|COVID-19 A Pandemic Of Fear||Source|
Dr. Harvey Risch: “Hydroxychloroquine, Ivermectin, and Other Therapeutics Highly Effective in Early COVID Treatment”
In this episode, we sit down with Dr. Harvey Risch, a professor of epidemiology at the Yale School of Public Health and Yale School of Medicine. He says therapeutics, including hydroxychloroquine and ivermectin, can be highly effective against COVID when they are deployed early on and in combination with different medications.
In the interview, Dr. Risch criticized the U.S. Food and Drug Administration (FDA) for warning against hydroxychloroquine and chloroquine use to treat COVID-19 and revoking the emergency use authorization (EUA) for hydroxychloroquine and chloroquine.
But Dr. Harvey Risch argues that outpatient reports are exceedingly few because the medication is extremely safe and the emergency use authorization in March 2020 blocked outpatient use, and he believes the FDA has conflated heart rhythm problems from severe COVID infection with adverse effects from hydroxychloroquine use in hospitalized patients.
Risch has authored more than 300 original peer-reviewed publications and was formerly a member of the board of editors for the American Journal of Epidemiology.
Jan Jekielek: Dr. Harvey Risch, such a pleasure to have you on American Thought Leaders.
Dr. Harvey Risch: Thank you. Nice to be with you.
Mr. Jekielek: Dr. Risch, as a professor of epidemiology at Yale, you’ve been watching the development of this pandemic. Just characterize it for me in general. What are we looking at here, and how has the response fared?
Dr. Risch: Overall, I’d say that we’ve had a pandemic of fear, and the fear has affected almost everybody, whereas the infection has affected relatively few. It’s serious in some of those people, as we’ve seen. But by and large, it’s been a very selected pandemic, and predictable. We didn’t know at the beginning how predictable it was. At least we laypeople, so to speak, in the pandemic, didn’t know that.
I’m sure that the pharma companies and countries who had experienced it slightly before us had a better picture than we did, but it was very distinguished between young versus old, healthy versus chronic disease people. We quickly learned who was at risk for the pandemic and who wasn’t. However, the fear was manufactured for everybody, and that’s what characterized the whole pandemic—is that degree of fear and people’s response to the fear.
Mr. Jekielek: You’re saying it’s been manufactured. Explain this to me. How do you see this?
Dr. Risch: I think that the people who were in the nominal positions of authority initially spread a much worse picture of the dire nature of this. That everybody was at risk, everybody could die, everybody needed to find protection. Everybody needed to stay in their homes and not go out, not socialize, and so on—to protect themselves [and] society.
People were quite afraid of that message as anybody would be, because one trusted in those times with the government, authorities, scientific people, medical people in authority, [and] the public health institutions all saying the same message starting in about February, March of last year.
So, we all kind of believed this, and therefore, all of our anxiety levels were raised, and we all made decisions to curtail, to various degrees, our exposures to other people—some more than others. But I think everybody had levels of anxiety that really affected how they carried out their life at that time.
Mr. Jekielek: Yes. Let’s talk about the China piece of this … Actually, as you were talking about the fear element, there was all this imagery of people dropping dead ostensibly from the virus. There was all this imagery of lockdowns, and then there was all sorts of propaganda around the success of lockdowns in that system, and look how we’ve conquered, how few people have died because of our great policies. How does this intersect with what we saw here in North America?
Dr. Risch: We look at the videos that we got from Wuhan and the surrounding area in retrospect to see what was real about that, and what wasn’t. You have to recognize that almost every year there’s been an epidemic release from the live food markets in China, in various places. What was different about this one is that China has admitted to those right away and tried to fix them, whereas the present one, it did not do that.
It withheld information about it for two months, at least, and that withholding of information is a totally different behavior than how China has been in the past. That appears to be a very significant difference as to why it would do that. We know now that some of those videos were not truthful videos about that man falling over in the street and playing dead and things like that. We have reason to believe that those were artificial videos made to induce fear.
While the virus did get out in Wuhan and the lockdowns were there to suppress it, and they worked, in fact, when you suppress 100 percent of the population, you weld their doors shut and so on, you can do that. We’re not as draconian in the United States, at least haven’t been, and so it’s clear that the virus got out.
Whether there was an intention that it would be controllable on the local, but exportable to the rest of the world, is a risk-benefit equation that had to have been made in China at the time. In other words, China also faced the risk that this could get out and affect the whole country.
It did get to other places besides Wuhan, but I think they calculated that they would be able to control it better than we could. They also knew that chloroquine treated it because they had published on that five or more years in the past. We published on that too from NIAID at NIH, a paper on chloroquine and virus infections. I think it might’ve been SARS1 from 2005 that that was published, so we knew.
