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Corona Virus News & Info

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And here is another Medical Report from the New England Journal of Medicine

Who is in charge of America’s health care system.

Who determines what is safe and effective for us and who doesn’t?

one thing that I’ve learned through all this is physician heal thyself so it looks to me like I better be my own fecking doctor and diagnose myself

I am getting dizzy reading all the reports saying I am right and you are wrong

our medical system is broken.



Hydroxychloroquine with or without Azithromycin in Mild-to-Moderate Covid-19

Alexandre B. Cavalcanti, M.D., Ph.D., Fernando G. Zampieri, M.D., Ph.D., Regis G. Rosa, M.D., Ph.D., Luciano C.P. Azevedo, M.D., Ph.D., Viviane C. Veiga, M.D., Ph.D., Alvaro Avezum, M.D., Ph.D., Lucas P. Damiani, M.Sc., Aline Marcadenti, Ph.D., Letícia Kawano-Dourado, M.D., Ph.D., Thiago Lisboa, M.D., Ph.D., Debora L. M. Junqueira, M.D., Pedro G.M. de Barros e Silva, M.D., Ph.D., et al., for the Coalition Covid-19 Brazil I Investigators*

July 23, 2020
DOI: 10.1056/NEJMoa2019014
Article
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18 References

1 Citing Article

Abstract

BACKGROUND
Hydroxychloroquine and azithromycin have been used to treat patients with coronavirus disease 2019 (Covid-19). However, evidence on the safety and efficacy of these therapies is limited.

METHODS

We conducted a multicenter, randomized, open-label, three-group, controlled trial involving hospitalized patients with suspected or confirmed Covid-19 who were receiving either no supplemental oxygen or a maximum of 4 liters per minute of supplemental oxygen. Patients were randomly assigned in a 1:1:1 ratio to receive standard care, standard care plus hydroxychloroquine at a dose of 400 mg twice daily, or standard care plus hydroxychloroquine at a dose of 400 mg twice daily plus azithromycin at a dose of 500 mg once daily for 7 days. The primary outcome was clinical status at 15 days as assessed with the use of a seven-level ordinal scale (with levels ranging from one to seven and higher scores indicating a worse condition) in the modified intention-to-treat population (patients with a confirmed diagnosis of Covid-19). Safety was also assessed.

RESULTS
A total of 667 patients underwent randomization; 504 patients had confirmed Covid-19 and were included in the modified intention-to-treat analysis. As compared with standard care, the proportional odds of having a higher score on the seven-point ordinal scale at 15 days was not affected by either hydroxychloroquine alone (odds ratio, 1.21; 95% confidence interval [CI], 0.69 to 2.11; P=1.00) or hydroxychloroquine plus azithromycin (odds ratio, 0.99; 95% CI, 0.57 to 1.73; P=1.00). Prolongation of the corrected QT interval and elevation of liver-enzyme levels were more frequent in patients receiving hydroxychloroquine, alone or with azithromycin, than in those who were not receiving either agent.

CONCLUSIONS
Among patients hospitalized with mild-to-moderate Covid-19, the use of hydroxychloroquine, alone or with azithromycin, did not improve clinical status at 15 days as compared with standard care. (Funded by the Coalition Covid-19 Brazil and EMS Pharma; ClinicalTrials.gov number, NCT04322123. opens in new tab.)
Coronavirus disease 2019 (Covid-19), the disease caused by SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), is associated with considerable morbidity and mortality.1,2 Hydroxychloroquine has antiviral effects in vitro, and, in association with azithromycin, was suggested to decrease SARS-CoV-2 viral load in a small, nonrandomized study.3,4 On the basis of this evidence, hydroxychloroquine plus azithromycin has been used by some practitioners to treat patients with Covid-19. Furthermore, some national regulatory agencies have authorized the use of hydroxychloroquine in hospitalized patients with this disease.5,6 However, observational studies have suggested no beneficial effect of chloroquine or hydroxychloroquine in hospitalized patients with Covid-19.7,8 Previous randomized, controlled trials have shown no benefit of hydroxychloroquine for either postexposure prophylaxis or treatment of Covid-19.9-11 We performed a multicenter, randomized, open-label, controlled trial (Coalition Covid-19 Brazil I) to assess whether hydroxychloroquine, either alone or in combination with azithromycin, would be effective in improving clinical status at 15 days after hospital admission due to mild-to-moderate Covid-19.

Methods

TRIAL DESIGN AND OVERSIGHT
We conducted this three-group trial at 55 hospitals in Brazil. The trial was designed by the executive committee (see the Supplementary Appendix, available with the full text of this article at NEJM.org) and approved by the Brazilian National Commission for Research Ethics, the Brazilian Health Regulatory Agency (ANVISA), and ethics committees at the participating sites. The trial was funded by the hospitals and research institutes participating in Coalition Covid-19 Brazil (see the Supplementary Appendix). EMS Pharma provided additional funding and logistic support for the trial and also donated and supplied the trial drugs. EMS Pharma had no role in the conduct of the trial, the analysis, or the decision to submit the manuscript for publication. The trial was overseen by an independent international data and safety monitoring committee. The executive committee vouches for the completeness and accuracy of the data and for the fidelity of the trial to the protocol (available at NEJM.org).

PARTICIPANTS

The trial included consecutive patients who were 18 years of age or older and who had been hospitalized with suspected or confirmed Covid-19 with 14 or fewer days since symptom onset. Among the reasons for exclusion from the trial were the use of supplemental oxygen at a rate of more than 4 liters per minute as administered by a nasal cannula or at a level of at least 40% as administered by a Venturi mask; the use of supplemental oxygen administered by a high-flow nasal cannula or invasive or noninvasive ventilation; previous use of chloroquine, hydroxychloroquine, azithromycin, or any other macrolide for more than 24 hours before enrollment (and since the onset of symptoms); and a history of severe ventricular tachycardia or electrocardiographic findings with a corrected QT interval (QTc) of at least 480 msec. Complete information on the inclusion and exclusion criteria is provided in the Supplementary Appendix. All the patients provided written or electronic informed consent before randomization.

RANDOMIZATION, INTERVENTIONS, AND FOLLOW-UP

Patients were randomly assigned in a 1:1:1 ratio to receive standard care (control group), standard care plus hydroxychloroquine at a dose of 400 mg twice daily for 7 days (hydroxychloroquine-alone group), or standard care plus hydroxychloroquine at a dose of 400 mg twice daily plus azithromycin at a dose of 500 mg once a day for 7 days. Randomization was performed in blocks of six and was stratified according to the use or nonuse of supplemental oxygen at the time of randomization. Randomization was performed centrally by means of an electronic case-report form system (RedCap) as described in the Supplementary Appendix.12
The current standard care for Covid-19 was at the discretion of the treating physicians. The use of glucocorticoids, other immunomodulators, antibiotic agents, and antiviral agents was allowed (see the Supplementary Appendix). The administration of hydroxychloroquine or chloroquine was not allowed in the control group, and the use of macrolides was not allowed in the control group or the hydroxychloroquine-alone group. Guidance was provided to the investigators about how to adjust or interrupt treatment according to side effects and laboratory abnormalities.
Data were collected daily, from randomization until day 15, in the electronic case-report form. For patients who were discharged before day 15, a structured telephone call to the patient or the patient’s family was conducted on or after day 15 by an interviewer who was unaware of the assigned trial group in order to assess vital status and return to routine activities.

