There’s no shortage of controversies surrounding the COVID-19 pandemic, but the controversy over hydroxychloroquine is perhaps one of the most perplexing and frustrating. Doctors and health experts around the world have spoken out both for and against the use of the drug, some reporting spectacular benefits1 while others warn of mortal dangers.2
Game-Changer or Deadly Treatment?
In one international poll3 of 6,227 doctors in 30 countries, 37% rated the antimalaria drug hydroxychloroquine as “the most effective therapy” for COVID-19. The poll was done by Sermo, the world’s largest health care data collection company and social platform for physicians.
In Spain, where the drug was used by 72% of doctors, it was rated “the most effective therapy” by 75% of them. The typical dose used by a majority of doctors was 400 milligrams per day.
French science-prize winning microbiologist and infectious disease expert Didier Raoult, founder and director of the research hospital Institut Hospitalo-Universitaire Méditerranée Infection,4 reported5,6 that a combination of hydroxychloroquine and azithromycin, administered immediately upon diagnosis, led to recovery and “virological cure” — nondetection of SARS-CoV-27 in nasal swabs — in 91.7% of patients.
According to Raoult, the drug combination “avoids worsening and clears virus persistence and contagiosness in most cases.” No cardiac toxicity was observed using a dose of 200 mg three times a day for 10 days, along with 500 mg of azithromycin on Day 1 followed by 250 mg daily for the next four days. The risk of cardiac toxicity was ameliorated by carefully screening patients and performing serial EKGs.
As reported by The Highwire (see video above), July 2, 2020, Raoult is quoted as saying failure to prescribe hydroxychloroquine to a COVID-19 patient “should be grounds for malpractice.” Meanwhile, University of Oxford investigators claim the drug is useless and shouldn’t be prescribed at all in hospitalized patients.8
An interesting website tracking hydroxychloroquine trials is c19study.com.9 It lists more than 40 studies and meta-analyses showing positive results of the drug, compared to nine that have reached a negative conclusion.
The Zelenko Regimen
Dr. Vladimir Zelenko, a primary care physician in Monroe, New York, has also reported excellent results using the drug. He told radio host Sean Hannity he’d had a near-100% success rate using hydroxychloroquine, azithromycin and zinc sulfate for five days. “I’ve seen remarkable results; it really prevents progression of disease, and patients get better,” he told Hannity.
In the video above, Del Bigtree interviews Zelenko about the criticism levied against him for promoting use of the drug. According to Zelenko, hydroxychloroquine deniers “are guilty of mass murder.”
He points out hydroxychloroquine has been used for decades and is safe even for pregnant and nursing women, so he felt very comfortable prescribing it off-label. He prescribed 200 mg of hydroxychloroquine twice a day, 500 mg of azithromycin once a day and 220 mg of zinc once a day, for five days.
The treatment was initiated within the first five days of clinical symptoms of COVID-19, based on “clinical suspicion” of SARS-CoV-2 infection (not lab confirmed testing, as test results took three days and viral load typically explodes by Day 6).
June 30, 2020, Zelenko and two co-authors published a study,10 currently in preprint, which found treating COVID-19 patients who had confirmed positive test results “as early as possible after symptom onset” with zinc, low-dose hydroxychloroquine and azithromycin “was associated with significantly less hospitalizations and five times less all-cause deaths.”
As noted by Zelenko in Bigtree’s interview, the real virus killer in this combination is actually the zinc. The hydroxychloroquine merely acts as a zinc transporter, allowing it to get into the cell. The antibiotic, meanwhile, helps prevent secondary infections.
Concerted Coordinated Effort to Inhibit Use of Effective Drug?
According to Dr. Meryl Nass, the wildly divergent views on hydroxychloroquine appear to have little to do with its safety and effectiveness against COVID-19, and more to do with a concerted and coordinated effort to prevent its use. In the video11 above, Chris Martensen Ph.D., also reviews the “profound lack of integrity” we’re currently seeing when it comes to hydroxychloroquine.
Indeed, there are several reasons for why certain individuals and companies might not want an inexpensive generic drug to work against this pandemic illness. (A 14-day supply costs just $2 to manufacture12 and can retail for as little as $20.13)
One of the most obvious reasons is because it might eliminate the need for a vaccine or other antiviral medication currently under development.14 Hundreds of millions of dollars have already been invested, and vaccine makers are hoping for a payday in the billions if not trillions of dollars. In a June 27, 2020, blog post, Nass points out:15
“It is remarkable that a series of events taking place over the past three months produced a unified message about hydroxychloroquine, and produced similar policies about the drug in the U.S., Canada, Australia, NZ and western Europe.16
The message is that generic, inexpensive hydroxychloroquine is dangerous and should not be used to treat a potentially fatal disease, COVID-19, for which there are no (other) reliable treatments.
