Chloroquine Poisoning and Deaths But "Hey It Works"

Mish

Despite little evidence it work, a rush to buy Chloroquine pushed prices up 400%, and that's not all.

Dear Kyle Bass

Chloroquine Poisoning

Please pay attention to this report by the Johns Hopkins Center for Health Security regarding Chloroquine Poisoning

The drug chloroquine, currently being investigated as a potential treatment for COVID-19, resulted in multiple overdose deaths in Nigeria. In the short period after the drug was touted by US President Donald Trump, prices reportedly skyrocketed by more than 400% in some locations due to increased demand, despite a dearth of evidence indicating that it is effective against COVID-19.

Over the weekend, Nigeria reported several deaths due to “chloroquine poisoning." In response, Lagos State Health Commissioner Akin Abayoi published a video via the Lagos State Ministry of Health Twitter account warning against the unlicensed use of chloroquine and emphasizing that it has yet to demonstrate efficacy against COVID-19, and Nigeria’s Minister of Health Osagie Ehanire echoed the need for additional data in a statement posted on the Nigeria Ministry of Health website.

I believe we need a review of the definition of "Works"

Mike "Mish" Shedlock

Comments (96)
No. 1-43
tokidoki
tokidoki

Not sure how Kyle Bass can stay in business for so long. So he got the mortgage crisis right, but since then, he's been wrong pretty much EVERY SINGLE TIME.

I also would not trust a hedge fund manager who is nationalistic. His number one job is to earn returns for his clients, not be a right winger.

Total loser. Conflating anecdotes with .... "data".

Corto
Corto

Mish, seems those are cases of self medicating, likely, "more is better" mentality.

Nigeria reported two cases of chloroquine poisoning after U.S. President Donald Trump praised the anti-malaria drug as a treatment for the novel coronavirus.

Health officials are warning Nigerians against self-medicating after demand for the drug surged in Lagos, a city that’s home to 20 million people. Two people were hospitalized in Lagos for chloroquine overdoses, Oreoluwa Finnih, senior health assistant to the governor of Lagos, said in an interview.

“Please don’t panic,” she said via text message. “Chloroquine is still in a testing phase in combination with other medication and not yet verified as a preventive treatment or curative option.”

Tony Bennett
Tony Bennett

If anyone looking for evidence in flattening of the curve today … check the bond market.

Greggg
Greggg

Take as directed in Nigeria probably means if some works good, more would be way better. Nobody is going to overdose on 400 mg of hydrochloroquine. It does have side effects though.

njbr
njbr

For all you believers--where are the manufacturers of these magic compounds? China? India? Spain?

Has anyone bothered to find this out yet?

Jackula
Jackula

I have 100 grams I purchased over a month ago, thanks for the heads up. More data... COVID-19
Chloroquine Is Not a Harmless Panacea for COVID-19

— There's a real safety concern with malaria drug

Dan J. Vick MD, DHA, MBA, CPE March 23, 2020
A close up of a chloroquine tablet in a package
During a March 19 press conference, President Trump announced that chloroquine, a drug long used to treat malaria, was going to be made available for those stricken with COVID-19. This followed news of preliminary research, including a limited study in Australia, in which chloroquine showed promise in eradicating the coronavirus in some patients. Chinese research published in February suggested efficacy and safety of chloroquine in treating pneumonia associated with COVID-19. A subsequent Chinese study involving the use of both chloroquine and its molecular cousin, hydroxychloroquine, determined that hydroxychloroquine is the more potent of these two drugs in its inhibition of this novel coronavirus.

Controversy enveloped the announcement by the president, especially after he indicated that chloroquine has already been approved for this use by the FDA. The agency's commissioner, Stephen Hahn, MD, quickly clarified that larger studies still need to be conducted to determine the safety and effectiveness of chloroquine for treating COVID-19. Much of the discussion that continued in the media throughout the day concerned whether the drug will truly prove effective and, if so, how long will it be until this medication gets the green light for patient use. There was also confusion as to which drug is under consideration since some reports, and the president himself, made mention of hydroxychloroquine as well. The distinction is important, as will be seen shortly.

