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Hydroxychloroquine Research Is Hampered By Politics, Furor Over The Drug : Shots – Health News – NPR

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Hydroxychloroquine, a drug used to prevent malaria and treat certain autoimmune conditions, is being studied to treat or prevent COVID-19.

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Publicity around the drug hydroxychloroquine spiked this week when President Donald Trump revealed that he’s taking it to prevent COVID-19.

All the attention on the drug in recent months is increasingly spilling into science, and making it harder for some researchers to actually study whether the drug has potential for COVID-19.

Doctors have used hydroxychloroquine for decades to treat auto-immune conditions and to prevent malaria.

While the Food and Drug Administration has given emergency use authorization for doctors to try the treatment on COVID-19 patients, the agency has also cautioned about its possibly deadly side effects.

On Wednesday, the executive director of the World Health Organization’s emergencies program, Dr. Mike Ryan echoed other leading medical experts, saying at a press briefing that hydroxychloroquine and chloroquine have “yet to be found effective in the treatment of COVID-19” or for preventing the disease.

Because of potential side effects, Ryan says the WHO advises the drug “be reserved” for use in the context of clinical trials, which are now underway in many places.

But for some researchers, running such trials is becoming more difficult because of the controversy around the drug.

Missed opportunity

Dr. Jon Giles didn’t expect to have any problems drumming up interest in his clinical trial testing if hydroxychloroquine can help prevent COVID-19.

“We were getting calls all the time from people who were interested,” says Giles, an epidemiologist and rheumatologist at Columbia University.

For his study, Giles planned to give a short course of the medication to people who were “household contacts” of COVID-19 patients. Like many of the ongoing trials, it would be randomized with a control group.

By the end of April, Giles was ready to start enrolling people. But his team ran into a problem when they started calling potential participants.

“Pretty much everybody said, Well that’s the drug that’s dangerous to your heart, or, I talked to my friends and they said don’t take it, or that I saw on TV it’s dangerous,” says Giles.

Just a month earlier, he says demand for the drug was soaring. Some patients with auto-immune conditions couldn’t even get their prescriptions filled, after President Trump spoke enthusiastically about the drug.

In April, the FDA issued a warning about using the drug for COVID-19 patients without strict medical supervision in a hospital or as part of a clinical trial. The agency had received reports of serious heart-related adverse events and death in patients with COVID-19 receiving hydroxychloroquine and chloroquine.

But the back and forth headlines and the ongoing political wrangling seemed to make people wary of the medication, Giles says, even in the context of a carefully run clinical trial.

“It became almost impossible to get anyone interested,” says Giles.

Giles says the committee overseeing his study added a new requirement: that study participants needed to have had an ECG within the last year.

As a rheumatologist, Giles knows the medication better than most doctors because he prescribes it to many of his patients.

“It’s a very, very safe drug, it’s been used for over 75 years,” he says. “When I give someone hydroxychloroquine, I don’t get an ECG or do blood monitoring.”

Giles was planning to enroll otherwise healthy people and screen out anyone who could be at risk of heart problems. But that new requirement, plus the negative press, made it too difficult to find study subjects.

He gave up on doing the study. He says it’s a missed opportunity.

“It’s not unreasonable to think that a short course of this drug might have some protective ability,” he says.

Risks and potential

The concern over cardiac risk for hospitalized patients is real, says Dr. Mark Poznansky, director of the Vaccine and Immunotherapy Center in the Infectious Disease Division of Massachusetts General Hospital. Even though the drug has been used safely to prevent malaria, he says, “that is very different from using the drug in acutely ill patients with COVID-19.”

He recently published a review of the evidence for using hydroxychloroquine to treat COVID-19 that casts doubt on its effectiveness.

“The data up to date … doesn’t make one entirely optimistic that we are going to find something different in a clinical trial,” he says.

Poznansky notes a recent study of nearly 1,400 people with moderate to severe COVID-19 found no benefit and concluded that the drug should not be routinely used on patients.

He says the drug should only be used in the context of clinical trials, “or under strict compassionate use, in order to do no harm.”

Still, Poznansky doesn’t rule out that further well-designed trials could turn up better results.

‘The virus doesn’t care about politics’

At Henry Ford Health System in Detroit, cardiologist Dr. William O’Neill says enrollment for their clinical trial studying hydroxychloroquine to prevent COVID-19 plummeted in late April.

“It really caused a huge problem for us,” O’Neill says. “It set us back probably a month.”

