User:AndyChrist/sandbox

Just Sun

(ch 7) &mdash; thumb|right|165px| Jesus with seven horns and seven

title] author date  time  publisher

https://www.youtube.com/watch?v=llZ1uurWLmA&list=PLRgTUN1zz_oeQpnJxpeaEkFimDeepqyWf&t=2105

Hey guys and gals... I am back
Sorry for the long hiatus... I switched jobs which left me with less time to write. I am still at that job, but I have a lot more things I want to promote that aren't getting the mass attention they deserve. I am going to start with hydroxychloroquine, scientifically proven treatments for Covid 19 (remdesivir is not one of them), and then I suspect I will get into the question of whether or not Covid 19 has a lab origin (The case for it having a lab origin is a lot stronger than many people believe). A lot of the information I will present comes from Chris Martenson who has a PHD in pathology and has covered Covid 19 extensively during his Youtube videos. While I am not an expert like he is, I do have an undergraduate degree in molecular biology and I am familiar enough with the science to present it.

Hydroxychloroquine

Prior to the year 2020, hydroxychloroquine (HCQ) was an uncontroversial treatment for, , , and. Then COVID-19 became a concern and Donald Trump decided to promote HCQ as a possible cure (along with some crazier ideas like injecting bleach). Ever since, views on its effectiveness have been politicized without much regard to the underlying science. While you might know it if your only source of news is the mainstream media, a handful of studies have emerged that suggest Trump (cough) was right (cough)... HCQ works.

What is Hydroxychloroquine?
HCQ is one of a group of drugs related to, a natural compound found in the bark of the. In 1632, Spanish Jesuit missionaries 'discovered' quinine as a malarial treatment, though it was probably used by the indigenous Peruvian cultures well before then. Precisely how the quinine group of drugs are able to combat malaria hasn't been fully resolved, but the prevailing theory for is that the drug kills the parasite by interfering with its digestive process. When the parasite that causes malaria enters the body, it begins to eat hemoglobin. Normally, the parasite digests most of the protein and discards hemoglobin's heme unit by biocrystallizing it into a nontoxic and insoluble molecule called hemozoin. Chloroquine disrupts this process by accumulating in the parasite's food vacuoule and binding with the heme unit to form the highly toxic FP-chloroquine complex. FP-chloroquine then kills the parasite.

Hydroxychloroquine and chloroquine are highly similar (they only differ by one oxygen atom), but hydroxychloroquine has the advantage of being less toxic which is why it is more extensively studied as a treatment option for diseases. Like its cousin chloroquine, HCQ is highly effective against malaria. However, in order for it to be effective against SARS-CoV-2, HCQ must also possess anti-viral properties as SARS-CoV-2 is a virus and not a parasite. An article published in 2003 by Savarino postulated that HCQ was able to have an antiviral effect by increasing intracellular ph which results in "decreased phago-lysosome fusion, impairing viral receptor glycosylation." It also was postulated to have immune-modulating effects by inhibiting toll-like receptor signaling. HCQ is also a known zinc ionophore and proponents of HCQ will often include zinc as part of their recommended treatment protocol as they believe HCQ is effective by enabling zinc to enter an infected cell where the ion inhibits viral replication. One study which supports this conclusion is Zn2+ Inhibits Coronavirus and Arterivirus RNA Polymerase Activity In Vitro and Zinc Ionophores Block the Replication of These Viruses in Cell Culture This study was published in 2010 in the journal PLOS Pathogens, which is well before any of the controversy surrounding hydroxychloroquine and COVID-19 occurred. Another study, Hydroxychloroquine (HCQ) and azithromycin (AZ) plus zinc vs hydroxychloroquine and azithromycin alone: outcomes in hospitalized COVID-19 patients, examined the role zinc played and discovered that the number of patients discharged home significantly increased and the number of patients needing ICU, ventilation, or hospice care significantly decreased when zinc was added to the HCQ treatment regiment.

HCQ and Covid 19
Prior to 2020, chloroquine (hydroxychloroquine's close cousin) was shown to be effective against SARS-CoV, a pathogen that is related to SARS-CoV-2. A study published on August 22, 2005 in the Virology Journal, almost 15 years before Covid 19, concluded Chloroquine is a potent inhibitor of SARS coronavirus infection and spread. Other journal articles which suggested chloroquine could be effective against coronavirus were Effects of chloroquine on viral infections: an old drug against today's diseases? (2003), In vitro inhibition of severe acute respiratory syndrome coronavirus by chloroquine (2004), and New insights into the antiviral effects of chloroquine (2006). Doctors familiar with medical research began prescribing hydroxychloroquine to combat SARS-CoV-2 because it was a coronavirus and therefore hydroxychloroquine was a treatment option worthy of serious consideration. Two of the first countries to use HCQ were South Korea, who used hydroxychloroquine + zinc, and France, who used hydroxychloroquine + azithromycin. In the case of the USA, HCQ achieved prominence when Donald Trump promoted the drug as a treatment for COVID-19. This view was inline with some of his political advisers such as Rudy Giuliani, but certainly not all, Dr. Anthony Fauci being the principal skeptic. In the case of Rudy Giuliani, he conducted an interview with Dr. Vladimir Zelenko on his podcast Common Sense where Dr. Zelenko promoted the three drug regiment he was using to treat patients in New York - hydroxychloroquine (HCQ) + zinc + azithromycin (AZ). This was a combination of the South Korean and French approaches to treating the disease. Zelenko concluded that his treatment protocol was being effective based off of the results he was having treating his patients. More evidence supporting HCQ's effectiveness emerged as time progressed. Didier Raoult, the French doctor whom administered HCQ + azithromycin, was having a mortality rate under .5% with patients showing up at the hospital. Costa Rica, which began administering HCQ countrywide to treat patients, was having a lower case mortality rate when compared with the rest of the world. Brazil, which began treating patients with hydroxychloroquine and azithromycin, studied their treatment protocol and determined that HCQ's benefit was highly statistically significant (p< 0.001). Spain was also having similar results (p=0.002). Even a Texas nursing home had positive results using HCQ. None of these were double blind, randomized, placebo-controlled studies, but they were certainly enough evidence to suggest that a casual relationship between HCQ and COVID-19 recovery could be occurring, and that the relationship deserved to be researched further.

The 'scientific' studies that said hydroxychloroquine was harmful
Prior to 2020, HCQ was seen as safe. And not just safe. Safer than aspirin safe... Aspirin had 10,735 adverse events reported to the FAERS database in 2019 and hydroxychloroquine had 3,718. Although both drugs are widely used, those numbers could be misleading if more people in the USA take aspirin than hydroxychloroquine. ln any case, the FAERS data does suggest that not many people were harmed by hydroxychloroquine prior to 2019 as one would expect much higher numbers to be reported if the drug had significant adverse effects. As for the known side effects of HCQ prior to Covid 19, they include skin rashes, nausea, diarrhea, headaches, hair loss, tinnitus, and visual problems. In other words, nothing particularly harmful when compared to things like the complete destruction of one's lungs. Even after COVID-19, HCQ has remained standard of care for diseases such as lupus and rheumotoid arthritis, and continues to be prescribed to children and women who are pregnant or are nursing even though those patients are often excluded from drugs that aren't as safe as HCQ. And yet, once it was touted as a potential cure for Covid 19, HCQ was suddenly seen as harmful by many media outlets and health organizations. So how did this come to be?

The VA study
Outcomes of hydroxychloroquine usage in United States veterans hospitalized with Covid-19 was one of the first studies to suggest a positive correlation between HCQ treatment and death from COVID-19. In the results section, the paper stated there were 27 deaths (27.8%) in the HCQ group, 25 deaths (22.1%) in the HCQ + azithromycin group, and 18 deaths (11.4%) in the no HCQ group. Even before the paper had a chance to be peer reviewed (it was a preprint when it first appeared in the media), 'journalists' from organizations such as the Washington Post, CNN, Fox News, and the AP used this information to write articles with attention grabbing headlines such as More deaths, no benefit from malaria drug in VA study.

An obvious question readers may ask after reading such a headline is "Why did more deaths occur?" If one's job was to report the news, one might try to find the answer to that question by reading the paper they were reporting on. If one had done that, one would have come across this paragraph in the discussion section.

In other words, several doctors at the VA were using HCQ in a last ditch effort to try and save critically ill patients, it didn't work, and their efforts skewed the data as less seriously ill patients weren't being treated as often with HCQ. Problems such as this highlight why it is so important to have randomized clinical trials and control for variables such as when HCQ was administered. The VA study wasn't designed in that manner. To its credit, it said exactly that.

Neither the greater use of HCQ in critically ill patients nor the study limitations were discussed in the news article mentioned earlier. Instead the author wrote that the study didn't track side effects and then implied HCQ's side effects caused the increased death rate!

None of that seemed to matter to the news organizations that copy and pasted her work though.


 * AP News - More deaths, no benefit from malaria drug in VA study
 * Politico - More deaths, no benefit from malaria drug in VA virus study
 * NBC News - More deaths, no benefit from malaria drug in VA virus study
 * Medical X Press - More deaths, no benefit from malaria drug in VA virus study
 * US News and World Report - More deaths, no benefit from malaria drug in VA virus study
 * ABC News - More deaths, no benefit from malaria drug in VA virus study
 * AOL - More deaths, no benefit from malaria drug in VA virus study
 * Yahoo - More deaths, no benefit from malaria drug in VA virus study

To be fair, the "authors" did mention that the VA study was not a rigorous experiment. To be fair to the study, it might have been more rigorous than the reporting on it.

Surgisphere
Hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19: a multinational registry analysis was one of the next studies to suggest HCQ was dangerous. According to its authors, hydroxychloroquine had a 18% mortality rate when used to treat COVID-19 and the mortality rate raised to 23.8% when it was combined with an antibiotic, whereas the control group only had a 9.3% mortality rate. Media organizations such as US News and World Report, The Verge, NBC News, TIME, CBS News, The Wall Street Journal, FOX News, and CNN were quick to promote this study and its findings. There was only one problem...the study was a complete fraud. Thankfully, medical professionals who actually understand science, logic, and reasoning were not fooled and mentioned problems with The Lancet article before it had been retracted. The Guardian also managed to see The Lancet article for what it was. So what were the red flags that revealed the study to be fraudulent?

