Richard Charnin
5/5/2020
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Probabilities of clinical success using hydroxychloroquine with or without azithromycin +/- zinc against the novel betacoronavirus, SARS-CoV-2
Based on the current clinical information available, the success rates for a favorable outcome/clinical improvement are approximately 91.6% using hydroxychloroquine(HCQ) without or without azithromycin (AZ) and/or zinc and the death rate in this treated group is approximately 2.7%.
This table is provisional and is being updated as new data surface.
https://drive.google.com/file/d/1w6p_HqRXCrW0_wYNK7m_zpQLbBVYcvVU/view?fbclid=IwAR2YTimAuYPeSPP-igLU7YvHGpgFvySQ6PM7e8IxzhncK68HSrfRDpYNHwg
Please note that the Veteran’s Administration study conducted by Magagnoli J, Narendran S, Pereira F, et al. in South Carolina assessed a very sick population and the hydroxychloroquine was given late the course of the illness. Many patients were ventilated. We believe the 52 deaths reported in this population are not indicative or predictive of the average death rate observed in populations diagnosed in the early to mid stage of the CoVID-19 disease and treated with hydroxychloroquine. Based on the experienced clinicians observational data summarized above, the death count was only 11 out of over 2,000 patients treated with hydroxychloroquine.
Dr. Stephen Smith’s patients who were treated with HCQ and azithromycin did not require mechanical ventilation. He reports that severely ill CoVID-19 patients under 70 yrs of age were diabetic or prediabetic with high BMI.
He is convinced hydroxychloroquine works for his patients. His level of certainty is very high. – personally reported on 4.2.20 and again on subsequent dates in April 2020.
Clinicians are natural Bayesians and such philosophical and qualitative statistical analysis is consistent with our medical training, bedside clinical skills including history taking, examination, differential diagnosis, probable primary diagnosis, laboratory evaluations including serologies, EKG, chest X-ray, CT scan of lungs, objective gold standard test interpretation and clinical decision making. In other words, waiting for fixed randomized controlled trials during a pandemic when time is of the essence, a Bayesian approach to the assessment of diagnostic and therapeutic probabilities is wise and efficient and will save time, money and lives if the physicians are given a chance to retain their autonomy and practice medicine to the best of their abilities.