OUTCOMES

The primary outcome was clinical status at 15 days, evaluated with the use of a seven-level ordinal scale. Scores on the scale were defined as follows: a score of 1 indicated not hospitalized with no limitations on activities; 2, not hospitalized but with limitations on activities; 3, hospitalized and not receiving supplemental oxygen; 4, hospitalized and receiving supplemental oxygen; 5, hospitalized and receiving oxygen supplementation administered by a high-flow nasal cannula or noninvasive ventilation; 6, hospitalized and receiving mechanical ventilation; and 7, death.
Secondary outcomes included clinical status at 7 days, evaluated with the use of a six-level ordinal scale (see below and see the Supplementary Appendix); an indication for intubation within 15 days; the receipt of supplemental oxygen administered by a high-flow nasal cannula or noninvasive ventilation between randomization and 15 days; duration of hospital stay; in-hospital death; thromboembolic complications; acute kidney injury; and the number of days alive and free from respiratory support up to 15 days. A day alive and free from respiratory support was defined as any day in which the patient did not receive supplemental oxygen or invasive or noninvasive mechanical ventilation, from randomization to day 15. Patients who died during the 15-day window were assigned a value of 0 days alive and free from respiratory support in this assessment. Safety outcomes are listed in the Supplementary Appendix. All the trial outcomes were assessed by the site investigators, who were aware of the trial-group assignments (except as noted above for patients who had been discharged before day 15 and who were assessed for the primary outcome by means of a blinded telephone interview). No formal adjudication of trial outcomes was performed.

SAMPLE-SIZE CALCULATION AND PROTOCOL CHANGES

We had originally planned for the trial to include 630 patients, using the intention-to-treat analysis population, with a six-level ordinal outcome as the primary outcome, as described in the Supplementary Appendix. However, before the first interim analysis was conducted, we changed the primary-outcome assessment to the seven-level ordinal scale and the main analysis population from the intention-to-treat population to a modified intention-to-treat population that included only patients with a diagnosis of Covid-19 that had been confirmed by reverse-transcriptase–polymerase-chain-reaction (RT-PCR) testing (using the test available at each site).
The change to the use of the seven-level ordinal scale was adopted because on April 10, 2020 (before the first enrolled patient had reached 15 days of follow-up), we established the capability to obtain 15-day information on limitations on activities with the use of blinded telephone interviews. We therefore added another level to the six-level ordinal outcome, dividing the first level (not hospitalized) into two levels (level 1, not hospitalized and with no limitations on activities; and level 2, not hospitalized but with limitations on activities). The change to the modified intention-to-treat population was adopted because, under the hypothesis that treatment would have beneficial effects on the primary outcome only for patients who had a confirmed diagnosis, the inclusion of unconfirmed cases would decrease the estimated effect size and power. As a related change, we added external adjudication of unconfirmed cases, which were classified as probable, possible, or probably not Covid-19 (see the Supplementary Appendix).
The sample size was revised with the use of the overall distribution of the seven-level ordinal outcome at day 15 observed among the first 120 patients, with the levels 1 through 7 having the following proportions of patients: 60%, 19%, 7%, 1%, 1%, 5%, and 7%, respectively. With 630 patients who had undergone randomization and 510 patients included in the modified intention-to-treat analysis, we calculated that the trial would have 80% power to detect an odds ratio of 0.5 between groups (two-by-two comparisons), at a significance level of 5% and with Bonferroni adjustment for multiple comparisons (α=5%, divided by 3 for each comparison).13

STATISTICAL ANALYSIS

The primary outcome was analyzed by mixed ordinal logistic regression with random intercept according to site, assuming proportional odds. We report all two-by-two comparisons. Binary outcomes were assessed with the use of a mixed logistic-regression model, except for in-hospital mortality, which was assessed with a Cox proportional-hazards model. Continuous outcomes were evaluated by means of generalized linear regression or mixed models for repeated variables, as appropriate. All models were adjusted for age and the use of supplemental oxygen at admission.
We also performed sensitivity analyses that included all the patients who had undergone randomization (intention-to-treat population) and sensitivity analyses for the primary outcome for the following groups: patients with definitive, probable, or possible Covid-19; and patients with definitive or probable Covid-19. Two additional populations were considered. An efficacy population included patients with a confirmed diagnosis who received at least one dose of the assigned trial drug. The safety population included patients according to the medications received, regardless of the assigned trial group or the result of Covid-19 testing.
We planned three interim analyses, to be conducted when 120 patients, 315 patients, and 504 patients had completed 15 days of follow-up. However, only the first interim analysis was conducted. Owing to faster-than-expected enrollment, primary-outcome data for the second and third interim analyses were available only after trial recruitment was finished. After discussion with the data and safety monitoring committee, the second and third interim analyses were cancelled. The data and safety monitoring committee used Haybittle–Peto14 stopping boundaries, with a P-value threshold of less than 0.001 to interrupt the trial for safety and a P-value threshold of less than 0.0001 to interrupt the trial for efficacy. We did not adjust the final values of the hypothesis test for sequential analyses.
Analyses were performed with the use of R software (R Core Team).15 P values for the primary outcome were adjusted with the use of Bonferroni correction. No P values are reported for secondary outcomes; the widths of the confidence intervals for the secondary outcomes have not been adjusted for multiple comparisons, so the intervals should not be used to infer definitive treatment effects. P values for the safety analyses were not adjusted given the importance of identifying potential signals of harm. Additional details about the statistical analyses are provided in the Supplementary Appendix.

Results

CHARACTERISTICS OF THE PATIENTS

We recruited 667 patients, including 504 patients with confirmed Covid-19. The numbers of enrolled patients according to site are presented in Table S1 in the Supplementary Appendix. A total of 217 patients were randomly assigned to receive hydroxychloroquine plus azithromycin, 221 to receive hydroxychloroquine, and 229 to receive standard care (control group) (Fig. S1). The first patient underwent randomization on March 29, 2020; the last patient underwent randomization on May 17, 2020; and follow-up was completed on June 2, 2020. Two patients were excluded after randomization (1 withdrew consent after randomization and 1 had been enrolled twice). The 15-day follow-up was completed for all the remaining 665 patients.
Table 1.

Characteristics of the Patients at Baseline (Intention-to-Treat Population).
The characteristics of the patients are shown in Table 1 and Table S2. Most patients (584 patients [87.8%]) underwent randomization within 10 days after symptom onset. The mean age of the patients was 50 years, and 58% of all the included patients were men. A total of 42% of the patients were receiving supplemental oxygen at baseline. The baseline data for the modified intention-to-treat population are shown in Table S3. A comparison between the patients in the modified intention-to-treat population and those without a confirmed diagnosis of Covid-19 (161 patients) is shown in Table S4. Patients without a confirmed diagnosis of Covid-19 had a higher prevalence of chronic pulmonary obstructive disease or smoking, a lower prevalence of diabetes, and were less frequently receiving supplemental oxygen than patients who had a confirmed diagnosis. Details concerning adherence to the trial regimen and the use of other medications are presented in Tables S5 and S6, respectively.
PRIMARY OUTCOME
Table 2.

Primary and Secondary Outcomes (Modified Intention-to-Treat Population).
Figure 1.

Status of Patients on Day 15.
The primary outcome (status on the seven-point ordinal scale at day 15) was assessed in all patients who were still in the hospital on day 15 exactly and in outpatients (by means of telephone interview) as close to day 15 as possible (see the Supplementary Appendix and Fig. S2). Among patients with confirmed Covid-19, there were no significant between-group differences in the proportional odds of having a higher (worse) score on the seven-point ordinal scale at 15 days (hydroxychloroquine plus azithromycin vs. control: odds ratio, 0.99; 95% confidence interval [CI], 0.57 to 1.73; P=1.00; hydroxychloroquine alone vs. control: odds ratio, 1.21; 95% CI, 0.69 to 2.11; P=1.00; and hydroxychloroquine plus azithromycin vs. hydroxychloroquine alone: odds ratio, 0.82; 95% CI, 0.47 to 1.43; P=1.00) (Table 2). The distribution of patients’ scores on the seven-level ordinal scale at 15 days is shown in Figure 1.
Figure 2.

Distribution of the Ordinal-Scale Results over Time.
The estimates and standard errors for the mixed-model analysis of the primary outcome are shown in Table S7. The distribution of patients in the ordinal-scale categories over time is shown in Figure 2. In this figure, levels 1 and 2 of the seven-level scale are combined (equivalent to the six-level scale previously described) because data on activity limitation were not available on a daily basis for outpatients.
In the intention-to-treat analysis, there was also no significant effect of treatment with either hydroxychloroquine plus azithromycin or hydroxychloroquine alone as compared with the control group (Table S8). Other sensitivity analyses showed similar results (Table S9). The results for the primary outcome were not different across the three prespecified subgroups (Table S10).

