Name:	architect -	Reply
Subject:	Uh Oh Carlson
Date:	11/28/2020 10:59:45 PM

The European Union Medecines Agency has initiated a review of Chloroquine and Hydroxychloroquine after the E.U.'s drug regulator warned that some COVID 19 patients being treated with the drugs had exhibited psychiatric disorders and suicidal behavior associated with the treatment. 

Name:	CRD -	Reply
Subject:	Uh Oh Carlson
Date:	11/29/2020 9:31:08 AM

So for those of us who actually READ an article and not post a headline from CNN, here is the scoop:

Italics are from the actual paper.  

1.  It is already known that chloroquine and hydroxychloroquine, even used in approved doses for authorised indications, can cause a wide spectrum of psychiatric disorders. Psychotic disorders and suicidal behaviour are listed in the product information of some chloroquine or hydroxychloroquine-containing medicines as rare side effects or side effects occurring at an unknown frequency.

translation for Archie - Search any pharmaceutical data base or App, such as Epocrates, and these adverse reactions are listed for HC. Just like cardiac arrhythmias, nothing new.  

2.  EMA’s safety committee (PRAC) has recommended updating the product information for all chloroquine or hydroxychloroquine-containing medicines following a review of all available data that confirmed a link between the use of these medicines and the risk of psychiatric disorders and suicidal behaviour.

Translation for Archie - 6, that's right a mere 6, Spanish patients out of who knows how many total patients that receive HC, developed "Psychiatric Disorders" after receiving "higher than authorised doses" of HC.  This is what led to the initiation of the May 2020 review.  This is what reviewing "all available data" means in Europe?   God help the Europeans.

3. The review confirmed that psychiatric disorders have occurred and may sometimes be serious, both in patients with and without prior mental health problems.

Translation for Archie - So of the 6 patients that triggered this far reaching review, it may very well have been possible that they already had a pre-existing psychiatric condition that they were being treated for with these "higher than authorised doses" of HC.  What a shocker.

4. The PRAC recommends updating the product information for these medicines to provide better information to healthcare professionals and patients on the risk of suicidal behaviour and psychiatric disorders.

Translation for Archie - The PRAC review simply recommends highlighting the already existing adverse reactions sections on package inserts regarding psychiatric exacerbations a/w HC.

So bottom line, 6 Spanish patients who received HC at an unknown dose and frequency, for an unknown length of time, who may or may not have had a pre-existing psychiatric condition at the time, who may or may not have been receiving psychiatric treatment for said psychiatric condition, developed a well known serious adverse side effect of standard doses of HC and this had led to bold facing the package insert for professionals.  

Archie, if you question my summary here, please correct me.  

Name:	architect -	Reply
Subject:	Why should I correct someone
Date:	11/29/2020 9:59:35 AM (updated 11/29/2020 10:09:37 AM)

who just confirmed what I posted?

Oh BTW CRD is COVID a serious concern yet?  I mean 380,000 new cases and 3700 are dead since you and I sat down to enjoy turkey and pecan pie!

Name:	CRD -	Reply
Subject:	Why should I correct someone
Date:	11/29/2020 12:28:26 PM

Serious and contagious, absolutely.  Can common sense and simple protocols limit the spread and infectivity, absolutely.  Crisis, again for the upteenth time with you, no.

Name:	CRD -	Reply
Subject:	Why should I correct someone
Date:	11/29/2020 12:33:33 PM

Not quite Archie, the review was initiated in May 2020.  They have found SIX cases.  In 6  months.  Did you point that out?  I have simply pointed out the discrepancy in what the review stated and what you posted.  Again, if you want to post factual information, I am all for debate.  If you come here and post headlines, we have right to call you out.  You post headlines and innuendo far more frequently than fact.  