While others are focusing on the drug effectiveness component in this debate, I am more concerned about the safety with regard to chloroquine. What I haven't seen mentioned is the contraindication for use of the drug in people who have glucose-6-phosphate dehydrogenase (G6PD) deficiency. For those who need a refresher from medical school, G6PD deficiency is an X-linked recessive genetic condition, and therefore almost always occurs in males. It is found predominantly in people of African or Mediterranean origin. As a result of mutations in the G6PD gene, the amount of G6PD is either reduced or its structure is significantly altered so that it cannot perform its usual enzymatic functions.

G6PD has two primary functions: it plays a role in carbohydrate processing and, important for this discussion, it helps protect cells from the harmful effects of free oxygen radicals. These reactive oxygen molecules are byproducts of normal cell function. G6PD is involved in a chemical reaction known as the pentose phosphate pathway and produces another molecule called NADPH. The latter has a direct role in ridding cells of the free oxygen radicals before they build up to toxic levels. This function is especially essential for red blood cells, which, unlike other cells in the body, lack additional NADPH-producing enzymes.

In the presence of a buildup of reactive oxygen species, red blood cells are prematurely destroyed, causing a condition called hemolytic anemia. This can result in jaundice, shortness of breath (from decreased oxygen carrying capacity of the remaining red blood cells), and tachycardia. In severe cases, it can cause acute kidney failure and death. However, many people with G6PD deficiency are asymptomatic and not aware that they have it until something triggers an episode of hemolytic anemia. Common triggers include bacterial or viral infections and treatment with certain drugs. One drug commonly associated with hemolytic anemia in G6PD deficiency is ... chloroquine.

Should this be a concern in the present debate over treating COVID-19 patients? In my opinion, yes. G6PD deficiency is rather common; in fact, it is the second most common human enzyme defect, affecting some 400 million people worldwide. It affects 1 in 10 African-American males in the U.S. It is common enough that it was written into an episode of the long-running TV series MAS*H. In this episode, the character Corporal Klinger, who was of Mediterranean descent, became seriously ill after being given an anti-malarial drug. He was found to have hemolytic anemia and an association was made with the drug. The ending credits included a brief commentary on G6PD deficiency.

Given the challenges of knowing who may or may not have G6PD deficiency, it would seem prudent not to use chloroquine to treat COVID-19 patients who may be at risk for this genetic condition. The last thing they need is to have a serious respiratory disease compounded by hemolytic anemia, resulting in further loss of oxygenation.

Hydroxychloroquine, on the other hand, does not induce hemolytic anemia in people with G6PD deficiency despite the molecular similarity to chloroquine. It has shown effectiveness in inhibiting the pandemic coronavirus during in vitro testing. Perhaps this is the drug to which the president and Hahn were referring. Hydroxychloroquine is where the FDA should direct its testing efforts, and quickly, to determine whether this may be the silver bullet for treating COVID-19.

Dan J. Vick, MD, DHA, MBA, CPE, a pathologist and former hospital executive, is a member of the graduate teaching faculty in the Master of Health Administration Program, School of Health Sciences, in the Herbert H. & Grace A. Dow College of Health Professions at Central Michigan University in Mount Pleasant.

Last Updated March 23, 2020

Maxx2000
Maxx2000

Mish, I highly respect your column and recommend it often. I am appalled that you obviously are spouting off here without doing any research. There is more than "one case". Please do a few more key strokes and find huge anecdotal evidence of efficacy. Please refer to WSJ of March 23rd. This is a highly proven drug that was discovered in 1934. Of course morons and children can poison themselves even with Tylenol. Clearly this is downplayed because of optics and politicism. Please Mish, don't go down this road. You are losing my respect and will look hugely stupid when the truth finally comes out.