Hydroxychloroquine has been used safely for 65 years in many millions of patients. And so the message was crafted that the drug is safe for its other uses, but dangerous when used for COVID-19. It doesn’t make sense, but it seems to have worked. Were these acts carefully orchestrated? You decide.
Might these events have been planned to keep the pandemic going? To sell expensive drugs and vaccines to a captive population? Could these acts result in prolonged economic and social hardship, eventually transferring wealth from the middle class to the very rich?”
The fight over hydroxychloroquine may also have political underpinnings. As noted by investigative reporter Sharyl Attkisson in a May 18, 2020, Full Measure report, “never before has a discussion about choices of medicine been so laced with political overtones.”
Trials Undermine Safety and Efficacy by Using Toxic Doses
Nass’ article17 lists what has occurred with regard to hydroxychloroquine so far, the intention being to keep it as a living document that will be added to as time goes on.
Nass says she wrote it in such a way that it might be read as a “to do list … to be carried out by those who pull the strings,” with the intention of suppressing use of the drug. At the time of this writing, Nass’ list18 contains 27 bullet point entries. I highly recommend reading through it, as I will only highlight a select few here.
Several items on Nass’ list detail the various ways in which safe and effective use of the drug were undermined, which allowed for a false narrative of danger to be crafted.
For example, Nass points out that three large, randomized multicenter clinical trials all used excessive dosages known to be toxic.19 These include the following. She also discusses these trials in other in-depth articles:20,21,22
•The U.K. Recovery Trial23,24,25 — Funded in part by the Bill & Melinda Gates Foundation, Wellcome Trust and the U.K. government through Oxford University,26 this study randomly assigned patients to usual care or to one of five primary drug treatments: lopinavir-ritonavir; a corticosteroid (low-dose dexamethasone); hydroxychloroquine; tociizumab; or azithromycin. They also used convalescent plasma.
Patients received 2,400 mg of hydroxychloroquine during the first 24 hours — three to six times higher than the daily dosage recommended27 followed by 400 mg every 12 hours for nine more day for a cumulative dose of 9,200 mg over 10 days. The trial ended its hydroxychloroquine arm on June 4, reporting “no benefit.”
•The Solidarity Trial28 — Launched by the World Health Organization and funded by 43 countries and 203,000 individuals and organizations,29 this trial also compares standard of care against four drug options, including hydroxychloroquine, among patients in 35 countries.
Strangely, the WHO does not specify the daily dosage used in the trial. However, the registration of the Canadian30 and Norwegian31 portions of the trial lists a dosage of 2,000 mg on the first day, and a cumulative dose of 8,800 mg over 10 days. This is only 400 mg less than the U.K.32 Recovery Trial’s toxic dose.
The hydroxychloroquine arm was halted May 25,33 following the publication of the Surgisphere study34 in The Lancet. June 3, after tremendous controversy had been raised over the veracity of the study, and a day before the study was retracted for using fabricated data,35,36 (and this despite having undergone peer-review), the hydroxychloroquine arm was restarted.37
June 17, 2020, the hydroxychloroquine arm was stopped again, this time “based on evidence from the Solidarity trial, U.K.’s Recovery trial and a Cochrane review of other evidence on hydroxychloroquine.”38
•The REMAP-CAP Trial (Randomized, Embedded, Multifactorial Adaptive Platform Trial for Community-Acquired Pneumonia)39 — Here, patients either received nothing, a combination of lopinavir and ritonavir, or hydroxychloroquine alone or in combination with lopinavir and ritonavir.
REMAP used the same toxic dose as the Recovery Trial but for six days instead of 10. What’s more, only critically ill hospitalized patients were included in this trial. Nass addresses other concerns as well in her June 19 blog40 about this study.
Is Lifesaving Medicine Withheld to Ensure Profits?
What possessed the study designers and investigators of these three huge clinical trials to use such exaggerated dosages? Hydroxychloroquine has been on the market for 65 years and both toxic and the effective dosages for a variety of ailments are well documented. Doctors who have reported excellent treatment results in the field stayed within the recommended hydroxychloroquine dosages.
Were they trying to purposely sabotage these trials using dosages known to be toxic? Doctors have also reported that best results are observed when the drug is administered early, while symptoms are still mild or moderate, yet in these trials the drug was not given until it was too late.
A July 1, 2020, retrospective analysis41,42,43 of 2,541 patients in the Henry Ford Hospital System in Detroit, Michigan, found use of hydroxychloroquine alone cut mortality by more than half, from 26.4% to 13.5%. (Hydroxychloroquine in combination with azithromycin had a mortality rate of 20.1%, and azithromycin alone had a mortality rate of 22.4%.)
