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== The VA study ==

== The VA study ==

Outcomes of hydroxychloroquine usage in United States veterans hospitalized with Covid-19, also known as the VA study, was one of the first studies to suggest that the use of [[hydroxychloroquine]] could be harmful... The paper stated there were 27 deaths (27.8%) in the HCQ group, 25 deaths (22.1%) in the HCQ + azithromycin group, and 18 deaths (11.4%) in the no HCQ group.<ref name=VAstudy>[https://www.medrxiv.org/content/10.1101/2020.04.16.20065920v1.full.pdf Outcomes of hydroxychloroquine usage in United States veterans hospitalized with Covid-19] by Joseph Magagnoli et al. (April 21, 2020) 10.1101/2020.04.16.20065920v1</ref>  The first flaw in this study was that it was small... it only had 368 patients.  The second flaw was that it delayed treatment with [[hydroxychloroquine]]... the drug works best when it is given early in the disease progression.  The third and most egregious flaw was that it was giving [[hydroxychloroquine]] preferentially to the sickest patients.   

Outcomes of hydroxychloroquine usage in United States veterans hospitalized with Covid-19, also known as the VA study, was one of the first studies to suggest that the use of [[hydroxychloroquine]] could be harmful. The paper's results said there were 27 deaths (27.8%) in the HCQ group, 25 deaths (22.1%) in the HCQ + azithromycin group, and 18 deaths (11.4%) in the no HCQ group.<ref name=VAstudy>[https://www.medrxiv.org/content/10.1101/2020.04.16.20065920v1.full.pdf Outcomes of hydroxychloroquine usage in United States veterans hospitalized with Covid-19] by Joseph Magagnoli et al. (April 21, 2020) 10.1101/2020.04.16.20065920v1</ref>  The first flaw was that it was a small study. It only had 368 patients and small studies are more prone to errors than larger ones.  The second flaw was that it delayed treatment with [[hydroxychloroquine]]... the drug works best when it is given early in the disease progression.  The third and most egregious flaw was that it was giving [[hydroxychloroquine]] preferentially to the sickest patients.   

{{cquote|Baseline demographic and comorbidity characteristics were comparable across the three treatment groups. However, hydroxychloroquine, with or without azithromycin, was more likely to be prescribed to patients with more severe disease, as assessed by baseline ventilatory status and metabolic and hematologic parameters. Thus, as expected, increased mortality was observed in patients treated with hydroxychloroquine, both with and without azithromycin.<ref name=VAstudy/>}}  

{{cquote|Baseline demographic and comorbidity characteristics were comparable across the three treatment groups. However, hydroxychloroquine, with or without azithromycin, was more likely to be prescribed to patients with more severe disease, as assessed by baseline ventilatory status and metabolic and hematologic parameters. Thus, as expected, increased mortality was observed in patients treated with hydroxychloroquine, both with and without azithromycin.<ref name=VAstudy/>}}  