1. The data was too clean
About the paper published in The Lancet: Data coming from five different continents cannot be so homogeneous. There is either data manipulation (not mentioned in Material and Methodes), or incorporation of faked data. - Dr. Didier Raoult

People from different countries have different cultures and this results in different behaviors and lifestyles among their citizens. One example mentioned by both Dr. Didier Raoult and Dr. Chris Martenson was smoking. In North America and Australia, rates of smoking are closer to 14% and in Europe it is closer to 20 - 30%. One would expect this variation in smoking prevalence to be reflected in the study's data set, but the authors claimed that 10% of North Americans, 9.7% of South Americans, 9.7% of Europeans, 10.3% of Africans, 9.4% of Asians, and 10.0% of Asians in the study smoked. This discrepancy made the data appear fake, which was the point Dr. Raoult was making in his tweet.

Some people decided to criticize his logic.

Oh, please. You’re so full of (Pile of poo emoji). You can’t refute the study; so you start lying and insinuating data fabrication? Pathetic. (Face with rolling eyes emoji) - Dr. David Gorski

Two weeks later, Donald Trump replied with a tweet of his own. "Lancet article retracted! Now who is full of (Pile of poo emoji)?" - (sarcasm)

Another problem with clean data was pointed out by the twitter user arkancideisreal.

The objective of is to try and account for the influence of confounding variables. For example, one doesn't want more obese people to be in the HCQ group when compared to the non-HCQ group because obesity is a comorbidity and any observed increase in deaths could be due to this confounding variable. To try and eliminate this problem, researchers will reduce the number of patients they are comparing so that they have patient groups that are highly similar. This type of analysis is difficult for 5 factors because each time you add a factor, people will be eliminated from the group and their elimination will effect the other variables being controlled for. For example, if one had 7 Asian individuals in both the HCQ and control groups and two of the Asians in the HCQ group were eliminated because their body mass index was too high but all 7 Asians in the control group remained, now the Asian confounding variable isn't being accounted for. Once one gets out to 23 factors, the likelihood that a large number of patients in the HCQ group will have similar statistics as a large number of patients in the control group is vanishingly small, thus table S7B strongly suggests that the authors lied.

2. Impossible to collect the data in a month and a half without violating privacy laws
Usually to submit to a database like Surgisphere you need ethics approval, and someone from the hospital will be involved in that process to get it to a database. - Dr. Allen Cheng Pretty much all countries except China have strict privacy laws. This is particularly true for western countries in regards to their citizen's health data and yet The Lancet study said that patient data had been collected from Europe, Australia, and North America in a really short time frame. This fact leads inquiring minds to ask "How did they get the data?" Surgisphere, the company behind the paper, said they questioned existing repositories of data. While some electronic repositories of health data do exist, each hospital system has their own repository that is not linked to the repositories of other hospital systems and access to each repository requires its own ethical approval. Obtaining such approval is not easy, particularly when one has to do it for multiple different countries, each of whom has their own unique set of rules and regulations surrounding access to patient records. Even if one were to gain access, all the information one wishes to include (such as whether or not a patient was a former smoker) may not have been entered into the database by the hospital. Moreover, one would need to gain access to pathology databases which are complete separate from hospital record databases and be able to match the information from pathology databases to a particular individual's hospital record. Maybe in China that is possible, but not in western countries unless one is a doctor or nurse of that particular patient.

3. Only four authors
Usually with studies that report on findings from thousands of patients, you would see a large list of authors on the paper. Multiple sources are needed to collect and analyse the data for large studies and you usually see that acknowledged in the list of authors.” - Dr. Allen Cheng The Lancet study had only four authors, three of whom were heart specialists and therefore were not responsible for data collection or statistical analysis.

4. Too many Australian deaths
The following was also revealed in The Guardian article the quotes from Dr. Allen Cheng came from.

Yep. That is a problem, but it gets worse for Surgisphere...

5. Two of the authors were related
And the story is not that I am related to Dr. Desai by marriage. That’s old news. Many people from the Brigham were at that wedding and media knew about it. Despite this I still do not have the information of what happened at Surgisphere. But there has to be locals who do. - Dr. Amit Patel

No conflict of interest there...

6. And there were even more problems...
This study led doctors from around the world to sign an open letter to its authors and Richard Horton (the editor of The Lancet) essentially asking for its retraction. Among the reasons given were "not adhering to standard practices in the machine learning and statistics community", "no mention of the countries or hospitals that contributed to the data source", "implausible ratios of chloroquine to hydroxychloroquine use", and "mean daily doses of hydroxychloroquine that are 100 mg higher than FDA recommendations." The Lancet eventually caved and retracted the paper just like they had done with their publication of Andrew Wakefield's paper. Unfortunately, just like with the vaccine and autism scare, the damage had already been done. As the open letter points out, "the WHO has paused recruitment to the hydroxychloroquine arm in their SOLIDARITY trial. The UK regulatory body, MHRA, requested the temporary pausing of recruitment into all hydroxychloroquine trials in the UK (treatment and prevention), and France has changed its national recommendation for the use of hydroxychloroquine in COVID-19 treatment and also halted trials."

All due to a study that was a complete pile of poo emoji.

The RECOVERY Trial
Another study commonly cited by the media is the UK's RECOVERY Trial, which is a comprehensive evaluation of possible treatment options for COVID-19. HCQ was one of the drugs tested, but the results were not statistically significant. The following is how Professor Peter Horby and Professor Martin Landray presented their findings.

That statement is not correct. If the study convincingly ruled out HCQ, it would have a p value less than .05. It didn't. It had a p value of .10. In any case, the researchers were correct to conclude that the study only applies to hospitalized patients and therefore can't be used to conclude that HCQ won't work for people who use the drug closer to the time they were infected. A useful analogy is thinking of Covid-19 like a car crash and HCQ as an airbag. In order for for an airbag to be effective, it has to be deployed after the car crash but before the occupant crashes through the windshield. In the case of Covid-19, the argument is that anti-virals such as HCQ must be deployed after catching the virus but before it causes massive damage... having the airbag deployed after one hits the windshield just doesn't work. By focusing only on hospitalized patients, the RECOVERY trial failed to address the more pertinent issue of whether HCQ can be used to treat the disease before one has to be hospitalized.

Failure to address early treatment options was not the RECOVERY trial's biggest limitation, however. All drugs, when taken in the wrong doses, can become toxic. A good example of this is. In low doses, it is an effective and medically useful anticoagulant. In high doses, it is known as rat poison. In the case of HCQ, the maximum recommended daily dose is 800 mg, but the RECOVERY trial used a daily dose of 2400 mg of HCQ, a dose that is three times higher than the recommended maximum daily dose! When Martin Landray was asked why he used such a high dose in his trial, he said "the chosen dosage is in line with the dosages used for other diseases such as amoebic dysentery." That was a curious response considering isn't used to treat amoebic dysentery. is. This has lead to speculation that the doctors of the RECOVERY trial confused the two drugs.

Th University of Minnesota studies
A Randomized Trial of Hydroxychloroquine as Postexposure Prophylaxis for Covid-19 is a study authored by David Boulware and published in the New England Journal of Medicine. Unlike the prior studies mentioned, this study did not say HCQ was harmful. Rather it is often cited by the media to suggest that HCQ has no net benefit. There are several studies that come to the same conclusion, most of whom administered HCQ too late in the disease progression for the anti-viral to be effective. Boulware's study is different in that it aimed to examine the effects of HCQ on a random selection of people shortly after they were exposed to COVID-19, which is a good methodology. Unfortunately, the study also had major limitations.
 * 1) Almost all data was reported by the participants - Self-reported data is extremely unreliable which is why most studies are done with researchers administering the drugs. Self-reporting adds variables such as 'forgetting if one took the drug or not' that wouldn't occur in a more controlled setting.
 * 2) A lack of testing for COVID-19 - Only 3% of the participants were tested for COVID-19 as the study was conducted when test kits weren't widely available. Instead they were declared to be COVID-19 positive even if their only symptom was a cough or if they had two symptoms of common things like headache and myalgia. Moreover, participants didn't have to have a known exposure to SARS-CoV-2 (such as a Covid-19 significant other). Instead they could have simply traveled to an area where SARS-CoV-2 was transmitting and thought they caught the pathogen. That is not rigorous diagnostics as other pathogens such as the common cold or the flu can cause the same symptomology.
 * 3) The patient cohort was young - It is well established that the elderly are most at risk and therefore most likely to see benefit from HCQ.
 * 4) The treatment was delayed - The authors were trying to prove whether or not HCQ can prevent the incidence of COVID-19 and that requires drugs to be taken quickly after exposure. Placebos and HCQ were delivered to participants through the mail.

The following is how the authors presented their results.

The incidence of new illness compatible with Covid-19 did not differ significantly between participants receiving hydroxychloroquine (49 of 414 [11.8%]) and those receiving placebo (58 of 407 [14.3%]); the absolute difference was −2.4 percentage points (95% confidence interval, −7.0 to 2.2; P=0.35).

Dr. Cohen counterargues- In the current trial, the long delay between perceived exposure to SARS-CoV-2 and the initiation of hydroxychloroquine (≥3 days in most participants) suggests that what was being assessed was prevention of symptoms or progression of COVID-19, rather than prevention of SARS-CoV-2 infection."

In other words, the study cannot be used to assess HCQ's ability to prevent incidence like Boulware claimed because the participants weren't given the drugs quickly enough.

The French newspaper France Soir looked at the study's data and concluded HCQ had some benefit for individuals treated for COVID-19 1-2 days after exposure (at 90% confidence, which doesn't quite make it to p <.05). France Soir also reported that Dr. Boulware scheduled a presentation for October 5, 2019 where he disclosed having received a research grant from Gilead Sciences. Gilead is the maker of remdesivir. To Boulware's credit, he recognizes the study's flaws. According to Dr. Lewis, "He also points out that day 1-3 use had statistical significance and he’s gearing his other studies accordingly. He intends to investigate this significance further." The University of Minnesota conducted another study entitled Hydroxychloroquine in Nonhospitalized Adults With Early COVID-19: A Randomized Trial with a similar trial design, with Boulware as a co-author. Like its predecessor, it used internet surveys and overnight shipping of the drugs. During the trial, a major problem occurred... "the low event rate of hospitalizations or deaths in the trial would have required increasing the sample size to 6000 participants" and they only had 491 participants. Instead of making the study more robust by adding more participants, the study incorporated "overall symptom severity" instead of hospitalization as an endpoint. While more people had PCR confirmed Covid-19 than the earlier study, only 58% of participants received SARS-CoV-2 testing.

The study failed to reach statistical significance which should be unsurprising given its limitations. The results were positive, however, with HCQ having a P value of .21 for lower rate of ongoing symptoms and a P value of .29 for a lower rate of hospitalization.