More than 90% of the patients had received the drug or drugs within 48 hours of admission into the hospital. No adverse heart-related events were observed among those given hydroxychloroquine.
All three trials above that used toxic hydroxychloroquine doses — Recovery, Solidarity and REMAP — also failed to include zinc, which appears to be a key factor. As noted by Zelenko above, the hydroxychloroquine is really only used to drive the zinc in to the cells. Nass observes:44
“The conclusions to be drawn are frightening:
- WHO and other national health agencies, universities and charities have conducted large clinical trials that were designed so hydroxychloroquine would fail to show benefit in the treatment of Covid-19, perhaps to advantage much more expensive competitors and vaccines in development.
- In so doing, these agencies and charities have de facto conspired to increase the number of deaths in these trials.
- In so doing, they have conspired to deprive billions of people from potentially benefiting from a safe and inexpensive drug, when used properly, during a major pandemic. This might contribute to prolongation of the pandemic, massive economic losses and many increased cases and deaths.”
Facets That Need To Be Discussed
Aside from that, there are two additional facets of what’s going on that are not yet being discussed:
1.What we’re seeing happen right now is that patients are being turned into guinea pigs en masse. As of June 16, 2020, the U.S. Food and Drug Administration stated the only way a patient should receive hydroxychloroquine is by enlisting in a clinical trial.45
Similarly, in the U.K., treating physicians have been asked to enroll all hospitalized COVID-19 patients into the Recovery and REMAP trials. As of July 9, 2020, Recovery had enrolled more than 12,000 subjects.46
What this means is that thousands of patients are having their treatment selected via randomization by computer rather than by their own doctors’ choice of treatment. The U.K., by the way, has one of the highest COVID-19 death rates in Europe already.47 By removing physician and patient choice of treatment, the death toll might end up being far worse than it needs to be.
Importantly, will this trend continue post-COVID? Now that doctors are being groomed to accept having their patients treated by randomization rather than with the treatment any given doctor believes to be best, will they sign up their future non-COVID patients as subjects just as easily?
2.Secondly, three recent papers48,49,50 argue that the excessive doses of hydroxychloroquine used in the Recovery Trial were not actually toxic. This creates a serious contradiction that has yet to be addressed. As noted by Nass in an email to me:
“For argument’s sake, say they are right, and even high doses are safe. Well then, why are the FDA, European Medicines Agency, pharmacy boards, governors, etc. restricting this drug that is so safe you can even overdose it and be fine?
Either the drug is so toxic at normal doses that it can’t be used for a life-threatening illness, or it is perfectly safe at extremely high doses. You can’t have it both ways.”
Zinc Is a Crucial Key
In conclusion, let us circle back to where we started — with the reports of treatment success. A study51 posted on the prepublication server medRxiv, May 8, 2020, compared outcomes in hospitalized COVID-19 patients treated with either hydroxychloroquine and azithromycin alone, or Zelenko’s triplet regimen of hydroxychloroquine, azithromycin and zinc.
While the addition of zinc sulfate had no impact on the length of hospitalization, ICU duration or duration of ventilation, univariate analysis showed it was associated with other positive effects:
- Increased hospital discharge frequency
- Decreased the need for ventilation
- Decreased ICU admission rates
- Decreased the rate of transfer to hospice for non-ICU patients
- Decreased mortality
As noted by the authors:52
“After adjusting for the time at which zinc sulfate was added to our protocol, an increased frequency of being discharged home (OR 1.53 …) reduction in mortality or transfer to hospice remained significant (OR 0.449 …). This study provides the first in vivo evidence that zinc sulfate in combination with hydroxychloroquine may play a role in therapeutic management for COVID-19.”
In short, to maximize effectiveness, you need zinc. As explained in “Is Quercetin a Safer Alternative to Hydroxychloroquine?” hydroxychloroquine acts as a zinc ionophore,53,54 meaning it shuttles zinc into your cells, and zinc appears to be a “magic ingredient” required to prevent viral replication.55
If given early, zinc along with a zinc ionophore should, at least theoretically, help lower the viral load and prevent the immune system from becoming overloaded. As noted in the preprint paper, “Does Zinc Supplementation Enhance the Clinical Efficacy of Chloroquine / Hydroxychloroquine to Win Todays Battle Against COVID-19?” published April 8, 2020:56
“Besides direct antiviral effects, CQ/HCQ [chloroquine and hydroxychloroquine] specifically target extracellular zinc to intracellular lysosomes where it interferes with RNA-dependent RNA polymerase activity and coronavirus replication.