O’Neill attributes the drop in enrollment to the FDA warning and a highly publicized study of over 300 hospitalized veterans with COVID-19. The authors of that study found the drug did not reduce the need for a ventilator and even linked hydroxychloroquine to higher death rates. However, the study wasn’t a rigorous controlled trial and the results weren’t peer reviewed.

“That was interpreted as a warning that the drug is dangerous,” says O’Neill. But he says, using it for prevention is a different matter than treating already sick patients. “Everything that we see about hydroxychloroquine suggests that the earlier you use the drug, the more likely it is to be effective.”

O’Neill says the fact that President Trump is touting this drug means it now has become a political flashpoint.

“It has made people absolutely committed to proving him wrong,” he says.

“The problem with that is this is not politics, this is life and death,” he says. “We’re talking about a treatment. Who would be rooting for us not to find a therapy, for God’s sakes?”

Multiple clinical trials involving hydroxychloroquine are underway at the University of Washington in Seattle. But Dr. Christine Johnston says recruitment has become a major challenge.

“We are hearing now from some participants that the study and the drug feel too political and they just don’t want to participate at all,” says Johnston. “As physicians, we would not do something that we thought was harmful.”

Johnston’s colleague, professor Dr. Ruanne Barnabas, is trying to recruit 2,000 patients to test whether the drug can prevent COVID-19.

“A clinical trial is the only way that we will be able to answer this question quickly and with high confidence,” she says.

Researchers at Duke University are also testing if hydroxychloroquine can be a new tool for prevention during the pandemic. But Duke professor of medicine Dr. Susanna Naggie says they need to be able to recruit enough people.

“I do worry that there are many well controlled trials that are underway where we won’t get an answer,” says Naggie. “That, I think, would be a shame.”

Another researcher conducting large trials, Dr. Wesley Self, says the coverage of hydroxychloroquine has felt a bit like an “emotional roller coaster,” which has led to more questions from patients.

“I actually find it helpful,” says Self, an emergency physician at Vanderbilt University Medical Center. We’re giving people relatively low doses of hydroxychloroquine, which we believe are quite safe. And we’re monitoring for side effects very closely.”

Self is the lead investigator of the ORCHID trial that focuses on hydroxychloroquine in treating hospitalized COVID-19 patients.

“This is a perfect situation for a clinical trial to really understand what the balance of those benefits and risks are,” he says.

Another large clinical trial is looking at whether hydroxychloroquine and the antibiotic azithromycin can keep people with COVID-19 from being hospitalized or dying.

“We think the way that this medication works, it would be better to take it early, rather than later, especially when somebody is really really sick already,” says Dr. Davey Smith, head of Infectious Diseases and Global Public Health at University of California San Diego School of Medicine.

“In reality, the virus doesn’t care about politics and science should also not care about politics,” Smith says. “I just want an answer one way or the other.”

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With debates over, Conservative leadership candidate turns to final membership push

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OTTAWA — Now that the second official debate of the race is out of the way, Conservative leadership hopefuls will turn their attention to signing up as many supporters as they can before a fast-approaching deadline.

The party’s leadership election organizing committee says it is already breaking records for how many new members candidates have drawn in ahead of the June 3 cutoff date for new members being able to vote.As of last week, officials were bracing for a voting base of more than 400,000 members by the deadline.

In comparison, the party had nearly 270,000 members signed up to vote in its 2020 leadership contest.

The six candidates vying to replace former leader Erin O’Toole met on stage Wednesday for a French-language debate in Laval, Que. — a province where the Conservative Party of Canada has never won more than a dozen seats.

A rowdy crowd of several hundred booed and cheered throughout the night as candidates took turns lacing into each other’s records, including on controversial pieces of Quebec legislation.

Ottawa-area MP Pierre Poilievre, a perceived front-runner in the race who has been drawing large crowds at rallies across Canada, repeatedly stressed his opposition to the Quebec secularism law known as Bill 21, which prohibits certain public servants in positions of power from wearing religious symbols on the job.

Former Quebec premier Jean Charest and Ontario mayor Patrick Brown — considered his main rivals — both accused Poilievre of not clearly stating his position on the law when speaking to Quebecers, which he denied.

Ontario MPs Scott Aitchison and Leslyn Lewis, as well as Independent Ontario MPP Roman Baber, are also vying to be leader.

Grassroots Conservatives are looking for leadership candidates who can draw many new faces into the party, including in Quebec where membership numbers are low.

Under new rules adopted last year, a riding must have at least 100 members in order for candidates to nab the full amount of points available to them in the ranked-ballot system used to determine a winner.

A winner is chosen when a candidate earns more than 50 per cent of the votes. In the event they don’t, whoever earns the fewest number of votes nationally is dropped from the ballot and the votes they received are redistributed to whichever candidate was marked as their second choice.

