My guest this week is the lawyer and writer Philip Howard, author of Not Accountable: Rethinking the Constitutionality of Public Employee Unions, among many other books.
“The thing that is missing the most is moral authority” A quote from the conclusion of Mr Howard. I found myself nodding in agreement. Unfortunately I immediately caught myself. When we can’t agree on what a woman is, good luck with finding a consensus on what is moral. Is that not the rot on which the society is decaying?
Loved the podcast and Mr. Howard’s remarks. I am afraid our society no longer has any foundation on which to rebuild.
The concept of subsidiarity absolutely should apply to health and public health! Empowered patients and empowered doctors treating illness as it presents in individuals is the only rational way to avoid the inevitable problems which come from centralized authority insulated from the results of its policy descisions. Remdesiver was a top-down decision foisted upon doctors even after it was known how toxic it is from failed trials for ebola treatment, for goodness sake! It's odd that this discussion would carve out such a broad exception as public health while suggesting that empowering teachers in the classroom is necessary.
Maybe the reason that OHSA has 4000 rules because they scale their fines to the number of violations and it is really about funding themselves on this regulation structure and less about actually promoting workplace safety.
This podcast is probably the most important one Glenn has ever had from the point of of what constitutes good government. And since government has arrogated to itself so much power and control to have the government on its knees vis a vis their employees is a denial of the entire theory of democracy. A perfect example of this to be seen in the odious Randi Weingarten calling the shots to the White House in terms of when schools in the US can reopen during the post covid period. We can never get control over our government until government unions are ruled unconstitutional and that control of government workers is returned back to the voters and tax payers where it belongs.
As a Local 21 union member, I was among the unionized civil service public employees until my 2021 retirement. Interesting discussion. Please abolish the teachers’ unions.
Good discussion. My only disagreement was his opinion that the public should follow Public Health mandates to take vaccines. My opinion has shifted on that, especially in light of the knowledge that FDA and PH employees are not the watchdogs that they are tasked with being and are beholden to the hand that feeds them rather than the public they should be serving.
This shows how the childhood vaccine schedule has changed since the pharmaceutical companies were relieved of most of their liability by the vaccine injury act of 1986.
In pediatric medical training 20 years ago, we were taught that fever and lethargy could be a side effect of vaccines, but that was all normal and expected.
Vinay Prasad is a brilliant young cancer doctor and researcher at UCSF. This is his analysis of the CDC current recommendations for vaccine boosters this year.
It is also important to note that Paul Offit who is a 70’ish vaccine inventor and sits on the FDA advisory board said in September he did not plan to get a booster this year due to his existing immunity.
See the book Turtles all the Way Down for a good account of how all of the vaccine safety data is degenerate and referenced to OTHER vaccines as a “control”.
To prove that a treatment is in the interest of your patient, you need first a placebo controlled (or proven best practice controlled) study to prove effectiveness and safety and THEN, you need to be able to show that the treatment (such as a vaccine) has a NET benefit that outweighs the risk of harm.
Pharmaceutical companies like to cite “relative risks” and they have done this a lot with vaccines. If your risk of severe outcomes from the disease is 0.5% for example and the vaccine reduces that to 0.1% then the “relative risk reduction” is 0.4%/0.5% = 80%.
This is an ABSOLUTE risk reduction of 0.4% ARR
Do you take it? You need to know one more thing... what is your risk of a serious side effect from the vaccine? If it is much greater than the ARR you have NET HARM.
If the risk of harm is much less than the risk reduction, then you might want to get the vaccine... depending on how serious the outcome risk of infection is and your risk tolerance.
Finally, studies done prior to the the widespread outbreaks of infection of COVID have no relevance to present day effectiveness of the vaccines in people with previous exposure.
The FDA CDC and public health have proven themselves to be fully corrupt and incompetent.
Public health guidance should come from thoughtful scientists like Jay Bhattacharya and Vinay Prasad and Marty Makary... not the captured pharmaceutical company shills.
See: The vaccine injury act of 1986.
And then study the proliferation of vaccines that have developed since the pharmaceutical companies were relieved of most liability for injuries in the past 30 years
Ivermectin was tested and found to be worthless. Hospitalization and COVID death rates were lower in vaccinated people in the United Ststes. The economy of the United States began to improve faster in the United States than in other Western countries despite the shutdowns.
I made no mention of Ivermectin or Hydroxychloroquine. I am perplexed as to why you mentioned them … did anyone actually claim bleach as a treatment? Could you pass along proof of that claim?
If you are not aware of the the change in the definition by those who would most benefit from it, it indicates a lack of knowledge of the governments machinations during the covid outbreak. From the myriad posts you have made in this tread you seem to posit yourself as an expert in this area.
We now have the most senior officials of our public healthcare apparatus admitting 6 feet had no basis in science nor did wearing mask. Does this not put into doubt most of their proclamations?
In my household, we have a child suffering from the side effects of a “vaccine” that allegedly doesn’t have any. Clearly, the vaccine’s benefits are marginal.
I am sorry to hear about your child’s illness. Vaccines that are currently released to the public to treat COVID have shown clear benefit. The J&J vaccine was pulled after there was a suggestion of an increased possibility of blood clots. This would not be the action taken if there were a conspiracy between the FDA and BigPharma.
