Yale epidemiology professor Harvey Risch has hit back against critics who say he's been the subject of personal attacks over his insistence that hydroxychloroquine is highly effective in treating COVID-19 if administered early in the disease's progression.
In a Washington Examiner Op-Ed, Risch writes that the pushback against his advocacy for the drug has been "furious."
Dr. Anthony Fauci has implied that I am incompetent, notwithstanding my hundreds of highly regarded, methodologically relevant publications in peer-reviewed scientific literature. A group of my Yale colleagues has publicly intimated that I am a zealot who is perpetrating a dangerous hoax and conspiracy theory. I have been attacked in news articles by journalists who, ignorant of the full picture, have spun hit pieces from cherry-picked sources. -Harvey Risch
Risch says the personal attacks are a "dangerous distraction from the real issue of hydroxychloroquine's effectiveness, which is solidly grounded in both substantial evidence and appropriate medical decision-making logic."
He adds that there a no studies - published or in pre-print - which disprove his theory that HCQ should be used on high-risk outpatients, and that "assertions to the contrary, whether by Faucci, the FDA, or anyone else, are without foundation. They constitute misleading and toxic disinformation."
Covid-19 has 'two main stages' according to Risch, and HCQ works well in the first, but not the second, later stage of the disease:
At the first stage, it is a flu-like illness. That illness will not kill you. If you are a high-risk patient and begin treatment immediately, you will almost certainly be done with it in a few days. When not treated, high-risk patients may progress. The virus then causes severe pneumonia and attacks many organs, including the heart. In this second stage, hydroxychloroquine is not effective.
So, as Risch points out, it's important to distinguish which patients HCQ works best for; "Does it not work in those who have just started to have symptoms, or those sick enough to require hospitalization?"
Secondly, Risch notes that most low-risk patients, those below 60 with no underlying comorbidities, typically survive without treatment. High risk patients are those over the age of 60, or those with chronic conditions such as obesity, diabetes, hypertension, and immunocompromised individuals.
"High-risk patients need immediate treatment when they first show symptoms," Risch writes. "One should not wait for the COVID-19 test result, which can take days and be wrong."
Every randomized controlled trial to date that has looked at early outpatient treatment has involved low-risk patients, patients who are not generally treated. In these studies, so few untreated control patients have required hospitalization that significant differences were not found. There has been only one exception: In a study done in Spain with low-risk patients, a small number of high-risk nursing home patients were included. For those patients, the medications cut the risk of a bad outcome in half.
I reiterate: If doctors, including any of my Yale colleagues, tell you that scientific data show that hydroxychloroquine does not work in outpatients, they are revealing that they can’t tell the difference between low-risk patients who are not generally treated and high-risk patients who need to be treated as quickly as possible. Doctors who do not understand this difference should not be treating COVID-19 patients. -Harvey Risch
Read the rest of Risch's Op-Ed here.