Hydroxychloroquine Derangement Syndrome

Trump derangement syndrome (TDS), according to Urban Dictionary, is a “Contagious, debilitating psychiatric disorder manifesting in a precipitous decline in intellectual and emotional stability and resilience.” The contagious and debilitating bits sound much like the Wuhan flu.

TDS, also known in infectious disease circles as Covfefe-45, not to be confused with Covid-19, has mutated into another form, namely hydroxychloroquine derangement syndrome, referring to the abject media hysteria over the innocuous prescription medication. Attorney General William Barr even noticed and, “Claimed that the Washington press corps is on a ‘jihad’ against President Trump over his promotion of an anti-malaria drug to treat the novel coronavirus.”

This is simply a small battle in the larger war against all things Trump, which the left and the media (sorry to be repetitive) have been engaged in since June 2015 when candidate Trump rode down the escalator at Trump Tower announcing his candidacy.

Yet this battle is inexplicable, other than to be attributed to the novel Covfefe-45 virus, known to cause hysteria, irrationality, and loss of common sense.

Ever since President Trump began talking about hydroxy as a potential “game changing” treatment option for the Wuhan Coronavirus, the media has been treating this drug as a cross between cyanide and strychnine, warning of death to anyone who dares to take it, ironically in an attempt to avoid high probability death due to respiratory failure.

If Trump had never mentioned hydroxy, the media would view the drug favorably, or at least neutrally. But in the age of Trump, anything he favors is immediately despised and opposed by the left.

Hydroxy was FDA approved in 1955 for the prevention and treatment of malaria, as well as for lupus and rheumatoid arthritis. With 65 years in use, its side effect profile is well known. It is certainly not “novel,” like the Chinese virus killing thousands worldwide.

Sure, it has potential side effects, as do all prescription medications. In the case of hydroxy, those with a rare cardiac arrhythmia, easily detected with an EKG, shouldn’t take it. Similarly, someone with a bleeding tendency shouldn’t take anticoagulants, but that’s why these medications require a doctor’s prescription and are not stocked in the candy aisle at the drug store.

There have been “anecdotal reports” showing benefits of hydroxy in treating COVID, but not yet the holy grail of a prospective randomized clinical trial as the basketball player and scarf queen (Drs. Fauci and Birx) would prefer.

Yet the media can’t help themselves in their hostility toward this drug, which I would wager they or their spouses would be eager to take if they tested positive for the Wuhan virus.

The VA health system recently published the results of their experience using hydroxy for COVID. The media was giddy with delight, even though few actually appeared to have read the study. Instead their hysterical headlines reflected their hydroxy derangement syndrome.

From CNN, “Study finds no benefit, higher death rate in patients taking hydroxychloroquine for Covid-19.”

AP in perfect harmony wrote, “More deaths, no benefit from malaria drug in VA virus study.”

Even Fox News, lurching to the left as fast as the Drudge Report, ran this headline, “COVID-19 treatment hydroxychloroquine showed no benefit, more deaths in VA virus study.

See, see. Trump was wrong. He’s an idiot and dangerous. He promoted this deadly drug since he wants to Make America Dead Again. COVID affects darker skinned individuals preferentially and Trump is a racist for pushing a drug that kills blacks. It’s Charlottesville all over again. Orange man bad. You get the picture.

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What does this vaunted VA study actually say? Did anyone in the media actually review it? Probably not, so let’s look. Here it is.

At the very beginning, the paper offers this rather large caveat, that it has “not been peer reviewed” and “reports new medical research that has yet to be evaluated and so should not be used to guide clinical practice.” That won’t stop the wise guys, as Trump likes to call some of them, at CNN and MSNBC from using headlines to guide clinical practice, scaring the daylights out of anyone considering taking hydroxy.

The study was a “retrospective analysis”, not the “prospective randomized clinical trial” so favored by the ivory tower doctors in their crisp white coats.

The study looked at patients receiving hydroxy alone, hydroxy and azithromycin, or neither. It was a look back, not randomized and not prospective, or forward looking. The study suffers from selection bias where, “Groups of participants may differ in ways other than the interventions or exposures under investigation. When this is the case, the results of the study are biased by confounding.”

There was no mention of zinc, which many believe is necessary to use with hydroxy. Hydroxy facilitates zinc entering into cells, stopping viral replication. Without zinc in this cohort of patients, it makes sense that the two hydroxy groups didn’t fare as well, missing an essential component of the treatment.

It’s not that the study is worthless, but it is “anecdotal”, similar to the studies showing benefit to hydroxy that are discounted by the smart set in the media and medical establishment.

The study itself, in the discussion section, makes the point well.

Hydroxychloroquine, with or without azithromycin, was more likely to be prescribed to patients with more severe disease, as assessed by baseline ventilatory status and metabolic and hematologic parameters. Thus, as expected, increased mortality was observed in patients treated with hydroxychloroquine, both with and without azithromycin.

In other words, the three groups were not comparable, a feature of randomization. Sicker patients received these medications. Sicker patients, by the fact that they were sicker, were also more likely to die. As they did. The healthier patients received nothing and fared better, as expected. The media asserted that the hydroxy killed these patients when in reality they died from the virus, which may not have been adequately or aggressively treated.

An honest and inquisitive media might get off their high horses and ask relevant questions. Why should hydroxy only be reserved for the sickest patients, when such treatment may be too little too late? Should hydroxy be used much earlier in the course of infection?

We do know, based on 65 years prescribing experience, that hydroxy is relatively safe. Some studies say it is effective, others say it is not. Yet if it can save one life, it is worth it, to borrow a phrase from the left. Looking at the totality of data and experience with hydroxy, the risk/benefit ratio favors benefit.

Perhaps that ratio may change over time, as is most thinking on the virus including clinical manifestations and best treatment practices.

Yet the hair-on-fire media remain hell bent on discrediting hydroxy, regardless of the facts, simply because the big bad orange man recommended it as a potential treatment option for COVID. Derangement indeed. Forget the media chattering class. Think for yourself. Trust yourself.

Brian C Joondeph, MD, is a Denver based physician and freelance writer whose pieces have appeared in American Thinker, Daily Caller, Rasmussen Reports, and other publications. Follow him on Facebook,  LinkedIn, Twitter, and QuodVerum