A good plan, violently executed now, is better than a perfect plan next week.
— General George S. Patton Jr. on the wisdom of taking prompt action based on limited information.
On Wednesday, March 18, 2020, Jim Santilli of Macomb County, Michigan, became seriously ill with severe cardiac and respiratory symptoms. He went to Henry Ford Macomb Hospital, where he was admitted and immediately tested for COVID-19. While he waited four days for the test results, his condition deteriorated “by the hour” to the point where he thought he was going to die.
In an interview with radio host Steve Gruber, the 38-year-old Santilli said that he was slowly drowning and, by Saturday, was convinced that he “would not live until midnight.” Then, on Saturday evening, after all other treatment options had been exhausted, an infectious disease physician administered a combination of the antimalarial drug hydroxychloroquine (HCQ) and the antibiotic azithromycin. Within a few hours he experienced a dramatic improvement in his condition and began to believe that he could survive. After four days of medication, he was discharged to go home.
“I am living proof that this worked!” Santilli exclaimed. He added that unquestionably the HCQ and azithromycin had saved his life, and he praised President Trump for having brought public attention to the protocol.
Though he had no way of knowing, Santilli had been lucky in more ways than one. For, on March 24, 2020, the same day that Santilli returned home, Michigan’s Department of Licensing and Regulatory Affairs issued a “Reminder of Appropriate Prescribing and Dispensing” to “Licensed Prescribers” (physicians) and “Dispensers” (pharmacists).” Here are the opening paragraphs:
The Department of Licensing and Regulatory Affairs has received multiple allegations of Michigan physicians inappropriately prescribing hydroxychloroquine or chloroquine to themselves, family, friends, and/or coworkers without a legitimate medical purpose.
Prescribing hydroxychloroquine or chloroquine without further proof of efficacy for treating COVID-19 or with the intent to stockpile the drug may create a shortage for patients with lupus, rheumatoid arthritis, or other ailments for which chloroquine and hydroxychloroquine are proven treatments. Reports of this conduct will be evaluated and may be further investigated for administrative action. Prescribing any kind of prescription must also be associated with medical documentation showing proof of the medical necessity and medical condition for which the patient is being treated. Again, these are drugs that have not been proven scientifically or medically to treat COVID-19. [Emphasis added.]
The “reminder” went on to threaten the licenses of physicians who prescribed or pharmacists who dispensed HCQ or chloroquine for the treatment or prevention of COVID-19 infections. And, taking a page from the Third Reich’s playbook, it also threatened the licenses of health-care professionals who failed to report such “inappropriate prescribing practices.”
At the time Michigan issued this threat, clinical trials in China, South Korea, and France had already demonstrated the efficacy of treating and likely preventing COVID-19 infections with HCQ alone or in combination with azithromycin. Moreover, Michigan’s Henry Ford Hospital System (where HCQ was used to save Santilli’s life) and the University of Michigan Hospital had already adopted COVID-19 treatment protocols that included the use of HCQ. And, as you will see below, it was being widely used by Michigan health-care professionals to successfully treat COVID-19 during the 23 days leading up to Michigan’s ominous “reminder.”
This ban prompted Santilli to grant an interview to Alicia Maria Rowe of Gateway Pundit in which he criticized Michigan’s Democrat Gov. Gretchen Whitmer for banning the use of HCQ to treat COVID-19. He attributed Whitmer’s actions to the fact that President Trump had expressed optimism about HCQ’s potential. He again stressed that, within two or three hours of receiving his first dose of HCQ with azithromycin, he had a “180-degree” improvement in his condition.
You can watch Santilli’s interview below:
Santilli was not alone in criticizing Whitmer. The Detroit News featured an opinion piece titled “Michigan’s doctors fight coronavirus, governor’s office,” in which the author criticized Whitmer’s actions and ended with this stinging conclusion:
The implications of Whitmer and her administration’s knee-jerk scare tactics should terrify all Michigan residents. Not only is our state’s top leader threatening the selfless health care workers who are on the frontline trying to save lives, but she’s denying possible life-saving medications to actual COVID-19 victims.
Finally, on March 31, 2020, Michigan’s Bridge Magazine reported that, in an apparent policy shift, the Whitmer administration was “pursuing a request” for HCQ from the Strategic National Stockpile. The article included this revealing passage:
Hydroxychloroquine may not be a “miracle cure,” but there is enough evidence to “justify its use” at this point, said Dr. Marcus Zervos, head of the infectious diseases division at Henry Ford Health System.