Speaking to reporters following Wednesday’s debate, which saw Charest and Brown repeatedly attack Poilievre but not one another, Charest said Brown should not be underestimated in the race.

Entering as the mayor of Brampton, Ont., Brown had a reputation in Tory circles for his ability to organize from his time as leader of Ontario’s Progressive Conservatives.

He has spent the race criss-crossing the country, meeting with different immigrant and ethnic communities, encouraging them to take out a membership in the party to change Canada’s conservative movement.

Among those he’s focused his attention on are people from the Tamil, Chinese, Sikh, Nepalese, Filipino and Muslim communities.

Brown promises them a better seat at the political table and pledges to end the lottery system to make family reunification easier. He has also spent the last few weeks equating Poilievre’s name with two of the world’s most controversial right-wing leaders — former U.S. president Donald Trump and Marine Le Pen, the far-right French politician who recently failed to win a general election.

“The guy I’m running against is trying to replicate what you’d call the Trump version of conservatism or the Le Pen version of conservatism,” Brown told Muslim community members in Surrey, B.C., last week.

In another recent address to a Muslim gathering in Burnaby, B.C., Brown took aim at the crowds Poilievre has been attracting.

“Sort of looks like a Trump rally,” he said, before criticizing the lack of racial diversity.

Brown made similar remarks during Wednesday’s debate when he accused Poilievre of trying to court the support of people akin to Pat King, a leading voice of the Ottawa convoy protest who has also espoused the so-called white replacement conspiracy theory.

Poilievre has denounced King’s remarks.

After Quebec, Poilievre was set to travel to New Brunswick, followed by Thunder Bay, Ont., Winnipeg and Saskatoon. He will bring his campaign message of “freedom” from everything from the cost of living to COVID-19 public-health restrictions.

This report by The Canadian Press was first published May 26, 2022.

 

Stephanie Taylor, The Canadian Press

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Your Promises Are empty and Similar

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“Your promises give us such a thrill,
but they won’t pay our bills,
We want money, that’s what we want(&Need).

The Political Parties in Ontario are trying to bribe us all with our own money. Election Madness, with the NDP promising should they be elected to form the next government, they would set a weekly price cap on the price of gasoline. The Conservatives have promised to temporarily cut the gas tax starting in July. Liberal Steven Del Duca says price caps do not work, while the NDP claims tax cuts do not prevent Energy Corporations from raising their prices.

The Liberal’s platform plank regarding Transit points to a buck-a-dollar ride. The NDP is calling for free transit (possibly in certain regions).

The Doctor shortage is easily solved, so The NDP claim, by hiring 300+ more doctors and thousands of nurses. Their pay will have to be very high in order to attract professional medical talent to Ontario. Medical Professionals have moved to The USA, receiving salaries and enticements many of our current medical pros could only dream of.

So we have political leaders promising billions of dollars to attract our attention and hopefully our vote. Where this money is coming from is usually not discussed. Real numbers are never presented. We have experienced massive spending these past three years, and the international and domestic lenders are demanding to be repaid, yet these promises continue. Not one Political Leader has the courage to tell us the truth, believing we “cannot handle the truth”, but that we would rather sit in the glow of imaginary promises that one only hears during an election.

A powerHouse Premier with a broad array of accomplishments, a Liberal Leader trying to gain a few seats and save His leadership status, a NDP Leader whose very political life is under review(She does not win, She’s gone), a Green Party Leader also seeking a few more seats. That is their political state presently. We are waiting for certain tax increases to come. Someone has to pay for these political visions of future circumstances. The bills and invoices are in the mail, and will certainly arrive this July.

“Politicians are the same all over. They promise to build bridges even when there are no rivers”.(N.K)

Steven Kaszab
Bradford, Ontario
skaszab@yahoo.ca

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Opinion: The paranoid style in Conservative politics has deep roots – The Globe and Mail

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Here are some of the things certain candidates for Conservative leader think, or want Conservative voters to think, threaten Canada and Canadians.

Candidate Pierre Poilievre warns his followers that the government of Canada “has been spying on you everywhere. They’ve been following you to the pharmacy, to your family visits, even to your beer runs.”

The government hasn’t been doing anything of the kind, of course: A private company prepared a report to the Public Health Agency of Canada on population movements during the pandemic, using anonymous, aggregated cellphone data. The data allow researchers to count how many people visited a pharmacy or a beer store, not which people did; still less are individuals followed from place to place.

