August
12, 2020
Anthony
Fauci, MD
National Institute of Allergy
and Infectious Diseases
Washington, D.C.
Dear
Dr. Fauci:
You
were placed into the most high-profile role regarding America’s response to the
Coronavirus pandemic. Americans have relied on your medical expertise concerning the
wearing of masks, resuming employment, returning to school, and of course
medical treatment.
You
are largely unchallenged in terms of your medical opinions. You are the de
facto “COVID-19 Czar”. This is unusual in the medical profession in which
doctors’ opinions are challenged by other physicians in the form of exchanges
between doctors at hospitals, medical conferences, as well as debate in medical
journals. You render your opinions unchallenged, without formal public
opposition from physicians who passionately disagree with you. It is
incontestable that the public is best served when opinions and policy are based
on the prevailing evidence and science, and able to withstand the scrutiny of
medical professionals.
As
experience accrued in treating COVID-19 infections, physicians worldwide
discovered that high-risk patients can be treated successfully as an
outpatient, within the first 5 to 7 days of the onset of symptoms, with a
“cocktail” consisting of hydroxychloroquine, zinc, and azithromycin (or
doxycycline). Multiple scholarly contributions to the literature detail
the efficacy of the hydroxychloroquine-based combination treatment.
Dr.
Harvey Risch, the renowned Yale epidemiologist, published an article in May 2020 in the American Journal of
Epidemiology titled “Early Outpatient Treatment of Symptomatic,
High-Risk COVID-19 Patients that Should be Ramped-Up Immediately as Key to
Pandemic Crisis”. He further published an article in Newsweek in July 2020 for the general public
expressing the same conclusions and opinions. Dr. Risch is an expert at
evaluating research data and study designs, publishing over 300 articles. Dr
Risch’s assessment is that there is unequivocal evidence for the early and safe
use of the “HCQ cocktail.” If there are Q-T interval concerns, doxycycline can
be substituted for azithromycin as it has activity against RNA viruses without
any cardiac effects.
Yet,
you continue to reject the use of hydroxychloroquine, except in a hospital
setting in the form of clinical trials, repeatedly emphasizing the lack of evidence
supporting its use. Hydroxychloroquine, despite 65 years of use for malaria, and
over 40 years for lupus and rheumatoid arthritis, with a well-established
safety profile, has been deemed by you and the FDA as unsafe for use in the
treatment of symptomatic COVID-19 infections. Your opinions have influenced the
thinking of physicians and their patients, medical boards, state and federal
agencies, pharmacists, hospitals, and just about everyone involved in medical
decision making.
Indeed,
your opinions impacted the health of Americans, and many aspects of
our day-to-day lives including employment and school. Those of us who prescribe
hydroxychloroquine, zinc, and azithromycin/doxycycline believe fervently that
early outpatient use would save tens of thousands of lives and enable our
country to dramatically alter the response to COVID-19. We advocate for an
approach that will reduce fear and allow Americans to get their lives back.
We hope that our
questions compel you to reconsider your current approach to COVID-19 infection.
Questions
regarding early outpatient treatment
1. There are generally two
stages of COVID-19 symptomatic infection; initial flu like symptoms with
progression to cytokine storm and respiratory failure, correct?
2. When people are admitted to
a hospital, they generally are in worse condition, correct?
3. There are no specific
medications currently recommended for early outpatient treatment of symptomatic
COVID-19 infection, correct?
4. Remdesivir and
Dexamethasone are used for hospitalized patients, correct?
5. There is currently no
recommended pharmacologic early outpatient treatment for individuals in the flu
stage of the illness, correct?
6. It is true that COVID-19 is
much more lethal than the flu for high-risk individuals such as older patients
and those with significant comorbidities, correct?
7. Individuals with signs of
early COVID-19 infection typically have a runny nose, fever, cough, shortness
of breath, loss of smell, etc., and physicians send them home to rest, eat
chicken soup etc., but offer no specific, targeted medications, correct?
8. These high-risk individuals
are at high risk of death, on the order of 15% or higher, correct?
9. So just so we are clear—the
current standard of care now is to send clinically stable symptomatic patients
home, “with a wait and see” approach?
