Long discussions have ignited the web and social networks, the role of hydroxychloroquine as a treatment against the Covid-19. These exchanges often boil down to throwing herself at the figure the results of various studies and varied. It follows a debate of experts on the validity of the study and of the various protocols, allowing us to give everyone the opportunity to move forward with a certain bad faith, his arguments directed. In fact, it is always possible to find an argument in favour of the outcome of a study if it tends to demonstrate the inefficiency of the hydroxychloroquine, and vice versa.
When its effectiveness is not in question, we talk about its side effects. The reality is that this medication is prescribed for 65 years (1955). Its side effects and precautions of use are well documented.
A debate almost incomprehensible for the French
It is increasingly difficult for viewers or readers know where to head, the debate of experts on points of detail so small that we forget the essential : there have been deaths, too many dead and sick. While the experts in a certain medical world disconnected from the realities of struggle on the sets of tv, other doctors fought the disease without having the right to prescribe in their soul and conscience (according to the state reasonably established medical science). The study in The Lancet has done a lot of harm to patients, since it was followed by the immediate effects such as the suspension of the authorizations of prescription and delivery of hydroxychloroquine. The World Health Organization (WHO) took decisions to suspend the trial or to prohibit simply the deliverance in the city of this medicine. The Swiss did the same in the vicinity of the may 27, 2020.
The study is fraudulent and was retracted from the 4 June, but the swiss patients remained deprived of this treatment until June 11, “The FOPH has decided to lift the measures put in place for its prescription and its delivery. Plaquenil® Hydroxychloroquine Zentiva® can be ordered directly from the wholesaler.” According to the critics of hydroxychloroquine, these 15 days of prohibition would have had to be without impact on the survival of patients. However, this is not the case : just look at the evolution over time of the proportion of deaths among the new cases are resolved, to see that the hydroxychloroquine, single-molecule forbidden in this period of time, walking.
Hydroxychloroquine saves lives.
It took the collaboration of three users to solve this puzzle (see the article “history of a discovery”) : the discovery of a temporary suspension of strict of the HCQ in Switzerland, the index nrCFR* effectiveness of the treatment, the observation of a “kicker” of ~2 weeks in this index for the Swiss, the link with the suspension, and finally, the analysis concludes that the statistical significance of this correlation with a very high degree of certainty (>99%). All analyses were done using data from the international “global time series” “Deaths” and “Recovered” from Johns Hopkins University updates each night.
Hydroxychloroquine Switzerland, index nrCFR created by Michel Jullian
Let’s focus on the period in which hydroxychloroquine has been prohibited in Switzerland, that is to say, from 27 may to 11 June 2020, may 27, is 5 days after the publication of the study portrayed in The Lancet, which claimed to demonstrate the toxicity and the ineffectiveness of the hydroxychloroquine. The consequences of this publication have had a global reach resulting in the suspension of the hydroxychloroquin, and depriving many patients of treatment. This prohibition on the grounds of “precaution” has surely done far more harm to patients than what our ministers of Health have said.
Looking at the curve of evolution of this index for Switzerland, we note a “wave of on-lethality” of two weeks from 9 to 22 June, shifted a dozen days compared to the period of the suspension of the use of hydroxychloroquine by the WHO. This shows, with no rebuttal possible, the effect of the termination of the use of this medicine in Switzerland (a country that follows the recommendations of the WHO, headquartered in Geneva). During the weeks preceding the ban, the index nrCFR fluctuated between 3% and 5%. Some 13 days after the start of prohibition, the index nrCFR increases significantly to between 10% and 15% for 2 weeks. Some 12 days after the end of prohibition, the case fatality falls back to its low normal level.
What are the arguments the minister of Health, the expert in randomized, controlled studies could they object to a proof mundanely observational blatant ?
A statistically significant difference
For those of you who are not convinced of the outcome, observational, we conducted a test of statistical difference in comparing the three periods : 28 may – 8 June, 9 – 22 June, 23 June – 6 July. The period from June 9 to 22, is the one where the index has risen some 13 days after the suspension of the hydroxychloroquine. There is of course an effect of a delay between the cessation of the prescribing of the drug and the death potential, which explains the delay of 13 days.
We observe, therefore, that for the period from 28 may to 8 June, the index is 2.39% and then goes on to 11,52%, or 4.8 times more before falling back to 3%.
In making the test of statistical significance between the various observations, the difference is significant at 99% with a p<0.0001. 13 days after the resumption of the prescription of the HCQ the index moves down 3%, and it is again an effect significant.
And for France
This index for France over the same period is found in the graph below. It is noted that in the period of prohibition of hydroxychloroquine in Switzerland, the index nrCFR was almost identical between France and Switzerland.
Comparison between France and Switzerland, index nrCFR created by Michel Jullian
Editor’s Note :
Thanks to Nathalie Izzo (@Nathalienath19) and Annie Wypychowski.
*The index nrCFR was created by Michel Jullian.
Author(s): Michel Jullian and Xavier Azalbert for FranceSoir