SECONDARY OUTCOMES

There were no significant differences in any of the secondary outcomes (Table 2). A total of 43 patients received mechanical ventilation during the first 15 days (11.0% of the patients assigned to receive hydroxychloroquine plus azithromycin, 7.5% of those in the hydroxychloroquine-alone group, and 6.9% of those in the control group). The mean (±SD) numbers of days alive and free from respiratory support were 11.1±4.9 in the group assigned to receive hydroxychloroquine plus azithromycin, 11.2±4.9 in the hydroxychloroquine-alone group, and 11.1±4.9 in the control group.
A total of 18 patients died in the hospital during the trial (5 patients assigned to receive hydroxychloroquine plus azithromycin, 7 in the hydroxychloroquine-alone group, and 6 in the control group). There were no significant between-group differences with regard to the secondary outcomes of thromboembolic complications or acute kidney injury within 15 days, either in the prespecified analyses (Table 2) or in post hoc analyses that accounted for the competing risk of death (Table S11). Marginal estimates of effects for the primary and secondary outcomes are shown in Table S12.

SAFETY

Table 3.

Adverse Events (Safety Population).
Adverse events in the safety population are reported in Table 3. More adverse events were reported in patients who received hydroxychloroquine plus azithromycin (39.3%) or hydroxychloroquine alone (33.7%) than in those who received azithromycin alone (18.0%) or none of the trial drugs (22.6%). Serious adverse events occurred in nine patients (Table 3). Prolongation of the QTc interval was more common in patients receiving hydroxychloroquine plus azithromycin or hydroxychloroquine alone than in patients in the control group; however, fewer patients in the control group had serial electrocardiographic studies performed during follow-up than did patients in the other two groups. Elevation in liver-enzyme levels was more common in patients receiving hydroxychloroquine plus azithromycin than in the control group. Adverse events in the intention-to-treat population and in the modified intention-to-treat population are shown in Tables S13 and S14, respectively.

Discussion

In this open-label, multicenter, randomized, controlled trial involving hospitalized patients with confirmed mild-to-moderate Covid-19, a 7-day course of hydroxychloroquine either with azithromycin or alone did not result in better clinical outcomes as measured by a seven-level ordinal scale at 15 days. There was also no effect on any of the secondary outcomes. Occurrence of any adverse event, elevation of liver-enzyme levels, and prolongation of the QTc interval was more frequent in patients receiving hydroxychloroquine with azithromycin or hydroxychloroquine alone than in those receiving neither agent.

The prescription of short courses (<28 days) of hydroxychloroquine or chloroquine in the United States increased almost 2000% between March 21, 2019, and March 21, 2020, with a subsequent decrease.16 In Brazil, hydroxychloroquine has been formally recommended for the treatment of Covid-19 by the Ministry of Health since March 25, 2020, for severe cases and since May 20, 2020, for mild cases.5,6 However, no clinical benefit has been observed to date in randomized, controlled trials evaluating hydroxychloroquine for the treatment of Covid-19.9-11 In addition, higher doses of chloroquine (600 mg twice daily for 10 days) were possibly associated with higher mortality.17 Our trial enrolled patients with mild-to-moderate Covid-19 who were receiving no more than 4 liters per minute of supplemental oxygen. Hydroxychloroquine was administered relatively early after symptom onset (median, 7 days), which is earlier than the median time from symptom onset to treatment in a trial of remdesivir treatment for Covid-19.18 Furthermore, the addition of azithromycin did not improve outcomes as had been suggested by observational case series.4

Our trial has several limitations. First, although the point estimate of effect suggests no major difference between the groups with respect to the primary outcome, the trial cannot definitively rule out either a substantial benefit of the trial drugs or a substantial harm. For the comparison between hydroxychloroquine and control, for example, our data are compatible with odds ratios as low as 0.69 and as high as 2.11. Second, the trial was not blinded. Third, despite intense efforts to maintain adherence to the assigned treatments, a lack of medications that were perceived as beneficial by clinicians and patients led to some protocol deviations. Fourth, the use of hydroxychloroquine plus azithromycin was widespread among patients hospitalized with Covid-19 in participating hospitals. The enrollment of patients with no previous use of these medications was challenging, so we decided to enroll patients provided that their previous use since the onset of symptoms was limited to 24 hours. Finally, although the median time from symptom onset to randomization was 7 days, we included patients up to 14 days after the beginning of symptoms; it is conceivable that interventions that may limit viral replication (e.g., hydroxychloroquine) may be more effective earlier in the course of the disease.

In this trial involving hospitalized patients with mild-to-moderate Covid-19, we did not find a significant difference in a 15-day ordinal clinical-status outcome among groups that received standard care, hydroxychloroquine alone, or hydroxychloroquine plus azithromycin. Patients who received hydroxychloroquine, either with azithromycin or alone, had more frequent events of QTc interval prolongation and elevation of liver-enzyme levels than patients who did not receive either agent.
Supported by institutions participating in the Coalition Covid-19 Brazil and by EMS Pharma, which provided partial funding, the trial drugs, and logistic support.
Disclosure forms provided by the authors are available with the full text of this article at NEJM.org.
Drs. Cavalcanti and Zampieri contributed equally to this article.
This article was published on July 23, 2020, at NEJM.org.
A data sharing statement provided by the authors is available with the full text of this article at NEJM.org.
Author Affiliations
From HCor Research Institute (A.B.C., F.G.Z., L.P.D., A.M., L.K.-D., T.L., D.L.M.J., P.G.M.B.S., L.T., E.O.A.-S., L.N.L., I.S.M.), Brazilian Research in Intensive Care Network (A.B.C., F.G.Z., R.G.R., L.C.P.A., V.C.V., T.L., F.G.R.F., A.S.-N., F.R.M.), Hospital Sírio Libanês Research and Education Institute (L.C.P.A.), BP–A Beneficência Portuguesa de São Paulo (V.C.V.), International Research Center, Hospital Alemão Oswaldo Cruz (A.A.), Brazilian Clinical Research Institute (P.G.M.B.S., R.D.L.), Hospital São Camilo (A.T.S.), Hospital Moriah (L.S.E.), Academic Research Organization of Hospital Israelita Albert Einstein (R.H.M.F., O.B.), Hospital Israelita Albert Einstein (L.S.E., A.J.P., A.S.-N.), Hospital Sepaco (F.G.R.F.), and Hospital Santa Paula (O.C.E.G.), São Paulo, Hospital Moinhos de Vento, Porto Alegre (R.G.R., M.F.), Hospital Naval Marcílio Dias, Rio de Janeiro (V.C.S.D.), Hospital Giselda Trigueiro, Natal (E.P.M.), Instituto Tacchini de Pesquisa em Saúde, Hospital Tacchini, Bento Gonçalves (N.A.G.), Hospital Bruno Born, Lajeado (F.F.C.), Hospital Baia Sul, Florianópolis (I.S.M.), Hospital Regional Hans Dieter Schmidt, Joinville (C.R.H.F.); Angiocor Blumenau, Blumenau (A.P.M.K.), and EMS Pharma, Hortolândia (R.B.A., M.F.B.O.) — all in Brazil; and Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (R.D.L.).
Address reprint requests to Dr. Cavalcanti at HCor Research Institute, Rua Abílio Soares 250, 12th Fl., São Paulo, 04005-909, Brazil, or at abiasi@hcor.com.br.
A list of the Coalition Covid-19 Brazil I Investigators is provided in the Supplementary Appendix, available at NEJM.org.
Supplementary Material
ProtocolPDF4313KB
Supplementary AppendixPDF655KB
Disclosure FormsPDF550KB
Data Sharing StatementPDF72KB
References (18)
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Citing Article (1)
Figures/Media
Table 1.
Characteristics of the Patients at Baseline (Intention-to-Treat Population).*

Table 2.
Primary and Secondary Outcomes (Modified Intention-to-Treat Population).*

Figure 1.
Status of Patients on Day 15.

