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Early treatment of Covid-19 with Hydroxychloroquine: a country-based analysis
HCQ Trial ^
| 09/01/2020
Posted on 09/03/2020 9:13:00 AM PDT by SeekAndFind
SUMMARY:
Many countries either adopted or declined early treatment with HCQ, effectively forming a large trial with 1.8 billion people in the treatment group and 663 million in the control group. As of September 1, 2020, an average of 53.7 per million in the treatment group have died, and 459.3 per million in the control group, relative risk 0.117. After adjustments, treatment and control deaths become 111.8 per million and 678.7 per million, relative risk 0.16. The probability of an equal or lower relative risk occurring from random group assignments is 0.007. Accounting for predicted changes in spread, we estimate a relative risk of 0.23. The treatment group has a 77.1% lower death rate. Confounding factors affect this estimate. We examined diabetes, obesity, hypertension, life expectancy, population density, urbanization, testing level, and intervention level, which do not account for the effect observed.
Trial Setup
Treatment. We investigate early or prophylactic treatment for COVID-19 with hydroxychloroquine (HCQ), which has been adopted or declined in different countries. Since the severity of COVID-19 varies widely based on age and comorbidities, treatment was generally only initiated in higher risk individuals. The primary endpoint was death.
Treatment groups. Entire countries made different decisions regarding treatment with HCQ based on the same information, thereby assigning their residents to the treatment or control group in advance. Since assignment is done without regard to individual information such as medical status, assignment of individuals is random for the purposes of this study.
We focus here on countries that chose and maintained a clear assignment to one of the groups for a majority of the duration of their outbreak, either adopting widespread use, or highly limiting use. Some countries have very mixed usage,
(Excerpt) Read more at hcqtrial.com ...
TOPICS: Health/Medicine; Science; Society
KEYWORDS: covid19; covidcure; hcq; hydroxychloroquine
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To: SeekAndFind
Science Deniers are happy to deny the science, if it helps the Narrative. They choose Truth over Facts.
2
posted on
09/03/2020 9:14:56 AM PDT
by
ClearCase_guy
(If White Privilege is real, why did Elizabeth Warren lie about being an Indian?)
To: Mrs. Don-o; tellw; Huskrrrr; Jane Long; Freedom'sWorthIt; Freedom56v2; BDParrish; Phx_RC
Ping for your perusal.
This study analyzes deaths per capita with data from
[Our World in Data]. To determine the effectiveness of treatment, the study could compare the death rates for the entire populations in the treatment and control groups, however they use the average of the individual country rates in each group in order to minimize effects due to differences between countries. Since randomization was done at a coarse country level, adjustments were made for differences between countries and analyze confounding factors.
Case statistics.
Study analyzes deaths rather than cases because case numbers are highly dependent on the degree of testing effort, criteria for testing, the accuracy and availability of tests, accuracy of reporting, and because there is very high variability in case severity, including a high percentage of asymptomatic cases.
To: ClearCase_guy
A number of confounding factors affect the results, which we investigate here. For reference, the results before adjustments are shown in
Figure 2.
Figure 2. Deaths per million for countries using widespread early HCQ versus those that do not,
before adjustments.
Deaths per million for countries with widespread early HCQ versus those that do not, after adjustment for differences in demographics.
To: SeekAndFind
Demographic adjusted deaths per million for countries using widespread early HCQ versus those that do not, with an extended prediction for the following 90 days.
To: SeekAndFind
| Study type |
In Vitro |
PrEP |
PEP |
Early treatment |
Late treatment |
| Number of studies |
12 |
9 |
3 |
19 |
53 |
| Percentage positive |
100% |
100% |
100% |
100% |
60% |
Table 1.
Distribution of studies regarding HCQ for COVID-19. Note that the degree of positive or negative effect, and confidence therein varies widely.
Late treatment studies.
Most studies focus on late treatment with hospitalized patients, and the results are very mixed. We found 28 of the studies reported positive effectiveness, while 19 reported negative effectiveness, both with varying degrees of effect and confidence. We do not consider the late treatment studies further here since we are concerned with early treatment, other than to note that these studies suggest HCQ may potentially be beneficial in a hospital setting if used very quickly and with patients that have not reached a more advanced stage of the disease; and it may be of limited or negative value with later stage disease. Three studies consider higher dosages than typically used
[Borba, Horby, World Health Organization (B)], and the results suggest that these dosages in late stage patients may be harmful.
To: SeekAndFind
To: SeekAndFind
In France, early treatment with HCQ has not been widely used, but one exception is in Marseille.
Table 2 shows the death statistics until the end of May for these two locations for 2020 and compared with the previous two years. Paris shows a large increase, while Marseille does not
[Covid19Crusher (B)].
|
|
Change from previous years |
|
|
2018 |
2019 |
2020 |
2020/2018 |
2020/2019 |
| Paris |
6,055 |
5,927 |
7,972 |
+32% |
+35% |
| Marseille |
1,321 |
1,509 |
1,304 |
-1% |
-14% |
Table 2.