People knew. The scientific community knew that these viruses existed—that they were hazardous, they could be treated. But nobody knew exactly the extent, the ramifications of how well the treatment would work, whether that was enough by itself, what the hazards of using that drug were, what the long-term ramifications—all of that was still unknown territory.
Mr. Jekielek: This is something, of course, that you’ve been very vocal about—the potential use of therapeutics, and then the mass discounting of the use of therapeutics at the same time. Where are we at with respect to all this right now?
Dr. Risch: Let me just say how I got into this because it puts a picture on this. I’m a member of the Connecticut Academy of Science and Engineering. In early 2020, it formed a committee of nonstandard, not real public health people. My dean Sten Vermund was it in, I was in it to try to figure out how to help the state to reopen the state after its lockdown.
We started looking at behavioral aspects. We had a psychologist in it. We had aerodynamic aspects. We had people who design jet airplanes. It was a very eclectic bunch of scientists trying to figure out how we could help the situation.
I started looking at the disparate information in medical and lay media about early treatment, and it just didn’t make sense that hydroxychloroquine was being badmouthed by the media when it was being studied in hospital patients, and saying that it didn’t work for outpatients when it hadn’t been studied in outpatients.
An outpatient disease is totally different from a hospital disease. It’s like night and day. Outpatient disease is like when you get the flu. You have fevers and chills and muscle aches, headache, sore throat, runny nose and cough. That’s a typical flu-like illness, outpatient.
Inpatient is a very severe pneumonia where the immune system debris fills up the lungs, and it’s a totally different disease. The virus is more or less long gone by that time, and it’s the immune system that’s overreacting to create that. So, it’s a different disease, requires different treatment, and yet, this was being pedaled as something that didn’t work in hospital disease, therefore it didn’t work in outpatient disease.
So, I wrote a paper looking at just hydroxychloroquine and remdesivir, which were the two agents that were being talked about in studies at the time in early-mid 2020, and I didn’t expect much to come out of that other than to say, “Look, here’s something that we could be using.”
My naïve state, thinking about it as just science here, and I had already Dr. Zelenko, who had been using it very successfully. He had treated 800 patients. He had had two or three deaths, two people who were too late to treat, one who didn’t stay on the regimen. So essentially, he was saying that his regimen of hydroxychloroquine and zinc, vitamin D, and other things, supportive medications that he was using, and the recipe for treatment worked extremely well.
It’s like, don’t believe your lying eyes. He knows that it worked because he was dealing with those 800 patients himself. Many of them were high-risk patients, so he knew that it was working.
I came into this. I wrote an op-ed for Newsweek saying, “Here it is. We should use it. There’s no cost, and even if it doesn’t work, it’s 100 percent safe because it’s been used in tens of billions of doses for 60 years in hundreds of millions of people. Even if it doesn’t work, it can’t do any harm.” Then I got pushback from my colleagues saying what do I know about infectious disease and epidemics and so on.
I’m a cancer epidemiologist, but they didn’t do their homework because after medical school I got a Ph.D. on mathematical modeling of infectious epidemics, and I published on that. I had a very clear idea of how epidemics come and go, and what herd immunity is, when it happens and how it happens, and all of that stuff.
The idea about using drugs to treat things is something that I do as just a regular part of my cancer epidemiology studies. So, this was not a great leap for me to be involved in these topics, and for them it was just smear. I didn’t respond to that, which is appropriate. They have their freedom of speech to say what they want to say. I have my freedom of speech to say what I want to say, and let the readers decide which seems the truest or the most accurate.
Mr. Jekielek: Just watching this as someone who’s worked in Madagascar, in Africa, I know how often hydroxychloroquine is used in these parts of the world to treat malaria, for example, for however long. It’s extremely safe. What I’m saying is you don’t have to be a medical doctor or a professor of epidemiology to know this.
Dr. Risch: I know, or the CDC.
Mr. Jekielek: Yes.
Dr. Risch: I had a guide to using it for malaria, and it said it’s safe for everyone—safe for pregnant women, in utero, young children, for elderly, frail people, safe for everybody. So, anybody can use it.
Mr. Jekielek: Yes, but suddenly it’s not safe anymore.
Dr. Risch: Right.
Mr. Jekielek: What were you thinking?
Dr. Risch: I was thinking of cognitive dissonance. In other words, here I know it’s safe. At that time when I wrote the paper, there were five studies. Within another four or five months, there were 10 studies involving more than 40,000 patients who had been studied, including some national studies in Iran and Saudi Arabia—with tens of thousands of patients that provided very clear fivefold or better protection against mortality with this drug, and that’s not even using the recipe.