Name:	CRD -	Reply
Subject:	Why should I correct someone
Date:	11/29/2020 1:10:14 PM

If your intention was to be factually accurate, your post should have read something like this:

The European Union Medecines Agency, via their Pharmacovigilance Risk Assessment Committee,  initiated a review in May 2020 of Chloroquine and Hydroxychloroquine after the E.U.'s drug regulator warned that some (actually 6 patients reported by the Spanish Medicines Agency over 6 months who may or may not have had a pre-existing psychiatric condition), COVID 19 patients being treated with higher than authorised doses of the medications, had exhibited psychiatric disorders and suicidal behavior (which is a long understood known adverse effect of these medications in normal dosing) in association with the treatment. 

The review was so scientifically significant, that the recommendation is that the PRAC recommends updating the product information for these medicines to provide better information to healthcare professionals and patients on the risk of suicidal behaviour and psychiatric disorders, which should already be known to providers prescribing these medications in the first place. 

Markedly different than your post and factually accurate, wouldn't you say Archie?

Name:	Lifer -	Reply
Subject:	Why should I correct someone
Date:	11/29/2020 2:13:38 PM

I would be interested to know the ratio of phsychotic instance to number of scripts written both pre and post covid.  I expect it would graph a pretty straight line, but I guess wrong a lot...lol.

Name:	architect -	Reply
Subject:	You have yet to debunk anything in my post.
Date:	11/29/2020 3:26:44 PM (updated 11/29/2020 3:28:46 PM)

and you know it.  Eschew obfuscation CRD.

Name:	CRD -	Reply
Subject:	You have yet to debunk anything in my post.
Date:	11/29/2020 3:59:58 PM

It is what you left out Archie that changes the whole complexion of your post.  You know it.  I know it.  Par for the course with you.

Name:	architect -	Reply
Subject:	You STILL have not debunked anything in my post.
Date:	11/29/2020 8:16:15 PM (updated 11/29/2020 8:23:49 PM)

Period.

Bottom Line...EU health authorities are investigating the drugs for possible serious unwanted negative side effects and have so warned constituent services while strongly recommending extreme caution.

Name:	CRD -	Reply
Subject:	You STILL have not debunked anything in my post.
Date:	11/29/2020 10:49:55 PM

You are correct Archie. 

Some patients with COVID19 being treated with HC may have shown psychiatric symptoms after its use. All six of them.

So do patients being treated with HC for Lupus. 

So do patients being treated with HC for RA. 

So do patients being treated with HC for prevention or treatment for malaria. 

So do patients with a known psychiatric disorder who receive HC with no cause/effect at all.

What exactly is your point?  You have failed to offer any rational, intelligent reasoning on why this statement somehow implicates HC.  But we all know that since Trump endorsed HC, you must reject all logic and proceed to identify any fault in its use.  Unfortunately, I am left scratching my head as to this EU statement's significance and your excitement over it. 

Name:	architect -	Reply
Subject:	My point is my post was factual and correct
Date:	11/30/2020 8:48:27 AM (updated 11/30/2020 8:53:46 AM)

and you continue to confirm it everytime you try to debunk it.  I guess what else can you expect from a ''doctor'' who thought a disease that killed 12,500 people while a Democrat was presdient was a catastrophe but one that has (so far) killed 266,000 while a Republican was president was not particularily worrisome!

Now, does a politician's support of a drug carry more weight with your medical opinion than the thinking of the vast vast majority of your fellow professionals in the medical and scientific community? 

Name:	CRD -	Reply
Subject:	Your post was partly factual
Date:	11/30/2020 11:32:14 AM

and mostly irrelevant in the context of pharmacotherapeutics.

Regarding H1N1, 61 million infections.  Compare to COVID in the US.  Those deaths that you mention, were in individuals under the age of 65 with a significant number of children and yound adults.  Biden had a Thanksgiving party in 2009.  At the peak of the second wave.  Since a large number of children had no resistance to this unique H1N1 virus, why didn't Obama and Biden close schools then?  Why were the numbers of infections in the tens of millions?  Why was there no lockdown?  The vaccine was not available until after the peak of the SECOND wave.  Trump has a vaccine being set for delivery this month.  There is much to be critical of Biden for with that administrations handling of H1N1.  His COS said as much. And as well, much to admire about the Trump administration's handling of a much more lethal pathogen.  