The primary outcome was clinical status evaluated at 15 days according to a seven-level ordinal scale. The scores on the scale were defined as follows: a score of 1 indicated not hospitalized with no limitations on activities; 2, not hospitalized but with limitations on activities; 3, hospitalized and not receiving supplemental oxygen; 4, hospitalized and receiving supplemental oxygen; 5, hospitalized and receiving oxygen supplementation administered by a high-flow nasal cannula or noninvasive ventilation; 6, hospitalized and receiving mechanical ventilation; and 7, death. The percentages shown have been rounded to whole numbers.
Figure 2.
Distribution of the Ordinal-Scale Results over Time.

Shown is the course of ordinal-scale results as assessed over the time since randomization. However, not all levels of the seven-level scale are shown. Because data on activity limitation were not available on a daily basis for outpatients, levels 1 and 2 (i.e., the levels for patients who were not hospitalized and had no limitations on activities and for those who were not hospitalized but who had limitations on activities, respectively) were combined (equivalent to the six-level scale described in the Methods section). Thus, in this figure, levels 1 and 2 indicate not hospitalized. A total of 36 patients were discharged after a 1-day hospital stay (7 patients who had been assigned to receive hydroxychloroquine plus azithromycin, 8 in the hydroxychloroquine-alone group, and 21 in the control group). Missing data are shown at the bottom of the graphs.
Table 3.
Adverse Events (Safety Population).*




More aboutVIRAL INFECTIONS


https://www.nejm.org/doi/full/10.1056/NEJMoa2019014
 

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Why Americans Fear the COVID-19 Vaccine (8 min 25 sec):​
Published on Aug 4, 2020 by ReasonTV​

YouTube viewer comments:

  • Helix, 20 minutes ago: If Reason is worried about the misinformation Twitter is spreading about vaccines, wait till they see what Twitter is saying about communism!
  • Arch Stanton, 26 minutes ago: Vaccine Safety Act of 1986: vaccine companies indemnified against lawsuits
  • Art Camera, 29 minutes ago: As many times as the so called experts have lied to us, who in their right mind could possibly continue to believe this crap?
  • Jason Johnson, 39 minutes ago: How could refusers continue to spread the disease? Spread it to who? Those who have been vaccinated? Well if that's the case... Then I don't want the vaccine because it simply must not be worth a shit
  • Kennedy1op, 32 minutes ago: I don't trust a vaccine with a virus that has 20-30 mutations
 

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Uglytruth

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Seems more ain't buyin the BS!

The More We Know The Better We Can Respond
The State of Ohio has implemented the Ohio Public Health Advisory System. It currently takes 7 indicators to evaluate the public health of all 88 Ohio Counties.

LEVEL 1 - Yellow
0–1 Indicators met
LEVEL 2 - Orange
2–3 Indicators met
LEVEL 3 - Red
4–5 Indicators met
LEVEL 4 - Purple
6–7 Indicators met

This system sets up a County like Seneca to get to and stay at a Level 3. Because it focuses on positive cases, regardless of people getting sick, or even having symptoms, it will make it look like things are more dire than they really are.

Rating a County Level 3 until they drop below 100 new cases per 100,000 in the past 2 weeks, will keep us at a level 3.

The 2019 County census according to Siri on my iPhone was 55,178. Therefore, we would only need 56 cases to make the 100/100,000 threshold. That is only 4 positive cases per day over a 2 week period. And to meet indicator #1, we only need 2 positive cases per day over a 2 week period. With increased testing, and looking for positives, we will likely get to and stay at a level 3.

Our hospital admissions are so low, that it will not take much of a normal flu season to push us into red. (See the story: By the Numbers Below)
Summary of Alert Indicators
1. New cases per capita
Flagged if greater than 50 cases per 100,000 residents over the last two weeks. Allows for counties with different population sizes to be appropriately compared.

2. Sustained increase in new cases
Flagged if increasing trend of at least 5 consecutive days in overall cases by onset date over the last 3 weeks. Reflects disease spread in the population.

3. Proportion of cases not in a congregate setting
Flagged if proportion of cases that are not in a congregate setting goes over 50% in at least one of the last 3 weeks. Used as indicator of greater risk of community spread.

4. Sustained increase in Emergency Department (ED) visits for COVID-like illness
Flagged if increasing trend of at least 5 consecutive days in the number of visits to the emergency department with COVID-like illness or a diagnosis over the last 3 weeks. Provides information on the health care seeking behavior of the population and a sense of how concerned residents are about their current health status and the virus.

5. Sustained increase in outpatient visits for COVID-like illness
Flagged if increasing trend of at least 5 consecutive days in the number of people going to a health care provider with COVID symptoms who then receive a COVID confirmed or suspected diagnosis over the last 3 weeks. Provides information on the health care seeking behavior of the population and a sense of how concerned residents are about their current health status and the virus.

6. Sustained increase in new COVID hospital admissions
Flagged if increasing trend of at least 5 consecutive days in the number of new hospitalizations due to COVID over the last 3 weeks. Important indicator of hospital burden and disease severity.

7. Intensive Care Unit (ICU) bed occupancy
Flagged if percentage of the occupied ICU beds in each region goes above 80% for at least three days in the last week, AND more than 20% of ICU beds are being used for COVID-19 positive patients for at least three days in the last week. Provides an indication of the capacity available to manage a possible surge of severely ill patients
 

Uglytruth

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Seneca County Covid Hospital Admissions

I was introduced to a new webpage as part of the Ohio Department of Health Covid-19 site. Click Here to see the webpage. Click on Seneca County to see the numbers I am showing you.



As you read above, there are 7 indicators that help make up the Ohio Public Health Advisory System. The individually color coded system that is supposed to let us know without having to think too hard, how each County is doing, throughout the State of Ohio.



One of the indicators is hospital admissions with Covid-19. With all of the hoopla, I assumed people were going to the local hospital in great numbers and being admitted. I was shocked to find out in Seneca County we had 3 people admitted in three full weeks between July 8-28.

Number of admissions per day

July 8 - 0 admissions

July 9 - 0 admissions

July 10 - 0 admissions

July 11 - 0 admissions

July 12 - 1 admission

July 13 - 0 admissions

July 14 - 0 admissions

July 15 - 0 admissions

July 16 - 0 admissions

July 17 - 0 admissions

July 18 - 0 admissions

July 19 - 0 admissions

July 20 - 0 admissions

July 21 - 0 admissions

July 22 - 1 admission

July 23 - 1 admission

July 24 - 0 admissions

July 25 - 0 admissions

July 26 - 0 admissions

July 27 - 0 admissions

July 28 - 0 admissions


Although the webpage does provide much more info than we have had before, they don't make it easy to figure out what things look like right now. They work on a 7 or 14 day running average. So it took a little work to figure out how many admissions on which days. Even at the high point on the chart above, Seneca had 0.29 or about 1/4 of a person on average per day admitted to the hospital. The chart shows you zero, but does not show you how high one would be.



Franklin County, which is Columbus, we hear that they are so bad. The most recent date on their chart was July 28. They had a running 7 day average of 2.57 people from Franklin County admitted to all of their hospitals total. They have 1,316,756 people who live in their county, and of those 1.3Million people 2.5, or less than 3 people were admitted to any of their hospitals with Covid-19. I would bet more people than that fell off ladders and were admitted. We can be sure that more than 2.5 people were injured in auto accidents in all of Franklin County, and admitted to one of their hospitals. But are we making everyone stop driving? Are we even slowing the speed limit on the I-270 loop to 25 or 35mph?



Don't get me wrong, I'm not saying that this is nothing. I'm just saying we need to see it for what it is, and react or respond with appropriate measures.
 

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An Arizona State University professor who posted on Twitter for years about social justice issues and recently detailed her fight with COVID-19 was said to have died last week — but she actually never existed.
1596666329406.png

BethAnn McLaughlin — who announced the made-up professor’s death on July 31 — admitted to The New York Times on Tuesday that she was behind the hoax.

“I take full responsibility for my involvement in creating the @sciencing_bi Twitter account,” she said in a statement through her lawyer.