The Detroit-based hospital system is using hydroxychloroquine in combination with other therapies in an attempt to reduce the likelihood of complications, Zervos said Tuesday in a video chat with reporters. About 800 patients — half in Detroit — have been treated with the drug since March 1 at various Henry Ford hospitals, according to a spokeswoman.
“We have had a number of success stories — patients that have been severely ill, we’ve gotten them off the ventilator and out of the hospital,” Zervos said. But hydroxychloroquine appears to have greater benefits “if we’re able to start the therapy earlier,” he added. [Emphasis added.]
So it is that many of the patient “success stories” referenced by Dr. Zervos undoubtedly came about during the 23-day period preceding Michigan’s March 24, 2020, threat to take disciplinary action against health-care providers who thereafter used HCQ to treat COVID-19. Was Gov. Whitmer aware of these successful patient outcomes? If so, then what was her motive for threatening the professional licenses of Michigan health-care providers who used HCQ to treat COVID-19? Was it because, as her critics have claimed, she was in a political snit with President Trump?
In short, during the week that Michigan’s ominous “reminder” was in effect (a lethal eternity for COVID-19 patients), did Michigan physicians have to take into account the risk of losing their licenses if they used HCQ to save their patients because the governor wanted to demonstrate her opposition to all things Trump?
Which brings us to New York’s COVID-19 crisis.
On March 23, 2020, New York Gov. Andrew Cuomo issued Executive Order 202.10, which, among other things, decreed the following:
No pharmacist shall dispense hydroxychloroquine or chloroquine except when written as prescribed for an FDA-approved indication; or as part of a state approved clinical trial related to COVID-19 for a patient who has tested positive for COVID-19, with such test result documented as part of the prescription. No other experimental or prophylactic use shall be permitted, and any permitted prescription is limited to one fourteen day prescription with no refills. [Emphasis added.]
This order was purportedly calculated to preserve the available supply of HCQ and chloroquine, which was running low after President Trump had expressed optimism about it possibly being a “game changer” in the fight against the pandemic.
On March 28, 2020, the FDA authorized “emergency use” of HCQ to treat adult and adolescent patients “hospitalized with COVID-19 for whom a clinical trial is not available, or participation is not feasible.”
The net effect of the interplay between Cuomo’s order and the FDA’s authorization has been to limit the use of HCQ to treating patients who are either hospitalized or participating in a “state approved” clinical trial. In other words, New York physicians are forbidden by law to use HCQ to treat COVID-19 on an outpatient basis as soon as possible after the onset of symptoms.
On the same day that Cuomo issued his executive order, Dr. Vladimir (Zev) Zelenko, a New York physician, wrote a letter to the Israel Ministry of Health concerning his HCQ-based protocol for treating COVID-19. His letter stated that he and his team had used a combination of HCQ, azithromycin, and zinc sulfate to successfully treat 500 high-risk COVID-19 patients and had “ZERO deaths, ZERO hospitalizations, and ZERO intubations [ventilator uses]” and “no serious negative side effects.”
He concluded his letter as follows:
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. [Emphasis added.]
In a subsequent appearance on Rudy Giuliani’s televised podcast Common Sense, Dr. Zelenko pointed out that HCQ and azithromycin are being used in combination in many New York ICUs with only “mild to moderate success.” The reason for this is that, by the time patients reach the ICU, many have already had their lung tissues “napalmed” by COVID-19 and are suffering from Acute Respiratory Distress Syndrome (ARDS). Even with HCQ and azithromycin, 40 to 50 percent of ICU patients suffering from ARDS will die.
In short, he believes that it is important to treat patients as soon as COVID-19 is confirmed and well before they reach the hospital or ICU. As he put it, “Hit the infection hard and early.”
But to do that now would be a violation of Gov. Cuomo’s executive order.
As you can see, Dr. Zelenko and Dr. Zervos of the Henry Ford Medical System agree that HCQ provides greater benefit if it is used before the patient becomes severely ill. And they are not alone.