Retrospective studies from New York
There is no question that retrospective studies are not the best science. One has to use statistics to try and account for all kinds of variables such as delayed onset of treatment, not giving a patient a drug due to a patient's risk factors, and other variables such as differences in comorbidities. Some of these factors can be controlled for in certain situations. For example, if patients are seen by the same group of doctors, then differences such as when a particular drug is administered may not vary widely, but even in that situation other variables will persist such as screening for risk factors. The main advantage of retrospective studies is that ethical concerns are limited to protecting patient privacy as no patients are being given placebos or potentially harmful drugs.

In the case of New York, three retrospective studies were conducted, two of which said HCQ treatment had no effect, and a third which said HCQ had a net benefit.

Observational Study of Hydroxychloroquine in Hospitalized Patients with Covid-19
Joshua Geleris studied the patients who came to the New York–Presbyterian Hospital (NYP)–Columbia University Irving Medical Center (CUIMC). Having the results come from one hospital could mean that some of the variables one might encounter with a multi-hospital analysis are controlled for, that doesn't hold true in this case. While the hospital initially recommended dosing for HCQ at 400 mg, these recommendations were subsequently removed and treatment was left to the doctor's discretion. Moreover, it was only until after patients reached the emergency room that they were given HCQ (see figure S3), and even then only 45.8% received it within 24 hours. That is pretty late to be giving HCQ. In any case, what did they find?

In short, the researchers found that if you give HCQ in an ER preferentially to patients who were more severely ill at baseline, there is no significant difference between those given HCQ and those who weren't given it. It is difficult to figure out how to interpret that result. Is there no effect in an ER setting as evidenced by the similarity of outcomes between the two groups? Does it mean that there was a net positive effect to HCQ because the sicker patients weren't dying as often as one might otherwise expect?

The short answer? Nobody really knows because there are too many variables not being accounted for.

Association of Treatment With Hydroxychloroquine or Azithromycin With In-Hospital Mortality in Patients With COVID-19 in New York State
Eli Rosenberg analyzed the data from 25 different hospitals in the New York Metropolitan area, a situation that is far from ideal. As there was no guidebook for doctors to go by for treating COVID-19, different doctors at different hospitals had different ways of treating the same disease. Rosenberg tried to account for this problem by randomizing the hospitals, but randomization is not a substitute for controlling the variables one can control such as when HCQ is administered. That having been said, having randomization is better than not having it.

Because of the study's inherent problems (and the inherent problems of all retrospective studies), the confidence intervals of their findings were large. "HQ + AZ" had a hazard ratio that ranged from .76 (meaning net benefit) to 2.40 (meaning net harm). "HCQ alone" ranged from .63 to 1.85 and "AZ alone" ranged from .26 to 1.21. This study also showed a higher prevalence of heart problems with HCQ (hazard ratio from 0.96 to 3.81), but no statistical significance was obtained for HCQ, either negative or positive.

No findings does not mean that HCQ doesn't work and/or is harmless. It just means that there are no findings. One explanation could be that HCQ didn't work and/or is safe. Another explanation was that the trial was poorly designed. A third factor could be that the trial wasn't large enough to achieve statistical significance. Only after the likelihood of the later two factors are seen as small (usually through the use of multiple, well-executed studies that consistently come up with the same result), can one begin to make the case that the null hypothesis is correct.

Risk Factors for Mortality in Patients with COVID-19 in New York City
The third study was conducted by Takahisa Mikami and it analyzed the medical records of the Mount Sinai Health System. One of the first things that stands out in this study was its sheer size - it analyzed the results of 6493 patients whom had laboratory-confirmed COVID-19. By contrast, Geleris's study had 1446 patients, Rosenberg's study had 1438 patients, and the VA study had only 368 patients. When it comes to statistics, size definitely matters, and this one could be a center for the NBA... its even larger than the RECOVERY trial (not larger than Surgisphere though). While size is important, it is not a substitute for skill so let's take a more in-depth look at the study.

The study divided patients into ambulatory and hospitalized sub-groups. Ambulatory was defined as "patients whose encounter was an office visit, emergency department (ED) visit, or telehealth/telemedicine." Hospitalized was defined as "inpatients and ambulatory patients who were subsequently admitted to the hospital." This subdivision is important as it helps control for two of the most important factors, namely the timing of HCQ use and the overall health of the patients using the drug. Because of its sheer size, the study was able to do this subdivision without impacting its ability to achieve statistically significant results... even the subdivisions were larger than the studies conducted by Geleris and Rosenberg. The subgroups were then further subdivided into survivors and non-survivors, with the end date being April 17, 2020 (meaning a patient had to have died or discharged by that date to be included in the study). Then they did a whole bunch of statistical stuff (Cox Regression analysis, inverse probability weighting (IPTW) based on propensity scoring) to determine what the statistical results were. So what did they find?

The confidence interval for HCQ in this study ranged from .41 to .67, which indicates that HCQ was associated with decreased risk of in-hospital mortality. If we use the .53 hazard ratio, people given HCQ were 47% less likely to die. As shown by the supplementary figure four of the study, the survival of patients was significantly higher for patients taking HCQ. (P < 0.001). That is a highly significant finding and a strong indicator that HCQ works. There were no statistical results presented for HCQ among the ambulatory patients, though it was reported that the majority of them did not receive the drug.

Scientific studies that say hydroxychloroquine has a statistically significant net benefit
One of the arguments raised by individuals wishing to dismiss HCQ as a treatment option for COVID-19 is that the evidence supporting its efficacy is anecdotal. That actually isn't the case. Research studies such as the one conducted at Mount Sanai hospital have be done and statistically significant results have been achieved. That is science not anecdote. Of course, like with any scientific analysis, the conclusions could be wrong and the results need to be scrutinized (unlike what The Lancet did with Surgisphere's data). So here is a novel thought. Why don't we scrutinize the data logically instead of doing whatever Richard Horton thinks passes as empiricism?

Prevent Senior Institute in Brazil
One of the early studies published on HCQ as a possible treatment for COVID-19 was Empirical treatment with hydroxychloroquine and azithromycin for suspected cases of COVID-19 followed-up by telemedicine which was published as a preprint on April 15 by the Prevent Senior Institute in São Paulo, Brazil. The study had limitations that made it less than ideal... it wasn't randomized and it had to assume that patients who were exhibiting flu-like symptoms during São Paulo's SARS-CoV-2 pandemic had contracted SARS-CoV-2 (testing wasn't widely available at the time), but the study also had several strengths. Unlike retrospective studies like the VA study, it had a natural control group - it offered to give HCQ and azithromycin to 636 symptomatic outpatients, 412 of whom accepted the treatment (the treatment group) and 224 of whom refused the medications (the control group). It also used HCQ early which is when antivirals are most effective and the patients were monitored by telemedicine (unlike Boulware's study). So what where the results?

That is a highly significant result, not "anecdote". Actually, highly significant results as the study showed two things.
 * 1)  Need for hospitalization is substantially reduced (2.8 times less) when patients are treated with HCQ.
 * 2)  Patients who are treated with HCQ before the seventh day of symptoms do significantly better than patients who receive the treatment late.

These are potentially life-saving results in a study that was in a preprint before the VA study was in a preprint and yet receives no love from the mainstream media. It was also slightly larger than the VA study.

Gómez Ulla in Spain
Another early study with highly significant results was Early Hydroxychloroquine Is Associated with an Increase of Survival in COVID-19 Patients: An Observational Study (published as a preprint on May 5). This study is unique in that it was an observational study that actually acted more like a case-control study. The following is how the researchers described the situation at the hospital. "During the first days of the pandemic, HCQ was not considered in the local protocol. Afterwards, there were shortages in HCQ distribution. Because of that, we had two populations of patients treated and not treated with HCQ although they had similar characteristics. That gave us the opportunity to investigate the differences observed between the two groups." Thus it has a control group, namely patients before HCQ was considered and patients that were treated after they ran out of HCQ, and it had a treatment group, namely patients who received the drug when it was available. The study also had the advantage of enrolling "all 18-85 years old inpatients from Central Defense Hospital “Gómez Ulla”, Madrid, Spain, who were hospitalised for COVID-19 and had a definitive outcome'." The enrollment of everyone reduces the likelihood of selection bias, although it doesn't completely eliminate it (some people were excluded because of things like pre-existing arrythmias or drug interactions).

This study focused on a different patient cohort than the Brazil study as these were people presenting to the hospital rather than people seeking treatment right after they were infected which means it is closer to the Mount Sanai study. So what did they find?

P=0.002 is another highly significant result with potentially life saving implications that was in a preprint after the VA study but before Surgisphere. The main disadvantage of this study was that it was small... 166 patients is not a high number.

This study also received no love from the mainstream media.

IHU Méditerranée Infection hospital in France
Dr. Didier Raoult is a French microbiologist, doctor, and professor who heads the Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (Emerging Infectious and Tropical Disease Research Unit) at Aix-Marseille University and is affiliated with the IHU Méditerranée Infection hospital. When SARS-CoV-2 reached France and COVID-19 patients began showing up at the IHU Méditerranée Infection hospital, Dr. Raoult promoted hydroxychloroquine + azithromycin as a treatment protocol. As he is a director of a lab that specializes in emerging infectious diseases, his research team collected a lot of data in order to study the effectiveness of the treatment. His team provided the media and the medical community preliminary evidence that HCQ + AZ was working throughout the research process and published a small study on March 20, but his much larger retrospective analysis study wasn't published until June 25. Entitled Outcomes of 3,737 COVID-19 patients treated with hydroxychloroquine/azithromycin and other regimens in Marseille, France: A retrospective analysis, it is a thorough examination of the HCQ treatment option and it is most definitely not anecdote... this is medical science done with a high level of precision.

The study was simply massive. While it had less patients than Mount Sanai's (it had 3,737 patients), the study had researchers involved throughout the process which gave them a lot of data to work with and use in their analysis. For example, 2,065 low-dose CT scan characteristics were performed among the patients in order to evaluate the effect the virus was having on the lungs. They also "recorded lymphocyte, eosinophil and platelet counts; fibrinogen; D-dimer and other coagulation factors; electrolytes; zinc; lactate dehydrogenase (LDH); creatine phosphokinase (CPK); C-reactive protein; and HCQ serum dosage. Viral load was analysed by qPCR from nasopharyngeal swabs at admission and during the follow-up." The study was not without its problems...it was an observational study and its control group consisted mostly of people who had risk factors for HCQ or where seen before HCQ + AZ became the hospital's go-to treatment. But it is difficult to argue with results and this study had a lot of those. So what did they find?

Now those are some good looking numbers. A case fatality rate of 0.9% is ridiculous when compared to other studies, although the fact that patients with milder symptoms were included in the study (as well as those with more severe symptoms) certainly helped. For comparison, across the channel, the RECOVERY trial's case fatality rate was 25.7% for hydroxychloroquine and 23.5% for usual care.

