Source: Brasil Sem Medo
Study that rejects hydroxychloroquine use in Covid-19 patients is not science, but instrumentalization of science.
The twilight of quinine
A study published in the prestigious scientific journal The Lancet , on the 22nd, seemed to definitely change the direction of the public debate on the use of chloroquine and hydroxychloroquine in the treatment of symptoms of Covid-19.
Commanded by Mandeep Mehra, an Indian cardiovascular disease specialist who teaches at Harvard, USA, and has 5,000 citations in his curriculum, the study collected more than 96,000 samples from patients infected with the coronavirus, of which about 15,000 were subjected to some type of treatment with antimalarial – either alone or in association with macrolides, such as azithromycin.
Comparing the results of the 15 thousand patients who underwent some type of treatment with chloroquine and hydroxychloroquine with the 81 thousand who did not use any combination of these drugs, the conclusion was devastating:
We have not been able to confirm a benefit in hospital use of chloroquine or hydroxychloroquine in patients diagnosed with Covid-19, either used alone or in combination with a macrolide. Each of these treatments was associated with both a decrease in the number of recovered patients and an increase in cases of ventricular arrhythmia.
Simply put: chloroquine is bad.
Based on this result, the World Health Organization (WHO) announced that it will not even start a clinical study involving scientists from 100 countries on the effectiveness of treatment with chloroquine and hydroxychloroquine, as planned.
The hammer was beaten: hydroxychloroquine sucks. Science seemed to have given its verdict.
Note on the scientific method
However, we know that there is no verdict of science, as if we could consider science to be a single and unanimous monolith that comes out trumpeting indisputable truths. In the real world what exists is the word of that particular scientist, or, at most, that group of scientists. However, even the group of scientists, however vast and multifaceted, is never science incarnate. It is always a group, a group that can be contested and eventually refuted by other private scientists or by other groups, smaller or larger.
That is to say, science always progresses by dialectical confrontation, not by exclamations that take on the appearance of apodictic need simply by the number of voices that shout them or by the international organ that serves as a megaphone.
The politicization of the pandemic
For Dr. Mehra’s study was put on the table for discussion and many leading researchers have declared that due to his methodology he is practically useless – at least to assess the object he proposed.
One of these challenges came from Brazil.
Representative of a group of 300 scientists, 25 of whom signed an open letter to, they say, pseudoscientists who are politicizing the pandemic, chemist laureate Marcos Eberlin – who has over 25,000 citations in academic articles – gave an interview to the French newspaper Frances Soir to expose her impressions of the study. In the conversation, Marcos was adamant:
“When we received the publication from The Lancet , by Professor Mehra, we were shocked. We first tried to understand the merits of the study, but very quickly the group realized that it was an effort to discredit hydroxychloroquine and dual therapy ”
Marcos Eberlin
[Dual therapy is how the combined therapy of hydroxychloroquine and azithromycin became known and administered by the acclaimed French virologist Didier Raoult, doctor and researcher who adds more than 150 thousand citations in scientific articles]. (Emphasis added.)