10. Are you aware that
physicians are successfully using Hydroxychloroquine combined with Zinc and
Azithromycin as a “cocktail” for early outpatient treatment of symptomatic,
high-risk, individuals?
11. Have you heard of the
“Zelenko Protocol,” for treating high-risk patients with COVID 19 as an
outpatient?
12. Have you read Dr. Risch’s
article in the American Journal of Epidemiology of the early outpatient
treatment of COVID-19?
13. Are you aware that
physicians using the medication combination or “cocktail” recommend use within the first 5 to 7 days of the onset of
symptoms, before the illness impacts the lungs, or cytokine storm evolves?
14. Again, to be clear, your
recommendation is no pharmacologic treatment as an outpatient for the flu—like
symptoms in patients that are stable, regardless of their risk factors,
correct?
15. Would you advocate for
early pharmacologic outpatient treatment of symptomatic COVID-19 patients if
you were confident that it was beneficial?
16. Are you aware that there
are hundreds of physicians in the United States and thousands across the globe
who have had dramatic success treating
high-risk individuals as outpatients with this “cocktail?”
17. Are you aware that there
are at least 10 studies demonstrating the efficacy of early outpatient treatment
with the Hydroxychloroquine cocktail for high-risk patients — so this is beyond
anecdotal, correct?
18. If one of your loved ones
had diabetes or asthma, or any potentially complicating comorbidity, and tested
positive for COVID-19, would you recommend “wait and see how they do” and go to
the hospital if symptoms progress?
19. Even with multiple studies
documenting remarkable outpatient efficacy and safety of the Hydroxychloroquine
“cocktail,” you believe the risks of the medication combination outweigh the
benefits?
20. Is it true that with regard
to Hydroxychloroquine and treatment of COVID-19 infection, you have said
repeatedly that “The Overwhelming Evidence of Properly
Conducted Randomized Clinical Trials Indicate No Therapeutic Efficacy of
Hydroxychloroquine (HCQ)?”
21. But NONE of the randomized
controlled trials to which you refer were done in the first 5 to 7 days after
the onset of symptoms- correct?
22. All of the randomized
controlled trials to which you refer were done on hospitalized patients,
correct?
23. Hospitalized patients are
typically sicker that outpatients, correct?
24. None of the randomized
controlled trials to which you refer used the full cocktail consisting of
Hydroxychloroquine, Zinc, and Azithromycin, correct?
25. While the University of
Minnesota study is referred to as disproving the cocktail, the meds were not
given within the first 5 to 7 days of illness, the
test group was not high risk (death
rates were 3%), and no zinc was given,
correct?
26. Again, for clarity, the
trials upon which you base your opinion regarding the efficacy of
Hydroxychloroquine, assessed neither the full cocktail (to
include Zinc + Azithromycin or doxycycline) nor administered treatment within the first 5 to 7 days of symptoms, nor
focused on the high-risk group, correct?
27. Therefore, you have no
basis to conclude that the Hydroxychloroquine cocktail when used early in the
outpatient setting, within the first 5 to 7 days of symptoms, in high risk
patients, is not effective, correct?
28. It is thus false and
misleading to say that the effective and safe use of Hydroxychloroquine, Zinc,
and Azithromycin has been “debunked,” correct? How could it be “debunked” if
there is not a single study that contradicts its use?
29. Should it not be an absolute
priority for the NIH and CDC to look at ways to treat Americans with
symptomatic COVID-19 infections early to prevent disease progression?
30. The SARS-CoV-2/COVID-19
virus is an RNA virus. It is well-established that Zinc interferes with RNA
viral replication, correct?
31. Moreover, is it not true
that hydroxychloroquine facilitates the entry of zinc into the cell, is a
“ionophore,” correct?
32. Isn’t also it true that
Azithromycin has established anti-viral properties?
33. Are you aware of the paper
from Baylor by Dr. McCullough et. al. describing established mechanisms by
which the components of the “HCQ cocktail” exert anti-viral effects?
34. So- the use of
hydroxychloroquine, azithromycin (or doxycycline) and zinc, the “HCQ cocktail,”
is based on science, correct?