As zinc deficiency frequently occurs in elderly patients and in those with cardiovascular disease, chronic pulmonary disease, or diabetes, we hypothesize that CQ/HCQ plus zinc supplementation may be more effective in reducing COVID-19 morbidity and mortality than CQ or HCQ in monotherapy. Therefore, CQ/HCQ in combination with zinc should be considered as additional study arm for COVID-19 clinical trials.”
So far, no major clinical trial has bothered to follow this rather commonsense advice. Unfortunately, due to the corruption and politicization of science on this matter, it’s hard to offer any clear recommendations. In the end, it probably comes down to who you trust.
Quercetin — An All-Natural Safe Home Alternative
That said, if you suspect you’ve contracted COVID-19, it probably wouldn’t hurt to give a version of Zelenko’s regimen a try, at the first sign of symptoms. As explained in “Is Quercetin a Safer Alternative to Hydroxychloroquine?” quercetin is also an ionophore and has the same mechanism of action as hydroxychloroquine — it improves zinc uptake by your cells.
So, you might not need the drug. You could also swap out the antibiotic for a natural antibacterial such as olive leaf or oregano oil. You can find more information about this in “How to Improve Zinc Uptake with Quercetin to Boost Immune Health.”
Personally, I’m taking quercetin and zinc at bedtime as a prophylactic each day. The reason it’s best to take them in the evening, several hours after your last meal, and before the long fast of sleeping, is because quercetin is also a senolytic (i.e., it selectively kills senescent or old, damaged cells) that is activated by fasting. So, why not maximize the timing and use of quercetin?
Sources and References
- 1 Townhall.com April 6, 2020
- 2, 8 The Guardian June 5, 2020
- 3 Sermo April 2, 2020
- 4 Institut Hospitalo-Universitaire Méditerranée Infection
- 5 Travel Medicine and Infectious Disease May-June 2020; 35: 101738
- 6 New York Times May 12, 2020
- 7 J Med Virol. 2020 May 3
- 9 c19study.com
- 10 Preprints.org June 30, 2020; 2020070025, DOI: 10.20944/preprints202007.0025.v1
- 11 Youtube, Garbage Science: Be Wary of What You’re Being Told
- 12 Science Magazine April 10, 2020
- 13 Good Rx Hydroxychloroquine
- 14 Gates Notes April 30, 2020
- 15, 17, 18, 19 Anthraxvaccine.blogspot.com June 27, 2020
- 16 Reuters May 27, 2020
- 20, 44 Anthraxvaccine.blogspot.com June 14, 2020
- 21, 37 Age of Autism June 16, 2020
- 22, 40 Anthraxvaccine.blogspot.com June 19, 2020
- 23 Recovery Trial
- 24 BMJ 2020;369:m1626
- 25 Science Translational Medicine June 5, 2020
- 26 Recovery Trial Protocol 2020
- 27 Uptodate.com Hydroxychloroquine
- 28 The Solidarity Trial
- 29 World Health Organization March 27, 2020
- 30 Clinicaltrials.gov Identifier: NCT04330690, CATCO Solidarity
- 31 Clinicaltrials.gov Identifier: NCT04321616
- 32 ClinicalTrials.gov July 7, 2020
- 33 NBC News May 25, 2020
- 34 The Lancet May 22, 2020 DOI: 10.1016/S0140-6736(20)31180-6
- 35 Anthraxvaccine.blogspot.com May 29, 2020
- 36 Zendo May 28, 2020 Open Letter to Mehra et al and The Lancet
- 38 WHO.int Solidarity Clinical Trial for COVID-19 Treatments
- 39 REMAP-CAP, COVID-19 Antiviral Therapy (PDF)
- 41 International Journal of Infectious Diseases July 1, 2020 DOI: 10.1016/j.ijid.2020.06.099
- 42 Epoch Times July 2, 2020
- 43 Just the News July 3, 2020
- 45 NIH.gov Covid-19 Treatment Guidelines
- 46 Recoverytrial.net June 16, 2020
- 47 The Guardian May 29, 2020
- 48 medRxiv June 23, 2020
- 49 medRxiv June 16, 2020
- 50 Moru Tropical Health Network June 20, 2020
- 51, 52 medRxiv May 8, 2020 DOI: 10.1101/2020.05.02.20080036 (PDF)
- 53 PLOS ONE 2014; 9(10): e109180
- 54, 55, 56 Preprints April 6, 2020 DOI: 10.20944/preprints202004.0124.v1
The views and opinions expressed in this commentary are those of the author and do not necessarily reflect the official position of Citizens Journal.