Dr. Lanny

NEJM; Flush it!

The once prestigious New England Journal of Medicine recent publication on July 23, 2020 is misleading to say the least. “Hydroxychloroquine with or without Azithromycin in Mild-to-Moderate Covid-19 from study in Brazil resulted in news reports that this medication was not effective in mild to moderate cases of Covid-19. The news reporter likely read the title and not the manuscript. A reader of the news article would justifiably presume these were early cases of mild to moderated magnitude.
However, the news report read by more people than the manuscript was misleading to say the least. There was no mention about the patient cohort studied in this news publication. The inclusion criteria for the patient population in the NEJM study was a magnitude of infection such that it required hospitalization. Furthermore, some of the hospitalized patient’s conditions were such they required supplemental oxygen. Then the NEJM accepted the hospitalized patient as designated; mild to moderate classification.

I read the news report as mild to moderate condition of the patients studied being early cases. If I read only the NEJM title I would have come to a similar conclusion. The patients studied had mild to moderate condition, presumptively of early onset and not a group reported upon that were so sick they were hospitalized and some on oxygen.

In addition, follow up reports on clinical studies by reputable journals require at least a one to two years. The term of this study was just 15 days before gaining headlines. It is unlikely to find a competing world record short term report published by NEJM citing information to the contrary.

I am not privileged to the NEJM’s publication policies, bias or political agenda. I do not know if the news reporter read beyond the journal headline. I do not know their policies or agenda.
Whatever the reality, this is an all-time low in medical and news journalism. Flush it!

7/26/2020

Coronavirus in perspective.

7/9/2020: To date there have been 544,739 deaths due to the coronavirus.
https://covid19.who.int/?gclid=Cj0KCQjwgJv4BRCrARIsAB17JI59AtdDLhLPtxu0fad1zakLXArmfNrNmzXCXrFRxomaayLunQbmhlgaAvMgEALw_wcB

To put this in perspective see the following from:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6747855/#bibr6-1176934319876938

Influenza A is one of the deadliest infectious diseases in human history, and it can be ranked equally with the bubonic plague in the ability to create large-scale fear and terror despite the great effort of humans to control it.1-3 From the first outbreak in 1918, called the “Spanish flu” and caused by the H1N1 strain, influenza A has killed 4 to 5 times more people than the number of casualties in World War I.

The following site estimated 50 million died, one-third of the world’s population at that time.

https://www.livescience.com/spanish-flu.html

In 1957, the Asian flu, caused by influenza A H2N2, began in China and spread around the world, killing 1.1 million people in total.3

Ten years later, a new strain of H3N2 lead to the eruption of a new pandemic called the “Hong Kong flu” that caused the death of 1 million people.3

In 2009, the strain that caused a deadly pandemic in World War I returned with a new type called H1N1pdm09; the result was approximately 575,000 deaths.3 Along with the deadly strains that infect humans, other strains, like H5N1, cause problems that can indirectly and catastrophically effect humans.4 The H5N1 outbreak appeared in Vietnam in 2003 when a massive avian infection led to the forcible killing of poultries, crippling the agriculture industry.4

Le KP, Do PC, Amaro RE, Le L. Molecular Docking of Broad-Spectrum Antibodies on Hemagglutinins of Influenza A Virus. Evol Bioinform Online. 2019;15:1176934319876938. Published 2019 Sep 16. doi:10.1177/1176934319876938.