Questions
regarding safety
1. The FDA writes the
following: “in light of on-going serious cardiac adverse events and their
serious side effects, the known and potential benefits of CQ and HCQ no longer
outweigh the known and potential risks for authorized use.”So not only is the
FDA saying that Hydroxychloroquine doesn’t work, they are also saying that it
is a very dangerous drug. Yet, is it not true the drug has been used as an
anti-malarial drug for over 65 years?
2. Isn’t true that the drug
has been used for lupus and rheumatoid arthritis for many years at similar
doses?
3. Do you know of even a
single study prior to COVID -19 that has provided definitive evidence against
the use of the drug based on safety concerns?
4. Are you aware that
chloroquine or hydroxychloroquine has many approved uses for hydroxychloroquine
including steroid-dependent asthma (1988 study), Advanced pulmonary sarcoidosis
(1988 study), sensitizing breast cancer cells for chemotherapy (2012 study),
the attenuation of renal ischemia (2018 study), lupus nephritis (2006 study),
epithelial ovarian cancer (2020 study, just to name a few)? Where are the
cardiotoxicity concerns ever mentioned?
5. Risch estimates the risk of
cardiac death from hydroxychloroquine to be 9/100,000 using the data provided
by the FDA. That does not seem to be a high risk, considering the risk of death
in an older patient with co-morbidities can be 15% or more. Do you consider
9/100,000 to be a high risk when weighed against the risk of death in older
patient with co-morbidities?
6. To put this in perspective,
the drug is used for 65 years, without warnings (aside for the need for
periodic retinal checks), but the FDA somehow feels the need to send out an
alert on June 15, 2020 that the drug is dangerous. Does that make any logical
sense to you Dr. Fauci based on “science”?
7. Moreover, consider that the
protocols for usage in early treatment are for 5 to 7 days at relatively low
doses of hydroxychloroquine similar to what is being given in other diseases
(RA, SLE) over many years- does it make any sense to you logically that a 5 to
7 day dose of hydroxychloroquine when not given in high doses could be
considered dangerous?
8. You are also aware that
articles published in the New England Journal of Medicine and Lancet, one out
of Harvard University, regarding the dangers of hydroxychloroquine had to be
retracted based on the fact that the data was fabricated. Are you aware of
that?
9. If there was such good data
on the risks of hydroxychloroquine, one would not have to use fake data,
correct?
10. After all, 65 years is a
long-time to determine whether or not a drug is safe, do you agree?
11. In the clinical trials that
you have referenced (e.g., the Minnesota and the Brazil studies), there was not
a single death attributed directly to hydroxychloroquine, correct?
12. According to Dr. Risch,
there is no evidence based on the data to conclude that hydroxychloroquine is a
dangerous drug. Are you aware of any published report that rebuts Dr. Risch’s
findings?
13. Are you aware that the FDA
ruling along with your statements have led to Governors in a number of states
to restrict the use of hydroxychloroquine?
14. Are you aware that
pharmacies are not filling prescriptions for this medication based on your and
the FDA’s restrictions?
15. Are you aware that doctors
are being punished by state medical boards for prescribing the medication based
on your comments as well as the FDA’s?
16. Are you aware that people
who want the medication sometimes need to call physicians in other states
pleading for it?
17. And yet you opined in March
that while people were dying at the rate of 10,000 patient a week,
hydroxychloroquine could only be used in an inpatient setting as part of a
clinical trial- correct?
18. So, people who want to be
treated in that critical 5-to-7-day period and avoid being hospitalized are
basically out of luck in your view, correct?
19. So, again, for clarity,
without a shred of evidence that the Hydroxychloroquine/HCQ cocktail is
dangerous in the doses currently recommend for early outpatient
treatment, you and the FDA have made it very difficult if not impossible in
some cases to get this treatment, correct?
Questions
regarding methodology
The Key to Defeating COVID-19 Already Exists. We Need to Start
Using It
1. In regards to the use of
hydroxychloroquine, you have repeatedly made the same statement: “The Overwhelming Evidence from Properly Conducted Randomized
Clinical Trials Indicate no Therapeutic Efficacy of Hydroxychloroquine.” Is
that correct?
2. In Dr. Risch’s article
regarding the early use of hydroxychloroquine, he disputes your opinion. He
scientifically evaluated the data from the studies to support his opinions.
Have you published any articles to support your opinions?