Name:	CRD -	Reply
Subject:	Your post was partly factual
Date:	11/30/2020 3:24:01 PM (updated 11/30/2020 3:26:35 PM)

And I must re-phrase, a more lethal virus to the elderly and to those with co-morbidities, especially obesity and hypertension.

Name:	architect -	Reply
Subject:	Is there even the slightest possibility
Date:	11/30/2020 5:17:18 PM (updated 11/30/2020 5:21:00 PM)

that there was no lockdown called for with H1N1 was because it was a death sentence for 0.0002% of the peole who got it vs 2% for COVID 19.  Are you even capable of recognizing there a difference...a BIG difference.  If you can't see it may God protect anybody who ever reclines on your examination table.

If you criticize Biden and Obama for not calling for stricter measures for a disease that killed 1 of every 50,000 effected how does it make sense that you have not done the same for Trump in the case of a disease that is 1000 times more deadly killing 1 out of every 50 infected?  Can you see even a teeny tiny bit of nonsensical hypocrisy there CRD?  Is your politically biased and blinded brain able to grasp how stupid you sound.

Finally, my post was 100% factual as you well know.

Name:	CRD -	Reply
Subject:	Is there even the slightest possibility
Date:	11/30/2020 6:56:28 PM

Sorry Archie, but your decimal points are off by a factor of 1000.  The case fatality rate early in March for COVID was as high as 3%.   CFR =number of deaths/number of people who actually had the disease.  In March, we did not realize that one could be seropositive and have no symptoms.  The denominator was small.  Since then the denominator has risen and there are now 82 seroprevalence studies worldwide that all agree that the median CFR is about .2%, translated for you Archie, 2 per 1000, not your erroneous number of 2 per 100.  That is fact, something that at times eludes you. 

COVID is not equally dangerous to everybody.  We know that.  There is a thousand fold difference between the mortality rate in older individuals, 70 and up and the mortality rate in children.  If COVID was a disease that preferentially attacked and killed children, I would react much differently.  I hold Biden to that standard as well and he failed miserably.  By closing schools in this current COVID pandemic, we are asking those individuals who face very little, if actually any risk, to bear the burden of controlling this disease.  With H1N1, I may have thought differently.

You sure are opinionated Archie, certainly your right, but you have little science, training and facts with which to base your opinions upon.   And when your intellect is called into question, you resort to your typical degradation of the various messengers.  I enjoy this at times, because I believe it is informative for others on this forum, but I must say, you do yourself no favor by exposing yourself as a fool at times masquerading as someone with a keen comprehension of actual facts.

Name:	rude evin -	Reply
Subject:	Is there even the slightest possibility
Date:	11/30/2020 7:16:07 PM

Whoa.......as they say down where I’m from, that tree don’t have no bark no more.....

Name:	lakngulf -	Reply
Subject:	Is there even the slightest possibility
Date:	11/30/2020 7:44:55 PM

Yes rude, that was a beat down, drop the keyboard (mic)

Name:	architect -	Reply
Subject:	CRD eschew obfuscation
Date:	11/30/2020 11:46:59 PM (updated 12/1/2020 12:07:50 AM)

To begin, you have a lot of chutzpah to condemn me for ignoring science when you know as well as I do that almost all scientist do not agree with you about this Virus! You may not like that fact but it is the fact.  I guess it is possible that all them are wrong and you and MM are right but it is also possible the the sun will explode tomorrow.

Now, 13,771,000 infected / 272,660 dead = 50.506....1 in 50 die! 2 in 100 die! 2.0% die! NOT 0.2%!

Bottom line One out of every 50 positive case has died. Now, I may not be a hot shot ''scientist'' like you and able to spout $100 words that mean nothing to 99% of humanity, but I can apparently do elementary school arithmatic better than you and the above equation comes out as ''2% of the people who get Covid DIE''...period, full stop!