Edit to add:
The fact that distancing did not work does not change the fact that vaccine use decreases the risk of hospitalization and death.
It is also the case that there was a lower risk of transmission with the initial COVID variant. The vaccines did not stop transmission of subsequent variants.
The thing with the early treatment options (emphasis on EARLY) is that the studies I have read were conducted on hospitalized patients, already quite sick, and did not follow dosing protocols that advocating physicians used. In one study on Hydroxychloroquine, one of the lead study authors had just signed on with a Pharma company developing another Covid treatment, a conflict of interest he did not disclose. Anecdotally, I personally know two people who were able to get Ivermectin EARLY and symptoms resolved within 3 days. Riddle me this: why are we not hearing from people or the families of people who tried HCQ or Ivermectin and found either to be ‘worthless’? All we hear about are the RCT’s that found them ‘worthless’. We know people were still able to find these drugs; I’d think those harmed or at least not helped would be put on blast, but that has not been the case. Curious, no?
Anecdotal evidence is not a valid means of analyzing medical data.
Hundreds of (mostly small) clinical trials were launched in the spring of 2020 to evaluate if hydroxychloroquine could prevent or treat COVID-19. According to publicly available data, 247 such trials were registered.2 In this gold rush, some of these trials competed for the same patients including, unfortunately, trials that we collectively participated in. Regrettably, before the first randomized controlled trial was complete,3 hydroxychloroquine became a cause célèbre. It was endorsed by an array of notable (and polarizing) individuals and supported by a variety of confounded observational studies. Many providers began prescribing the drug4 and patients began to either request hydroxychloroquine or, alternatively, to fear it due to the ensuing public pushback against the public promotion of this unproven treatment and a high-profile article which was subsequently retracted.5 Consequently, most outpatient trials failed to enroll to completion, and none were independently large enough to definitively refute a small benefit in this setting.
Against this backdrop, the publication in this issue of The Lancet Regional Health – Americas of a large, double-blind randomized controlled trial of hydroxychloroquine in 1372 participants with initially mild COVID-19 conducted by the COPE-COALITION V group is noteworthy and laudable.6 Although this well-designed and conducted trial fell short of its recruitment goal of 1620 infected participants – stymied by the high rate of enrolled participants in whom the infection could not be confirmed by PCR or serology – it is the largest outpatient therapeutic trial of hydroxychloroquine published to date. Like dozens of smaller trials published before, it failed to demonstrate any benefit to hydroxychloroquine in preventing progression of COVID-19 among outpatients with initially mild COVID-19.
Interesting that you should post this link to the Lancet study. It is actually Dr. Boulware to whom I referred about not disclosing his conflicts of interest.
From what I recall, the dosing was off - and not given with Zinc and Azithromycin. Zinc and the Z-pack inhibit viral replication; HCQ is what I see referred to as a 'zinc ionophore', allowing zinc into the cell to hinder viral replication. This is the protocol that every doctor I read advocate - the three in conjunction, EARLY in the viral stages. The dosing in the Boulware study was also well north of what the advocating doctors recommended, which is what triggered the adverse reactions.
In fact, the NIH treatment guidelines used to include this information in their treatment guidelines. Knowing how uncomfortable information can sometimes disappear from government websites, I downloaded the PDF, and this is copied from an earlier version. Just as I suspected, the section on HCQ has been completely removed.
"Chloroquine is an antimalarial drug that was developed in 1934. Hydroxychloroquine, an analogue of chloroquine, was developed in 1946. Hydroxychloroquine is used to treat autoimmune diseases, such as
systemic lupus erythematosus and rheumatoid arthritis, in addition to malaria.
Both chloroquine and hydroxychloroquine increase the endosomal pH, which inhibits fusion between SARS-CoV-2 and the host cell membrane.1 Chloroquine inhibits glycosylation of the cellular
angiotensin-converting enzyme 2 (ACE2) receptor, which may interfere with the binding of SARS-CoV to the cell receptor.2 In vitro studies have suggested that both chloroquine and hydroxychloroquine may block the transport of SARS-CoV-2 from early endosomes to endolysosomes, possibly preventing the
release of the viral genome.3 Both chloroquine and hydroxychloroquine also have immunomodulatory effects, which have been hypothesized to be another potential mechanism of action for the treatment of COVID-19. Azithromycin has antiviral and anti-inflammatory properties. When used in combination with hydroxychloroquine, it has been shown to have a synergistic effect on SARS-CoV-2 in vitro and in molecular modeling studies.4,5 However, despite demonstrating antiviral activity in some in vitro systems, neither hydroxychloroquine plus azithromycin nor hydroxychloroquine alone reduced upper or lower respiratory tract viral loads or demonstrated clinical efficacy in a rhesus macaque model.6
The safety and efficacy of chloroquine or hydroxychloroquine with or without azithromycin and
azithromycin alone have been evaluated in randomized clinical trials, observational studies, and/or
single-arm studies. Please see Table 2b for more information.
Recommendation
• The COVID-19 Treatment Guidelines Panel (the Panel) recommends against the use of chloroquine or hydroxychloroquine and/or azithromycin for the treatment of COVID-19 in hospitalized patients (AI) and in nonhospitalized patients (AIIa).
