Treatment options for Covid patients
Against Corona, the FOPH relies on patent-protected medicines and ignores cheaper and, above all, much more effective alternatives
by Werner Vontobel
(12 January 2021) The Federal Office of Public Health (FOPH) knows how to avoid infection with Corona. But as far as the treatment of the disease is concerned, it has learned nothing. It continues to maintain that the new virus can only be combated with a completely new – and thus patent-protected – drug. Of the many patent-protected candidates, however, only Remdesivir from the US pharmaceutical company Gilead remains. The nine "other important drugs" listed on the homepage are painkillers and anaesthetics for the late phase of the disease.
RKI: "Remdesivir had no influence"
And Remdesivir does not really help either. In a "Scientific Consensus Statement" there is not a word about a curative effect, but merely that it should only be administered when the patient is suffering from oxygen deprivation. It goes on to say that the FOPH has obtained sufficient supplies of Remdesivir and that it costs 390 dollars per injection or 2340 dollars per 6-day treatment. Gilead is obviously getting its money's worth.
What good the expensive drug does can be read at the Robert Koch Institute (RKI): "According to the data of the WHO Solidarity Study, the use of Remdesivir has no influence on the duration of hospitalisation as well as on the need for mechanical ventilation." However, similar to the FOPH, the RKI also allows a 5-day treatment as soon as possible after the onset of respiratory distress. The EU has also bought Remdesivir worth 1.2 billion euros in advance.
Non-patented alternatives are better than Remdesivir
Of course, there are also differing trials on Remdesivir. The most optimistic one comes – who is surprised? – from the manufacturer itself and reports a relative reduction in mortality of 38 per cent. But even if we take this optimistic figure as a yardstick, the following active substances have shown even better results in trials:
Aspirin: reduction in mortality of 47 per cent. In this trial at the Medical School of Maryland, 412 Covid patients were divided into two groups: those who had previously taken aspirin and the aspirin abstainers. (trial here)
Hydroxychloroquine (HCQ) in the early stages: 66 percent lower mortality. This was the result of a meta-analysis of 26 trials in which HCQ was used shortly after diagnosis. In only two of the studies was the reduction lower than the 38 percent that Gilead reported for Remdesivir. In six studies, mortality was even reduced by more than 80 percent. The learning process for the use of HCQ is probably not yet complete. (trial here)
Black cumin plus honey: 78 per cent lower mortality even in severe cases; and 100 percent lower mortality – i.e. none at all – in mild cases. The study was based on 313 Covid patients in a hospital in Pakistan, where black cumin and honey are traditional remedies. Why not try it out on COVID-19? (trial here)
Azithromycin (AZT) in the early stage: 84 per cent fewer hospitalisations, only 1 death per 141 patients compared to 13 out of 377 in the control group – although this figure is not significant because of its small size. AZT was supplemented with zinc and small doses of HCQ. (trial here)
Ivermectin in the early stage: 87 per cent reduction in mortality compared to usual treatment, 48 per cent reduction in severe cases. This is a meta-analysis of 28 studies mostly from developing countries where covid-19 is mostly treated with HCQ and azithromycin. (trial here)
Vitamin D3: 96 per cent reduction in ICU admissions. In this randomised, double-blind trial in Cordoba, mortality was even reduced from 15.4 to 0 per cent, but because of the small number of patients, this figure was not significant. In this study, Covid patients were treated with high doses of the active form of vitamin D immediately after admission to hospital. In addition, there are many studies that show the effectiveness of vitamin D3 as a preventive measure or immediately after infection. (trial here, supplementary trial here)
The list is far from complete. For example, very good results are reported from Brazil and Vietnam with gargling with antiseptic mouthwashes; no wonder, since the virus enters through the mouth and nose. Of course, there are question marks behind all these studies: none is nearly as comprehensive as the one with Remdesivir, which included a total of more than 11,000 patients in 405 hospitals in 30 countries. Many also have methodological shortcomings such as unequal control groups, inadequate documentation, etc. But overall, it is hard to avoid the realisation that there must be better therapies than Remdesivir.
Early treatments are indicated
This must be the case above all because Remdesivir is very expensive and, because of the strong side effects on the kidneys, it can only be used after extensive examinations in hospital – and thus usually much too late. The alternatives mentioned above, on the other hand, hardly ever cost more than 20 Swiss francs [= US$ 22] (AZT about 40 Swiss francs) per treatment, can be used on an outpatient basis – i.e. early and preventively – and their few side effects are known and easy to control. HCQ, for example, was available without prescription in France just a year ago.
So what is the average citizen supposed to do with this information? Probably the most important finding from all these studies is that it is best to treat Covid-19 as early as possible, i.e. at the GP level. But they cannot be expected to scrape together all this information on the internet and evaluate it. This learning process should be orchestrated by the FOPH and the medical associations.
Homework not done
But they have obviously not done their homework and have not learned anything. The FOPH homepage still says: "Covid-19 cannot be cured with antibiotics, because these only work against bacteria and not against viruses." And why do the antibiotics AZT or Ivermectin apparently work after all? If you ask specifically, the FOPH declares itself not responsible: "Treatment recommendations for possible COVID-19 therapies that you have listed are made by the medical societies and not by the FOPH." One should please turn to the competent professional bodies. That would be the Zurich Medical Association, for example. But even this does not help the family doctors. Under "Recommendations for dealing with persons with the disease", GPs are only told: "All persons tested positive should isolate themselves.”
But this is not how a doctor is supposed to deal with his patients. The white coat obliges them to give patients hope: "take X, that has helped everyone." Even if all the therapies mentioned were only half as effective, the doctor would have to prescribe at least one of them – if only because of the placebo effect.
More nocebo is not possible
A maximum nocebo effect,* on the other hand, is achieved when the GP has to say on the orders of the FOPH: "There is nothing I can do for you. Isolate yourself, and if you have difficulty breathing, I will have you admitted to hospital." That sounds ominous: according to the FOPH, 14,471 Covid patients have been hospitalised since the beginning of October, and 5,613 (or 39 per cent) have died – though not all of them in hospital. Nevertheless, the risk of hospitalisation is about as high as pulling the trigger twice with a six-shot revolver in Russian roulette. More nocebo is not possible.
Source: www.infosperber.ch from 12.01.2021
(Translation «Swiss Standpoint»)
* Just as the term placebo effect refers to the positive effect of a mock treatment (e.g. administration of tablets without active substances), nocebo effect refers to its negative consequences [editor's note].