My bark is still substantially in place!

BTW:  You are one sorry azz doctor as well as human being considering your rather dismissive view of the value of old people compared to the younger set.  Most cultures value age.

Name:	phil -	Reply
Subject:	CRD eschew obfuscation
Date:	12/1/2020 9:41:23 AM

"BTW:  You are one sorry azz doctor as well as human being considering your rather dismissive view of the value of old people compared to the younger set.  Most cultures value age."

Yup and a few posts below you talk about how great Cuomo is/was - yet he stuffed nursing homes with Covid + patients killing many running up those death numbers for elderly. Where is your value for those old people??????

Name:	rude evin -	Reply
Subject:	Agree LNG, and
Date:	12/1/2020 10:57:33 AM

I might add richly deserved. I don’t personally know CRD but only thru his postings and he probably is the most calm level headed and respectful debater here on the forum, so for him to put a bite on the most arrogant , aggressive fact free close minded pontificator here was a delight.

I’ve met quite a few people in my 75 years as you have, all of whom would populate the whole spectrum of personalities, but I don’t think I’ve encountered anyone who is as thin skinned as Archie OR who speaks in broad moralistic, stereotypical generalities as he does on this forum.

Back in my working career days, these people were generally seen as very bright and narrowly focused and could produce good results, BUT, you would keep them busy in a cubicle away from any possible customer contact.

Name:	CRD -	Reply
Subject:	CRD eschew obfuscation
Date:	12/1/2020 12:47:42 PM

Read this article and get back to me Archie.  

3. Havers FP, Reed C, Lim T, et al. Seroprevalence of Antibodies to SARS-CoV-2 in 10 Sites in the United States, March 23-May 12, 2020. JAMA Intern Med. Published online July 21, 2020. doi:10.1001/jamainternmed.2020.4130.

You should, after critical reading, be able to see the flaw in your elementary calculation.  If you would like, I will walk you through many such articles in the literature that attempt to quantify not only the CFR, but also the IFR.  These numbers can be stratified according to age groups, states, ethnicities, time periods, available health care faciities, and so on.  Your calculation may be correct, it proves your calculator is working,  but your number is irrelevant and not used to base public health policy. 

Happy reading.

And BTW, not once have I ever commented that I hold the younger aged individuals in any more regard than our most vulnerable aged population.   Quite the contrary, my stance has been to do all we can do in order to protect the most vulnerable (as in not infesting nursing homes with COVID patients ala Cuomo) hiring nursing home staff with already acquired COVID immunity if possible, taking meals and other assundries to homes of the retirees, limiting visitations and when necessary, in vast open spaces or outdoors.  Meanwhile, those who are the least vulnerable should NOT bear the burden of limiting the spread of COVID and should be allowed to resume life as normal as can be utilizing aggressive hygiene measures, consistent social distancing as herd immunity is built.  This benefits us all. 

Just my opinion Archie.  I try to base mine upon the literature I research and read and not MSM news headlines. 

Name:	architect -	Reply
Subject:	CRD eschew obfuscation and do the math!
Date:	12/1/2020 2:47:07 PM (updated 12/1/2020 2:49:47 PM)

In the USA 270,000 have died from the virus and 13,700,000 have tested positive for the virus.  270,000 is approximately 2% of 13,700,000, at least it is in my granddaughters math textbook! I cannot speak for JAMA but somehow l have to feel JAMA would agree.

Put that in your CFR and IFR and smoke it!

Name:	Lifer -	Reply
Subject:	7th grade school yard response
Date:	12/1/2020 4:34:22 PM

To a thoughtful and reasonable post just means the good Doctor has beaten you once again.   It is so much fun to watch.  I prefer the the brash in your face confrontation but his intellectual and diplomatic responses bring joy to so many, so please by all means continue to make baseless, senseless arguments to throw at him.