And he continued:
“ We analyzed the research and all 300 were sharing the work. Everything seemed questionable to us: the methodology, the sampling, the statistical methods used. For example:
* the dosage of hydroxychloroquine administered (1.2 g) [Dosage considered lethal according to the alert of Dr. Paolo Zanotto, virologist at USP with 7.5 thousand citations. It is worth mentioning that this dosage was the same that caused a series of deaths in an experiment in the state of Amazonas];
* the selection was not random[I mean, it was not a randomized test, as Dr. Mehra himself admitted in an interview with the same France Soir. He said: ‘The set of patients represents a very homogeneous population and, to be completely honest with you, we applied all the principles of scientific research to conduct a study closer to a randomized clinical trial. But it would still be very unscientific on my part to say that this is a randomized clinical study because it is not. And we will never know if we have lost certain factors or effects. ‘ The randomized test is the most suitable to evaluate the effectiveness of a pharmacological therapy];
* patients received hydroxychloroquine even though they had heart problems, which could not be done. It is a gross medical error to give this medicine to patients suffering from heart problems;
* the study implied that the patients observed had just been diagnosed when they received treatment two days after going to the hospital; but in fact it had been ten days since they had Covid-19 ” . [Enthusiasts for the use of these drugs for patients infected with the Chinese virus claim that the efficacy is precisely in the early treatment, started in the first 48 hours after the patient started to present the symptoms. Now, if the patient needed to be hospitalized, it is because he was already with the disease in an advancing state, and, in patients like this, all specialists agree, the treatment with hydroxychloroquine is really little or not effective];
And he concludes:
“ Medical science requires that all these factors be taken into account. This is not science, it is an instrumentalization of science. We were all shocked because that is what destroys science’s reputation. ”
Marcos Eberlin
For Eberlin, all these distortions or ambiguities are explained by a politicization of the pandemic, politicization that would be marking the scientific debate. Taking the Brazilian case as an example, he says that there is a clear relationship between, on the one hand, those who support President Bolsonaro and consequently bet on chloroquine, and, on the other, the opponents of the president, a group that fights day and night to discredit the remedy.
There is also, according to the scientist, a dispute of interests in the pharmaceutical industry:
“In addition to the political part, we were able to link this study to large pharmaceutical laboratories. A member of the group just told me about links between a ‘respirator’ company and people who contributed to this study ”.
In the land of kangaroos
Aside from the reactions of scientists from around the world, such as Dr. Raoult himself and researchers at Columbia University, Mehra’s study was involved in a controversy over data incompatibility.
On Thursday (28), a report in the British newspaper The Guardian showed that health authorities in Australia contested the data of deaths by Covid-19 reported in the survey. While the work claims that by April 21, 73 Australians were victimized by Covid-19, data from Johns Hopkins University show that until that day the number of deaths was at the mark of 67 people.
After that, the Australian Federal Department of Health confirmed the incongruity and stated that the researchers did not take information from the National Disease Notification System as a source. In the same vein, hospitals in the two locations most affected by the pandemic, Victoria and New South Wales, have attested to the same incompatibility in the numbers of Dr. Mehra and his team.
Consulted by the English newspaper The Lancet stated:
“We asked the authors for clarification. We know that they will be urgently investigated and we await their answers ”.
In response, Dr. Sapan Desai, one of the authors of the survey [not found on Google Scholar], said the figures were taken from a data collector he founded, Surgisphere. The justification for the error, announced by Dr. Desai himself, is that data from an Asian hospital was mistakenly added to Australian statistics.
To this, Dr. Allen Cheng, an important epidemiologist from Melbourne, Australia, – with about 16 thousand citations – questioned:
“If they get it wrong, what else could not be wrong?”
Furthermore, Dr. Cheng questioned the small number of researchers, only four, involved in such a vast and complex work:
“Generally, in studies that investigate thousands of patients, you see a large list of authors … Multiple sources are needed to collect and analyze data for a broader study, and we generally see this recognition in the list of authors.”
Cheng added that it would be a mistake to abruptly stop clinical tests with hydroxychloroquine.
Conclusion
It was on the basis of this at least questionable study that the World Health Organization (an organisation that in itself has been severely criticized by heads of state, such as Trump and Taro Aso, Japan’s deputy prime minister, on account of their repeatedly favorable positions towards China), prompted several countries to discard treatment with chloroquine.
This is what public debaters are defending as scientific seriousness against denialist obscurantism.
Tupiniquim addendum
Meanwhile, the Brazilian National Health Council, under the command of PT activist Fernando Zasso Pigatto, is recommending as treatments for plague: therapies with flowers, homeopathies, reiki and acupuncture. Obviously, the National Health Council is against the use of hydroxychloroquine.
Related: LancetGate: Surgisphere – is the company which provided the data to the study serious?