3. You repeatedly state that
randomized clinical trials are needed to make conclusions regarding treatments,
correct?
4. The FDA has approved many
medications (especially in the area of cancer treatment) without randomized
clinical trials, correct?
5. Are you aware that Dr.
Thomas Frieden, the previous head of the CDC wrote an article in the New
England Journal of Medicine in 2017 called “Evidence for Health Decision Making
– Beyond Randomized Clinical Trials (RCT)”? Have you read that article?
6. In it Dr. Frieden states
that “many data sources can provide valid evidence for clinical and public
health action, including “analysis of aggregate clinical or epidemiological
data”-do you disagree with that?
7. Frieden discusses
“practiced-based evidence” as being essential in many discoveries, such SIDS
(Sudden Infant Death Syndrome)-do you disagree with that?
8. Frieden writes the
following: “Current evidence-grading systems are biased toward randomized
clinical trials, which may lead to inadequate consideration of non-RCT data.”
Dr. Fauci, have you considered all the non-RCT data in coming to your opinions?
9. Risch, who is a leading
world authority in the analysis of aggregate clinical data, has done a rigorous
analysis that he published regarding the early treatment of COVID 19 with
hydroxychloroquine, zinc, and azithromycin. He cites 5 or 6 studies, and in an
updated article there are 5 or 6 more-a total of 10 to 12 clinical studies with
formally collected data specifically regarding the early treatment of COVID.
Have you analyzed the aggregate data regarding early treatment of high-risk
patients with hydroxychloroquine, zinc, and azithromycin?
10. Is there any document that
you can produce for the American people of your analysis of the aggregate data
that would rebut Dr. Risch’s analysis?
11. Yet, despite what Dr. Risch
believes is overwhelming evidence in support of the early use of
hydroxychloroquine, you dismiss the treatment insisting on randomized
controlled trials even in the midst of a pandemic?
12. Would you want a loved one
with high-risk comorbidities placed in the control group of a randomized
clinical trial when a number of studies demonstrate safety and dramatic
efficacy of the early use of the Hydroxychloroquine “cocktail?”
13. Are you aware that the FDA
approved a number of cancer chemotherapy drugs without randomized control
trials based solely on epidemiological evidence. The trials came later as
confirmation. Are you aware of that?
14. You are well aware that
there were no randomized clinical trials in the case of penicillin that saved
thousands of lives in World War II? Was not this in the best interest of our
soldiers?
15. You would agree that many
lives were saved with the use of cancer drugs and penicillin that were used
before any randomized clinical trials–correct?
16. You have referred to
evidence for hydroxychloroquine as “anecdotal”- which is defined as “evidence
collected in a casual or informal manner and relying heavily or entirely on
personal testimony”- correct?
17. But there are many studies
supporting the use of hydroxychloroquine in which evidence was collected
formally and not on personal testimony, has there not been?
18. So it would be false to
conclude that the evidence supporting the early use of hydroxychloroquine is
anecdotal, correct?
Comparison
between the US and other countries regarding case fatality rate
(It
would be very helpful to have the graphs comparing our case fatality rates to
other countries)
1. Are you aware that
countries like Senegal and Nigeria that use Hydroxychloroquine have much lower
case-fatality rates than the United States?
2. Have you pondered the
relationship between the use of Hydroxychloroquine by a given country and their
case mortality rate and why there is a strong correlation between the use of
HCQ and the reduction of the case mortality rate.?
3. Have you considered
consulting with a country such as India that has had great success treating
COVID-19 prophylactically?
4. Why shouldn’t our first
responders and front-line workers who are at high risk at least have an option
of HCQ/zinc prophylaxis?
5. We should all agree that
countries with far inferior healthcare delivery systems should not have lower
case fatality rates. Reducing our case fatality rate from near 5% to 2.5%, in
line with many countries who use HCQ early would have cut our total number of
deaths in half, correct?
6. Why not consult with
countries who have lower case-fatality rates, even without expensive medicines
such as remdesivir and far less advanced intensive care capabilities?
Giving
Americans the option to use HCQ for COVID-19
1. Harvey Risch, the
pre-eminent Epidemiologist from Yale, wrote a Newsweek Article titled: “The key to defeating COVID-19 already exists. We need to start
using it.” Did you read the article?