The study also showed that HCQ was associated with a shorter duration of viral shedding, as one might expect when an antiviral is working as an antiviral. 10.6% of patients using HCQ and AZ had the virus persist longer than ten days versus 20.6% of patients using other treatments. That result had a statistical significance of P<0.001. HCQ was also associated with decreased risk of transfer to the ICU or death and decreased risk of hospitalization, both of which were statistically significant results (P<.001). The study also had zero cases of torsade de pointe despite having treated over 3000 patients. That is a critically important finding as the main argument opponents of HCQ use is that it causes torsade de pointe which can lead to sudden death. It must be noted that Raoult's numbers are helped by the fact that he screened out people who had risk factors for HCQ and QTc prolongation was monitored through EKGs in hospitalized patients.

Gandalf Dr. Raoult is too prominent of a figure for the mainstream media to ignore. The following are some examples of how they have portrayed him and his work.


 * French doctor defiant on hydroxychloroquine despite study   - MSN

Raoult, a distinctive figure with his shoulder-length shaggy grey hair, ended the video by repeating another controversial claim that "this is the end of the epidemic". Looking at the records of 96,000 patients across hundreds of hospitals, the study published in The Lancet found that administering the drugs actually increased the risk of dying.

The study Dr. Raoult was defiant of was Surgisphere's...


 * The Trumpian French Doctor Behind the Chloroquine Hype - The source of the hopes for a coronavirus cure should raise a lot of red flags - Slate

The title says it all. There are some legitimate concerns contained within the article such as the research not being a double-blind placebo controlled trial, but the coverage was hardly balanced. For example, it failed to mention that the drug chloroquine was shown to have efficacy against SARS CoV before Dr. Raoult promoted HCQ as a cure.


 * Hydroxychloroquine: Europe Turns Away From Doctor Who Championed Drug With ‘Irresponsible’ Study - Forbes

The results from two new drug trials have failed to find evidence that hydroxychloroquine works to treat Covid-19... One was the RECOVERY trial, supported by a grant to the University of Oxford in the U.K. The other was from researchers at the University of Minnesota.

So a travel writer is arguing that the doctors in the RECOVERY trial who prescribed three times the maximum recommended dose for HCQ and had a 25.7% case fatality rate are the ones being responsible and the doctors whom ceased treatment in 12 patients with QTc prolongation and had a 0.9% case fatality rate are the ones being irresponsible? Interesting. As for the Minnesota study she mentioned, the author failed to state that Boulware believed day 1-3 HCQ use had enough statistical significance to warrant further investigation. She also defended Surgisphere after their study had been retracted, citing the company's claim that the release of their data would violate third party client confidentiality agreements.

Alex, here is some unsolicited advice; Stick to writing about travel 'cause science ain't your thang.

Dr. Zelenko
Before Dr. Immanuel's video went viral, the medical professional most prominently associated with HCQ in the United States was Dr. Vladimir Zelenko, a general practitioner who treats patients in the state of New York. Since the time he first told Rudy Giuliani about the positive results he was having with HCQ + AZ + zinc, he has coauthored a preprint entitled COVID-19 outpatients – early risk-stratified treatment with zinc plus low dose hydroxychloroquine and azithromycin: a retrospective case series study. The study has some problems in its current form, the most glaring of which is that "only outcome data for hospitalization and all cause death was available" for the untreated control group. Ideally, one would wish to use propensity matching with these results, with age being one of the factors being accounted for, but that simply isn't possible with the data the researchers had available to them. Of the studies supporting HCQ use, Dr. Zelenko's is the weakest. This having been said, the study is notable due to its incorporation of zinc, its study of outpatients, and Dr. Zelenko's prominence in the media. So what were the results?

It is a small study with serious questions concerning its control group, but Dr. Zelenko was able to find a statistically significant reduction in the hospitalization rate of patients treated with HCQ.

Dr. Zelenko is another figure who is too prominent to be ignored.

A misstatement by Zelenko about a randomized clinical trial being conducted by St. Francis Hospital "drew scrutiny of federal prosecutors"... Zelenko had thought the St. Francis's study had FDA approval when it had only been approved by the hospital's internal review board. Thankfully, prosecutors don't appear to be treating the misstatement too seriously. The Daily Beast article Controversial Doc in Trump’s Ear Calls Malaria Drug Study ‘Garbage' was far less kind and used the misstatement (as well as the time-machine based Lancet paper) to attack Dr. Zelenko's credibility.

Vanity Fair was also highly critical and accused Dr. Zelenko of using his political connections to commit the unfathomable crime of helping St. Francis Hospital's outpatient primary care to obtain:

"1. Hydroxychloroquine 200mg. 10000 pills"

"2. Azithromycin 500mg 5000 pills"

"3. Zinc sulfate 220 mg 5000 pills."

A Hasidic Jew helping a Catholic hospital get life saving drugs? Scandalous. The author clearly deserves a Pulitzer.

The Henry Ford Health System
When SARS-CoV-2 hit Detroit, the Henry Ford Health System set up a COVID-19 task force and established uniform treatments across all of its 6 hospitals in order to assess what their treatment protocol should be. The "patient population received aggressive early medical intervention", which means that treatments were given early, and the treatment of hydroxychloroquine + azithromycin was reserved "for selected patients with severe COVID-19 with minimal cardiac risk factors." The fact that hospitalized patients were studied means that the study is closer to Mount Saini's study than it is with Brazil's study of outpatients. Before we get to the results, the study also mentioned why HCQ + AZ was chosen as a potential treatment option. Given the political controversy surrounding HCQ, what they had to say is particularly important.

There is no mentioning of Donald Trump or Rudy Giuliani. Or patients with lupus and rheumatoid arthritis struggling to get HCQ. Or COVID-19 patients self-medicating with fish-tank cleaner. Or Surgisphere. And if you didn't know who Andreani and Gautret worked for, no mentioning of Dr. Didier Raoult and his magical staff (pun intended). All they cared about was the science. In this case, the analysis went something like this.

"Hey, there are these recent studies that say HCQ works against SARS-CoV-2 and its a safer treatment than chloroquine, although both drugs are highly similar. And there is this 2003 paper that explains why chloroquine works as an antiviral.  And it has anti-thrombic effects?  It is looking pretty good.  Oh, and there is this 2019 study that says AZ also has antiviral properties.  And there is this  French guy who heads an institute for emerging diseases.  He has a bunch of people working for him and they started using AZ + HQ within cells to test it out and it worked.  Then they started a small study which showed that the combination of HCQ + AZ helped patients get rid of the virus faster.  I don't want my patients to have SARS-CoV-2 any longer than they have to.  I think I will try what the French dude is doing."

That kind of analysis may not always generate attention grabbing headlines, but boy is it important. Then again, sometimes science gets the attention it deserves - Hydroxychloroquine lowers COVID-19 death rate, Henry Ford Health study finds.

Without further ado, here are the results.

In other words, HCQ cut the death rate by over half. This study is not without its own problems. It is similar to Dr. Raoult's study in that the control group consisted mostly of people with risk factors for HCQ and it is an observational study.

USA Today attempted to "Fact-check" the article, correctly pointing out that it showed a 50% reduction in death rates, HCQ had no safety problems, and the study was limited by being an observational study, but then it made assertions that were more misleading. The following was what they had said:

Some counterpoints.
 * The study is not an outlier. Spain's study had very similar results and had control groups. Mount Sanai's study also had similar results and it is the largest study of its kind to date. Brazil's study, France's study, Dr. Zelenko's study, India's study, other studies such as this one from Lebanon, and even the Boulware study the article cited to defend its position, have all had positive results, and only Boulware's study failed to reach statistical significance.  The outliers are the studies which haven't had positive results, all of which had inherent problems such as the drug being given late, the drug being given in toxic doses, or the study being a complete fraud.
 * The following is how John MeComb described the problem of randomized trials with control groups (in regards to COVID-19 and Zelenko's study).The control group would have to be people with symptoms at high risk for progression of disease. Would this not be unethical for this kind of study? I for one would not want to be in such a control group and, as a patient, if informed as such would decline. As a physician, under the current circumstances, it would violate my hippocratic oath to place people in such a control group... The "control group" has to be a preponderance of the evidence at this point.
 * While steroids do work and were given about twice as often to patients given HCQ in the study, steroid use doesn't explain the 66-71% hazard reduction - steroids only reduce one's risk by about a third and the net effect would only be about 1/6th once one considers the percentage of people not being treated with HCQ but still given steroids. If one was so compelled, one could go through the data and account for the confounding variable of steroids... if it wasn't already done for you. The HCQ and non-HCQ propensity-matched patients of the study both received steroids 44.2% of the time.  As the study states, "The Cox regression result for the two propensity matched groups (Table 4) indicates that treatment with hydroxychloroquine resulted in a mortality hazard ratio decrease of 51% (p = 0.009)."  51% hazard reduction is not as good as 71%, but it is still pretty freaking good.
 * In the same USA Today article - "Remdesivir and COVID-19: New data suggests the experimental drug can shorten how long people are sick." Shorter duration of sickness is not as good as 51% reduction of death...  The lady doth protests too much, methinks.

The ICMR COVID-19 Research Team in India
In the studies we have mentioned so far, HCQ has been taken after the patient was infected, but what if the drug was taken before a person was exposed to SarsCov2? Could it still work? India studied that very question among its healthcare workers and published their findings in a study entitled Healthcare workers & SARS-CoV-2 infection in India: A case-control investigation in the time of COVID-19. So what did they find?

It worked. (They also found PPE worked.)

AOR stands for adjusted odds ratio and it represents how likely a certain outcome will occur given exposure to the variable of interest. In this case, the outcome is SARS-CoV-2 infected and the variable of interest is the use of HCQ. Odds ratios above 1 mean that that outcome is more likely to occur given exposure to the variable. In the above results, "Performing endotracheal intubation" was associated with a high likelihood of being SARS-CoV-2 infected (4.33). Odds rations that are below 1 mean that the outcome is less likely to occur. In the above results, "4 or more maintenance doses of HCQ" was associated with a significant decline in the odds of health care workers becoming SARS-Cov-2 infected (0.44). This means that people who took HCQ were about half as likely to become infected than those who didn't take the drug (the confidence interval ranged from .22 to .88). India's researchers also found that HCQ's dose-response relationship had statistical significance (P <0.001).

Other Studies
There are even more studies that could be cited and, if one is interested, one can go to C19study.com which has a fairly comprehensive list of all of the studies involving HCQ and COVID-19. The overall consensus of these studies is that when HCQ is taken early, it works. If instead it is taken late in the disease progression, the data is more inconclusive.

