(07-30-2020 08:14 PM)JRsec Wrote: Well my thread search only goes back to May. The discussion I was referencing was our first on the subject and I'm guessing in mid March to early April. I'll check my posts search later.
Thank you
I am more than happy to be told that between March and May, I may have learned something. I really don't remotely think so, but that's fine. The conversation I quoted where I clearly said it WAS manmade was directly with you. I recall speaking with lefties on the Rice forum about it (they were blaming Trump cutting the budget to the CDC in 2018 for the outbreak... and I discovered it was more likely Obama cutting the 10yr oversight/training program with the Chinese in 2014). I don't remember exactly when that was, but it was quite early on. Those things all run together in my mind so that is why I recall the associations and train of thought. That doesn't mean I remember it 100%.
Quote:The current conversation is about the First Line responders wanting hydroxychloroquine at least listed so that the MD's can write the prescriptions without fearing some kind of negative review from the state's licensing board. In many states this isn't a problem, in some states it's a big problem. The Dr's should be free to do what is best for their patients. And the patient should have the right to waive liability to receive a treatment that might save their life. I think this should also be true in most terminal illness but that is ancillary to this discussion.
You very adequately distinguished the protocol of the FDA and its rationale. I find that line of discussion to be circular in nature with regard to the OP. It's vague enough and allows for the selection of parameters in the testing that seems to justify whatever the bureaucracy of the FDA wants it to have in the way of their ruling.
The main issue is that the Front Line Care providers have clearly seen things differently.
I get this, but this has nothing to do with the interpretation of the EUA which is all I was speaking about. The FDA does not regulate 'off label' use of drugs... it merely 'recommends' on-label usage and 'controlled' off-label usage...
Their formal approval process is long and cumbersome and unlikely to be very useful for COVID. By the time they approve a drug for it, we will likely have saved thousands with it and the issue may actually be over. I really don't know why, other than for show... anyone asked for an EUA.
I agree 100% that these are front-line decisions... not FDA decisions... and while the system is flawed as heck, that is why they only recommend. The only thing I was addressing was the false statements some have made that the FDA had said that the drugs were ineffective... or that they had banned its use. The CDC HAS cautioned against hoarding... like we saw with TP and like we saw years ago with some antibiotics during an anthrax scare... but that's not a ban, nor does it stop doctors from prescribing as appropriate. If state boards like pharmacies are blanket denying prescriptions, I don't support that. They (Pharmacists) do have responsibilities, but they are not the prescribing physician. They do not have access to the patients medical charts or history. They ARE experts in drug interactions, dosing, chemical compounding etc, but they are not remotely qualified to practice medicine. I don't know of one MD that wouldn't rip a PharmD a new one for telling them how to practice medicine and treat their patients. They are each experts in their own areas.
Quote:You did not address the faulty study by the Lancet which formed Fauci's basis for not recommending hydroxychloroquine initially. The study proved bogus in methodology and was found to be the product of a group that had an agenda. The story was not only retracted by the Lancet but repudiated.
Methodology is at question with the Brazil study as well. Your point was that recommending Hydroxychloroquine for being prescribed for other than its original tested purposes was justified by its use in the Brazil study. But its use in the Brazil study was against the guidelines of its manufacturer, Bayer. And it wasn't an initial treatment of a diagnosed case of COVID 19 but rather a late stage use. To discredit this drug on that basis is also a bogus claim. Clearly in many countries other than our own, countries that haven't had the infection rates or morbidity rates that we have had, the drug when administered early in connection with supplements of zinc, or with the anti-biotic azithromycin, proved highly effective.
I know next to nothing about the specificities of these studies. I was merely responding to the false statements being made. My point was that the 'reasons' being reported had to do specifically with the same things that I had been addressing with regard to the EUA.... and that you address here. SOME studies don't show efficacy because of the dosage, the population being tested (late stage), the combinations being used... all the things you note... and SOME of those things don't work under those conditions. That doesn't mean that the drug doesn't work at all. It doesn't mean that these studies somehow 'over-rule' other studies that DO show efficacy under different conditions.
It's like a coach calling a play that doesn't work against cover 2 being quoted as saying that 'it doesn't work' and 'we shouldn't run it' (against that defense).... and somebody claiming that this means that the coach is saying the play doesn't EVER work under any conditions and has 'banned' it from being called. That's what I've seen being done here by those who want to simply 'make fun' of others, especially Trump.