So my main beef is that in the year before the 'vaccines' were introduced, which we now know did not prevent infection nor transmission of the Covid virus, this drug, when used in combination with Zinc and a Z-pak was discarded, even though they could have worked, because they didn't get the results they wanted in Rhesus Macaque monkeys. Unconscionable decision.
The information about the early recommendations recommending hydroxychlorquine is not hidden. Other studies found no benefit of hydroxychloroquine on COVID
The RECOVERY Trial from the University of Oxford is a large, randomized, controlled, open-label study evaluating a number of potential treatments for patients hospitalized with COVID-19. The study is being conducted by researchers at the University of Oxford in the UK (the hydroxychloroquine arm is now halted).
In the RECOVERY Trial, investigators reported that there was no beneficial effect or reduction of death in hospitalized patients with COVID-19 receiving hydroxychloroquine.
In this study, 1561 patients received hydroxychloroquine and were compared to 3155 patients receiving standard care only. No difference was found in the primary endpoint, which was the incidence of death at 28 days (26.8% hydroxychloroquine vs. 25% usual care, 95% CI 0.96-1.23; p=0.18).
In addition, hydroxychloroquine treatment was associated with an increased length of stay in the hospital and increased need for invasive mechanical ventilation.
Based on this data, investigators stopped enrollment in the RECOVERY hydroxychloroquine arm on June 5th, 2020.
In a multicenter, randomized, open-label, controlled trial published in July 2020 by Cavalcanti and colleagues in the New England Journal of Medicine (NEJM), hydroxychloroquine use was studied in patients who were hospitalized with mild-to-moderate COVID-19.
Patients received hydroxychloroquine (400 mg twice daily for 7 days), hydroxychloroquine with azithromycin (hydroxychloroquine 400 mg twice daily + azithromycin 500 mg once daily for 7 days), or standard care only.
The clinical status of these patients at day 15 was not improved as compared with the patients receiving only standard care.
In addition, researchers noted that prolonged QT intervals (which may lead to abnormal heart rates and death) and elevated liver enzymes were higher in patients receiving hydroxychloroquine, either with or without azithromycin.
A randomized, double-blind, placebo-controlled trial from Skipper and colleagues was conducted in 423 outpatients (not in the hospital) with early COVID-19. It was published in the Annals of Internal Medicine in July 2020.
Patients received oral hydroxychloroquine (800 mg once, followed by 600 mg in 6 to 8 hours, then 600 mg daily for 4 more days) or a placebo (inactive treatment).
Researchers found that over a 14 day period a change in symptom severity and the percent of patients with ongoing symptoms did not differ significantly between groups, signaling no effect from the hydroxychloroquine treatment.
However, side effects were significantly greater in the group receiving hydroxychloroquine compared to placebo (43% hydroxychloroquine versus 22% placebo (P < 0.001). Rates of hospitalizations and deaths did not differ significantly.
Hydroxychloroquine has no clinical benefit and has problematic side effects. I cannot change your mind. I offer data that supports the vaccines over hydroxychloroquine in preventing serious disease or hospitalization. You reject the other data. Life goes on.
I recently saw a clip of Bill Maher discussing vaccines with Roseanne Barr. I asked myself why would I believe anything these entertainers offered regarding my health. I do pay attention when a well known pediatric immunologist like Paul Offitt questions if low risk people should still be recommended to have COVID vaccination at this stage of the disease.
28 RCTs (n=286 915 in vaccination groups and n=233 236 in placebo groups; median follow-up 1–6 months after last vaccination) across 32 publications were included in this review. The combined efficacy of full vaccination was 44·5% (95% CI 27·8–57·4) for preventing asymptomatic infections, 76·5% (69·8–81·7) for preventing symptomatic infections, 95·4% (95% credible interval 88·0–98·7) for preventing hospitalisation, 90·8% (85·5–95·1) for preventing severe infection, and 85·8% (68·7–94·6) for preventing death
I know. Another Substack writer, Jessica Rose, posted a graphic depicting the number of vaccinations kids get these days. I pulled my son's card (born 1995) and compared the two and was astonished. I also pulled the immunization card for one of my stepsons, born 1982 and was further astonished. I am convinced, despite the cries of 'that theory has been debunked' that the proliferation of kids with autism has a strong correlation to the number of vaccines, especially the multi-purpose shots. We need to revisit this nonsense.
I worked as a formally trained public health professional for 30 years until 2021 retirement. Please abolish public health- all rotten apples. Last week, I asked a PhD colleague for opinion of my “pediatric-Trans is illegitimate due to the lack of scientific evidence” statement. He refused to respond.
Well, this guest was interesting enough when he was specific, but I spent most of the interview wondering what he’s talking about. For one thing, he wants accountability but not specific standards, like complaining OSHA has too many rules when companies should just instill a “safety culture”. Okay, companies do that, and accidents still happen. Having standardized systems and practices (like yes, lighting stairwells) is pretty essential to that safety culture. The accountability comes when managers have a spine and enforce accountability both in private and public sectors.
I really don’t know what he’s talking about in schools either. Where I live, principals go into classes unannounced and regularly. And getting rid of bad teachers isn’t near the problem of finding and retaining good teachers. Education pays terribly and teachers are not sufficiently respected for their work; it really shows what we as a society value. That seems to be a much more pressing issue than teachers unions or whatever point he was trying to make.