HCQ, QT elongation, and torsade de pointes
One of the recurring arguments opponents of HCQ make is that is it is dangerous because it could lead to sudden death visa vi QT elongation. This is a valid concern if there is evidence that HCQ actually causes death through QT elongation. So why don't we evaluate the evidence?

The clinical name for sudden death caused by excessive lengthening of the QT interval is and it is monitored through EKGs. Some people have long QT intervals due to genetic factors, but QT elongation can also be acquired through medications. There are several medications that have this effect, including Abarelix, Aclarubicin, Alfuzosin, Alimemazine, Amiodarone, Anagrelide, Apalutamide, Apomorphine, Aripiprazole, Arsenic trioxide, Artemether, Artenimol, Asenapine, Astemizole, Atomoxetine, and Azithromycin (and those are just the A's). . Because of the concern of torsades de pointe, people taking these medications in a hospital setting will be monitored and the course of their medication may be altered due to perceived risk. The following is how the Henry Ford study described their procedure. An electrocardiogram (ECK) based algorithm was utilized for hydroxychloroquine use. QTc>500 ms was considered an elevated cardiac risk and consequently hydroxychloroquine was reserved for patients with severe disease with telemetry monitoring and serial QTc checks. People with naturally long QT intervals or other cardiac risk factors may also be excluded from the use of drugs that prolong QT due to the risk of torsades de pointes.

The largest study to monitor cardiac risk in regards to COVID-19 and HCQ use was the one conducted by Didier Raoult's team where 3,119 patients were treated with HCQ and AZ. Of those patients, QT prolongation was only observed in 25 of them (0.67%) and this led to cessation of treatment in 12 of the cases. There were zero cases of torsades de pointes. The Henry Ford Health System study was somewhat smaller (1985 patients treated with HCQ) and they reserved the HCQ + AZ treatment to people with minimal cardiac risk factors. They also had zero cases of torsades de pointes. Thus, the likelihood of HCQ-induced torsades de pointes in two large studies was zero, with the caveat that the researchers screened out patients with HCQ risk factors and used EKGs to monitor their patients for risk.

Alright, one may argue, but that was in hospitalized patients. What about people who aren't monitored at a hospital? According to Dr. Zelenko, the question "Has there been any cardiac arrhythmias using the combination of HCQ and AZ?" has been addressed by electrophysiologists in the USA who used their equivalent of "WhatsApp" to discuss the problem amongst themselves. The answer was no in the outpatient setting. In the ICU setting, the answer becomes more muddled as COVID-19 can cause cardiomyopathy which, in turn, can cause QT elongation. Thus it is uncertain whether it is HCQ or COVID-19 that is the cause.

As HCQ is commonly used in outpatient settings for diseases such as malaria, the likelihood of sudden death from its use has already been addressed. A massive study entitled The cardiotoxicity of antimalarials was conducted by the WHO in 2016 and found the following:

Hmmm... so out of hundreds of millions of doses being administered, the likelihood of sudden death is zero? Well not quite zero as shown by this case report, although that person didn't die due to medical intervention. But the risk is still really low, particularly when compared to the risk associated with being harmed by SARS-CoV-2 (or malaria, for that matter). If one has risk factors such as a naturally long QT interval, HCQ may still pose some risk, which is probably why it is not an over-the-counter medication. But if one is healthy, it is difficult to beat HCQ's safety profile. Just don't expect to hear that from the mainstream media as they are in the business of promoting a false narrative.

AP
British researchers on Friday published their research on the only drug shown to improve survival — a cheap steroid called dexamethasone. Two other studies found that the malaria drug hydroxychloroquine does not help people with only mild symptoms... the only other therapy that’s been shown to help COVID-19 patients is remdesivir, an antiviral that shortens hospitalization by about four days on average.

The above quote was taken from Marilynn Marchionne's New studies clarify what drugs help, hurt for COVID-19, an article so rife with errors that it would be laughable if it wasn't so disgusting.

Error/Claim #1 - Dexamethasone is the only drug shown to improve survival.

That's not true. All drugs which have studies that have statistically significant correlations (p<.05) linking their use to increased survival are drugs "shown to improve survival" and HCQ has a lot of those studies. Granted, one can take issue with the results and argue that there are reasons not to believe them (like with Surgisphere, for example), but the onus of proof is on the person seeking to refute the studies. You can't just ignore the fact that the studies exist.

In addition to HCQ, there are other drugs the author failed to mention that have shown to improve survival.


 * 1) The drugs in what is known as MATH+ protocol -  Methylprednisolone (another steroid), Ascorbic acid, Thiamine, Heparin, and plus (melatonin, zinc, vitamin D, atorvastatin, famotodine (a.k.a. pepsid) and magnesium).  Oral prednisone is used as a substitute for methylprednasone on day 8 of the treatment. That protocol has been known since at least May 11, which is a full month before the RECOVERY trial discovered that the steroid dexamethasone also works.
 * 2) Vitamin D
 * 3) Pepsid (preliminary, but encouraging, optional part of the MATH plus protocal)
 * 4) Ivermectin
 * 5) Tocilizumab (Published in The Lancet, but promising)
 * 6) Anakinra (Published in The Lancet, but promising)

Error/Claim #2 - Two other studies found that the malaria drug hydroxychloroquine does not help people with only mild symptoms.



The two studies referenced were a small study from Spain and the Minnesota study Boulware co-authored. Like the Minnesota study, the Spain study had positive results that supported HCQ use but it failed to reach statistical significance, likely due to its small sample size (it only had 293 people which is much smaller than the 6000 people the Minnesota study said were needed to reach statistical significance). The fact that these were the two studies chosen as evidence "against" HCQ is a clear-cut case of cherry picking. The fact that studies with statistically significant positive results such as the ones conducted at Prevent Senior Institute in Brazil, Gómez Ulla in Spain, IHU Méditerranée Infection in France, the Henry Ford and Mount Sanai hospitals in the USA, and by the ICMR COVID-19 Research Team in India were not mentioned in the article are fallacies of omission.

Error/Claim #3 - The only other therapy that’s been shown to help COVID-19 patients is remdesivir.

What about the plasma therapy that was covered on 60 minutes and analyzed in this study? Forgot about that one, didn't you? (Actually, the study is really small and other studies have shown that plasma therapy doesn't work late in the disease progression, but if the criterion of proof is "as good as or better than remdesivir," then it has been shown to help. Of course, that is a really low bar to pass...)

Error/Claim #4 - HCQ is harmful

The article goes on to report "Now, details published on a research site for scientists show that the drug may have done harm. Patients given hydroxychloroquine were less likely to leave the hospital alive within 28 days — 60 percent on the drug versus 63 percent given usual care."

Any reporter worth their salt would then say something to the effect of "That may have been due to the fact that the researchers treated their patients with toxic levels of HCQ," but that isn't mentioned. Moreover, inclusion of the RECOVERY data is a double standard. If one argues that the not statistically significant positive results in the Boulware and Spain studies don't support HCQ use, then one can't logically argue that the not statistically significant negative results from the RECOVERY trial refute HCQ use.

The article goes on to make other unsubstantiated claims, all in what appears to be a concerted effort to promote remdesivir over other treatment options (including the new inhaled version Gilead is working on). Get it now... "supplies are very limited." (That phrase was actually said).

The aforementioned flaws didn't stop NBC, Yahoo, US News and World Report, MSN, The Daily Mail, and ABC from copying and pasting it (among others).

Marilynn Marchione is the same author who wrote More deaths, no benefit from malaria drug in VA study and conveniently omitted the part where the VA study says "hydroxychloroquine, with or without azithromycin, was more likely to be prescribed to patients with more severe disease."

BBC
If it was just one bad apple, then other independent journalists could correct the misinformation by pointing out the flaws in the argument and provide the public with strong, fact-based, counter-arguments. Unfortunately, Marilynn Marchione's reporting style is par for the course. Another example is Coronavirus: Dexamethasone proves first life-saving drug, written by Michelle Roberts, which says the following:

The Recovery Trial, running since March, also looked at the malaria drug hydroxychloroquine, which has subsequently been ditched amid concerns it increases fatalities and heart problems. The antiviral drug remdesivir, meanwhile, which appears to shorten recovery time for people with coronavirus, is already being made available on the NHS.

There is no reason for the antiviral drugs remdesivir and HCQ to be mentioned in an article about the steroid dexamethasone unless one was trying to make a comprehensive analysis of the medical literature, which this article clearly wasn't doing. If one wanted to add context, then the author could have instead talked about the closely related drug methylprednasone and the MATH+ protocol. And, in order to inform the reader, one could explain that the MATH+ protocol has a 6.6% mortality rate in one hospital and a 3.3% mortality rate in another whereas the RECOVERY trial is rocking a 41% mortality rate among patients on a ventilator, 25% mortality rate among those on oxygen therapy, and a 13% mortality rate on those patients who did not require respiratory intervention. The author could also explain that a 1/3 reduction of those numbers visa vi dexamthasone is still really bad standard of care. Instead the public is left uninformed. Given that this comes from the BBC and therefore the audience is primarily British people, it might be useful for their audience to know just how bad Oxford is doing when compared to hospitals across the pond. You know, before they sign up to be poisoned...

"The Worldwide Leader in Public Deception Advertising News"
Dr. Chris Martenson, a pathologist and YouTube podcaster, provided another interesting example of how the media has covered HCQ, this time from CNN and their Senior Medical Correspondent, Elizabeth Cohen. The first article she wrote, Yet another study shows hydroxychloroquine doesn't work against Covid-19, was published at 4:57 PM ET on Monday, May 11. That was prime time news coverage and the article covered Rosenburg's retrospective study. The second article she wrote, "Study finds hydroxychloroquine helped coronavirus patients survive better," covered the Henry Ford study's results and was published at 11:24 PM on Thursday, July 2 (right before July 4 celebrations). Apparently that title and publishing time wasn't enough so CNN updated the article on July 3, 1:31 PM so that it reads "Study finds hydroxychloroquine may have boosted survival, but other researchers have doubts" and they added some criticisms, such as screening patients for HCQ risk factors may have skewed the results. That is a valid point, and one needed for balance, but no such "balanced" treatment was given to the New York study. If the author had added a counterpoint from other scientists, it would read something like this:

"Among a number of limitations, this study included patients who were initiated on hydroxychloroquine therapy at any time during their hospitalization... Because treatment regimens likely varied substantially (including delayed initiation) across the 25 hospitals that contributed patients to the study, it is not surprising that the case-fatality rate among the New York patients was significantly higher than in our (the Henry Ford) study. "

As of August 1, 2020, CNN's coverage of the VA study also made no attempt at "balance". Heck, they didn't even bother to update their article on Surgisphere's study even though The Lancet had retracted it.