Modrich
Modrich

News alert "overdosing on certain drugs can cause death". Really. If i stick to the recommended dose will it likely kill me. What about the guy in California who was so close to death he said his goodbyes. He demanded they give him chloroquine and guess what, he didnt die of an overdose and is now recovering in hospital. Wheres the balance in your post. Preliminary reports in China,South Korea and France show the drug is effective in treating patients to some degree. Hydroxychloroquine a similar drug is being tested (drug has lower toxicity). If you were on your deathbed wouldnt you want the choice. I know i would.

wootendw
wootendw

If I had a potentially fatal illness and there was a potential, but unapproved cure for it, I'd certainly try it. No organization containing the name "Johns Hopkins" would deter me.

frozeninthenorth
frozeninthenorth

The drug may actually work for some strange reason (something with hanging the PH of the cells), but its a "dangerous drug" because its easy to overdose. You know the story two Tylenol is good so four will be better (huge problems with liver). It looks like a promising drug but it needs serious investigation. The Montreal based Institute of Cardiology has begun trials of the drug (looking for 6,000 patients) to get a base line on whether this works! Still potentially good news

Ebowalker
Ebowalker

This post is ridiculous. You are starting to lose it man

vboring
vboring

Small study with 100% recovery with chloroquine and another drug within 6 days: https://www.covidtrial.io/

No information on how serious the cases were, patient background, etc. Lots of missing data. Still, 100% in 6 days is 100% in 6 days.

There are claims chloroquine is also prophylactic, preventing people from getting covid. I wouldn't use chloroquine for that. Too many side effects.

I have started drinking tonic water, though. Tiny doses of quinine (the natural compound chloroquine is modeled after) can't possibly hurt. The small chance it will help is worth it given I like tonic water.

Greggg
Greggg

BaronAsh
BaronAsh

What a load of fear-mongering rubbish from Establishment John Hopkins.
Why not read the report from France, Mish, peer-reviewed.
Why not cite the others from China and Australia who also recently treated Corona with it?
In terms of bad side effects, it is one of the safest on the market having been used for 70 years.
All drugs can be abused. All of them can have bad side effects.

You just want it not to work out because your slant is to find the negative, point out flaws. What if it is a simple thing that works, Mish, and they were trying to hide it.

Why do we all need flu shots if this stuff works.

I had really bad flu and bought it just before Trump's speech (having read the news about the French study the day before). In one day the flu just vanished. Probably I didn't have corona but still: why don't we all know about it already?

Because of experts like Fauci and John Hopkins who are all shills for Big Pharma, that's why.

We are being played. This is a Big Lie in operation. The virus is real, but the narrative around it is blown out of all proportion. I bet you less people died in Wuhan from this thing than usually die in car crashes during the same period.

LegitJerry
LegitJerry

Mish, I thought you were a Libertarian that championed personal responsibility and lack of government interventions.

Looks like you’re rooting for your Gold positions to moon. It’s not TDS. it’s a calculated disinformation campaign to get people into gold.

ohno
ohno

Notice it's an executive that gets the drug. It's not approved for anyone else yet and one of these companies just sent over 100k doses FREE overseas.No idea if it works or not but ive read promising things on it. The side effects are NOT promising though but if you're going to die anyway........

abend237-04
abend237-04

@gregggg, Thanks for the link below: This guy is good and the entire MED CRAM video is worth watching.