Will have a listen later, but I'll preemptively say that I never hear a convincing argument from these anti public sector union types that addresses the main reason public sector unions were made central in the U.S.: dismantling the spoils system.
We had to go through a US presidential assassination (Garfield) to learn this lesson. Boss Tweed and Tammany Hall held NYC in its corrupt hands because of this.
When public service jobs are not defended by autonomous unions, they effectively become an army of vassals beholden to the incumbent political office holder for their job. Want that promotion? You'd better donate. Don't want to lose your contract renewal for next year? You'd better phone bank the minimum hours and sign the ledger for it.
Yes, there are a ton of imperfections even in carrying out this function independently. Merit does not always get rewarded. But at least the rank and file are able to make a career out of civil service and improve in their craft without getting swept out simply because 5000 favors were promised by someone else who got into power.
I'm not saying there isn't room for improvement either, but most critics want to wholesale do away with protections, without considering the major reasons we got to this situation, nor offer convincing stop gaps that will prevent us from regressing back to a spoils system.
The answer isn't a whole replacement with vendor contracting. It may work for single deliverables like a bridge gettting built, and be great for external compliance and audit, but it certainly isn't working for prisons, homeless shelters, environment/water management, and in education the results have been at best mixed. The major health care companies let us know loudly and clearly in 2009 as Obamacare was being debated that they did not want to be in a public vendor position either. It certainly isn't saving the taxpayer money, even with competitive bidding.
Thank you for spelling your first name correctly. Too many of us mis-spell. Your comment is an important part of the discussion. I am the fence with regard to organized labor. My Local 21 rubber-stamped any DEI position and encouraged membership to join in on DEI activity; while allowing (a): DEI to duct-tape employees mouths at home and (b) DEI to fire loud-mouths like witch-Hepworth based on fake premise.
While my position and prestige were far below that of Jordan Peterson or Amy Wax; each had components of disciplinary action identical to mine. Witch-Hepworth says “Abolish DEI”.
Without some kind of organizing to represent their collective interest as employees, who could keep their job across administrations free from reprisal for not acting as their employer's henchmen? How else would their members (and the general public, for whom they actually work, not their politician bosses) get any guarantee that competent, accomplished workers doing the public good wouldn't be replaced by less qualified party loyalists?
I'm not saying there is no possible alternative, it's just that no one's come up with a convincing one.
We need to remove one of the two; public sector unions or civil service protections. I vote to remove the former. It’s bad to have elected officials beholden to government employees.
Maybe the best guest you have had on in terms of the importance of the issues he raises - the administrative state and public employee unions. I would like to see more on these issues.
There is an argument being advanced within the profession that exploitation of physician labor by nonmedical administrators is driving doctors out of what is referred to as the Corporate Practice of Medicine. But of course, there is always an argument that the interests of patients and the personal best interests of physicians are somewhat at odds.
I look forward to listening to this discussion. I have long thought as Mr. Howard does as regards public employee unions. Having worked under two private sector unions (both while in the employ of the same company), The United Food and Commercial Workers Union and the Teamsters, and have seen first-hand the corruption in unions in general, I am not a fan, and I tend to believe that there are enough government protections for employees in any job that unions have outlived their usefulness. The majore difference that I see between private and public employee unions is the collective bargaining aspect. When my employer 'bargained' with the unions, he sent his legal representative to bargain on his behalf. This rep could only offer what he knew my employer would agree to, and could not be bought off by the unions, because ultimately, the contract would have to be signed by my employeri - no dummy. When public sector unions negotiate a contract, they are dealing with politicians who will likely not be in office when the fallout from their over-promising comes to bite - not them, but the taxpayers who are left holding the bag. Why do they overpromise? Because public employee unions can throw around large wads of cash in the form of campaign 'donations' to ensure that their employees get all that they are asking for. Not a fair fight. And while public employees enjoy their fat pensions 'guaranteed by the full faith and credit' of the government funded solely by tax revenues, retirees from the private sector will have their retirement dollars reduced by the taxes necessary to fund these fat pensions. As I tell many people, it's you and me, baby, who is the 'full faith and credit' of the government.
“The thing that is missing the most is moral authority” A quote from the conclusion of Mr Howard. I found myself nodding in agreement. Unfortunately I immediately caught myself. When we can’t agree on what a woman is, good luck with finding a consensus on what is moral. Is that not the rot on which the society is decaying?
Loved the podcast and Mr. Howard’s remarks. I am afraid our society no longer has any foundation on which to rebuild.
The concept of subsidiarity absolutely should apply to health and public health! Empowered patients and empowered doctors treating illness as it presents in individuals is the only rational way to avoid the inevitable problems which come from centralized authority insulated from the results of its policy descisions. Remdesiver was a top-down decision foisted upon doctors even after it was known how toxic it is from failed trials for ebola treatment, for goodness sake! It's odd that this discussion would carve out such a broad exception as public health while suggesting that empowering teachers in the classroom is necessary.
Maybe the reason that OHSA has 4000 rules because they scale their fines to the number of violations and it is really about funding themselves on this regulation structure and less about actually promoting workplace safety.