YouTube (which is owned by Google)
The subscribers to Chris Martenson's podcast self-reported a more stealthy form of censorship - they kept being unsubscribed to his podcast without them pushing the "unsubscribe" button (including Chris's fiancé). There could be other forms of censorship at play, such as downplaying the importance of the "likes" a video gets and other algorithmic factors, but that is too difficult to assess without inside knowledge of Google's content selection process.

The media truly hates HCQ
On July 28, 2020, Dr. Stella Immanuel promoted HCQ in a video that went viral. She also said we didn't need to wear masks, which is bad advice, but beyond that nothing particularly dangerous was mentioned. Unless, that is, one believes HCQ treatment to be dangerous, which it isn't as long as QTc intervals are monitored in hospitalized settings and the drug is taken in less than toxic doses. What is more telling than her belief in the virtues of HCQ was the social and news media's response to it.
 * Twitter banned Donald Trump Jr.'s account for his posting of the video and deleted Donald Trump's retweet of it.
 * Facebook took the video down “for sharing false information about cures and treatments for COVID-19.”
 * Youtube removed the video for violating its "Terms of Service" or "Community Guidelines.”
 * The video could still be found on the website for America's Frontline Doctors, but then Squarespace decided that the website violated their acceptable use policy and suspended their account.

[https://www.dailymotion.com/video/x7v96lo You could still see the video at Daily Motion... but then it was taken down.]

It is becoming evident that the social media giants are playing whack-a-mole in order to censor public discourse.

Dr. James Todaro, a popular twitter user who was involved in exposing the Surgisphere article to be a fraud, also happens to be one of the America's Frontline Doctors featured in the video. He provided a link that, as of August 1, was still up on Vimeo.

He also provided another example of Google censorship.

And he provided an example of Google's hypocrisy.

Our video was taken down by Facebook & YouTube last night. Surprise surprise. You know what YouTube video is still up from 2 months ago though? The video with Surgisphere founder Sapan Desai on the results of the fake Lancet study that the WHO mistakenly endorsed immediately.

Several news networks also contributed to the onslaught (just google Dr. Immanuel), including NBC Nightly News which incorporated ad hominem attacks against Dr. Immanuel and America's Frontline Doctors rather than any in-depth analysis of the science (apparently Dr. Anthony Fauci's medical opinion is the only one that matters). The title of the news's segment was "Trump under fire for sharing coronavirus misinformation on social media," which leads one to ask "What misinformation?" Dr. Immanuel was speaking from personal experience and the results she was seeing with her patients and her staff. Moreover, there is already convincing scientific evidence that supports her belief that HCQ works. If HCQ had no effect, then it is unlikely that we would have multiple studies with p values less than .001. That is literally what a p value less than .001 means.

Dr. Immanuel said the people she considered to be fake scientists kept insisting on having the results from randomized trials, an argument she disagreed with because when people are dead they are dead and she wasn't going to wait on the results before treating patients. The counter argument that we should have randomized clinical trials is a valid concern, but one that raises an important question, namely "Why haven't we had one yet given all the controversy surrounding HCQ?" A partial answer was provided by the twitter user gummibear737.

Dr. Fauci (NAIDI Director) has effectively shut down the only RTC that could have proven the efficacy of #Hydroxychloroquine in symptomatic adult outpatients. This study had its enrollment cut from 2000 to 20 subjects. Just “following the science” I guess.

Maybe Facebook should consider banning all statements from Dr. Anthony Fauci? The overwhelming, prevailing clinical trials that have looked at the efficacy of hydroxychloroquine have indicated that it is not effective in coronavirus disease. - Dr. Anthony Fauci

That truly is misinformation.

The future of HCQ
On March 28, 2020, the FDA authorized the emergency use of hydroxychloroquine and chloroquine, which was later revoked on June 15 while maintaining the belief that the drug is fine for malaria, lupus, and rheumatoid arthritis. The official statement said that "We made this determination based on recent results from a large, randomized clinical trial in hospitalized patients that found these medicines showed no benefit for decreasing the likelihood of death or speeding recovery." Considering the WHO had halted the HCQ arm of its SOLIDARITY trial due to Surgisphere, the only trial that fits this description is the UK's RECOVERY trial.

On April 24, 2020, the "FDA issued a Drug Safety Communication (DSC) cautioning against the use of hydroxychloroquine or chloroquine for COVID-19 outside of the hospital setting or a clinical trial due to risk of arrhythmias." Data from the FAERS database was the basis for this statement. While there have been some reports of possible problems with HCQ in regards to COVID-19, FAERS data is not causal... it is simply data collection and therefore doesn't account for confounding variables. For example, if people with COVID-19 took HCQ and died from cardiomyopathy due to the progression of COVID-19, HCQ will still be reported as having an adverse event even though COVID-19 was the true cause. Moreover, FAERS data is not broken down into "fatal ICU adverse events" and "fatal adverse events prior to an ICU setting," which probably needs to happen in order to make a declarative statement that HCQ poses a greater risk to COVID-19 outpatients than it does to lupus outpatients... if all of the fatal events with HCQ are occurring in an ICU setting, then the data doesn't suggest HCQ's use outside of that setting is dangerous. The risk of HCQ-induced torsade de pointes also has to be compared against the risk of not taking the drug to combat COVID-19. If the risk associated with taking the drug is lower than the risk of not taking it, then HCQ use is still warranted.

In her viral video, Dr. Immanuel reported seeing patients from far away because their local doctors were too afraid to prescribe the drug and being reported to the medical review board, a threat Dr. Immanuel also received. Yale's Epidemiology Professor Dr. Harvey Risch reported the same thing on Fox News. This represents a public health concern and is a violation of patient rights. An apt comparison would be restricting a rape victim's access to emergency contraceptives... HCQ is quickly becoming the new "Plan B".

On July 29, the state of Ohio officially banned pharmacies from fulfilling HCQ prescriptions to patients for COVID-19. Dr. James Todaro reported that this was "a direct infringement on the patient-doctor relationship." Ohio governor Mike DeWine reversed the decision at 9:30 A. M. on July 30, presumably due to public outrage.

Anyone in the USA reading this should be very concerned about these developments. Patients should be allowed to chose for themselves whether or not HCQ's benefit outweighs the risk and there are people who are actively trying to take away that right and impose their will, irrespective of how well-informed the patient's choices may be.

That is truly sick.

Spain???
https://www.youtube.com/watch?v=wJzGqVyAtlg&list=PLRgTUN1zz_oeQpnJxpeaEkFimDeepqyWf&index=27

Motivated reasoning among the mainstream media?
https://www.usatoday.com/story/news/factcheck/2020/07/21/fact-check-hydroxychloroquine-hasnt-helped-covid-19-studies-show/5407547002/

https://www.msn.com/en-us/health/medical/hydroxychloroquine-helps-coronavirus-patients-recover-new-study-shows/ar-BB16iRkw

www1.health.gov.au/internet/main/…

https://threadreaderapp.com/thread/1264032084944814082.html

https://www.chicagomaroon.com/article/2019/6/27/uchicago-google-sued-federal-class-action-suit-dat/

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31180-6/fulltext#sec1

https://www.youtube.com/watch?v=uggOJcZBFoI&list=PLRgTUN1zz_oeQpnJxpeaEkFimDeepqyWf&index=14

https://www.youtube.com/watch?v=IUD_wvkNhnk&list=PLRgTUN1zz_oeQpnJxpeaEkFimDeepqyWf&index=13

https://www.youtube.com/watch?v=T1Hw09ncBfE&list=PLRgTUN1zz_oeQpnJxpeaEkFimDeepqyWf&index=12

https://www.youtube.com/watch?v=llZ1uurWLmA&list=PLRgTUN1zz_oeQpnJxpeaEkFimDeepqyWf&index=11

https://www.youtube.com/watch?v=LjyNw8qgkaw&list=PLRgTUN1zz_oeQpnJxpeaEkFimDeepqyWf&index=10

France study
https://www.youtube.com/watch?v=1MAoJnu7-sw&list=PLRgTUN1zz_oeQpnJxpeaEkFimDeepqyWf&index=5

his is  Dr.  Raoult and his coworkers and

HCQ's hazard ratio of .18 for the risk of transfer to ICU or death is a substantial reduction in risk. The shorter  Moreover,

France study - Low-dose computed tomography (CT) scans highlighting lung lesions in 592 of the 991 (59.7%) patients with minimal clinical symptoms.- Not good... Almost 60% of people with mild cases had lung damage.
 * 1) Clinical factors (age, comorbidities, NEWS-2 score), biological factors (lymphocytopenia; eosinopenia; decrease in blood zinc; and increase in D-dimers, lactate dehydrogenase, creatinine phosphokinase, and C-reactive protein) and moderate and severe lesions detected in low-dose CT scans were associated with poor clinical outcome. -These are important findings as it is suggestive of treatment options (such as adding zinc in people with low levels of zinc in their blood).
 * 2) Treatment with HCQ-AZ was associated with a decreased risk of transfer to ICU or death (Hazard ratio (HR) 0.18 0.11–0.27) - These results are further detailed in table 4 and figure 3. Patients treated with HCQ and AZ had to go to the ICU or died 2.5% of the time versus 9.4% of people treated with other treatments (P<0.001)  Time to death was also delayed and occurred less frequently when patients were treated with HCQ and AZ (P<0.001)
 * 3) Decreased risk of hospitalization ≥10 days (odds ratios 95% CI 0.38 0.27–0.54) - This is further detailed in table 4.  HCQ + AZ = 3.5%  Other treatments = 14.2% (P<0.001)
 * 4) Shorter duration of viral shedding (time to negative PCR: HR 1.29 1.17–1.42) - This i
 * 5) QTc prolongation (>60 ms) was observed in 25 patients (0.67%) leading to the cessation of treatment in 12 cases including 3 cases with QTc> 500 ms. No cases of torsade de pointe or sudden death were observed.- This is a critically important finding as the main argument opponents of HCQ use is that it causes torsade de pointe which can lead to sudden death.  Dr.  Raoult and his coworkers treated over 3000 patients and had zero cases of torsade de pointe.

These results strongly suggest HCQ works.

The results of this study suggests that HCQ works when patients are treated early, but it doesn't seem to work as well during the later stages of the disease. This is in line with what one would expect with antiviral treatment as the virus is still in its replication cycle early on and that is when antivirals are going to be of the most use.