sleicht
sleicht

The issue here is the risk//benefit ratio. In circumstances of a potentially fatal disease without an established effective therapy, the passive default position is to treat symptoms and complications and probably watch patients die. In this instance you have a cheap, relatively safe (especially hydroxychoroquine) well known medication with experimentally proved credible mode of actions, positive anecdotal case reports and an epublication of a small double blind placebo controlled trial from France. It is a no brainer to offer this therapy to seriously ill patients. I am very disturbed by my colleagues who have become so brainwashed and complacent from expert protocols and guidelines that they have lost the ability to think for themselves and would prefer to watch people die than try something that "may work". It's relatively nontoxic. It's not expensive And it doesn't prevent or preclude use of other effective medications (if they existed) as alternative cancer therapies might. I would also add for clarification that the FDA has no authority in this. It regulates what pharmaceutical companies can claim in advertising and controls access to new experimental drugs used on a compassionate basis. It has NO AUTHORITY over physician use of established medications. Physicians can use any med for any reason though it obviously has to have a good rationale or you have medicolegal risks. In fact it should be noted, the FDA ENCOURAGES the novel use of approved medications as a way to expand the envelope of knowledge. I find the resistance to using this medication by my colleagues illogical and disheartening.
S Leicht, M.D. FACP,FAAD

Sechel
Sechel

Loving the embrace of the scientific method. On a side note a college friend is touting vitamin D and other unproven cures. It's everywhere.

Sechel
Sechel

I suspect it may work in some cases but not be statistically significant. I'm a smart , I've been right before. Sound familiar?

awc13
awc13

hmmm, yes, nigeria. a world renowned medical system in nigeria

RonJ
RonJ

Watch the commercials for FDA approved drugs. Many have potential serious side effects, some including death.

Actor Daniel Dae Kim took chloroquine as part of his treatment and he called it a "secret weapon" in his treatment. A French doctor gave it to some 100 patients and none died. All recovered within several days.

“Yes, this is the drug that the President mentioned the other day,” Kim said in Saturday’s video. “It is also the drug that Dr. Anthony Fauci cautioned us about. He said that evidence that the drug was promising is anecdotal, and that is correct. It means it wasn’t studied, and it’s only based on personal accounts. Well, add my name to those personal accounts, because I am feeling better.”

Overdose deaths in Nigeria. The key word is overdose. The French patients were not overdosed.

Zinc is a good for dealing with colds. Overdosing zinc is not a good thing for the body. The key is proper usage.

Rtnelson24
Rtnelson24

“Chloroquine is a potent inhibitor of SARS Coronavirus infection and spread”- non.nih. Chloroquine is effective in preventing the spread of SARS CoV in cell culture. Favorable inhibition of virus spread was observed when the cells were either treated with chloroquine prior to or after SARS CoV infection. In addition, the indirect immunofluorescence assay described herein represents a simple and rapid method for screening SARS-CoV antiviral compounds.“

nlm.nih.gov - 2005-

If it worked for SARS CoV, then it’s not much of a leap that it might work for SARS CoV-2.

There real question is why wasn’t this drug tested and approved for use against SARS back in 2005? Trials showed it worked. If it had been approved, we could have tried this on CoV-2 when it first appeared, instead of just talking about trials 60 days after CoV-2 arrived.

Why do you think all the tension with Dr Fauci and Trump? Fauci has been part of NIH for 30 years, and they had chloroquine info for 15 years, but did nothing with it.

awc13
awc13

i am watching the president's daily briefing. the media is just plain stupid they are spending a lot of questions on why the economy can't be shut for months or even a year and how could that be worse then the disease itself

Casual_Observer
Casual_Observer

An overdose of tylenol can kill you too. Overdosing is generally not recommended for most drugs and has bad side effects including death.

Cbb
Cbb

Daily maximum dose of Chloquine is 1,000 mg( 1 grams)/day.
2,000 mg/day is toxic and can kill the patient.

tz3
tz3

Tylenol (Acetominophen) will kill you with a smaller "excessive dose" by destroying your liver, especially if you also consume alchohol (someone should also check fructose as it is metabilized).

Meanwhile US poison control centers had to issue a warning not to drink or inhale bleach.

tz3
tz3

Man takes too much Aquarium Cleaner (chlorquonine phosphate), dies shortly thereafter, wife blames Trump.

AshH
AshH

News flash: 100% of people that die from an overdose on chloroquine did not die from COVID-19.

Captain Ahab
Captain Ahab

Is it possible that Dr. Fauci has connections to Glaxo? Chloroquine costs pennies per pill, which might explain lots of things.

