Hydroxychloroquin as a prophylaxis for SARS-Cov2 infection

[CaseyInsights]

The Times of India reports on 20 May 2020, that 10,000 policemen (over age 40) in Mumbai, were offered the drug. Only 4,500 accepted the offer. To date there have been 618 infections and nine deaths from the SARS-Cov2 virus among the police in Mumbai.

However while infections occurred among both groups there is no mortality among the cohort that took hydroxychloroquin. And those that took the drug and contracted the virus had mild symptoms. (Hat tip: Peak Prosperity - Day 118)

timesofindia.indiatimes.com...

To be sure this is not a multi-center, randomized, double-blind, placebo controlled trial. But it is nevertheless interesting.

As for dosing requirements the ‘Indian Council of Medical Research’ suggest the following: ‘400mg twice per day on day one, followed by 400mg once weekly for the next seven weeks; to be taken with meals’. They have of course highlighted contraindications.

Full paper here -

mohfw.gov.in/pdf/Advisoryon...

If the results indicated so far holds then the question to be asked is how does hydroxychloroquin work. Evidence here from cell culture: Mechanism of action and overview of antiviral properties.

See here - youtu.be/S6kPUFseTWQ(Not working as expected?)

Not too sure we would get inconvertible evidence going forward, but let’s keep an open mind on this treatment. I fear in some parts of the world this pandemic could spiral out of control, before a vaccine arrives.

In closing some advice for Americans on this forum, let’s not paint this virus red or blue ✨🏋️‍♀️✨

[parkie13]

Few days ago I tried to get some from River Pharmacy in Canada. They took my order, however I got a email stating that India was not sending any out of the country for individual orders so my order was canceled.

[MBAnderson]

"Coronavirus Live Updates: Hydroxychloroquine May Harm Coronavirus Patients, Study Shows" New York Times

nytimes.com/2020/05/22/us/c...

[CaseyInsights in reply to MBAnderson]

Can Hydroxychloroquine cause injury? Of course it can: it’s a drug and it comes with side-effects. Not even the gold standard for Parkinson treatment - Sinemet - can escape this double edged sword.

In the USA over 150 die and an estimate of 55,000 to 80,000 ending up in the ER for acetaminophen poisoning: the key ingredient in Tylenol and hundreds of other over-the-counter products. Info here:

theatlantic.com/national/ar...

So if this happens in an over the counter drug, I do imagine what would happen if hydroxychloroquine was easily available.

But I was careful to list what the ‘Indian Council of Medical Research’ (ICMR) recommended. In that paper you will find contraindications and who is authorized to administer it. Here it is again for easy reference

mohfw.gov.in/pdf/Advisoryon...

The evidence collected so far indicates that hydroxychloroquin is useless once the virus has progressed, but given the experience with the police in Mumbai, we can not rule out its prophylactic effect.

India, seem to have an export ban in place despite their assurance to Donald Trump that they will lift the ban on exports. See @parkie13 post above on her experience when she attempted to purchase the drug.

‘Ask your doctor if Hydroxychloroquine is right for you’ ✨🍷✨

[MBAnderson in reply to CaseyInsights]

Thank you for this.

[asmckay]

As I understand it, hydroxychloroquine is an ionophore for zinc - ie it has the effect of concentrating zinc, in the cells and it is the ZINC which has the effect on the virus. This property of hydroxychloroquine is known - there are studies back to 2014 which show this in connection with its effects on malaria. I wonder if this could explain why hydroxychloroquine taken in small amounts as a prophylactic even without extra zinc appears to work whilst as a treatment (in trials in which is was used in larger amounts without accompanying zinc (as reported yesterday), it did not. My thought is that the body could have enough background zinc to maximise the potential effect of small prophylactic doses , but lack enough zinc to benefit where doses are larger and more intense.

Some of the trials relating to Covid-19 have used hydroxychloroquine, zinc and azithromycin (to deal with bacterial infections which follow on from CV infection). Those seem to have worked.

President Trump seems to be taking zinc along with his hydroxychloroquine

Zinc seems to support several kinds of white blood cell including natural killer cells and T cells. It also reduces inflammatory cytokines and reduces oxidative stress. All good. If natural killer cells and T cells meet viral particles, they kill them. If we have enough natural killer cells and T cells to deal with the quantity of viral particles we encounter we may even throw off the virus without our adaptive immune system (antibodies) ever needing to kick in. If we don't have enough, surviving virus will replicate. . So we should maximise our body's production of white blood cells eg by ensuring good sleep, exercising and eating well.

[CaseyInsights]

Hydroxychloroquin.

We are not yet done with this story.

Here in a Newsweek article dated 23 July 2020, Harvey A. Risch, MD, PhD , Professor of Epidemiology, Yale School of Public Health advocates for its use.

newsweek.com/key-defeating-...