As of ???, the FDA removed its approval of HCQ, which its not what HCQ is meant to do anyway (Emergency use is after you have crashed through the windshield and there are better treatments that exist for that stage of the disease). The more important question is whether HCQ should be administered early on in the disease progession or if it (and drugs like it such as ) should be used in a preventive capacity. Studies such as suggest that it should be a part of our treatment protocol, though this claim remains contested. The fact that HCQ costs (get) and drugs like remdesivir cost have led some people to speculate that the controversy surrounding HCQ's effectiveness has a monetary component as well as political one.

https://www.youtube.com/watch?v=QwXM821iBrI&list=PLRgTUN1zz_oeQpnJxpeaEkFimDeepqyWf&index=30&t=702s

https://www.youtube.com/watch?v=eD3ztjqYGbg&list=PLRgTUN1zz_oeQpnJxpeaEkFimDeepqyWf&index=21 - 60 minutes

https://www.nature.com/articles/nm.3985

Still to do: Get reference for Math+, thiamin and incorporate in note and body of article

Misandry within feminism
The most notable misadranist within feminism was Valerie Solanas for her SCUM manifesto, promotion of gendercide, and shooting of Andy Warhol, but their have been other brave feminists to follow in her footsteps.
 * Ti-Grace Atkinson - As president NYC chapter of the National Organization of Women (NOW), as"the first outstanding champion of women's rights" and "a 'heroine' of the feminist movement."  This was after Solanas shot Warhol.
 * Sally Miller Gearhart - An author of feminist science fiction novels, Gearhart wrote in her non-fiction essay The Future — If There Is One — Is Female that "the proportion of men must be reduced to and maintained at approximately 10% of the human race." One option she advocated for was male infanticide.
 * Mary Daly - Perhaps best known as the feminist professor who lost tenure for violating title 9 as she refused to admit male students into her classes, Daly also said the following in response to Gearhart's position. "If life is to survive on this planet, there must be a decontamination of the Earth. I think this will be accompanied by an evolutionary process that will result in a drastic reduction of the population of males."

Several people have noticed and criticized elements of misandry found within feminism many of whom have no connection with the Men's Rights movement. One such critic and definitely not MRA advocate is the porn-hating feminist Andrea Dworkin. In her essay Biological Superiority: The World's Most Dangerous and Deadly Idea, she spoke of an event that took place in New York City as part of Lesbian Pride Week in 1977. Dworkin gave the following description of the speaker's presentation. Amidst the generally accurate description of male crimes against women came this ideological rot, articulated of late with increasing frequency in feminist circles: women and men are distinct species or races (the words are used interchangeably); men are biologically inferior to women; male violence is a biological inevitability; to eliminate it, one must eliminate the species/race itself (means stated on this particular evening: developing parthenogenesis as a viable reproductive reality) The audience applauded the speech. Dworkin shamed them by saying "I am a Jew." Another two critics are the religious studies professors Paul Nathanson and Katherine Young. In their book Spreading Misandry: The Teaching of Contempt for Men in Popular Culture they made a comparison between the modern discourse on gender and the historical interactions of Jews and Christians. Even though misandry is clearly visible to anyone with eyes or ears to hear, it is not visible to many people as a problem. On the contrary, most people ignore it. In fact, they have found at least three ways of doing so: they try to excuse it, trivialize it, or even justify it... The same problem that long prevented mutual respect between Jews and Christians, the teaching of contempt, now prevents mutual respect between men and women. Author and journalist Cathy Young is yet another critic (again having no connection with MRAs). In her article ''Feminists treat men badly. It's bad for feminism, she defended misadry as being a word, criticized the actual'' neologisms feminists use (specifically mentioning “mansplaining,” “manspreading” and “manterrupting"), and said that feminists were using “man” as a derogatory prefix. She also added "Dismissing concerns about wrongful accusations of rape with a snarky “What about the menz” is not a great way to show that women’s liberation does not infringe on men’s civil rights."

History of Misadry
defiito aaraham  disposaility femiism split

Paul Nathanson, Katherine K. Young, Wendy McElroy, and the author bell hooks have all oticed and criticized elemets of misadry foud withi femiism.

As a term, "misandry" is not a strict analogue of "misogyny," because the use of the term "misandry" is much more commonly restricted to concrete hatred or contempt held by individuals (cf. "man-hating feminists"), as distinct from the abstract "institutionalized" variety. This is because women have historically had little opportunity for direct influence on such institutions as the law, and thus no opportunity to build anything resembling "institutional misandry."

The men's rights activist Warren Farrell is illustrative of this split. Warren ega as a part of the National Organization for Women (NOW) amd was elected three times to the Board of Directors of its N.Y.C chapter. He then grew disillusioed with the orgaizatio, citig NOW's oppositio to the presumtio of joit custody as a momemt of truth. He wrote several ooks explaiig his positio amd susequetly was protested y femiists. A video of a portest that occured at the Uiversity of Toroto ca ve see [here https://www.youtube.com/watch?time_continue=44&v=iARHCxAMAO0].

Notable misandrists

 * Valerie Solanas - Perhaps best known as the woma who shot Amdy Warhol, Solanas was also a promiet femitst who advocated for gedercide (i.e. the elimiatio of the male sex). The Scum Manifesto by Valerie Solanas 1983 edition  http://www.ccs.neu.edu/home/shivers/rants/scum.html]
 * Mary Daly -
 * Mary Daly -
 * Mary Daly -

My philosophy - figure out a differet title.

In past articles and essays, I have mostly focused on the philosophy of other people rather than my own philosophy, with the notable exception of the essay on memetics. I am now going to explain to you the ethical philosophy that I use which is a form of utilitarianism. (My epistemological philosophy is still in development though I do have the essential ideas already fleshed out.) My beliefs are essentially a combination of Einstein's ideas on the is-ought problem, Bayesian utilitarianism, memetics, and game theory. As I will be referencing Albert Einstein's religious beliefs and my views on memetics from time to time, it may be useful for you to read those essays before reading this one. I will also attempt to use my philosophy to provide some clarity on gender issues as I feel this area is in desperate need of someone who can address the issue philosophically and can countermand the current sophists "addressing" the issue.

The Individual ideal - Empowerment
It is a simple idea, but one of the things I learned from reading Einstein's views on religion is that it is a mistake to view ethics from only the societal perspective. Instead what one must do is break down ethics into its essential components. For Einstein, these components were the individual and communal ideal, and mutual human relationship. I have adapted this to say that the components of ethics are the individual, interpersonal, and communal ideals. It is the same thing, just worded slightly differently.

In the case of the individual ideal, I asked myself "What could this ideal possibly be?" When the question is asked in this way, I think that the answer is obvious. The individual ideal is empowerment. Consider, for example, someone stranded on a deserted island. If this person had one signal flare and he could either fire it unproductively at a passing plane or wait a couple of days and use it productively when a boat passed by, which should he do? The answer almost everyone would come to is wait for the boat, and the underlying reason for that answer has to do with the fact that that is the action that would lead to the stranded person's empowerment.

When contemplating how to promote the individual ideal within a society, the best notion that I have come up with is the Quaker concept of "Truth-to-power." For those of you who may be unaware, the concept of "Truth-to-power" came into being in response to Hitler and McCarthyism. Quakers are pacifists and there were some of them in Germany trying to help out. These Quakers would do things like give coffee and blankets to Jews on trains headed to Auschwitz. After the war, they learned what happened to those Jews and this lead to fundamental problem with their faith. In essence, the question was "How can pacifists fight the evil of totalitarian regimes?" A few years later, McCarthyism took hold in the United States and the Quakers saw obvious parallels and questioned how to counteract this new threat. Their response was the concept of truth-to-power, the idea being that if one could get truth to prevail over McCarthy-inspired hysteria, then one could avoid the problems associated with totalitarianism. Exactly how effective it was then is debatable, and it does't really have enough of an epistemological foundation to serve as a way to achieve the communal ideal as it was originally intended to do, but I like it as a way of addressing the individual ideal. People have individual truths, subjective and unique as they may be (the homosexuals and heterosexuals individual truth is not the same, for example), and I am of the belief that empowerment is achieved when these individual truths are recognized and achieved up until the point were they start to conflict with the interpersonal ideal. Truth-to-power has the potential to aid in this process by creating a more honest and open society, but realistically that can only happen by getting rid of those people who would use that honesty to exploit others (either by social exclusion or more drastic measures).

A cell-phone ap to address the problem of rape? Before I address the issue of rape culture, I want to expose you to a quote from Albert Einstein that has hugely influenced the way I view culture, religion, and social values. As regards religion, on the other hand, one is generally agreed that it deals with goals and evaluations and, in general, with the emotional foundation of human thinking and acting, as far as these are not predetermined by the inalterable hereditary disposition of the human species. Religion is concerned with man's attitude toward nature at large, with the establishing of ideals for the individual and communal life, and with mutual human relationship. These ideals religion attempts to attain by exerting an educational influence on tradition and through the development and promulgation of certain easily accessible thoughts and narratives (epics and myths) which are apt to influence evaluation and action along the lines of the accepted ideals.

Before dismissing this as religious mumbo-jumbo, please note that Albert Einstein was not talking about religion in the classical sense. Rather what he was talking about was the ability of cultural institutions such as religions, schools, or things like the media to impart social values onto a culture.

I am a atheist amd it has iflueced my eliefs.

Memes are

How a Bayesian Utilitarian Would Address the Issue of Rape

Revelations brought about by the Me Too movement have shown that there is a cultural problem with sexual violence directed toward women. Men have also correctly pointed out that blaming men in general for the actions of a few men is the equivalent of blaming all Muslims for the actions of some Muslim terrorists. Both are logically valid positions. Another issue pertaining to sexual violence is determining if a rape occurred. Women have correctly pointed out that defense lawyers blame the victim in a courtroom setting and men have correctly pointed out that women have false accused men of rape which has led to false convictions. Both blaming the victim and incorrectly believing in false accusations occur because the court is trying to determine the statistical probability that rape occurred though they don't use that language because they are lawyers (a.k.a. professional sophists). So what can be done to correct the present set of circumstances? I have a simple solution – create a cell-phone ap.

In order to explain my position, I need to first explain how my ethical philosophy works at a societal level.

The Basic Idea
The basic idea is that some memes are better than other memes. Both the meme that drinking radioactive water is good for you and the meme that one can hide from a nuclear blast are wrong, but from a utilitarian perspective, the meme "Hide from a nuclear blast." is a lot less wrong than the meme "Drink radioactive water." Thus this memetic change results in a societal improvement.

The idea of using memes to create societal improvement works best with the philosophy of utilitarianism because you have to view the effect of ideas on a continuum towards an ultimate end which for utilitarianism is "the greatest happiness principle". This end enables a utilitarian to argue that certain memes like our radium example are bad because they don't help achieve that ultimate end. In essence, utilitarianism provides a framework for the ??? fallacy; the meme "Radioactivity good" is more fallacious than the meme "Radioactivity bad" due to the greatest happiness principle objective.