But Mr. Poilievre knows his followers don’t know this, and is quite content to mislead them. Just as he is when he claims he opposes allowing the Bank of Canada to issue a digital version of the dollar because the government would use the data generated thereby to “crack down” on its “political enemies.”

The point isn’t that such data couldn’t be misused in this way. The point is that Mr. Poilievre asserts, without evidence, that it is happening now, and assumes, without evidence, that worse will happen in the future – not as a possibility to be guarded against, but as an inevitability. This is the very definition of fear-mongering. Or, indeed, conspiracy theory. It encourages not prudent skepticism of government’s capacity, but baseless paranoia about government intentions.

But this is statesmanship itself next to the fears he and others have been spreading about the World Economic Forum, which sponsors an annual gathering of business and political leaders in Davos, Switzerland, that is the grand obsession of conspiracy theorists everywhere.

Mr. Poilievre hasn’t come right out and said what he thinks the WEF is up to (unlike former Conservative leadership candidate Derek Sloan, now the leader of the Ontario Party, who earlier this month accused the organization’s leaders of plotting to put microchips in “our bodies and our heads”), but he has made a point of saying that he will ban any member of his cabinet from attending its meetings – though several members of Stephen Harper’s cabinet did, including Mr. Harper himself.

Trudeau’s advantage: His house united, the other divided

Australia’s ‘teal wave’ is a wakeup call for Canada’s Conservatives

Then there’s candidate Leslyn Lewis, whose particular fear is the World Health Organization, or more precisely a package of amendments to its International Health Regulations put forward earlier this year by the United States. The amendments seem chiefly aimed at preventing the sort of information vacuum that hampered efforts to contain the coronavirus in the early days of the outbreak, notably stemming from China’s refusal to level with the world about what it had on its hands – but also abetted by the WHO’s own credulousness.

Thus, a critical amendment would require the WHO, should it find there is a public-health emergency “of international concern,” and having first offered assistance to the affected country, to share information with other countries about it, even if the first country objects. (Until now it had been left to the WHO’s discretion.) In conspiracy circles this has been cooked up into an open-ended power for the WHO to force countries into lockdown, take over their health care systems, even, in Ms. Lewis’s formulation, suspend their constitutions.

Where does one begin? The WHO does not have the power to dictate policies to member states. No country would ever agree to give it that power, let alone all 194 member states at once. And of all those countries, the least likely to agree to any such transfer of national sovereignty, let alone propose it, is the United States: the country that, for example, refuses to this day to participate in the International Criminal Court. The only way it could be done even in theory would be by passing the necessary enabling legislation through each country’s legislature, not by simply ratifying an amendment to a regulation.

We’ve been this way before. Remember the Global Compact for Migration? That anodyne collection of best-efforts promises of international co-operation in dealing with the world’s refugees was the subject of an earlier Conservative panic attack. Supposedly we would be permanently surrendering control of our borders to United Nations bureaucrats. It hasn’t happened, because that’s not actually how the world works.

Neither did Motion 103, a non-binding resolution of the House directing that a committee hold hearings on Islamophobia, lead to a ban on criticism of Islam, as still another Conservative fear campaign had claimed. Probably some of its proponents understood this at the time, but lots of their supporters didn’t.

And so it continues. Vaccine mandates become “vaccine vendettas.” Carbon pricing is equated with Chinese-style “social credit” scores. The Bank of Canada’s purchases of government bonds in the middle of the sharpest economic contraction since the Great Depression are depicted as if they were directly bankrolling the Liberal Party.

This cynical act is sometimes dressed up as “sticking up for the little guy” or “taking on the elites.” It is not. It is exploitation, pure and simple, shaking down the gullible for money and votes. It’s a con as old as politics. Before Mr. Poilievre can promise his audience to “give you back control over your lives,” he has to first persuade them that control has been taken away from them – and that he alone has the power to give it back. Or rather, that they should give him that power.

Populism has deep roots in the Conservative Party, at least since John Diefenbaker gathered the disparate populist movements that had sprung up in the West under the Progressive Conservative banner. As the party of the “outs,” those who for one reason or another were excluded from the Liberal power consensus, it has always tended to attract its share of cranks – not just populists but crackpots.

What’s different today? Three things. One, the targets of populist wrath are increasingly external to Canada: bodies like the WEF or the WHO, whose remoteness from any actual role in controlling our lives only makes them seem more darkly potent, to those primed to believe it.

Two, the “outs” no longer simply reject a particular political narrative, but increasingly science, and reason, and knowledge: the anti-expertise, anti-authority rages of people who have been “doing their own research.”

And three, the crackpopulists used to be consigned to the party’s margins. Now they are contending to lead it.

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