There is a fundamental problem with the government being its own constituency; able to elect itself.
This podcast is probably the most important one Glenn has ever had from the point of of what constitutes good government. And since government has arrogated to itself so much power and control to have the government on its knees vis a vis their employees is a denial of the entire theory of democracy. A perfect example of this to be seen in the odious Randi Weingarten calling the shots to the White House in terms of when schools in the US can reopen during the post covid period. We can never get control over our government until government unions are ruled unconstitutional and that control of government workers is returned back to the voters and tax payers where it belongs.
As a Local 21 union member, I was among the unionized civil service public employees until my 2021 retirement. Interesting discussion. Please abolish the teachers’ unions.
Good discussion. My only disagreement was his opinion that the public should follow Public Health mandates to take vaccines. My opinion has shifted on that, especially in light of the knowledge that FDA and PH employees are not the watchdogs that they are tasked with being and are beholden to the hand that feeds them rather than the public they should be serving.
This shows how the childhood vaccine schedule has changed since the pharmaceutical companies were relieved of most of their liability by the vaccine injury act of 1986.
https://x.com/insiderhcw/status/1613907309893193737?s=46
In pediatric medical training 20 years ago, we were taught that fever and lethargy could be a side effect of vaccines, but that was all normal and expected.
https://x.com/juliecobbe/status/1737661844775432365?s=46
Vinay Prasad is a brilliant young cancer doctor and researcher at UCSF. This is his analysis of the CDC current recommendations for vaccine boosters this year.
It is also important to note that Paul Offit who is a 70’ish vaccine inventor and sits on the FDA advisory board said in September he did not plan to get a booster this year due to his existing immunity.
https://youtu.be/kWYE360TK8g?si=HfjJ1fQ5gTbpvxdp
See the book Turtles all the Way Down for a good account of how all of the vaccine safety data is degenerate and referenced to OTHER vaccines as a “control”.
To prove that a treatment is in the interest of your patient, you need first a placebo controlled (or proven best practice controlled) study to prove effectiveness and safety and THEN, you need to be able to show that the treatment (such as a vaccine) has a NET benefit that outweighs the risk of harm.
Pharmaceutical companies like to cite “relative risks” and they have done this a lot with vaccines. If your risk of severe outcomes from the disease is 0.5% for example and the vaccine reduces that to 0.1% then the “relative risk reduction” is 0.4%/0.5% = 80%.
This is an ABSOLUTE risk reduction of 0.4% ARR
Do you take it? You need to know one more thing... what is your risk of a serious side effect from the vaccine? If it is much greater than the ARR you have NET HARM.
If the risk of harm is much less than the risk reduction, then you might want to get the vaccine... depending on how serious the outcome risk of infection is and your risk tolerance.
Finally, studies done prior to the the widespread outbreaks of infection of COVID have no relevance to present day effectiveness of the vaccines in people with previous exposure.
The FDA CDC and public health have proven themselves to be fully corrupt and incompetent.
Public health guidance should come from thoughtful scientists like Jay Bhattacharya and Vinay Prasad and Marty Makary... not the captured pharmaceutical company shills.
See: The vaccine injury act of 1986.
And then study the proliferation of vaccines that have developed since the pharmaceutical companies were relieved of most liability for injuries in the past 30 years
Ivermectin was tested and found to be worthless. Hospitalization and COVID death rates were lower in vaccinated people in the United Ststes. The economy of the United States began to improve faster in the United States than in other Western countries despite the shutdowns.
So why was the definition of vaccine changed?
Are you talking about the CDC or Merriam-Webster?
Do you argue that bleach, Ivermectin, and Hydroxychloroquine were more effective than vaccines, despite updating terminology?
https://www.washingtonpost.com/politics/2021/09/09/vaccine-skeptics-claim-new-cdc-gotcha-moment-they-havent-got-much/
Mr Redd.
I made no mention of Ivermectin or Hydroxychloroquine. I am perplexed as to why you mentioned them … did anyone actually claim bleach as a treatment? Could you pass along proof of that claim?
If you are not aware of the the change in the definition by those who would most benefit from it, it indicates a lack of knowledge of the governments machinations during the covid outbreak. From the myriad posts you have made in this tread you seem to posit yourself as an expert in this area.
We now have the most senior officials of our public healthcare apparatus admitting 6 feet had no basis in science nor did wearing mask. Does this not put into doubt most of their proclamations?
In my household, we have a child suffering from the side effects of a “vaccine” that allegedly doesn’t have any. Clearly, the vaccine’s benefits are marginal.
I am sorry to hear about your child’s illness. Vaccines that are currently released to the public to treat COVID have shown clear benefit. The J&J vaccine was pulled after there was a suggestion of an increased possibility of blood clots. This would not be the action taken if there were a conspiracy between the FDA and BigPharma.
Edit to add:
The fact that distancing did not work does not change the fact that vaccine use decreases the risk of hospitalization and death.
It is also the case that there was a lower risk of transmission with the initial COVID variant. The vaccines did not stop transmission of subsequent variants.