Greggg
Greggg

"An Arizona man has died and his wife is in critical condition after they ingested chloroquine phosphate - an aquarium cleaning product similar to drugs that have been named by President Trump as potential treatments for coronavirus infection".
NOTE: Chloroquine sulfate is the prescription drug. https://news.trust.org/item/20200323225613-cmq3v

Tee Canker
Tee Canker

Dude - see NY post article - these are people who are going to get hurt because they misunderstand: https://nypost.com/2020/03/23/man-dies-after-self-medicating-with-chloroquine-phosphate-to-treat-coronavirus/
The way to improve this is through education, not secrecy -- especially when there are so many doomsayers around.

crazyworld
crazyworld

GERMANY CLAIM THEIR SUCCESS WITH LOW DEATH RATE, LOW CRITICAL CASES NUMBER IS A RESULT OF TWO FACTORS:

  1. upon admission every Covid-19 hospitalized case receive the standard Chinese CHLOROQUINE treatment : 500 mgr first day and 250 mgr following days for about one week. BELGIUM just revealed their hospitals started the same procedure a few days ago. France in some place is going that way too.
  2. Germany test all people having a cold or a flu symptom whether or not they have ever met with infected people.

A. Does it work. Early to conclude so but if figures released are true it seems that "something" far less severe happen to the hospitalized patients in Germany.
B. If Chloroquine has such an impressive effect could the containment measures be lifted? Not at this point as people keep infecting like in any other country and at the same exponential speed as Chloroquine is only prescribed when infected people condition require an hospitalization. So without containment medical systems will be overwhelmed anyway whether Chloriquine decrease the severity of body damages or not in case of people hospitalized only.
C. Should chloroquine have a PREVENTIVE effect like it did for malaria (I used to be on Chloroquine daily intake for months when I used to travel to Malaria infested countries in the 80 ties)
If it works so outstandingly as it is claimed in case of Covid-19 infection and reduction of hospital critical cases, yes. But that is impossible to prove in the present state of the pandemic.

In the meantime, I repeat that it is logical that everybody must use a mask like they do in Asia (even do it yourself) now that we know that asymptomatic people (who dont know they have the infection and transmit it to everybody) ALSO infect other peoples.

texan4truth
texan4truth

Here is the letter from NY Dr.

Dr. Vladimir (Zev) Zelenko
Board Certified Family Practitioner
501 Rt 208, Monroe, NY 10950
845-238-0000
March 23, 2020
To all medical professionals around the world:
My name is Dr. Zev Zelenko and I practice medicine in Monroe, NY. For the last 16 years, I
have cared for approximately 75% of the adult population of Kiryas Joel, which is a very close
knit community of approximately 35,000 people in which the infection spread rapidly and
unchecked prior to the imposition of social distancing.
As of today my team has tested approximately 200 people from this community for Covid-19,
and 65% of the results have been positive. If extrapolated to the entire community, that means
more than 20,000 people are infected at the present time. Of this group, I estimate that there are
1500 patients who are in the high-risk category (i.e. >60, immunocompromised, comorbidities,
etc).
Given the urgency of the situation, I developed the following treatment protocol in the
pre-hospital setting and have seen only positive results:

