind me of a puppy dog chasing its tail - around and around in circles - but never accomplishing anything.
Yep...around and around we go. We will continue this dance for as long as people continue to pretend like the president isn't personally responsible for failed mitigation and tens of thousands of American deaths simply because he speaks out of narcissistic ignorance in the middle of a national health emergency. That lack of logic, wisdom and leadership is dangerous whether or not you want to acknowledge or talk about it.
You do seem to be chasing your tail here. Apparently it's difficult to admit that Trump has failed so pathetically at something. I can't imagine why when the facts, data and evidence is so clear and obvious. But sure, keep going on and on about a specific medication.
Trump lies all the time about anything and everything. He would love for the American people to believe that covid is well controlled in the usa, that if you take this drug (like Trump did?) you'll be fine, and that the Trump team deserves lots of credit for the terrific job they've done. Ignoring the evidence of that doesn't mean that it's not happening.
toomuchbaloney
16,026 Posts
1. Why would I ignore your comments, they aren't a source of irritation or other obnoxious emotion. You commented about how the thread made you feel sick, etc.
2. Kaepernick is an example of an American being held personally and professionally accountable for his free speech. Trump himself makes him an example. Why can't Trump be held to the same standard?
Your humor and logic are interesting but irrelevant to the Holy Crap concern that this thread is discussing relative to the president's habit of saying untrue, reckless, inflammatory, divisive, and dangerous things. You are welcome to start a thread to discuss the merits of one pharmaceutical treatment regime over another.
As for thinking that providers can't make decisions, you still haven't said why it is that you think that providers are deciding to withhold treatment options because they hate Trump. That is what you implied. No amount of projection changes that.