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Saturday, June 6, 2020

Distinguished Yale Professor of Medicine Calls for Widespread Use of HCL in Early Stages of COVID-19 (And is Ignored)

The Yale School of Public Health published an interview with Yale Professor Harvey Risch, MD, PhD concerning his study, accepted (passed peer review) in the American Journal of Epidemiology. Risch concluded that hydroxychloroquine (used in conjunction with two other drugs) should be “widely available” in the fight against the current pandemic, which he characterizes as the greatest health challenge of our time.

With widespread media claims (including statements by Dr. Anthony Fauci),  that hydroxychloroquine (HCL) is both ineffective and dangerous, it is worth examining why such a highly-credentialed scientist as Risch is going against the crowd and is receiving remarkably little attention in the process.

I therefore quote from his interview with the Yale School of public health:

First, Covid is really two diseases

Risch: “In the first few days, it is like a very bad cold. In some people, it then morphs into pneumonia which can be life-threatening. What I found is that treatments for the cold don’t work well for the pneumonia, and vice versa. Most of the published studies have looked at treatments for the cold but used for the pneumonia. I just looked at how well the treatments for the cold worked for the cold.” (Risch cites four of five extant studies that find HCL effective in treating the cold part of COVID-19.)

Second, HCL is effective only in treating the “cold” phase

Risch: “I think that there has been confusion about treating the cold versus treating the pneumonia. These medications don’t seem to work so well for treating the pneumonia. As early as possible is crucial, within the first five to six days of symptoms.”

Third, Early treatment is a possible game changer

Risch: “The game changer is to aggressively treat people as soon as possible, before they are hospitalized, to keep them from becoming hospitalized in the first place. Hydroxychloroquine plus the other medications is what we know about now. In a few months we may have data on other medications that also work. We just have to start with something now.

Fourth, HCL is already in wide use for treating the early phases of the disease

Risch: “An international survey of doctors who treat COVID-19 patients recently showed 72 percent of doctors in Spain say that they have been using them. I think that doctors need to be able to use their own clinical judgement about their patients and have objective information about drugs that can work for the early part of the infection, the cold part.”

Fifth: Risks from heart pacing are extremely low

Risch: “There is a concern that these medications do change the heart pacing a little and could cause cardiac arrhythmias. However, these arrhythmias are still very rare in people using these medications.” (In his American Journal of Epidemiology paper, Risch calculates the risk of death due to heart arrhythmias at 9 per 100,000).

My Takeaway

The most important takeaway is the proposition that HCL can be effective only if taken early in the course of the disease. Studies of hospitalized patients, according to this proposition, will inevitably show HCL is ineffective during the more advanced stages of the disease; thus the important of early treatment. If Risch is correct, the health risks are low and fears of fatal side effects are not justified for patients properly tested for heart disease.

Caution: I am not an MD, but I can read and understand the gist of well written medical articles.  


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