2. Are you aware that the cost
of the Hydroxychloroquine “cocktail” including the Z-pack and zinc is about
$50?
3. You are aware the cost of
Remdesivir is about $3,200?
4. So that’s about 60 doses of
HCQ “cocktail,” correct?
5. In fact, President Trump
had the foresight to amass 60 million doses of hydroxychloroquine, and yet you
continue to stand in the way of doctors who want to use that medication for
their infected patients, correct?
6. Those are a lot of doses of
medication that potentially could be used to treat our poor, especially our
minority populations and people of color that have a difficult time accessing
healthcare. They die more frequently of COVID-19, do they not?
7. But because of your
obstinance blocking the use of HCQ, this stockpile has remained largely unused,
correct?
8. Would you acknowledge that
your strategy of telling Americans to restrict their behavior, wear masks, and
distance, and put their lives on hold indefinitely until there is a vaccine is
not working?
9. So, 160,000 deaths later,
an economy in shambles, kids out of school, suicides and drug overdoses at a
record high, people neglecting and dying from other medical conditions, and
America reacting to every outbreak with another lockdown- is it not time to
re-think your strategy that is fully dependent on an effective vaccine?
10. Why not consider a strategy
that protects the most vulnerable and allows Americans back to living their
lives and not wait for a vaccine panacea that may never come?
11. Why not consider the
approach that thousands of doctors around the world are using, supported by a
number of studies in the literature, with early outpatient treatment of
high-risk patients for typically one week with HCQ + Zinc + Azithromycin?
12. You don’t see a problem
with the fact that the government, due to your position, in some cases
interferes with the choice of using HCQ. Should not that be a choice between
the doctor and the patient?
13. While some doctors may not
want to use the drug, should not doctors who believe that it is indicated be
able to offer it to their patients?
14. Are you aware that doctors
who are publicly advocating for such a strategy with the early use of the HCQ
cocktail are being silenced with removal of content on the internet and even
censorship in the medical community?
15. You are aware of the 20 or
so physicians who came to the Supreme Court steps advocating for the early use
of the Hydroxychloroquine cocktail.In fact, you said these were “a bunch of people spouting out something that isn’t true.”Dr.
Fauci, these are not just “people”- these are doctors who actually treat
patients, unlike you, correct?
16. Do you know that the video
they made went viral with 17 million views in just a few hours, and was then
removed from the internet?
17. Are you aware that their
website, American Frontline Doctors, was taken down the next day?
18. Did you see the way that
Nigerian immigrant physician, Dr. Stella Immanuel, was mocked in the media for
her religious views and called a “witch doctor”?
19. Are you aware that Dr.
Simone Gold, the leader of the group, was fired from her job as an Emergency
Room physician the following day?
20. Are you aware that
physicians advocating for this treatment that has by now probably saved
millions of lives around the globe are harassed by local health departments,
state agencies and medical boards, and even at their own hospitals? Are you
aware of that?
21. Don’t you think doctors
should have the right to speak out on behalf of their patients without the
threat of retribution?
22. Are you aware that videos
and other educational information are removed off the internet and labeled, in
the words of Mark Zuckerberg, as “misinformation.”?
23. Is it not misinformation to
characterize Hydroxychloroquine, in the doses used for early outpatient
treatment of COVID-19 infections, as a dangerous drug?
24. Is it not misleading for
you to repeatedly state to the American public that randomized clinical trials
are the sole source of information to confirm the efficacy of a treatment?
25. Was it not misinformation
when on CNN you cited the Lancet study based on false data from Surgisphere as
evidence of the lack of efficacy of hydroxychloroquine?
26. Is it not misinformation as
is repeated in the MSM as a result of your comments that a randomized clinical
trial is required by the FDA for a drug approval?
27. Don’t you realize how much
damage this falsehood perpetuates?
28. How is it not
misinformation for you and the FDA to keep telling the American public that
hydroxychloroquine is dangerous when you know that there is nothing more than
anecdotal evidence of that?
29. Fauci, if you or a loved
one were infected with COVID-19, and had flu-like symptoms, and you knew as you
do now that there is a safe and effective cocktail that you could take to
prevent worsening and the possibility of hospitalization, can you honestly tell
us that you would refuse the medication?