“My actions are inexcusable. I apologize without reservation to all the people I hurt.”

Since 2016, the anonymous account @Sciencing_Bi had posted frequently about sexual harassment and diversity in science, making connections with other academics online.

The account claimed to be an anthropology professor who had grown up in Alabama and “fled the south because of their oppression of queer folk,” according to the Times.

It also made pointed references to being Native American and began to identify as Hopi earlier this year.

And it was active in the career of McLaughlin, a neuroscientist, even promoting a petition for her to receive tenure Vanderbilt University, which was ultimately unsuccessful.

In April, @Sciencing_Bi announced its coronavirus diagnosis and then documented the symptoms including a loss of language fluency, according to Buzzfeed News.

The account blamed ASU for her condition, tweeting in June that the school “forced me to teach 200 person lectures instead of closing” in April.

She also claimed the university cut her salary by 15 percent while she was in the hospital.

Then, a seemingly distraught McLaughlin wrote in a lengthy, mournful Twitter thread on Friday that the anonymous professor had died.

“Looking at her side of the bed and crying. Just a lot of crying. I literally can do nothing,” she wrote.

The supposed death spurred outrage from others in academia, with a professor saying: “This person was a scientist who got Covid because they’d been forced to teach.”



https://nypost.com/2020/08/04/scientist-says-she-made-up-asu-professor-who-died-of-covid-19/
 

Uglytruth

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who announced the made-up professor’s death on July 31
That's ok. All the numbers are fake! If they were real the 6° of seperation would mean even grumpy old bastards like us would know many that died and even more that lived after having it........
 

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ABC123

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Ex-NYT reporter publishes new anti-lockdown book, calls out ‘90% of media’ on parroting same lines on Covid responses



Alex Berenson’s latest chapter in a series of books about Covid-19, the first of which was briefly censored by Amazon, questions both the media’s coverage of the pandemic and the effectiveness of lockdowns.

“I think it's really important, at a time when 90 percent of media… is saying the same thing, with very little pushback or smart questioning, to get different perspectives,” Berenson told Fox News about the self-published ‘Unreported Truths about COVID-19 and Lockdowns: Part 2: Update and Examination of Lockdowns as a Strategy.’

“Even if you disagree with me completely, it’s always good to know what other people are thinking,” he added.

The first part in the reporter’s series of Covid-19 books was censored by Amazon for allegedly spreading misinformation about the pandemic. The e-commerce company refused to publish the work, which questioned the hysteria around coronavirus, but ultimately folded after many blasted the company, including SpaceX founder Elon Musk, who accused the company of being a “monopoly.”



https://www.rt.com/usa/497205-alex-berenson-covid-lockdown-book/
 

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Remdesivir: George Soros & Bill Gates Partner with China on Coronavirus Drug!

February 11, 2020
Updated April 9, 2020



As drug manufacturers speed up their efforts to find a new treatment drug for the coronavirus outbreak that has devastated China and has caused a world-wide panic, a Chinese drug company just announced that it has started mass-producing an experimental drug from Gilead Sciences that has the potential to fight the novel coronavirus (1).

BrightGene Bio-Medical Technology, a Suzhou based company (2), just announced that it has developed the technology to synthesize the active pharmaceutical ingredients of Remdesivir, the drug developed by Gilead Biosciences. Its stock price surged 20% in Tuesday morning trading in Shanghai (1).

“While BrightGene said that it intends to license the drug from Gilead, its move to start manufacturing at this early stage is highly unusual and a potential infringement of the American company’s intellectual property.“(1) This comes a week after Chinese researchers at the Wuhan Institute of Virology filed an application to patent Gilead’s drug Remdesivir to treat the new coronavirus, a bid that would give China leverage over the global use of the therapy to fight the outbreak (1)(3)(4).

The decision to seek a patent instead of invoking a “compulsory license” option that lets nations override drug patents in national emergencies, signals China’s commitment toward intellectual property rights. The timing is uncanny! Right? Gilead will retain the global rights to market the antiviral medication, once approved (3). Gilead has also announced that it is partnering with the Chinese Health Authorities on the clinical trials of Remdesivir as a treatment for coronavirus (5). Remdesivir was originally developed in 2016 by Gilead as a treatment for the Ebola virus (13). Many have argued that China stole the patent from Gilead due to a technicality, but you will soon see that this is indeed not the case (14).

(5)

And who exactly is Gilead Biosciences? Gilead is partnered with Wuxi Pharmaceuticals (Wuxi AppTec) owned by New World Order philanthropist and mass manipulator himself, George Soros (6)(7)! Here is a printout of Soros Fund Managaement Portfolio which will confirm this (8)!


(8)
Wuxi Pharmaceuticals is conveniently located in the epicenter of the outbreak near Wuhan Institute of Virology that has been implicated as the Bioweapons manufacturer of this coronavirus (10)(11)(12)! Looks like China has both the Bioweapon and the cure! And let’s not forget the patent on the treatment drug! How charitable do you suppose China will be with the west?


But this story doesn’t end here. George Soros also owns Gilead Biosciences (15).


According to The Gateway Pundit, doctors at Providence Regional Medical Center successfully treated a coronavirus patient within hours using Gilead’s drug Remdesivir (16). Given the current outbreak that has taken the world by surprise, it’s important to look at all the current players. How is Gilead Biosciences tied to this viral outbreak?

Gilead endorsed and is involved in a drug purchasing group called UNITAID whose mandate is to create a “patent pool” for pharmaceutical companies to share their “drug patents” with other companies in order to produce generic drugs for distribution to poor African nations (17)(18). The royalties from the sales of these generic drugs are then paid to the patent holders (19). UNITAID emerged from the United Nations 2000 Millennium Declaration, which has now evolved into the UN Global Compact (20)(21). Their internet timeline shows that the UNITAID website Unitaid.org is also linked to Refunite.org an agency partnered with the UN Refugee Agency UNHCR that helps to connect refugees with their families using the internet (22)(23)(24)(25)(26).

(27)
UNITAID has several financial backers including: WHO, UNAIDS, Global Fund, and the Roll Back Malaria Partnership. In addition, UNITAID has corporate sponsorship from pharmaceuticals with the “Medicines Patent Pool” (28).

(28)
One billionaire investor behind UNITAID is George Soros himself (29). But why stop there? UNITAID is also financed by the Bill and Melinda Gates Foundation and also involves a partnership with the Clinton Health Access Initiative (CHAI) (30)(31). And interestingly enough both UNITAID and Gilead Biosciences supported Hillary Clinton for president in 2016 (32)(33).

(34)
UNITAID’s objectives are to exclude high and middle-income countries from “drug pool” while allowing “developing” countries to benefit from lower drug prices (35). In 2009 UNITAID’s board voted to exclude China and other more lucrative nations when considering targeted nations outside of Africa. However, since then all that has changed and UNITAID has now included China in its “drug pool” (36).

Minutes of the Executive Board of UNITAID dated December 5-6, 2018 in Marrakesh Morocco (which coincided with the signing of the UN Global Compact on Migration) stated the following (37)(38):

THE REPRESENTATIVE OF WHO informed the Board of a recent meeting coordinated by WHO with several global health partners (GPEI, GFF, Gavi, Unitaid, Global Fund) to support the development of a common health narrative. With regard to parliamentary engagement, he informed of a new Memorandum of Understanding (MoU) between WHO and the Inter-parliamentary Union and encouraged Unitaid to build on this commitment in its country work. He underlined the important role of Board members in supporting the Unitaid Secretariat by opening new doors and leveraging existing political and other connections. He also gave positive feedback on the recent Unitaid-WHO visit to China, which explored opportunities for engagement.
A year later we now have a Global Pandemic emerging from Mainland China and the Chinese are the holders of the patent for the treatment drug and they are also included in the United Nation’s UNITAID initiative that will see them benefit with lower drug pricing. Furthermore Gilead, a main supporter of UNITAID (39), has also announced that it is partnering with the Chinese Health Authorities on the clinical trials of Remdesivir as a treatment for coronavirus (5). And once approved, Gilead will retain the global rights to market the antiviral medication (3).


