What is the "Economic Standard"? HCQ, etc?

Regarding the HCQ Monograph from “The Economic Standard”. I can find no information regarding who or what the “Economic Standard” is. There are no authors listed for the monograph. The only name associated with it is the Editor-in-Chief, Erik Sass, who is a blogger and best known for his “Mental Floss…” history books. He has a BA in History and an MA in Journalism. There is no named Board of Directors, no named scientific or medical advisors or contributors, no reference to consultations with statisticians, epidemiologists, or Public Health experts. It is impossible to evaluate possible bias in selecting and evaluating the cited studies. We really don’t know where “The Economic Standard” originates from, the GOP, DNC, CIA, KGB, Koch Brothers, Soros, etc. Or it may simply be another mental floss by the historian/blogger/author Sass and unnamed friends.

It contains significant references, graphics, and “comparative data” from “HCQTrial.com”. This is a website, also without authors or institutions, using observational and population based methodology and statistical analysis that are very unorthodox to say the least, yielding very unusual results.

I wrote the above before trying to “Google” info regarding HCQTrial.com. I then came across this, the author and affiliation are readily available:

https://sciencebasedmedicine.org/hcqtrial-com-astroturf-and-disinformation-about-hydroxychloroquine-and-covid-19-on-steroids/

The Economic Standard monograph complains of bias in the headlines of lay press articles discussing HCQ. It is not bias if the headlines accurately represent the conclusions of study authors and the experts interviewed. These articles, unlike the monograph, also have named authors and experts.

So we have a monograph by a non-physician without named sources, that is claiming systematic misrepresentation of HCQ efficacy for “political ends”. What those political ends may be are not stated.

Other than India, HCQ has not been approved as an effective medication for COVD. France has not approved it despite Dr. Raoult’s early work (because methodological issues surfaced soon after). Neither Sweden, nor other Scandinavian countries have approved it. Nor has Great Britain. China has not approved HCQ (interestingly they have approved chloroquine, a more toxic relative). In India, the only country where HCQ is indicated for COVID use off of trial or MD supervision, a recent study has shown it is NOT effective as a prophylaxis in reducing COVID in health care workers (https://www.japi.org/w2f4d444/prevalence-of-flu-like-symptoms-and-covid-19-in-healthcare-workers-from-india).

HCQ is a known medication, and the FDA process to expand indications for medication is well established. The FDA evaluates medication safety and efficacy. Masks are a physical barrier, not a medication, and so have different standards. The FDA has limited regulations about surgical masks for PPE, and started re-evaluating surgical masks as PPE when there was a general shortage of PPE as part of the COVID emergency this past winter. As you know, it is the CDC, not the FDA, that recommends masks, even homemade masks, as source control, not for PPE.

The use of HCQ, under a doctor’s care, is certainly well established, but not in association with a COVID infection. COVID, the “novel” coronavirus, is still not a well understood infection. Early in the pandemic it was not yet associated with cardiac events. Many patients infected with COVID have no or minimal symptoms. Predating COVID there was clear evidence that HCQ was been associated with cardiomyopathy and conduction defects in some patients (1). We now know COVID infection is well associated with cardiac problems, especially myocarditis (2).

So there is a sound scientific basis for a concern between cardiac events, COVID infection, and HCQ use (3 (good review and discussion)).

Since many/most COVID infections are asymptomatic, and we know there are significant cardiac complications from even asymptomatic COVID infection, exposing people to additional risk from a treatment or therapy without clear evidence is not a prudent public health recommendation.

Given the above, it is reasonable to restrict HCQ to patients in a RCT, or under a physician’s care. As a medication it should be held to a higher standard than a mask.

There are currently several solid, randomized trials regarding HCQ prophylaxis underway. Limiting its use to RCT and under a doctor’s supervision is not some kind of US media or deep state conspiracy theory; it is a world-wide medical/scientific consensus. If there is evidence, not insinuation, of a world-wide conspiracy, where the leaders, doctors, and public health officials in nearly every nation are risking their citizens lives, let’s see it.

1) N. Costedoat-Chalumeau, J.-S. Hulot, Z. Amoura, G. Leroux, P. Lechat, C. Funck-Brentano, J.-C. Piette, Heart conduction disorders related to antimalarials toxicity: an analysis of electrocardiograms in 85 patients treated with hydroxychloroquine for connective tissue diseases, Rheumatology, Volume 46, Issue 5, May 2007, Pages 808–810, https://doi.org/10.1093/rheumatology/kel402

2) Puntmann VO, Carerj ML, Wieters I, et al. Outcomes of Cardiovascular Magnetic Resonance Imaging in Patients Recently Recovered From Coronavirus Disease 2019 (COVID-19). JAMA Cardiol. Published online July 27, 2020. doi:10.1001/jamacardio.2020.3557

3) https://www.cebm.net/covid-19/chloroquine-and-hydroxychloroquine/