Quote:There is a dire need to look into the ethics of the FDA in their refusal to leave this drug up to the discretion of the doctors without their fear of reprisals from the politically charged state entities. Why? Because the relationship between the FDA and Big Pharma is too comingled and because the personal investments of some of those serving in bureaucratic leadership and decision making capacities may have tainted their judgement.
So from my perspective, by focusing on the protocols of the FDA's endorsements, protocols which are ambiguous by design, the main point of the Front Line Medical teams' viewpoint is undermined. So I see that as a form of dissembling in as much as the discussion is no longer about witnesses where treatment is going on testifying to the efficacy of a drug and the focus is shifted to the bureaucracy and its protocols which are being used to obstruct it. And while your intent is to explain those protocols it distracts from, and undermines the discussion about the need of front line doctors to have this drug at their disposal, especially in states that have forbidden it.
Fair enough. I don't disagree at all on the above about reviewing the FDA... I think we only disagree here on what the FDA has done. In the letter revoking the EUA, the FDA recommends that the drug only be used for an off-label use in a hospital setting or in conjunction with a clinical trial.... which is what they would have said without the EUA. That's not a mandate that eliminates a physicians ability to prescribe it for an off-label use. I get your point that it can still discourage some from using it, but this has always been the case for every drug so it's nothing new... other than the attention its getting. Docs know this about the FDA... and those I know take it for what little its worth... which in my experience has a lot more to do with insurance and reimbursement than for practicing medicine. Some insurers won't cover drugs that aren't FDA approved for the diagnosis.... but in this case because the drugs are generic, that's not as big a deal.
At one point, I worked closely with behavioral health docs, and I can't think of one drug they use there that isn't used 'off label' as often as 'on'. This is a big deal there because they're always pushing the latest and greatest drug... the ones you see advertised on TV... because if they're covered at all, they still have a huge copay.
Quote:Now I didn't get back into the strategic implications of this, because the truth will out there completely. If that is not your concern so be it. But from my vantage point and those I know it truly is one. Especially when it comes to the issue of vaccines, which aren't likely at all. We are probably looking at containment treatments as we are with HIV. The primary purpose of this virus when it was developed was to shut down normal life which is the surest way to cripple a free societies economy. Lethality is ancillary. And the longer we ignore this aspect the more damage it will do and the more people will not take it seriously enough.
We will be safe when this virus is forced into hiding in the brain's lining where it can't be contagious. That's when life returns to normal. Treating the virus's initial outbreak will be very different from its long term treatment regimen, IMO.
I honestly can't address this. I don't have a frame of reference for it. My focus is more on population epidemiology than on the internal workings and pathology of diseases. This is not a dodge, I just don't have any significant knowledge base here and it is too specific a discussion for my 'opinions' to matter very much. My only thoughts on it months ago was that I would have expected a more 'frontal' assault. That opinion had given no thought to what you're describing as I was viewing this as a Coronavirus variant. What you're describing here would work much different than any previous Coronavirus or any of those others that have come out of China. I was not considering 'the long game'... and don't know enough about it to refute any of your comments. I too trust that the truth will eventually come out. If this is as you suspect, it's IMO a MAJOR act of war and a war crime.... a global genocide.
Quote:That said the FDA has hardly proven its effectiveness in this crisis. Front line response has been much more open minded, innovative, and effective. Politics and profit seem to be the obstacles here, and that means the protocol you explained is part of the problem, not the testing, but its use to make treatment recommendations has sure appeared to be tainted. So focus on what is right, eliminate the obstructive, and let the patients have more say in their treatment, it is their lives that are in the balance. If it was you or your family wouldn't you like to have that choice?
IMO, the FDA is useless in a crisis. This is not what they do. Their job is to promote safety in the everyday practice of medicine... to insure consistency in trials and other bureaucratic functions... Their job is not to discover or promote cures. By the same token, their job is not to practice medicine... and I see some on the left acting as if it is...
I've said numerous times, even here in my convo with stink... that you and your doctors should make these decisions. You may remember the movie 'WarGames'?? "Son, I'd piss on a spark plug if I thought it would do any good." That's a big part of my philosophy. Doc, tell me the risks and benefits and I'll make the call with your help.
Quote:And J.R. is correct though my screen name utilizes the sec part as a conference tag.
I honestly intended no offense at all when I did that. I merely intended to address you as JR... as I've done before, and was not careful with my typing. It literally never crossed my mind to call you 'junior'.
Thanks