The thing with the early treatment options (emphasis on EARLY) is that the studies I have read were conducted on hospitalized patients, already quite sick, and did not follow dosing protocols that advocating physicians used. In one study on Hydroxychloroquine, one of the lead study authors had just signed on with a Pharma company developing another Covid treatment, a conflict of interest he did not disclose. Anecdotally, I personally know two people who were able to get Ivermectin EARLY and symptoms resolved within 3 days. Riddle me this: why are we not hearing from people or the families of people who tried HCQ or Ivermectin and found either to be ‘worthless’? All we hear about are the RCT’s that found them ‘worthless’. We know people were still able to find these drugs; I’d think those harmed or at least not helped would be put on blast, but that has not been the case. Curious, no?
Anecdotal evidence is not a valid means of analyzing medical data.
Hundreds of (mostly small) clinical trials were launched in the spring of 2020 to evaluate if hydroxychloroquine could prevent or treat COVID-19. According to publicly available data, 247 such trials were registered.2 In this gold rush, some of these trials competed for the same patients including, unfortunately, trials that we collectively participated in. Regrettably, before the first randomized controlled trial was complete,3 hydroxychloroquine became a cause célèbre. It was endorsed by an array of notable (and polarizing) individuals and supported by a variety of confounded observational studies. Many providers began prescribing the drug4 and patients began to either request hydroxychloroquine or, alternatively, to fear it due to the ensuing public pushback against the public promotion of this unproven treatment and a high-profile article which was subsequently retracted.5 Consequently, most outpatient trials failed to enroll to completion, and none were independently large enough to definitively refute a small benefit in this setting.
Against this backdrop, the publication in this issue of The Lancet Regional Health – Americas of a large, double-blind randomized controlled trial of hydroxychloroquine in 1372 participants with initially mild COVID-19 conducted by the COPE-COALITION V group is noteworthy and laudable.6 Although this well-designed and conducted trial fell short of its recruitment goal of 1620 infected participants – stymied by the high rate of enrolled participants in whom the infection could not be confirmed by PCR or serology – it is the largest outpatient therapeutic trial of hydroxychloroquine published to date. Like dozens of smaller trials published before, it failed to demonstrate any benefit to hydroxychloroquine in preventing progression of COVID-19 among outpatients with initially mild COVID-19.
https://www.thelancet.com/journals/lanam/article/PIIS2667-193X(22)00085-0/fulltext
I don’t find it remarkable that those who faile hydroxychloroquine did not show up in droves.
Interesting that you should post this link to the Lancet study. It is actually Dr. Boulware to whom I referred about not disclosing his conflicts of interest.
https://revivethera.com/2020/03/revive-therapeutics-appoints-dr-david-boulware-md-as-scientific-advisor-for-infectious-diseases-including-covid-19/
From what I recall, the dosing was off - and not given with Zinc and Azithromycin. Zinc and the Z-pack inhibit viral replication; HCQ is what I see referred to as a 'zinc ionophore', allowing zinc into the cell to hinder viral replication. This is the protocol that every doctor I read advocate - the three in conjunction, EARLY in the viral stages. The dosing in the Boulware study was also well north of what the advocating doctors recommended, which is what triggered the adverse reactions.
In fact, the NIH treatment guidelines used to include this information in their treatment guidelines. Knowing how uncomfortable information can sometimes disappear from government websites, I downloaded the PDF, and this is copied from an earlier version. Just as I suspected, the section on HCQ has been completely removed.
"Chloroquine is an antimalarial drug that was developed in 1934. Hydroxychloroquine, an analogue of chloroquine, was developed in 1946. Hydroxychloroquine is used to treat autoimmune diseases, such as
systemic lupus erythematosus and rheumatoid arthritis, in addition to malaria.
Both chloroquine and hydroxychloroquine increase the endosomal pH, which inhibits fusion between SARS-CoV-2 and the host cell membrane.1 Chloroquine inhibits glycosylation of the cellular
angiotensin-converting enzyme 2 (ACE2) receptor, which may interfere with the binding of SARS-CoV to the cell receptor.2 In vitro studies have suggested that both chloroquine and hydroxychloroquine may block the transport of SARS-CoV-2 from early endosomes to endolysosomes, possibly preventing the
release of the viral genome.3 Both chloroquine and hydroxychloroquine also have immunomodulatory effects, which have been hypothesized to be another potential mechanism of action for the treatment of COVID-19. Azithromycin has antiviral and anti-inflammatory properties. When used in combination with hydroxychloroquine, it has been shown to have a synergistic effect on SARS-CoV-2 in vitro and in molecular modeling studies.4,5 However, despite demonstrating antiviral activity in some in vitro systems, neither hydroxychloroquine plus azithromycin nor hydroxychloroquine alone reduced upper or lower respiratory tract viral loads or demonstrated clinical efficacy in a rhesus macaque model.6
The safety and efficacy of chloroquine or hydroxychloroquine with or without azithromycin and
azithromycin alone have been evaluated in randomized clinical trials, observational studies, and/or
single-arm studies. Please see Table 2b for more information.
Recommendation
• The COVID-19 Treatment Guidelines Panel (the Panel) recommends against the use of chloroquine or hydroxychloroquine and/or azithromycin for the treatment of COVID-19 in hospitalized patients (AI) and in nonhospitalized patients (AIIa).