Dr. Stephen Smith, a preeminent infectious disease expert, recently appeared on the Laura Ingraham Show. Dr. Smith is a 1989 graduate of the Yale University School of Medicine who did postdoctoral training at, among other medical establishments, the National Institute of Allergy and Infectious Diseases (NIAI) in Bethesda, Maryland, which was then and remains under the directorship of Dr. Anthony Fauci. From 1992 to 1995, Dr. Smith was a Medical Staff Fellow in Infectious Diseases at the NIAI. From 1995 to 1996 he was a “Post-Doc” in the Molecular Virology Section, Laboratory of Molecular Microbiology, at the NIAI.
He and his colleagues at the Smith Center for Infectious Diseases in East Orange, New Jersey, have been treating COVID-19 patients. In his interview, he said that none of their patients who have been treated with HCQ and azithromycin has had to be put on a ventilator.
He pronounced the combination of HCQ and azithromycin to be an “absolute game changer” and added that “this regimen works.” He then closed with this stunning declaration:
I think this is the beginning of the end of the pandemic. I’m very serious.
You can watch Dr. Smith’s remarkable interview below:
In his daily pandemic media briefings, Gov. Cuomo has acknowledged that HCQ is being used in New York’s hospitals with good results. But he has characterized those successful patient outcomes as mere “anecdotal evidence.” He has expressed hope that clinical trials will confirm the “anecdotal evidence” but stated that the result of those trials are weeks, if not months, away. In fact, according to ClinicalTrials.gov, with but one exception, the estimated study completion dates for the 53 scheduled clinical trials of HCQ are years away.
But, as he daily reiterates the need for more ventilators, ICU facilities, and hospital beds, hitting the infection “hard and early” before the patient requires hospitalization remains forbidden thanks to his executive order. Given the clinical trials in China, South Korea, and France as well as the favorable treatment outcomes that he himself has noted and as reported by Drs. Zelenko, Zervos, and Smith, Cuomo should immediately allow physicians to use HCQ on an outpatient basis as soon as COVID-19 is diagnosed. This would not only enhance HCQ’s therapeutic benefit to patients but it would also alleviate New York’s need for ever more hospital beds, ICU facilities, and ventilators. So why isn’t he allowing that to happen?
This question leads us back to President Trump. Ever since he publicly expressed optimism about the potential effectiveness of HCQ in treating COVID-19, he has been flayed in the mainstream media as a snake oil doctor and conman selling false hope to a fearful public. The latest installment in this media campaign was at Sunday’s White House task force briefing (here is a heavily redacted and somewhat misleading video posted by the Washington Post) when an apparently exasperated CNN correspondent demanded of the president, “Why not let the science speak for itself? Why are you promoting this drug [HCQ]? You come out here every day talking about the benefit of this drug … ”
Despite his frustratingly tangled syntax, the president got off a good answer. After stating that he was only expressing hope that HCQ would work and that, given its known safety profile, it should be used, he said, “We don’t have time to go and say, ‘Gee, let’s take a couple of years and test it out. Let’s go and test with the test tubes and the laboratories.’ We don’t have time. I’d love to do that. But we have people dying today, as we speak there are people who are dying.”
Throw in a few expletives and references to fornicating barnyard animals, and that could have been General Patton speaking. Even without the benefit of meticulous clinical trials, immediate action is needed today — not next week, next month, or next year — to save lives. Under these dire circumstances, when patients are suffering, their lives are at stake, and we have a demonstrably effective treatment with a known safety profile, to delay HCQ’s use until clinical trials are completed would make the search for a perfect remedy the enemy of patient welfare.
Anecdotal or not, the proof on the medical front lines is that HCQ is every day saving the lives of COVID-19 patients. But rather than celebrate that blessed news, disgruntled progressive politicos and their media adjunct continue to portray the president as a scheming con man who must be exposed and stopped. So it is that, to advance their political agenda, they seek to discourage and restrict the use of HCQ even at the risk of patients suffering and dying.
Or, as Robespierre is purported to have said, “On ne fait pas d’omelette sans casser des oeufs.”
Translation: You can’t make an omelette without breaking eggs.
Eggs and patients suffering agonizing deaths. They’re all the same to the angry Left in its obsessive and unrelenting quest to turn this COVID-19 pandemic to its political advantage.
George Parry is a former federal and state prosecutor. He blogs at knowledgeisgood.net and may be reached by email at email@example.com.