30. Why not give our healthcare
workers and first responders, who even with the necessary PPE are contracting
the virus at a 3 to 4 times greater rate than the general public, the right to
choose along with their doctor if they want use the medicine prophylactically?
31. Why is the government
inserting itself in a way that is unprecedented in regard to a historically
safe medication and not allowing patients the right to choose along with their
doctor?
32. Why not give the American
people the right to decide along with their physician whether or not they want
outpatient treatment in the first 5 to 7 days of the disease with a cocktail
that is safe and costs around $50?
Final
questions
1. Fauci, please explain how a
randomized clinical trial, to which you repeatedly make reference, for testing
the HCQ cocktail (hydroxychloroquine, azithromycin and zinc) administered
within 5-7 days of the onset of symptoms is even possible now given the
declining case numbers in so many states?
2. For example, if the NIH
were now to direct a study to begin September 15, where would such a study be
done?
3. Please explain how a
randomized study on the early treatment (within the first 5 to 7 days of
symptoms) of high-risk, symptomatic COVID-19 infections could be done during
the influenza season and be valid?
4. Please explain how multiple
observational studies arrive at the same outcomes using the same formulation of
hydroxychloroquine + Azithromycin + Zinc given in the same time frame for the
same study population (high risk patients) is not evidence that the cocktail
works?
5. In fact, how is it not
significant evidence, during a pandemic, for hundreds of non-academic private
practice physicians to achieve the same outcomes with the early use of the HCQ
cocktail?
6. What is your recommendation
for the medical management of a 75-year-old diabetic with fever, cough, and
loss of smell, but not yet hypoxic, who Emergency Room providers do not feel
warrants admission? We know that hundreds of U.S. physicians (and thousands
more around the world) would manage this case with the HCQ cocktail with
predictable success.
7. If you were in charge in
1940, would you have advised the mass production of penicillin based primarily
on lab evidence and one case series on 5 patients in England or would you have
stated that a randomized clinical trial was needed?
8. Why would any physician put
their medical license, professional reputation, and job on the line to
recommend the HCQ cocktail (that does not make them any money) unless they knew
the treatment could significantly help their patient?
9. Why would a physician take
the medication themselves and prescribe it to family members (for treatment or
prophylaxis) unless they felt strongly that the medication was beneficial?
10. How is it informed and
ethical medical practice to allow a COVID-19 patient to deteriorate in the
early stages of the infection when there is inexpensive, safe, and dramatically
effective treatment with the HCQ cocktail, which the science indicates
interferes with coronavirus replication?
11. How is your approach to
“wait and see” in the early stages of COVID-19 infection, especially in
high-risk patients, following the science?
While
previous questions are related to hydroxychloroquine-based treatment, we have
two questions addressing masks.
1. As you recall, you stated
on March 8th, just a few weeks before the devastation in the Northeast, that
masks weren’t needed. You later said that you made this statement to prevent a
hoarding of masks that would disrupt availability to healthcare workers. Why
did you not make a recommendation for people to wear any face covering to
protect themselves, as we are doing now?
2. Rather, you issued no such
warning and people were riding in subways and visiting their relatives in
nursing homes without any face covering. Currently, your position is that face
coverings are essential. Please explain whether or not you made a mistake in
early March, and how would you go about it differently now.
Conclusion
Since the start of the pandemic,
physicians have used hydroxychloroquine to treat symptomatic COVID-19
infections, as well as for prophylaxis. Initial results were mixed as
indications and doses were explored to maximize outcomes and minimize risks.
What emerged was that hydroxychloroquine appeared to work best when coupled
with azithromycin. In fact, it was the President of the United States who
recommended to you publicly at the beginning of the pandemic, in early March,
that you should consider early treatment with hydroxychloroquine and a “Z-Pack.” Additional
studies showed that patients did not seem to benefit when COVID-19 infections
were treated with hydroxychloroquine late in the course of the illness,
typically in a hospital setting, but treatment was consistently effective, even
in high-risk patients, when hydroxychloroquine was given in a “cocktail”
with azithromycin and, critically, zinc in the first 5 to 7
days after the onset of symptoms. The outcomes are, in
fact, dramatic.
