Hi, my name is Gunther Schadow, MD, PhD, I used to be a Associate Professor at Indiana University, Schools of Informatics, Medicine, Regenstrief Institute Investigator. I am leaving the links to my ResearchGate and SemanticScholar profiles:
https://www.researchgate.net/profile/Gunther_Schadow
I have a long track record in medical informatics, been pretty influential in HL7, the father of UCUM (unitsofmeasure.org). Used to be co-director of biospecimen banking at IU school of medicine. I have a pharmaceutical data management company and am an FDA contractor running the HL7 SPL based listing system. There is a lot more but I am cutting it brief. During my PhD project I was at Anesthesia and Intensive Care Unit at Benjamin-Franklin Hospital in Berlin-Steglitz, Germany. That was over 20 years ago. At the time, that place was one of the world leaders in ARDS, I think there are still “Berlin Criteria”, etc. So, I have some background in some ICU patient care and before that, even before going to medschool, in geriatrical nursing.
I am residing nowadays in Latin America, Panama, Paraguay, and Brazil. And for that reason I am less keen on high-tech methods and more keen on practical public health interventions which can be deployed quickly to protect the vulnerable population. I am of the strong belief we must QUICKLY come down to an anti-viral treatment that can meaningfully reduce the time of disease and the shedding, and can be deployed in MASS, NOW, ASAP, ideally allowing self-treating over-the-counter all suspects and their contacts so as to slash the R-naught value to naught.
I am very connected to the poor and vulnerable population here, and I am highly aware of the deep problems with reliance on governmental public health. In Brazil, for example, the public health approach in this crisis is perilous and reckless driven by the President here undercutting all efforts by the health ministry, even again this weekend organizing a mass gathering where just another 1000 CoViD cases will be spread. That same President is denying the health ministry to use HCQ for all patients to try to speed up hospital discharge. And I know why he is denying it: because he and his corrupt friends personally confiscated and then sold all stock of HCQ in Brazil to the USA. I know this because I have been on the case on the day it happened. My pharmacist friend saw the orders all cancelled, his distributor said the Government took all stock, and on the same day the health ministry said the Government had “donated” the HCQ to the USA. That press briefing video was later censored / deleted of YouTube, so there is no record of this. But they don’t have enough HCQ in the country because they corruptly sold it, someone in the US FDA must have waived through the delivery, and someone must have received and paid. Brazil has no own API production for HCQ and relied on China and India imports, and India has total export constraints, not able to produce enough for its own looming domestic catastrophe. The world market is dry.
Anyway, this experience has really opened my eyes to the urgent need for non-governmental global research and collaboration networks such as this.
I have contacts into the favelas in Rio, and I know there is a huge amount of occult cases. I know the health system is completely unprepared.
The problem is huge. And the economy is hurting globally. Wealth, retirements, livelihoods are being destroyed. We MUST work faster to devise an existing drug that can be pushed ASAP. The best candidates I can see are:
- HCQ+azm - problem is massive shortage. The world market is dry. India has export ban on HCQ. The world can produce no more than 80 ton of HCQ API, and this is barely enough if you had a perfectly efficient distribution. But that doesn’t exist. Governments stock-pile. I think that none of the studies so far have used the right dosing.
- Ivermectine - could be a game changer, but the dose required is 20 times the usual dose. This alone can create a shortage again, besides being a bit iffy from a safety perspective. But we need bold action to speed up the studies. There is existing evidence for the safety and ethical use of IVM in high dose even if that is not for the direct benefit of the patient (malaria).
- Favipiravir - could work, it is not available widely, but then all other drugs are in short supply. This one needs to be made by creating little plants that the people could run in their countries.
I don’t see any other viable drug right now. The others are just even less well known as to their safety profile and even harder to be available in sufficient quantities.
I am interested in RAPID DATA and I think it’s ridiculous that everyone “announces” studies which are scheduled to deliver results in 2 months. I also think we need more people self-organized studies, because the governments are in the way of actually rolling out a working treatment that can stop the pandemic. This isn’t even a matter of money. The 150 million USD that a total onslaught with HCQ+Azm would cost is peanuts, but the governments, regulators are in the way. Even if we had all the data ready showing that it could work well enough.
“Could work well enough” is the operative term here.
My name is Hilda Mahmoudi, Research scientist, MD, MPH. My speciality is Community medicine. I got certification of “ Principle and Practice of clinical Research” from Harvard school of public health and collaborate with them for 4 years. I worked as Research faculty and educational instructor in NSU, and FIU, Florida.