Deaths as of the end of May each year for Marseille (using early treatment with HCQ) vs. Paris (generally not using early treatment with HCQ)
[Covid19Crusher (B)].
To: SeekAndFind
Andorra,
Anguilla,
Antigua and Barbuda,
Aruba,
Bahamas,
Barbados,
Belize,
Bermuda,
British Virgin Islands,
Brunei,
Brunei Darussalam,
Cayman Islands,
Curacao,
Curaçao,
Dominica,
French Polynesia,
Gibraltar,
Greenland,
Grenada,
Guam,
Iceland,
Isle of Man,
Liechtenstein,
Malta,
Monaco,
Montserrat,
New Caledonia,
Northern Mariana Islands,
Saint Kitts and Nevis,
Saint Lucia,
Saint Vincent and the Grenadines,
San Marino,
Sao Tome and Principe,
Seychelles,
Sint Maarten (Dutch part),
Turks and Caicos Islands,
United States Virgin Islands
These countries were excluded because their population is <1M.
Afghanistan,
Angola,
Bahrain,
Benin,
Burkina Faso,
Burundi,
Cameroon,
Central African Republic,
Chad,
Comoros,
Congo,
Cote d'Ivoire,
Côte d'Ivoire,
Democratic Republic of Congo,
Democratic Republic of the Congo,
Equatorial Guinea,
Ethiopia,
Gabon,
Gambia,
Ghana,
Guinea,
Guinea-Bissau,
Iraq,
Kenya,
Kuwait,
Liberia,
Madagascar,
Malawi,
Mali,
Mauritania,
Mozambique,
Niger,
Nigeria,
Oman,
Palestine,
Papua New Guinea,
Qatar,
Republic of Congo,
Rwanda,
Sao Tome and Principe,
Saudi Arabia,
Senegal,
Sierra Leone,
Somalia,
South Sudan,
State of Palestine,
Sudan,
Tajikistan,
Tanzania,
Togo,
Uganda,
United Arab Emirates,
United Republic of Tanzania,
Western Sahara,
Yemen,
Zambia,
Zimbabwe
These countries were excluded because <0.5% of the population is >80.
Mongolia,
Laos,
Japan,
Philippines,
Macau,
Hong Kong,
Sierra Leone,
Cambodia,
Timor-Leste,
Vietnam,
Malaysia,
Bhutan,
Venezuela,
Taiwan,
Slovakia,
St. Kitts and Nevis,
South Korea,
Indonesia,
Brunei,
Grenada,
Mozambique,
Uzbekistan,
Thailand,
Malawi,
São Tomé and Príncipe,
Czechia,
Dominica,
Bangladesh,
Zambia,
Chad,
Benin,
Sudan,
El Salvador,
Antigua and Barbuda,
Myanmar,
Bosnia and Herzegovina,
Côte d'Ivoire,
South Sudan,
Kenya
These countries were excluded because they quickly adopted widespread mask use.
Australia,
New Zealand,
North Korea,
Turkmenistan,
Solomon Islands,
Vanuata,
Samoa,
Kiribati,
Federated States of Micronesia,
Tonga,
Marshall Islands,
Palua,
Tuvalu,
Nauru
These countries were excluded because they have no or very little spread to date. They may be included in the future if they experience significant spread.
Algeria - widespread early treatment for high-risk patients for most of the outbreak
Adopted HCQ in early April and continued to use after WHO warning.
Bahrain - widespread early treatment (excluded due to young population)
Belarus - mixed use of early treatment with HCQ
There was early HCQ use but it was suspended outside of hospitals on WHO recommendation 6/2.
Brazil - early HCQ treatment was adopted relatively late
Late and very mixed use, increasing over time.
Burkina Faso - widespread early treatment (excluded due to young population)
Cameroon - widespread early treatment (excluded due to young population)
Canada - limited early treatment with HCQ
Physicians not allowed to use. New Brunswick used briefly until stopped by Health Canada.
To: ClearCase_guy
This is way more than merely “anecdotal” evidence, it approaches the point of overwhelming preponderance of evidence.
WHO, FDA, and the various state legislatures be damned.
10
posted on
09/03/2020 9:37:00 AM PDT
by
alloysteel
("The Best Is Yet to Come "- theme of 2020 RNC)
To: SeekAndFind
Chile - mixed use of early treatment with HCQ
Stopped use after WHO/Lancet reports around May 26.
Costa Rica - widespread early treatment for high-risk patients for most of the outbreak
Used early based on recommendation from China 3/18.
Cuba - widespread early treatment for high-risk patients for most of the outbreak
Using to treat at an early stage.