As clearly presented in the McCullough article from
Baylor, and described by Dr. Vladimir Zelenko, the efficacy of the HCQ cocktail
is based on the pharmacology of the hydroxychloroquine ionophore acting as the
“gun” and zinc as the “bullet,” while azithromycin potentiates the anti-viral
effect. Undeniably, the hydroxychloroquine combination treatment is supported
by science. Yet, you continue to ignore the “science” behind the disease. Viral
replication occurs rapidly in the first 5 to 7 days of symptoms and can be
treated at that point with the HCQ cocktail. Rather, your actions have denied
patients treatment in that early stage. Without such treatment, some patients,
especially those at high risk with co-morbidities, deteriorate and require
hospitalization for evolving cytokine storm resulting in pneumonia, respiratory
failure, and intubation with 50% mortality. Dismissal of the science results in
bad medicine, and the outcome is over 160,000 dead Americans. Countries that
have followed the science and treated the disease in the early stages have far
better results, a fact that has been concealed from the American Public.
Despite mounting evidence and
impassioned pleas from hundreds of frontline physicians, your position was and
continues to be that randomized controlled trials (RCTs) have not shown there
to be benefit. However, not a single
randomized control trial has tested what is being recommended: use of the full cocktail (especially zinc), in
high-risk patients, initiated within the first 5 to 7 days of the onset of symptoms.
Using hydroxychloroquine and azithromycin late in the disease process, with or
without zinc, does not produce the same, unequivocally positive results.
Dr. Thomas Frieden, in a 2017 New England Journal of
Medicine article regarding randomized clinical trials, emphasized there are
situations in which it is entirely appropriate to use other forms of evidence
to scientifically validate a treatment. Such is the case during a pandemic that
moves like a brushfire jumping to different parts of the country. Insisting on
randomized clinical trials in the midst of a pandemic is simply foolish. Dr.
Harvey Risch, a world-renowned Yale epidemiologist, analyzed all the data
regarding the use of the hydroxychloroquine/HCQ cocktail and concluded that the
evidence of its efficacy when used early in COVID-19 infection is unequivocal.
Curiously, despite a 65+ years safety
record, the FDA suddenly deemed hydroxychloroquine a dangerous drug, especially
with regard to cardiotoxicity. Dr. Risch analyzed
data provided by the FDA and concluded that the risk of a significant cardiac
event from hydroxychloroquine is extremely low, especially when compared to the
mortality rate of COVID-19 patients with high-risk co-morbidities. How do you
reconcile that for forty years rheumatoid arthritis and lupus patients have
been treated over long periods, often for years, with hydroxychloroquine and
now there are suddenly concerns about a 5 to 7-day course of hydroxychloroquine
at similar or slightly increased doses? The FDA statement regarding
hydroxychloroquine and cardiac risk is patently false and alarmingly misleading
to physicians, pharmacists, patients, and other health professionals. The
benefits of the early use of hydroxychloroquine to prevent hospitalization in
high-risk patients with COVID-19 infection far outweigh the risks. Physicians
are not able to obtain the medication for their patients, and in some cases are
restricted by their state from prescribing hydroxychloroquine. The government’s
obstruction of the early treatment of symptomatic high-risk COVID-19 patients
with hydroxychloroquine, a medication used extensively and safely for so long,
is unprecedented.
It is essential that you tell the truth
to the American public regarding the safety and efficacy of the
hydroxychloroquine/HCQ cocktail. The government must
protect and facilitate the sacred and revered physician-patient relationship by
permitting physicians to treat their patients. Governmental obfuscation and
obstruction are as lethal as cytokine storm.
Americans must not continue to die
unnecessarily. Adults must resume
employment and our youth return to school. Locking down America while awaiting
an imperfect vaccine has done far more damage to Americans than the
coronavirus. We are confident that thousands of lives would be saved with early
treatment of high-risk individuals with a cocktail of hydroxychloroquine, zinc,
and azithromycin. Americans must not live in fear. As Dr. Harvey Risch’s
Newsweek article declares, “The key to defeating COVID-19 already exists. We need
to start using it.”
Very Respectfully,
George
C. Fareed, MD, Brawley, California
Michael
M. Jacobs, MD, MPH, Pensacola, Florida
Donald
C. Pompan, MD, Salinas, California