(39)

UNITAID is the UN and this is bio-warfare, where they control the drugs. China did not steal Gilead’s patent; Gilead was a willing participant, they are even working with the Chinese government on clinical trials. The question remains, how will this impact western nations that are excluded from the acquisition of lower-priced treatment drugs? Will our economies be held hostage to Chinese imperialism? And has the coronavirus outbreak been the vehicle for George Soros, Bill Gates, and the United Nations to implement the New World Order? It sure look’s like it! Checkmate!

References:

  1. https://time.com/5782633/covid-19-drug-remdesivir-china/
  2. http://www.bright-gene.com/en/page.php?id=1
  3. https://nationalpost.com/news/world...accine-apply-for-a-patent-on-an-american-drug
  4. https://www.natlawreview.com/article/wuhan-institute-virology-applies-patent-gilead-s-remdesivir
  5. https://www.genengnews.com/topics/d...trial-of-remdesivir-as-coronavirus-treatment/
  6. https://www.prnewswire.com/news-rel...and-stability-testing-facility-300168817.html
  7. https://www.debtwire.com/info/china-“princeling”-fund-execs-spin-out-under-new-name-seek-usd-500m-boyu-raises-quiet-usd-2bn
  8. https://www.sec.gov/Archives/edgar/data/1029160/000101143811000207/form_13f-soros.txt
  9. https://wxpress.wuxiapptec.com/gile...ity-testing-facility/gilead-wuxi-partnership/
  10. https://www.europereloaded.com/indi...ncis-boyle-coronavirus-is-a-bio-weapon-video/
  11. https://greatgameindia.com/wuhan-institute-of-virology-epicentre-of-coronavirus/
  12. https://gnews.org/89749/
  13. https://en.wikipedia.org/wiki/Remdesivir
  14. https://nationalpost.com/news/world...accine-apply-for-a-patent-on-an-american-drug
  15. https://www.sec.gov/Archives/edgar/data/1029160/000101143811000207/form_13f-soros.txt
  16. https://www.thegatewaypundit.com/20...cation-significantly-improved-in-hours-video/
  17. https://unitaid.org/#en
  18. https://web.archive.org/web/2010051....org/events/symposiums/2008-aids-iac/unitaid/
  19. https://www.forbes.com/2009/12/15/aids-patent-gilead-healthcare-patent-pool.html#156b392e2222
  20. https://web.archive.org/web/20131124030101/http://www.unitaid.org/en/who/history-and-timeline
  21. https://en.wikipedia.org/wiki/Millennium_Development_Goals
  22. https://web.archive.org/web/20110515000000*/unitaid.org
  23. https://web.archive.org/web/20101231040755/http://refunite.org/
  24. https://en.wikipedia.org/wiki/REFUNITE
  25. https://web.archive.org/web/20110319142709/http://www.refunite.org/content/funders
  26. https://refunite.org/
  27. https://web.archive.org/web/20131124030101/http://www.unitaid.org/en/who/history-and-timeline
  28. https://web.archive.org/web/20131118225714/http://www.unitaid.org/en/how/partners
  29. https://www.forbes.com/2009/12/15/aids-patent-gilead-healthcare-patent-pool.html#156b392e2222
  30. https://web.archive.org/web/20110131135955/http://www.medicinespatentpool.org/WHO-WE-ARE2/Partners
  31. https://philanthropynewsdigest.org/...taid-announce-price-reductions-for-aids-drugs
  32. https://www.washingtonpost.com/graphics/politics/clinton-donors/
  33. https://www.opensecrets.org/orgs/summary.php?id=D000026221&cycle=2016
  34. https://web.archive.org/web/20110131135955/http://www.medicinespatentpool.org/WHO-WE-ARE2/Partners
  35. https://www.forbes.com/2009/12/15/aids-patent-gilead-healthcare-patent-pool.html#156b392e2222
  36. https://unitaid.org/country-profile/china/#en
  37. https://unitaid.org/assets/UNITAID_EB32_2019_2_Minutes-from-EB30-1.pdf
  38. https://news.un.org/en/story/2018/12/1028031
  39. https://web.archive.org/web/2010051....org/events/symposiums/2008-aids-iac/unitaid/
 

ABC123

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1596688020321.png

Disgraceful



Mother fined $1,652 for breaking Melbourne's COVID-19 restrictions screams as she's tackled to the ground and handcuffed by three cops while her daughter begs 'get off my mum, she's in pain'

Shocking footage shows a mother's dramatic arrest for breaking lockdown rules

She was pinned down at Hoppers Crossing in Melbourne's south on Saturday

Woman was allegedly pinched by the officers, leaving her with large bruises

In the dramatic video, her daughter is heard screaming that she's 'in pain'



Shocking footage has emerged showing a mother being pinned to the ground by three police officers for allegedly breaking COVID-19 lockdown restrictions.

The dramatic incident, which left the mum with horrific bruises under her arms, took place in Hoppers Crossing in Melbourne's south-west on Saturday.

The confronting footage, filmed by her daughter, shows the blonde woman screaming as the officers hold her face-down on the footpath and handcuff her arms behind her back.

Her terrified daughter is heard begging the officers to get off her mum, shouting 'she's in pain, she said she's in pain'.

In a Facebook post, written by a friend, it was alleged the police officers deliberately pinched her mother during the arrest, leaving her battered and bruised.



More

https://www.dailymail.co.uk/news/article-8597617/Confronting-moment-woman-tackled-ground-handcuffed-police-screams-terror.html
 

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Trump holds coronavirus news conference at White House

 

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https://www.conservativereview.com/...rned-universal-masking-wildfires-apply-virus/

Horowitz: Our government openly warned against universal masking during wildfires — It should apply to virus too

If you want to ascertain the science behind a given policy, look at the literature on the issue before it became political and a tool for social control. Thus, if one were to do that regarding the efficacy of masks, the side effects of long-term wearing, and the advice on children wearing them, he’d discover that the research was all on one side … until it became political.

One common public health challenge that might lead people to cover their faces is annual wildfire season in affected areas. For those who don’t live near forests, particularly out west, this might sound like a foreign concept, but for millions of Americans, dealing with the contaminated air from wildfires is a common occurrence. What’s also particularly helpful about researching forest fires is that the issue has not been politicized, at least not yet. So, what have governmental agencies said about covering one’s face in areas saturated with smoke from seasonal wildfires?

The California Department of Public Health has a section on mask wearing in its Q&A page for protecting against smoke inhalation from wildfires. In response to the question, “Should I wear a mask during a wildfire, even if it’s not really smoky where I am?” the California government could not be any clearer:

“Surgical masks, dust masks, bandanas or other face coverings do not offer protection from particle pollution. Inexpensive paper “comfort” or “dust” masks commonly found at hardware stores are designed to trap large particles and do not provide enough protection for your lungs.”

In other words, everyone understood until recently that masks are for visible contamination or perhaps larger bacteria, but not for microscopic particles, such as smoke particles or viruses. At least 90% of smoke particles are less than 1 micron (1,000 nanometers), which is 1/100th the size of the width of a human hair.
 

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Neil Diamond “Hands.. washing hands”

 

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Massive International Study Shows Countries with Early HCQ Use Had 79% Lower Mortality Rate — THIS IS HUGE! We Are Talking Over 100,000 American Lives!

By Jim Hoft
Published August 6, 2020 at 7:30am


The latest international testing of hydroxychloroquine treatment of coronavirus shows countries that had early use of the drug had a 79% lower mortality rate than countries that banned the use of the safe malaria drug.

This means that Dr. Fauci, Dr. Birx, the CDC, the liberal fake news media and the tech giants have been pushing a lie that has had deadly consequences!

America has lost (reportedly) over 150,000 lives.

And that could have been lowered by nearly 80% if HCQ use would have been promoted in the US!

plot1ax-1536x950.jpg


https://www.thegatewaypundit.com/202...merican-lives/


 

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On the spot report from real life, Louisville Kentucky, last night.