So my main beef is that in the year before the 'vaccines' were introduced, which we now know did not prevent infection nor transmission of the Covid virus, this drug, when used in combination with Zinc and a Z-pak was discarded, even though they could have worked, because they didn't get the results they wanted in Rhesus Macaque monkeys. Unconscionable decision.
The information about the early recommendations recommending hydroxychlorquine is not hidden. Other studies found no benefit of hydroxychloroquine on COVID
The RECOVERY Trial from the University of Oxford is a large, randomized, controlled, open-label study evaluating a number of potential treatments for patients hospitalized with COVID-19. The study is being conducted by researchers at the University of Oxford in the UK (the hydroxychloroquine arm is now halted).
In the RECOVERY Trial, investigators reported that there was no beneficial effect or reduction of death in hospitalized patients with COVID-19 receiving hydroxychloroquine.
In this study, 1561 patients received hydroxychloroquine and were compared to 3155 patients receiving standard care only. No difference was found in the primary endpoint, which was the incidence of death at 28 days (26.8% hydroxychloroquine vs. 25% usual care, 95% CI 0.96-1.23; p=0.18).
In addition, hydroxychloroquine treatment was associated with an increased length of stay in the hospital and increased need for invasive mechanical ventilation.
Based on this data, investigators stopped enrollment in the RECOVERY hydroxychloroquine arm on June 5th, 2020.
In a multicenter, randomized, open-label, controlled trial published in July 2020 by Cavalcanti and colleagues in the New England Journal of Medicine (NEJM), hydroxychloroquine use was studied in patients who were hospitalized with mild-to-moderate COVID-19.
Patients received hydroxychloroquine (400 mg twice daily for 7 days), hydroxychloroquine with azithromycin (hydroxychloroquine 400 mg twice daily + azithromycin 500 mg once daily for 7 days), or standard care only.
The clinical status of these patients at day 15 was not improved as compared with the patients receiving only standard care.
In addition, researchers noted that prolonged QT intervals (which may lead to abnormal heart rates and death) and elevated liver enzymes were higher in patients receiving hydroxychloroquine, either with or without azithromycin.
A randomized, double-blind, placebo-controlled trial from Skipper and colleagues was conducted in 423 outpatients (not in the hospital) with early COVID-19. It was published in the Annals of Internal Medicine in July 2020.
Patients received oral hydroxychloroquine (800 mg once, followed by 600 mg in 6 to 8 hours, then 600 mg daily for 4 more days) or a placebo (inactive treatment).
Researchers found that over a 14 day period a change in symptom severity and the percent of patients with ongoing symptoms did not differ significantly between groups, signaling no effect from the hydroxychloroquine treatment.
However, side effects were significantly greater in the group receiving hydroxychloroquine compared to placebo (43% hydroxychloroquine versus 22% placebo (P < 0.001). Rates of hospitalizations and deaths did not differ significantly.
https://www.drugs.com/medical-answers/hydroxychloroquine-effective-covid-19-3536024/#:~:text=In%20this%20study%2C%201561%20patients,1.23%3B%20p%3D0.18).
Hydroxychloroquine has no clinical benefit and has problematic side effects. I cannot change your mind. I offer data that supports the vaccines over hydroxychloroquine in preventing serious disease or hospitalization. You reject the other data. Life goes on.
I recently saw a clip of Bill Maher discussing vaccines with Roseanne Barr. I asked myself why would I believe anything these entertainers offered regarding my health. I do pay attention when a well known pediatric immunologist like Paul Offitt questions if low risk people should still be recommended to have COVID vaccination at this stage of the disease.
That all comes from confounded bullshit observational studies.
You do not believe in randomized controlled studies?
Do you have one to cite? One that addresses the hospitalization rates of vaccinated people in United States?
All of those that I know of are bullshit observational studies, completely useless due to confounding factors.
28 RCTs (n=286 915 in vaccination groups and n=233 236 in placebo groups; median follow-up 1–6 months after last vaccination) across 32 publications were included in this review. The combined efficacy of full vaccination was 44·5% (95% CI 27·8–57·4) for preventing asymptomatic infections, 76·5% (69·8–81·7) for preventing symptomatic infections, 95·4% (95% credible interval 88·0–98·7) for preventing hospitalisation, 90·8% (85·5–95·1) for preventing severe infection, and 85·8% (68·7–94·6) for preventing death
https://www.cdc.gov/mmwr/volumes/70/wr/mm7036e2.htm
The study was of children and adolescents. These are the “low-risk” groups for adverse COVID outcomes.
Interesting. I will look up vaccine injury act.
I know. Another Substack writer, Jessica Rose, posted a graphic depicting the number of vaccinations kids get these days. I pulled my son's card (born 1995) and compared the two and was astonished. I also pulled the immunization card for one of my stepsons, born 1982 and was further astonished. I am convinced, despite the cries of 'that theory has been debunked' that the proliferation of kids with autism has a strong correlation to the number of vaccines, especially the multi-purpose shots. We need to revisit this nonsense.
I worked as a formally trained public health professional for 30 years until 2021 retirement. Please abolish public health- all rotten apples. Last week, I asked a PhD colleague for opinion of my “pediatric-Trans is illegitimate due to the lack of scientific evidence” statement. He refused to respond.