The aforementioned framework enables one to address issues of "culture". Consider, for example, gun culture. Some memes pertaining to guns are going to result in less happiness for the society as a whole than other memes and one can argue that those memes that result in less happiness for the society are wrong. Thus, in order to improve our society, we have to root out the harmful memes and replace them with better memes.

In Regards to Sex
I outlined two separate issues when I first described the current cultural problems we are having in regards to male-female interactions. One is "How do we address sexual violence as a society as a whole?" and the other is "How can we determine if sexual violence has occurred?" I shall now attempt to use memetics to address both of these issues.

Creating a cell-phone ap to address the "false accusations as proof" and blaming the victim problems
We already have some safety measures when it comes sex such as “Wear a condom (and not the radioactive kind.)” What I am proposing is that we add one more, namely always use an ap to take a cell phone video of you and your sexual partner both stating that you consent to sex. Once you have that video, the ap then enables you to use an on/off consent function. If one is in an on again and off again relationship with someone, one simply needs to move the on/off button of the ap to the appropriate position to indicate the current status of the relationship. If one had a one-night-stand, then one can place the consent into a “Must make a new consent video for future sexual activity,” category so that no accidental or malicious “consent” can occur. It would also send the new categorization to the person one slept with which would be a clear indicator of the status of the relationship. If instead one is now going steady and is in a healthy relationship with someone, one can place the consent into a category “Must make a new video to indicate that sex is no longer consensual.” so the “consent” doesn’t accidentally get turned off.

Why the memetical change could work
People usually have their cellphones with them and that is particularly true when going on a date with someone so access will not usually be a problem. Video footage is difficult to fake and thus is a reliable and quick way of recording consent that could be used in court. If someone practices safe sex, then they already have pre-coitus procedures. If a guy were to be asked by a girl if they can record a consent video with them, there is virtually no chance a guy is going to say no because it means that they are going to get laid and they are not going to be charged with rape for it. The other way around, namely a guy asking a girl to record a consent video, is trickier as it can lead to the guy getting slapped in the face for his presumption. Thus the meme “girl ask guy for consent video” may have to be the predominant one. I am still trying to figure out what the appropriate male meme should be in regards to recording consent. As long as a woman records all of their sexual activity with consent videos without exception, then everyone the woman has had sex with can be called as a witness to testify that when sex is consensual, she records consent videos. Thus promiscuity would actually serve as proof in the court of law as opposed to something a defense lawyer might be able to turn into an ad hominem attack; The recording of consent videos when sex occurs increases the statistical probability that rape occurred when a consent video wasn't recorded.

Why it may fail
Unless you are a celebrity or a prominent organization, it is very difficult to spread memes and get them incorporated by a society and sometimes memes are seen as a passing fad. Even if you are a celebrity, your pull is often times limited to certain groups (Richard Dawkins has no pull with creationists, for example.). This limitation could result in the meme not reaching the critical mass it needs to be considered a part of the culture. The video consents need to be done every time, otherwise a defendant can just argue that they were one of the people that wasn’t recorded which could be quite damaging to a person’s case if the defense can produce witnesses that did have consensual sex with the accuser without consent videos. If one records a consent video and places it into the on position, one consents. If one were to change their mind after recording the video and putting it into the on position, there is virtually no chance that a conviction for rape could occur because the defense would have access to a video revealing consent and an ap providing data that consent was in the on position. Thus women have to be cognizant of who they give their consent to and not expect the court to correct their mistake. The court may reject the evidence for no apparent reason other than the fact that they are lawyers. And finally, the ap hasn’t been developed yet… it is just a thought experiment at this stage.

Before we can explore the issue of "Equal Work For Equal Pay" we must first define the premises of the argument.

Are the premises- P1- All people who do equal work deserve equal pay. P2 - Person A does equal work with Person B. Conclusion - Person A deserves to be paid equally with person B.

If these are our premises, then its going to result in a major transfer of wealth from first-world countries to third-world countries as there are a lot of people in third-world countries and they make a lot less money. The people who make equal pay for equal work arguments don't usually premise their arguments, but this is likely to be a minority viewpoint given that the people making these arguments usually want more money, not less.

Are the premises- P1- All people of country X who do equal work (irrespective of merit) deserve to be paid equally. P2 - Person A does equal work with Person B. Conclusion - Person A deserves to be paid equally with person B.

This is the argument for communism. And, as the Soviet Union found out, it doesn't work out too well. For example, paying bad farmers as much as good farmers because they are farmers doesn't work because hard work and skill isn't rewarded. Ultimately this destroys the economy of the country employing such premises. Many modern socialistic countries such as China or socialists such as Bernie Sanders also take into account the need to reward merit. Thus, unless the person arguing is a die-hard communist, this is not likely the premises that one is using.

Are the premises- P1- All people of country X who do equal work based upon merit deserve to be paid equally. P2 - Person A does equal work based upon merit with Person B. Conclusion - Person A deserves to be paid equally with person B.

This is a premised argument that is consistent with both capitalism and socialistic systems that take merit into account (in Bernie's case, he maintains capitalism while addressing socialistic aims through taxation). It has a catch though. In order to argue person A deserves to be paid as much as person B, you have to show that person A has as much merit as person B. For example, you can't assume that Taylor Swift deserves to be paid as much as the person you hired to sing at your wedding because they are both singers. While it may be possible to prove or disprove the idea that income disparities are due to merit for individual cases, it is far more difficult to use group data to come to the same types of conclusions. Given that this is the premised argument most likely used by those advocating for equal pay for equal work, the subsequent discussion will focus on these premises.

While this can often be done for individual cases, it is far

income gap disparities of a group as large as men and women of an entire country

not nearly as simple when you look at group data such as the income gap between.

https://yandoo.wordpress.com/2015/08/14/false-equivalence/

Isiah 11:2-3 has been used by biblical scholars to identify what these were believed to be. Based upon this passage, they were the 'spirit of the Lord', of wisdom, of understanding, of counsel, of might, of knowledge, and of fear of the LORD. Alternative views are that the seven graces of Romans 12:6-8 or the seven angels watching creation in 1 Enoch reflect the seven spirits of God. (The seven angels mentioned in 1 Enoch are Uriel, Raphael, Raguel, Michael, Sarakiel, Gabriel, and Ramiel).

1 Enoch refers to God as the Lord of Spirits which is likely in reference to these spirits. 1 Enoch also mentions the spirits held by the Elect One.

"And in him dwells the spirit of wisdom, And the spirit which gives insight, And the spirit of understanding and of might, And the spirit of those who have fallen asleep in righteousness." -1 Enoch 49:3

'The Elect One' is one of the titles 1 Enoch uses for a messiah figure.

future pages to work - resurrectio   zoroastriaism  ook of Eoch  commuio. sychretism

Books of Enoch https://www.ellopos.net/elpenor/greek-texts/ancient-greece/hesiod/works-days.asp?pg=5

http://www.jhsonline.org/Articles/article_196.pdf

https://digitalcommons.andrews.edu/cgi/viewcontent.cgi?article=1047&context=dissertations 200 B.C. and A.D. 70 http://www.logoschristian.org/enoch.html

Revelation 6:9-11??? Jude 6,7, 13??? 2 Peter 2:4-11?? 1 Peter 3:18-20???

For if God did not spare angels when they sinned, but cast them into hell and committed them to chains of gloomy darkness to be kept until the judgment; if he did not spare the ancient world, but preserved Noah, a herald of righteousness, with seven others, when he brought a flood upon the world of the ungodly; if by turning the cities of Sodom and Gomorrah to ashes he condemned them to extinction, making them an example of what is going to happen to the ungodly; and if he rescued righteous Lot, greatly distressed by the sensual conduct of the wicked…; then the Lord knows how to rescue the godly from trials, and to keep the unrighteous under punishment until the day of judgment, and especially those who indulge in the lust of defiling passion and despise authority. Bold and willful, they do not tremble as they blaspheme the glorious ones, whereas angels, though greater in might and power, do not pronounce a blasphemous judgment against them before the Lord. (2 Peter 2:4-11 ESV)

For Christ also suffered once for sins, the righteous for the unrighteous, that he might bring us to God, being put to death in the flesh but made alive in the spirit, in which he went and proclaimed to the spirits in prison, because they formerly did not obey, when God’s patience waited in the days of Noah, while the ark was being prepared, in which a few, that is, eight persons, were brought safely through water. (1 Peter 3:18-20 ESV)

https://archive.org/stream/apocryphapseudep02char#page/166/mode/2up ement (Daniel 8:17).[2]

Much of the early Patristic lit. shows acquaintance with 1 Enoch and Barnabas and Tertullian, for example, seem to rate the work almost as highly as Scripture. Gnostic and Apocryphal lit. also make use of 1 Enoch. However, by the 4th cent. a.d. the book had fallen into considerable disfavor in the W and Jerome declared it to be an Apocryphal work. Its use, however, evidently continued for a longer time in the E.

The Apocalypse of Ezra also says that the Son of Man was to come from the Davidic bloodline, a requirement for him to be a messiah. (4 Ezra 12:32)

Work On
Site managers -- This page is still in development. The following are rational wiki articles that were originally listed on this page that were cited as needing to be worked on and have yet to be included:
 * 1) Substituting explanation for premise: Asserting that, because a given explanation for why something occurs is bad, the thing does not occur. -  this is either another name for the bad reasons fallacy or a subset of it.  I couldn't find any outside sources using this terminology and none were cited on the page itself.
 * 2) My enemy's enemy: also known as the enemy of my enemy is my friend. The rational wiki article was cited as being needed for improvement.  There is a wikipedia article devoted to this topic, though I am not certain people have cited it as a fallacy before.  If it is considered to be one, it would be a subset of the fallacy of opposition.
 * 3) Jonanism: There is an urban dictionary inclusion of it but this appears to be more of a pejorative than a widely recognized fallacy category.
 * 4) Imprecision fallacy: This appears to be part of a different way of categorizing fallacies that was not used on this page.


 * 1) Package-Deal Fallacy
 * 2) Limited Depth
 * 3) Limited Scope
 * 4) Question-Begging Analogy (not the same as Begging the Question)

reasonable doubt http://www.jstor.org/stable/1341949?seq=1#page_scan_tab_contents http://www.washingtonpost.com/wp-dyn/content/article/2007/03/02/AR2007030200406.html https://papers.ssrn.com/sol3/papers.cfm?abstract_id=1815321

Fallacy collections
There are lots of fallacy collections in the Web. Some of them promote a particular agenda, but most fallacies listed in them are real and present in arguments everyday. Unfortunately, many are deprecated.

https://www.logicallyfallacious.com/tools/lp/Bo/LogicalFallacies/235/Insignificant-Cause

Availability Heuristic :

(IEP)