Background: The "D" Governor had relaxed rules about children playing team sports, he took his own children to play and saw children running around and playing and immediately removed his children and took them home. A few days ago he clamped down and said no more. Babies were dying. He said yesterday that if everybody wears a mask he might consider allowing children's outdoors team sports again in the future.

Reality: I attended the oldest grandson's private baseball team's game last night [not school related, they are off school on vacation]. I have been before, the parents are generally lower middle class, mostly white with some immigrants and black mixed in, mostly liberal from what I have heard them talking about to each other during games. Age of children about 13.

About 70 people attended as watchers from both teams, of all age groups. I only observed one person wearing a mask, he was elderly and stood about 50 feet from the game on a small berm, with a small group of people. Do you understand? One person out of all the players, coaches, umpires, watchers, people drifting by. Nobody except that one man even had a mask hanging off their neck. Nobody talked about it, that I heard. It was not even a subject that came up. It was a government park that they played at, very nice with great lights and bleachers. The bleachers were crowded, I sat with my son next to the bleachers for a time, and talked to my other grandchildren in the parking lot for about 20 minutes. Never saw a single incident at all.

That is all.
 

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Only read the visible text, they want an email address to see more.
 

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Hydroxychloroquine and Coronavirus ... Information I GUARANTEE You've Never Heard

Zinc is a very powerful way to strengthen your body against viruses. The National Institutes of Health notes:

Zinc is found in cells throughout the body. It helps the immune system fight off invading bacteria and viruses.​
Moreover:

An abundance of evidence has accumulated over the past 50 years to demonstrate the antiviral activity of zinc against a variety of viruses, and via numerous mechanisms.​
***​
Ionic zinc possesses unique and distinct antiviral properties against a number of human viruses .... Zinc has been shown to contribute to a number of innate and adaptive immune signaling pathways that have been comprehensively reviewed recently.​
***​
Upon recognition of microbial antigens ... a rapid and transient influx of free zinc ions occurs.​
***​
Zinc plays a significant role in the response to [interferons] by modulating secretion, cytokine potency, and receptor binding, as well as influencing signaling intermediates and pathway inhibitors.​

Harvard notes:

Zinc is a component of many enzymes and transcription factors in cells all over the body, and inadequate zinc levels limit the individual’s ability to mount an adequate immune response to infections. Multiple meta-analyses and pooled analyses of randomized controlled trials (RCTs) have shown that oral zinc supplementation reduces the incidence rate of acute respiratory infections by 35%, shortens the duration of flu-like symptoms by approximately 2 days, and improves the rate of recovery. The studies were conducted in the US as well as in multiple low- and middle-income countries such as India, South Africa, and Peru. The dose of zinc in these studies ranged from 20 mg/week to 92 mg/day. Dose does not appear to be the main driver of the effectiveness of zinc supplementation. [More on this below.]​
Zinc was shown to inhibit viral replication in many other types of coronavirus, including in the original SarsCov coronavirus. Many common colds are actually mild coronaviruses, and as UCHealth points out:

A Cochrane review updated in 2013 summarized 18 randomized controlled trials involving 1,781 participants across all age groups found that zinc – particularly in lozenge or syrup form – “inhibits replication of the virus” that cause the common cold and shortens average duration of the common cold when taken within 24 hours of onset of symptoms at a dose of more than 75 milligrams a day.​
A 2010 study led by University of Leiden Medical researchers in the Netherlands sought to understand how zinc inhibited that replication. The team reported that zinc inhibits a cousin of SARS-CoV-2: SARS-CoV, the original SARS of the 2003 outbreak.​
And it could be very helpful in fighting this specific type of coronavirus, SarsCov2 (i.e. Covid):

Interestingly, most of the risk groups described for COVID-19 are at the same time groups that were associated with zinc deficiency. As zinc is essential to preserve natural tissue barriers such as the respiratory epithelium, preventing pathogen entry, for a balanced function of the immune system and the redox system, zinc deficiency can probably be added to the factors predisposing individuals to infection and detrimental progression of COVID-19. Finally, due to its direct antiviral properties, it can be assumed that zinc administration is beneficial for most of the population, especially those with suboptimal zinc status.​
***​
The fact that zinc deficiency is responsible for 16% of all deep respiratory infections world-wide provides a first strong hint on a link of zinc deficiency with the risk of infection and severe progression of COVID-19 and suggests potential benefits of zinc supplementation.​
***​
Infections with coronaviruses go along with damage of the ciliated epithelium and ciliary dyskinesia consecutively impairing the mucociliar clearance. It was shown that physiological concentrations of zinc increase ciliary beat frequency. Moreover, zinc supplementation in zinc deficient rats had a positive effect on the number and the length of bronchial cilia .... Improved ciliary clearance does not only improve the removal of virus particle, it also reduces the risk of secondary bacterial infections ....​
***​
Zinc is essential for preserving tissue barriers​
***​
Zinc ... might decrease ACE-2 expression and thus viral entry into the cell.​
***​
As a virus, SARS-CoV2 is highly dependent on the metabolism of the host cell. Direct antiviral effects of zinc have been demonstrated in various cases .... Examples include coronaviridae [i.e. coronaviruses].​
***​
Zinc supplementation improves the mucociliary clearance, strengthens the integrity of the epithelium, decreases viral replication, preserves antiviral immunity, attenuates the risk of hyper-inflammation, supports anti-oxidative effects and thus reduces lung damage and minimized secondary infections.​

Need to Catch a Ride

However, it is difficult for zinc to get into your cells unless it catches a ride from a "zinc ionophore". An ionophore is just a substance which transports things across the lipid boundary of your cells.

Hydroxychloroquine is a zinc ionophore.

Another drug, clioquinol, is even more potent. One of the scientists who discovered that chloroquine is a zinc ionophore (Dr. Wei-Qun Ding from the University of Oklahoma) told me that he estimates that clioquinol is 10 times more powerful as a zinc ionophore compared to hydroxychloroquine.

Leslie Costello - an oncology professor at the University of Maryland - agrees that clioquinol is a more powerful zinc ionophore than hydroxychloroquine:

ZnClioquinol [i.e. clioquinol zinc ionophore] has a zinc-binding affinity of logKf=7-8; which is ideal for the competitive binding of most of the plasma zinc that exists in the exchangeable ZnLigands. In contrast, chloroquine zinc ionophore (ZnChloroquine) has a logKf=5-6. Consequently, it competitively binds with much less zinc that is delivered to the ... site.​
However, most scientists believe that clioquinol is much more dangerous than hydroxychloroquine.

Moreover, both clioquinol and hydroxychloroquine are only available in the U.S. by prescription. The science around hydroxychloroquine is so politically charged at the moment that it is difficult to obtain a prescription, and some have warned of dangerous side effects of hydroxychloroquine (I won't give you my own opinion on this issue; make up your own mind). And hydroxychloroquine is important for people with certain conditions such as lupus, and so- if everyone took hydroxychloroquine - it would create a shortage for those people.

More importantly, even those who believe that hydroxychloroquine is helpful against Covid say that it is only effective if taken very soon after catching the disease. But many people are asymptomatic (at least at first), and don't know they have Covid until it's too late.

So how can you know to take something when you don't even know you have a bug?

Fortunately, the main active ingredient in green tea, epigallocatechin gallate ("EGCG") has been shown by a team of Spanish scientists to be 60% as powerful a zinc ionophore as clioquinol, which is the world's most powerful zinc ionophore. Dr. Juan Bautista Fernández Larre - a professor in the Department of Biochemistry and Biotechnology at the Universitat Rovira i Virgili - and his team have published several scientific papers on the topic.

The following graph summarizes their findings:

In the graph, "CQ" stands for clioquinol, "EGCG" is the ingredient in green tea, and "QCT" stands for quercetin, a common ingredient in certain foods such as capers, red apple peels and red onions.