Well, this guest was interesting enough when he was specific, but I spent most of the interview wondering what he’s talking about. For one thing, he wants accountability but not specific standards, like complaining OSHA has too many rules when companies should just instill a “safety culture”. Okay, companies do that, and accidents still happen. Having standardized systems and practices (like yes, lighting stairwells) is pretty essential to that safety culture. The accountability comes when managers have a spine and enforce accountability both in private and public sectors.
I really don’t know what he’s talking about in schools either. Where I live, principals go into classes unannounced and regularly. And getting rid of bad teachers isn’t near the problem of finding and retaining good teachers. Education pays terribly and teachers are not sufficiently respected for their work; it really shows what we as a society value. That seems to be a much more pressing issue than teachers unions or whatever point he was trying to make.
Will have a listen later, but I'll preemptively say that I never hear a convincing argument from these anti public sector union types that addresses the main reason public sector unions were made central in the U.S.: dismantling the spoils system.
We had to go through a US presidential assassination (Garfield) to learn this lesson. Boss Tweed and Tammany Hall held NYC in its corrupt hands because of this.
When public service jobs are not defended by autonomous unions, they effectively become an army of vassals beholden to the incumbent political office holder for their job. Want that promotion? You'd better donate. Don't want to lose your contract renewal for next year? You'd better phone bank the minimum hours and sign the ledger for it.
Yes, there are a ton of imperfections even in carrying out this function independently. Merit does not always get rewarded. But at least the rank and file are able to make a career out of civil service and improve in their craft without getting swept out simply because 5000 favors were promised by someone else who got into power.
I'm not saying there isn't room for improvement either, but most critics want to wholesale do away with protections, without considering the major reasons we got to this situation, nor offer convincing stop gaps that will prevent us from regressing back to a spoils system.
The answer isn't a whole replacement with vendor contracting. It may work for single deliverables like a bridge gettting built, and be great for external compliance and audit, but it certainly isn't working for prisons, homeless shelters, environment/water management, and in education the results have been at best mixed. The major health care companies let us know loudly and clearly in 2009 as Obamacare was being debated that they did not want to be in a public vendor position either. It certainly isn't saving the taxpayer money, even with competitive bidding.
Thank you for spelling your first name correctly. Too many of us mis-spell. Your comment is an important part of the discussion. I am the fence with regard to organized labor. My Local 21 rubber-stamped any DEI position and encouraged membership to join in on DEI activity; while allowing (a): DEI to duct-tape employees mouths at home and (b) DEI to fire loud-mouths like witch-Hepworth based on fake premise.
While my position and prestige were far below that of Jordan Peterson or Amy Wax; each had components of disciplinary action identical to mine. Witch-Hepworth says “Abolish DEI”.
But the unions had nothing to do with dismantling the spoils system .. where did you get that idea?
Without some kind of organizing to represent their collective interest as employees, who could keep their job across administrations free from reprisal for not acting as their employer's henchmen? How else would their members (and the general public, for whom they actually work, not their politician bosses) get any guarantee that competent, accomplished workers doing the public good wouldn't be replaced by less qualified party loyalists?
I'm not saying there is no possible alternative, it's just that no one's come up with a convincing one.
We need to remove one of the two; public sector unions or civil service protections. I vote to remove the former. It’s bad to have elected officials beholden to government employees.
Maybe the best guest you have had on in terms of the importance of the issues he raises - the administrative state and public employee unions. I would like to see more on these issues.
Would be interesting to hear his take on unionization in healthcare. Healthcare is generally non-governmental in the U.S., but certainly occupies a special role of public service and an unusual marketplace. Some healthcare workers have long been unionized, but this is just recently become a trend with medical residents (e.g. https://www.npr.org/sections/health-shots/2023/03/23/1165539846/80-hour-weeks-and-roaches-near-your-cot-more-medical-residents-unionize).
There is an argument being advanced within the profession that exploitation of physician labor by nonmedical administrators is driving doctors out of what is referred to as the Corporate Practice of Medicine. But of course, there is always an argument that the interests of patients and the personal best interests of physicians are somewhat at odds.
I look forward to listening to this discussion. I have long thought as Mr. Howard does as regards public employee unions. Having worked under two private sector unions (both while in the employ of the same company), The United Food and Commercial Workers Union and the Teamsters, and have seen first-hand the corruption in unions in general, I am not a fan, and I tend to believe that there are enough government protections for employees in any job that unions have outlived their usefulness. The majore difference that I see between private and public employee unions is the collective bargaining aspect. When my employer 'bargained' with the unions, he sent his legal representative to bargain on his behalf. This rep could only offer what he knew my employer would agree to, and could not be bought off by the unions, because ultimately, the contract would have to be signed by my employeri - no dummy. When public sector unions negotiate a contract, they are dealing with politicians who will likely not be in office when the fallout from their over-promising comes to bite - not them, but the taxpayers who are left holding the bag. Why do they overpromise? Because public employee unions can throw around large wads of cash in the form of campaign 'donations' to ensure that their employees get all that they are asking for. Not a fair fight. And while public employees enjoy their fat pensions 'guaranteed by the full faith and credit' of the government funded solely by tax revenues, retirees from the private sector will have their retirement dollars reduced by the taxes necessary to fund these fat pensions. As I tell many people, it's you and me, baby, who is the 'full faith and credit' of the government.