==The RECOVERY Trial==

==The RECOVERY Trial==

One of the most commonly cited studies by the media is the UK's RECOVERY trial.  This trial gave the drug in hospitalized patients which is a bit late to be giving the drug, although studies such as the ones conducted at Mount Sanai hospital and the Henry Ford hospital system have shown that [[hydroxychloroquine]] can reduce the number of deaths in those patients by about 50%.  The RECOVERY trial's biggest flaw was that it used toxic levels of the drug... the maximum recommended dose for [[hydroxychloroquine]] is 800 mg per day<ref>[https://www.drugs.com/dosage/hydroxychloroquine.html Hydroxychloroquine Dosage] (Jun 15, 2020) ''Drugs.com''</ref> and the RECOVERY trial used a daily dose of 2400 mg<ref name =Recovery>[https://www.recoverytrial.net/files/protocol-archive/recovery-protocol-v6-0-2020-05-14.pdf/@@download Randomised Evaluation of COVID-19 Therapy (RECOVERY)] by Peter Horby et al. Version 6 (2020-05-14)</ref>, a dose that is three times higher! When one of the lead researchers, Martin Landray, was asked why he used such a high dose in his trial, he said "the chosen dosage is in line with the dosages used for other diseases such as amoebic dysentery."  That actually isn't correct... hydroxy''chloroquine'' isn't used to treat amoebic dysentery.  Diiodohydroxy''quinoline'' is.  This has lead to speculation that the doctors of the RECOVERY trial confused the two drugs.<ref name =Changingtimes>[https://changingtimes.media/2020/06/21/covid-19-hydroxychloroquine-treatment-rejected-by-giants-of-the-global-health-establishment/ Covid-19: hydroxychloroquine treatment rejected by giants of the global health establishment] by Annette Gartland (June 21, 2020) ''Changing Times''</ref><ref name =FranceSoir1>[http://www.francesoir.fr/politique-monde/recovery-trial-brexit-and-overdose Recovery trial: Brexit and overdose] by The Citizens’ Collective for ''FranceSoir'' (May 8, 2020) ''FranceSoir''</ref><ref name=CMOutrage>[https://www.youtube.com/watch?v=pnS4MbRribw&list=PLRgTUN1zz_oeQpnJxpeaEkFimDeepqyWf&t=2035 Outrage! Why The US Gov't Lied To Us About Masks] by Dr. Chris Martenson (Jun 16, 2020) ''PeakProsperity''</ref>

One of the most commonly cited studies by the media is the UK's RECOVERY trial.  This trial gave the drug in hospitalized patients which is a bit late to be giving the drug, although studies such as the ones conducted at Mount Sanai hospital and the Henry Ford hospital system have shown that [[hydroxychloroquine]] can reduce the number of deaths in those patients by about 50%.  The RECOVERY trial's biggest flaw was that it used toxic levels of the drug... the maximum recommended dose for [[hydroxychloroquine]] is 800 mg per day<ref>[https://www.drugs.com/dosage/hydroxychloroquine.html Hydroxychloroquine Dosage] (Jun 15, 2020) ''Drugs.com''</ref> and the RECOVERY trial used a daily dose of 2400 mg<ref name =Recovery>[https://www.recoverytrial.net/files/protocol-archive/recovery-protocol-v6-0-2020-05-14.pdf/@@download Randomised Evaluation of COVID-19 Therapy (RECOVERY)] by Peter Horby et al. Version 6 (2020-05-14)</ref>, a dose that is three times higher!  

 

It goes without saying that when you give the wrong dose of a drug, bad things happen.  Perhaps the only surprising thing about this trial is that the [[hydroxychloroquine]] deaths weren't much higher than the people who weren't given the drug.   

 

This study authored by Geleris is a retrospective study commonly cited in the media that analyzed patient data from the New York–Presbyterian Hospital (NYP)–Columbia University Irving Medical Center (CUIMC).  The following are inherent problems in this study.

*[[Hydroxychloroquine]] was given late.<ref name=Geleris>[https://www.nejm.org/doi/10.1056/NEJMoa2012410?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed Observational Study of Hydroxychloroquine in Hospitalized Patients with Covid-19] by Joshua Geleris et.al (June 18, 2020) ''The New England Journal of Medicine''</ref>}

*The treatment with [[hydroxychloroquine]] varied depending on which doctor was seen.<ref name=Geleris/>

*It was given to sicker patients preferentially (when compared to the control group).

{{cquote|Hydroxychloroquine-treated patients were more severely ill at baseline than those who did not receive hydroxychloroquine (median ratio of partial pressure of arterial oxygen to the fraction of inspired oxygen, 223 vs. 360).<ref name=Geleris/>}}

 

*The treatment with [[hydroxychloroquine]] varied depending on which doctor was seen.<ref name=Rosenburg>[https://pubmed.ncbi.nlm.nih.gov/32392282/ Association of Treatment With Hydroxychloroquine or Azithromycin With In-Hospital Mortality in Patients With COVID-19 in New York State] by Eli S Rosenberg et. al. (2020 May 11) ''JAMA''</ref>