Czech Republic - widespread early treatment (excluded due to early isolation)
Supported use since early March.
To: SeekAndFind
Even Cuba gets it. They use it because it works.
To: SeekAndFind
Djibouti - widespread early treatment (excluded due to small population)
France - limited early treatment with HCQ
Banned post WHO/Lancet. Used late stage in hospitals. Limited early treatment, some exceptions, especially in Marseille. Media very negative.
Germany - mixed use of early treatment with HCQ
We found several reports of early treatment early in the outbreak, confirmed by Sermo, later reports of trials paused post WHO/Lancet, current status of early treatment is unclear.
Ghana - widespread early treatment (excluded due to young population)
Greece - widespread early treatment for high-risk patients for most of the outbreak
Approved for use April 15, they disregarded WHO's recommendation to stop.
To: Trumpisourlastchance
India - widespread early treatment for high-risk patients for most of the outbreak
Widespread early use. Prophylaxis for healthcare workers and household contacts of confirmed cases.
Indonesia - widespread early treatment (excluded due to early isolation)
Used early. Disregarded WHO request to stop using HCQ.
Ireland - limited early treatment with HCQ
No early treatment.
Israel - mixed use of early treatment with HCQ
We initially believed that Israel had widespread early use for the majority of the outbreak, but we received reports that Israel's use for early treatment has not be as widespread as believed.
Italy - early HCQ treatment was adopted relatively late
Banned post WHO/Lancet. Some early treatment started late in Italy's outbreak.
To: SeekAndFind
Malaysia - mixed use of early treatment with HCQ
Used early since January until about 6/22.
Mexico - limited early treatment with HCQ
Not authorized outside of clinical trials. Doctors outside hospitals not allowed to prescribe. Some limited exceptions.
Morocco - widespread early treatment for high-risk patients for most of the outbreak
All patients treated on first symptoms.
To: SeekAndFind
Doctors will be fined if prescribing HCQ for COVID-19. Used for hospitalized patients.
Nigeria - widespread early treatment (excluded due to young population)
Reportedly everyone diagnosed is treated. Available OTC.
Pakistan - mixed use of early treatment with HCQ
Obtained from India, later banned.
Panama - mixed use of early treatment with HCQ
Dropped usage at the end of May, started again in July
Peru - early HCQ treatment was adopted relatively late
Some use, adopted late ~May 8. Reportedly more used in upper/middle classes. Health ministry promoted on June 8, but usage is controversial.
Portugal - mixed use of early treatment with HCQ
Banned post WHO/Lancet.
Qatar - widespread early treatment (excluded due to young population)
To: SeekAndFind
Qatar - widespread early treatment (excluded due to young population) South
Russia - widespread early treatment for high-risk patients for most of the outbreak
Approved for use April 15, they disregarded WHO's recommendation to stop.
Senegal - widespread early treatment for high-risk patients for most of the outbreak
Used early. Prof. Raoult was born in Senegal.
South Korea - widespread early treatment (excluded due to early isolation)
Promoted and prophylaxis for health care workers.
Spain - early HCQ treatment was adopted relatively late
We found limited information for Spain suggesting it was initially not used during rapid spread, was adoped later, and later became controversial.
Sweden - limited early treatment with HCQ
Doctors instructed not to use.
Switzerland - early HCQ treatment was adopted relatively late
Started using May 1.
To: SeekAndFind
Tunisia - mixed use of early treatment with HCQ
Was using but banned post WHO/Lancet.
Turkey - widespread early treatment for high-risk patients for most of the outbreak
Science board suggested beneficial in early stages. Reported everyone testing positive receives HCQ. Gradual adoption at the beginning.
Ukraine - widespread early treatment for high-risk patients for most of the outbreak
Government treatment protocol shows early use.
Use is banned outside of clinical trials. Media very negative.
FDA has warned against use, several states prohibit early use. Doctors may risk censure and their license for prescribing. Media very negative. Usage in late treatment in hospitals. Relatively minimal usage for early treatment.
Venezuela - widespread early treatment (excluded due to early isolation)
To: SeekAndFind
can anyone translate the chart and its data.
i can make nothing out of it...limited early hcq... widespread early hcq...
what are they showing...
19
posted on
09/03/2020 10:03:06 AM PDT
by
teeman8r
To: teeman8r
HCQ, for it to be effective has to be applied within 5 DAYS of symptoms and/or positive diagnosis. The intent is to PREVENT hospitalization. If you administer it AFTER the patient is serious enough to be hospitalized, the results are MIXED.
Limited early HCQ means it was applied correctly but was LIMITED to a few in the country’s population.
Widespread early HCQ means it was applied correctly and made available WITHOUT limitations to the country’s population.
Look at the death rates of countries in the charts that have limited usage vs those with widespread usage.
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