Harvey Risch is a MD and PhD Professor of Epidemiology at Yale University. In a video, he reviews the evidence for or against use of hydroychloroquine (HCQ) in early outpatient treatment of COVID-19. He likes it and favors it over ivermectin because he sees more and better data for the HCQ.
A key to his argument is differentiating between early and late COVID-19 disease. In the early phase (lasting 5-7 days), viral replication is predominant, causing the fever, chills, myalgias, malaise, etc. His late phase is when blood oxygen levels start to drop and patients are admitted to the hospital. I assume the late phase is the inflammatory response of the lungs, the cytokine storm. Of course, not everyone advances to the late phase. Many of the studies finding no benefit of HCQ involved hospitalized patients in the late phase. It’s too late then, according to Risch.
Dr Risch also says HCQ alone probably is not adequate. Many of the studies he cites utilized one or more of following: azithromycin, doxycycline, zinc, ivermectin, vitamin D, budesonide, low-dose aspirin, montelukast, colchicine, fluvoxamine, and others.
I don’t recall Dr Risch discussing who should be treated early with HCQ. I’m guessing just those with one or more risk factors for life-threatening disease, which might include everyone over 65-70 years old. Remember that the average survival rate for COVID-19 is over 99%.
His presentation is compelling. He’s reading his numbered slides, so you can get through it in half the time by turning off the sound and just reading. Why hasn’t YouTube (Google) censored this yet?
Steve Parker, M.D.
PS: I tried unsuccessfully to find the average age of those who die of COVID-19 in the U.S. But I ran across this report on the recent Italian experience (from Feb to Sept 2021):
MILAN, Oct 20 (Reuters) – People vaccinated against COVID-19 are highly unlikely to die of the disease unless very old and already badly ill before getting it, a study in Italy showed on Wednesday.
The study by the national Health Institute (ISS), contained in a regular ISS report on COVID-19 deaths, shows the average age of people who died despite being vaccinated was 85. On average they had five underlying illnesses.
The average age of death among those not vaccinated was 78, with four pre-existing conditions.
Cases of heart problems, dementia and cancer were all found to be higher in the sample of deaths among those vaccinated.
Note that median age in Italy is 47 compared to 38 in the U.S.