Last night, a little after 10pm, someone I'd lost touch with nearly 10 years ago shared a facebook opinion post on my timeline without comment.

The post was written by a critical care physician and he said HCQ had been proven ineffective in the treatment of critical care patients.

Although most of my posts about HCQ have been about censorship of information by BigTech, I had posted some about the drug itself, specifically, the use in prevention and an early treatment protocol.

But the post my long lost facebook friend had shared was about critical care. I didn't know how to take it. Were they just sharing a resource? A rebuttal? With no comment, it didn't seem like it was an invitation to engage.

Since the post was opinion with a side of condescension, I went straight for the 6 references the doctor linked to in support of his opinion and spent the better part of this afternoon reading and then I posted the following comment to the post I received on the off chance that it was an invitation to engage:

"I’ve been reading and researching for hours. So much to unpack. The bottom line is that the findings in the clinical studies referenced in Jon Casey's post don't conflict with or discredit what the Frontline Doctors have experienced in their observational studies.

5 of the 6 clinical studies Casey linked to involved hospitalized patients and high doses of the drug.

The Frontline Doctors haven’t made any claims about, or recommendations for, high dose use on hospitalized patients. They've said high doses are toxic.

Their observational data shows the drug is effective as a preventative and in early treatment - in low doses, and they specifically recommend its use:
1. As preventative, under the care of physician, a low dose of 200mg twice a week.
2. As an early treatment option, again lower doses combined with Zithromax and daily Zinc.

Interestingly, the clinical trial Casey said he was a part of didn’t actually publish any results. He said in his facebook post that the trial was stopped, and he provided a link, but the document he linked to doesn’t contain any conclusions. It’s a 103 page trial design and the abstract reads: “This document provides the rationale and background for the trial and highlights key design features....We describe lessons learned to improve the efficiency of future clinical trials, particularly in the setting of pandemics.”

In his facebook post, Casey said “...there was no evidence that hydroxychloroquine was helping patients.” Since his study involved only hospitalized patients being treated with high doses, it didn’t provide any data about the drug’s effectiveness as a preventative or as an early treatment protocol along with Zithromax and daily Zinc, which the Frontline Doctors found to be effective.

What I find particularly significant is something he didn’t say. He didn’t say he thought the drug was dangerous or that prescribing it was irresponsible. In fact, the third sentence of his trial design paper reads: “Hydroxychloroquine has generated substantial interest as a potential treatment for COVID-19 due to its widespread availability, antiviral and immunomodulatory activity, and established safety profile from historical use for other indications.”

I mentioned that 5 of those 6 studies involved hospitalized patients. The 6th study involved giving the drug or a placebo to 821 people POST exposure as a preventative and the paper concluded with: "This randomized trial did not demonstrate a significant benefit of hydroxychloroquine as post-exposure prophylaxis for Covid-19. Whether pre-exposure prophylaxis would be effective in high-risk populations is a separate question, with trials ongoing."

I learned much more than this, but basically, I didn’t find a compelling reason for preventing doctors from prescribing 200mg twice a week as a preventative or as part of an early treatment protocol and I found even more information about the potential benefits.

I'm not done researching and learning.

https://www.facebook.com/jon.casey1/posts/10102850006940088