  1. Any patient with shortness of breath regardless of age is treated.
  2. Any patient in the high-risk category even with just mild symptoms is treated.
  3. Young, healthy and low risk patients even with symptoms are not treated (unless
    their circumstances change and they fall into category 1 or 2).
    My out-patient treatment regimen is as follows:
  4. Hydroxychloroquine 200mg twice a day for 5 days
  5. Azithromycin 500mg once a day for 5 days
  6. Zinc sulfate 220mg once a day for 5 days
    The rationale for my treatment plan is as follows. I combined the data available from China and
    South Korea with the recent study published from France (sites available on request). We know
    that hydroxychloroquine helps Zinc enter the cell. We know that Zinc slows viral replication
    within the cell. Regarding the use of azithromycin, I postulate it prevents secondary bacterial
    infections. These three drugs are well known and usually well tolerated, hence the risk to the
    patient is low.
    Since last Thursday, my team has treated approximately 350 patients in Kiryas Joel and another
    150 patients in other areas of New York with the above regimen.
    Of this group and the information provided to me by affiliated medical teams, we have had
    ZERO deaths, ZERO hospitalizations, and ZERO intubations. In addition, I have not heard of
    any negative side effects other than approximately 10% of patients with temporary nausea and
    diarrhea.
    In sum, my urgent recommendation is to initiate treatment in the outpatient setting as soon as
    possible in accordance with the above. Based on my direct experience, it prevents acute
    respiratory distress syndrome (ARDS), prevents the need for hospitalization and saves lives.
    With much respect,
    Dr. Zev Zelenko
    cc: President Donald J. Trump; Mr. Mark Meadows, Chief of Staff
tokidoki
tokidoki

Great stuff:

States say doctors are stockpiling trial coronavirus drugs -- for themselves
States say doctors are stockpiling trial coronavirus drugs -- for themselves

Doctors are hoarding medications touted as possible coronavirus treatments by writing prescriptions for themselves and family members, according to pharmacy boards in states across the country. The stockpiling has become so worrisome in Idaho, Kentucky, Ohio, Nevada, Oklahoma, North Carolina and Texas that the boards in those states have issued emergency restrictions or guidelines on how the drugs can be dispensed at pharmacies. More states are expected to follow suit. "This is a real issue, and it is not some product of a few isolated bad apples," said Jay Campbell, executive director of the North Carolina Board of Pharmacy. The medications being prescribed differ slightly from state to state but include those touted by President Donald Trump at televised briefings as potential breakthrough treatments for the virus, which has killed more than 500 people in the United States and sickened at least 43,000. None of the drugs has been found to be effective in treating coronavirus or been approved by the U.S. Food and Drug Administration for such uses. Some of them - including chloroquine, hydroxychloroquine, and remdesivir - are commonly used to treat malaria, lupus, rheumatoid arthritis, HIV and other conditions. Pharmacists have been swapping stories on social media about the spike in prescriptions written by doctors for themselves or their families. "I have multiple prescribers calling in prescriptions for Plaquenil for themselves and their family members as a precaution. Is this ethical?" one person wrote Sunday in a Facebook group for pharmacists, referring to a brand name of hydroxychloroquine. Others weighed in - some noting similar experiences - and expressed their hesitancy to dispense such prescriptions. "I got called a communist for telling a...

SymS
SymS

I took Chloroquine the first time I went to Asia to protect against malaria. I just listened to a doctor on French television and he said millions of dose should be manufactured we don't have time to wait to see if it really works since time is critical, and the drug has few side effects.

Of course if people start to self-medicate and take high dose they may die. This is true for any medicines. Hell, you can even die of a water overdose...

BrettDyer
BrettDyer

Great content!
will be looking up for more updates! <a href="https://megacannabisdispensary.com/product-category/cannabis-oil/">Buy Cannabis oil online</a>

Bobby Slobby
Bobby Slobby

my source for chloroquinine and hydrochloroquinine are sold out. why , because the anecdotal evidence is mounting in spite of dumbass vague chastizing.

fglogan3
fglogan3

Hey Mish, for many years I have looked forward to reading your latest insights on the financial side of things. I ran across this headline looking for some data on Dr Zelenko and did a double take when I saw your name tied to it! Have you gone full Drudge and sold out to some left wing rag? Seriously, citing some rumor from Nigeria!!! Did you fall for an email scam while you were reading that report? Did you bother to find out how many pounds of the drug the deaths came from or at least confirm it was not from fish fertilizer?

Too bad, I had so much respect for you and now you are just another shill for something...

Now I will have a much stronger sense of skepticism reading ANYTHING you write since you apparently don't vet any info and write from rumors as well was knowledge...


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