Professor Fernández Larre explained to me by email:

Taking Clioquinol (CQ) as the standard, as is its the most potent ionophore we have tested in our liposomal assay, and assigning a 100% value to the clioquinol ionophoric activity , then pyrithione (PYR), which is not a polyphenol, displays also almost a 100% activity relative to clioquinol, whereas epigallocatechin gallate (EGCG) has 60% activity and quercetin (QCT) has only 30% the efficiency of clioquinol, on a equimolar basis.Nonetheless, this is a proof of concept assay, and exact ionophoric capacity of each compound will vary with the absolute and relative concentrations of the ionophore and of zinc; it will also depend on temperature, pH of the solution and lipid composition of the liposome (absolute and relative amounts of lecithin, other phospholipids, cholesterol, etc). It will also vary dependent on the fluorochrome used to detect zinc in the interior of the liposome (FluoZinc, Zinquin, etc) and on the concentration of the fluorochrome within the liposome, since different fluorochromes display different strengths to separate zinc from the polyphenol zinc complex.​
In any case, in the exact standardized conditions used in our assay, we can conclude the relative ionophoric effect of the different compounds tested.It is, I think, important to remark that the liposomal assay allows to elaborate a scale or a standard of ionophoric strength or ionophoric capacity or potential; and that, once established through this assay that a compound behaves as an ionophore in a liposome, we can say that it will also be ionophoric in any type of cell, as this effect is independent of content of protein, glycoprotein, glycolipids, of the cell membrane, although of course it will vary according to the fluidity of the cell membrane, that depends on its exact lipid composition.​
So what does this mean?

If professor Ding is correct that clioquinol is 10 times as powerful as as hydroxychloroquine, and given that EGCG is only .6 times as powerful as clioquinol, that means that EGCG could be a lot more powerful than hydroxychloroquine. In other words, EGCG could be 6 times more powerful than hydroxychloroquine as a zinc ionophore (EGCG =.6 times as potent as clioquinol which is times 10 as powerful as hydroxychloroquine ... so .6 times 10 = 6).

And green tea is super healthy for you anyway. So drinking it every day preventatively can only help you, and can't hurt you. You'll be maintaining a high baseline of zinc ionophores, and so bathing your cells with zinc to help ward of viral infections.

How to Take Zinc and EGCG

The Mayo Clinic notes that zinc should be taken on an empty stomach:

Zinc supplements are most effective if they are taken at least 1 hour before or 2 hours after meals.​
***​
When zinc combines with certain foods it may not be absorbed into your body and it will do you no good. If you are taking zinc, the following foods should be avoided or taken 2 hours after you take zinc:​
  • Bran
  • Fiber-containing foods
  • Phosphorus-containing foods such as milk or poultry
  • Whole-grain breads and cereals
Oysters and oyster extract is the highest food source of zinc, although many meats also contain good doses. (If you eat a lot of red meat you're probably getting enough zinc; but you still need a zinc ionophore to get it into your cells). If you take zinc supplements, don't take more than the recommended daily amount (40 mg a day is the upper limit for long term supplement use; indeed, too much zinc can actually suppress immunity), and studies imply that it is best to dissolve the zinc in your mouth (i.e. zinc lozenges).

The same is true for EGCG ... proteins bind with EGCG, so it can't be absorbed very well by your body. (And some green teas are higher in EGCG than others.) If you take EGCG supplements, never take high doses. For example, studies show that 800 mg/day can cause liver damage.

I'm not talking about taking away anything from your diet. For example, I'm not saying quit drinking coffee and instead drink tea. I still drink plenty of coffee ... but I just add green tea to my daily intake.

Note: I am not a health professional and this article is solely general information, and not intended to diagnose or treat. Please see your doctor before deciding to change anything you're doing.

Postscript: Exercise may also be helpful.
 

newmisty

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Only read the visible text, they want an email address to see more.
Easy, safe and well worth it. I can petdonally vouch for their efficacy.

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For decades, communist nations have systematically sought to subvert America, and now 42% of Americans have a positive impression of socialism. Our freedoms and values are increasingly encroached upon by socialist policies.


We systematically expose this communist subversion in an effort to free America, and the world, from it.

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Why I Wear My Mask | Welcome to the Masquerade

 

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FWIW found on FB

HOME RECIPE FOR HYDROXYCHLOROQUINE (HCQ)

Hydroxychloroquine: It is nothing but but Quinine.

Yes….tonic water has the exact same Quinine that this drug being used to treat the COVID-19 virus, has.

Quinine has many uses and applications. It is analgesic, anesthetic, antiarrhythmic, antibacterial, antimalarial, antimicrobial, anti-parasitic, antipyretic, antiseptic, antispasmodic, antiviral, astringent, bactericide, cytotoxic, febrifuge, fungicide, insecticide, nervine, stomachic, tonic...

If you ever feel a chest cold coming on or just feel like crap….
make your own Quinine.

It is made out of the peelings of Grapefruits and Lemons …but, especially grapefruits.

I will give you the recipe here and you take this concoction throughout the day…or you can make a tea out of it and drink it all day.

This should take away all your fears about this virus because you now have the defense against it and many other things.

If you take zinc with this recipe, the zinc propels the Quinine into your cells for much faster healing.

Here is all you need to do to make your very own Quinine:

Take the rind of 2-3 Grapefruits or Lemons

Take the peel only and cover it with water about 3 inches above the peels. Put a glass lid on your pot if you have one….a metal one is fine if you don’t.

Let it simmer for about 2 hours.

Do not take the lid off of the pot till it cools completely as this will allow the Quinine to escape in the steam.

Sweeten the tea with honey since it will be bitter. Take 1 tablespoon every couple of hours to bring up the phlegm from your lungs.

Discontinue as soon as you get better.
 

gringott

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I drink some tonic water whenever I feel I might have a start of a bug. Normally, later my body gets a little fever that night and sweat. I drink another one and most of the time no fever no sweat. If fever and sweat, I repeat until no more. No flu shots for years. No problem.
Started this treatment when I was in Honduras. Works for me.

Last few months we normally drink about 1 can a week. We get the more expensive little cans or bottles rather than the big plastic Sweppes jug.
 

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dacrunch

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FWIW found on FB

HOME RECIPE FOR HYDROXYCHLOROQUINE (HCQ)

Hydroxychloroquine: It is nothing but but Quinine.

Yes….tonic water has the exact same Quinine that this drug being used to treat the COVID-19 virus, has.

Quinine has many uses and applications. It is analgesic, anesthetic, antiarrhythmic, antibacterial, antimalarial, antimicrobial, anti-parasitic, antipyretic, antiseptic, antispasmodic, antiviral, astringent, bactericide, cytotoxic, febrifuge, fungicide, insecticide, nervine, stomachic, tonic...

If you ever feel a chest cold coming on or just feel like crap….
make your own Quinine.

It is made out of the peelings of Grapefruits and Lemons …but, especially grapefruits.

I will give you the recipe here and you take this concoction throughout the day…or you can make a tea out of it and drink it all day.

This should take away all your fears about this virus because you now have the defense against it and many other things.

If you take zinc with this recipe, the zinc propels the Quinine into your cells for much faster healing.

Here is all you need to do to make your very own Quinine:

Take the rind of 2-3 Grapefruits or Lemons

Take the peel only and cover it with water about 3 inches above the peels. Put a glass lid on your pot if you have one….a metal one is fine if you don’t.

Let it simmer for about 2 hours.

Do not take the lid off of the pot till it cools completely as this will allow the Quinine to escape in the steam.

Sweeten the tea with honey since it will be bitter. Take 1 tablespoon every couple of hours to bring up the phlegm from your lungs.

Discontinue as soon as you get better.
Actually, I beg to differ... Quinine is extracted from the bark of a South American tree. I haven't seen ANY references to extracting quinine from citrus fruit peels.

"Quinine was first isolated in 1820 from the bark of a cinchona tree, which is native to Peru. Bark extracts had been used to treat malaria since at least 1632 and it was introduced to Spain as early as 1636 by Jesuit missionaries from the New World. "

Personally, I take Indian Tonic Water (contains SMALL amount of Quinine for "flavoring" - was developed against malaria for the Brits in India, "Gin & Tonic") daily... and surprisingly, I don't get bitten by bugs any more (nor get nighttime leg cramps), but my wife who doesn't take the Indian Tonic gets bitten as soon as she steps outside... even though we have 3 mosquito zappers in the yard...
 
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