July 29th: The Breitbart Doctors
I was just thinking to myself the other day that I didn’t have much more to say for the moment on social media, because anything I can say I’ve already said before. And then this video with “America’s Frontline Doctors” came out.
Who am I? I worked in a COVID-19 center for over two months during the pandemic’s heaviest assault on my area. We treated sick patients, in various states of health and age, and some of them got better and others did not. For a while, we worked from the prevalent theories and inferences and gave hydroxychloroquine+azithromycin+zinc to every patient that came through the door if they did not have contraindications. Then REAL EVIDENCE came out, and we discussed it at all levels, and we stopped giving it, because multiple well-done studies showed that hydroxychloroquine did not do provide any benefit over supportive care with oxygen, positioning, steroids when needed, and when patients escalated, some of the newer treatments.
Now, on to this video: The most prominent person in the video is Dr. Stella Immanuel. She is an outpatient physician who claims to have treated >300 COVID-19 patients with the HCQ+Azithro+Zn combo. By now you’ve also probably seen the articles about who Dr. Immanuel is outside of COVID-19. Apparently gynecological problems are caused by having sex with demons, vaccines are inoculating religion out of children, and we put alien DNA in our medicines? These aren’t the words of a doctor you can take seriously or trust. These aren’t based in science. But anyway, she claims none of her patients have died.
1) We have no idea if this is true, since some of them apparently drove 2-3 hours to see her and I doubt she has follow-up. If any of them got sicker and went to the hospital, odds are she may not know about them until much later.
2) She’s claiming 100% cure. NO medication has 100% cure. If anyone freely throws around the words “always” or “never” in medicine, too often they are trying to sell something.
3) She says “we don’t need to wait for data.” What?
3a. There IS data – as mentioned, there are multiple high-quality studies that have shown that hydroxychloroquine provides no added benefit and have disproven initial theories about potential treatment effects. This does not include the two that were retracted, which I will get to.
3b. Evidence is literally what drives science and medicine, and there are tiers. Dr. Immanuel provides anecdotal evidence about her patients, with little analysis and follow-up. If I were to base my conclusions solely on my experiences at my COVID-19 center, I’d be at the same level. The last doc who speaks in the video mentions observational studies, that’s a slightly higher tier. But a MUCH higher tier of evidence is massive 5000-patient trial done across multiple centers, with proper analysis and follow up to see lasting effects on patients, that still shows no benefit. There are 243 active studies right now on hydroxychloroquine (shout out to Laurel Bristow, clinical researcher, who discussed this on her social media), including some that focus on outpatient settings. None of them are looking promising, some are already releasing conclusions.
Let’s talk about the retracted studies:
Yes, Sapan Desai, a man who was later found to be unreliable during training, selfish and motivated only by his own gain rather than helping others, submitted fake data to multiple journals to enhance the image of a company he created. Those studies had to be retracted and eroded a lot of trust. That sucked. He deserves to be stripped of his degrees. I have no words for how angry his actions make me. But there have been MULTIPLE other studies with real data that have shown no benefit. As you can see, the medical community does hold itself accountable and we do question our own studies…but the non-Desai studies haven’t been retracted. On the other hand, the one trial that claims to have shown HCQ benefit completely failed to take into account that they used high dose steroids on patients getting HCQ, steroids which have ACTUALLY been shown to benefit patients.
Oh, and that 2005 study in Virology? It talks about chloroquine inhibiting SARS-CoV (not the same virus, and there are dramatic differences) IN VITRO. IN VITRO. Meaning in cells, under a microscope. Lots of things work in vitro that do not work in human bodies. When put into practical application, the isolated in vitro effect does not happen. That’s what happens with hydroxychloroquine in COVID-19 in actual humans.
One of the Breitbart docs talks about the dosing in the trials. For one, there are multiple trials looking at lower doses. But the biggest trials that have shown no benefit used a higher dose of HCQ because they needed to achieve therapeutic levels faster. Based on evidence from patients with diseases that ACTUALLY benefit from HCQ, those lower doses eventually accumulate to a good level in blood and respiratory tissue, but that takes time, which COVID-19 patients often don’t have. Hence the higher dosages. Speaking of which, why are COVID-19-related HCQ prescriptions not being filled? It’s because that medicine has ACTUAL benefit in patients with rheumatoid arthritis, systemic lupus erythematosus (lupus), malaria, and other diseases, so prescriptions are reserved for those patients so they can get what they need and will actually benefit them.
One correct thing from the video – you should look at who is motivating doctors. The academic medicine bodies that are speaking out for proper safety measures against COVID-19, who emphasize that the pandemic will not die out overnight, are mostly actually motivated to further the field. Individuals like me have no other motivation than to care for patients – I’m not getting paid by anyone to make these posts. These “Frontline” doctors on the other hand were organized by Breitbart – an extremely biased right-wing opinion machine that tries to pass itself off as a news organization (you can see where at least one spectator asked questions that went off the planned talking points and these supposed frontline doctors could not begin to answer).
(Dr. Dan Erickson is in this video. I’ve posted about him, his lack of credentials, and his monetary motivations before, so I won’t take up more room here.)
Let’s talk about that name: “America’s Frontline Doctors.” The idea that Dr. Fauci isn’t listening to doctors is laughable. You know why these doctors can call themselves that? Because doctors on the ACTUAL frontlines, primary care physicians with patients displaying COVID-19 symptoms who send them to the ER, emergency physicians, hospitalists and ICU docs, are too busy trying to save people’s lives while following actual evidence, which does not leave them enough time to hold a press conference and tout a miracle cure. We all know that if something sounds too good to be true, it probably is, and that applies to the Breitbart docs’ claims of the infallibility of hydroxychloroquine.
There is not yet a cure for COVID-19. Prevention is preferable to cure. Wear your mask, maintain social distancing, wash your hands, and be careful.