That’s just using hydroxychloroquine either by itself or with zinc, by and large, in these studies. It was very clear that the evidence was extremely strong, as strong of evidence as I’ve ever seen in anything in my career in epidemiology for an association, the magnitude of an association.
What people don’t understand about epidemiology is that the science of epidemiology deals with the representativeness of the samples that we take in order to study something. We don’t study whole populations, and we don’t study everybody who’s ever used a drug.
We take a sample of the population, a sample of people who’ve gotten cancer, and a sample of this and that, and we have to know that those samples are accurate and generalized to the whole population, that they represent everything. So, we agonize. What we do for our bread and butter is agonizing how good the samples are.
We deal with the problem of what’s called confounding when a sample is biased. When some other variable is really causing the relationship that we’re studying. So, this was the claim that these studies, because they’re not randomized, were biased. They were confounded. But in fact, it’s not true.
There’s a whole literature showing that modern epidemiologic studies that are not randomized provide exactly the same results as randomized studies, and this was described in a meta analysis, a giant analysis of more than 10,000 studies that showed that modern epidemiologic studies that are not randomized give answers within 10 percent on average compared to the randomized control trials when the randomized trials are done accurately and not misrepresented and not subverted, which many of them have been in the last couple years.
This is my bread and butter of the field that I understand and how it does these studies. What these studies were purporting to say was accurate, and a very strong signal. So I was nonplussed to find that people were saying, “These are anecdotal.” When Dr. Fauci would come in and say, “Oh, that evidence is anecdotal,” and I’m looking at 40,000 patients.
I’m looking at clinicians who’ve now treated more than 150,000 patients with fewer than two dozen deaths with hydroxychloroquine, and he’s saying it’s anecdotal, and I’m saying, “These 50 doctors all know that it’s not anecdotal. They’ve been using it in their practices for a year or a year-and-a-half.”
So, where is this disconnect? This disconnect has to be on purpose. It’s not an accident. It’s a smear campaign against the drug for a purpose. Where is the purpose coming from for why one would suppress something that costs 80 cents a day to treat? It’s even cheaper than ivermectin. Ivermectin is $10 a day or whatever it is. Hydroxychloroquine is a tenth of that.
You have to address what’s the economic playing field as to what is causing all of these events and all of these people to be making the arguments that they have, and in fact, without citing data? So, you find that people who disagree with me don’t provide counterevidence.
They say, “The FDA disagrees with you,” or, “The CDC disagrees with you,” or, “The WHO disagrees with you.” But is that evidence? Well, no, and in fact, Karl Popper, the philosopher of science in the 1950s, said studies of what scientists believe do not reflect on studies of how nature behaves.
Mr. Jekielek: That’s a great line, right?
Dr. Risch: Right. It’s a great line because I’m studying nature, not the beliefs of scientists. If I wanted to study the beliefs of scientists, it would be a different paper in a different journal.
Mr. Jekielek: We’re both laughing, but you’re suggesting that a lot of people died that didn’t need to, actually, aren’t you?
Dr. Risch: We believe that if the mortality numbers are accurate, and there are reasons not to believe that because as I said at the beginning, this has been an epidemic of fear, that agencies have magnified the fear component in order to control behavior.
People who died in motorcycle accidents with a positive COVID test became deaths from COVID. We didn’t really know how many were real COVID, and then there was a study done that showed that 94 percent of COVID deaths had other causes listed. Only 6 percent of nominal deaths from COVID had only COVID as the cause of death, and nothing else. But that’s the other extreme. That’s too far of an extreme.
People have conditions that aren’t really the cause of death that may or may not have been contributory, and this is a whole gray zone. COVID might’ve been the straw that broke the camel’s back, so to speak, or maybe it was just contributory.
Maybe it was the end stage heart failure that was the cause of death that was exacerbated enough when COVID hit and made their lung function reduced. But it was really the heart disease that was the cause of death. It’s really hard when you get down to it to identify the single responsible cause of death.
We don’t really know the degree to which this was manipulated to make the numbers of deaths larger because of COVID than what really was some other rational way of calculating the numbers of deaths. It’s very hard to understand this. Even with the statistics that we have, it’s very hard to understand.
Mr. Jekielek: I’ve heard discussed a number of times the recommendation to the CDC to study how many of the children that are listed as having died with COVID actually died from COVID, It’s something like in the 400 or something like this. Right?
Dr. Risch: From October to October of 2020 to this year, I think there were 491 deaths in the five-to-11-year range with COVID. Now, that’s the problem. Kids in the hospital with some serious underlying condition that happened to be COVID-positive, that are asymptomatic and tested and found to be battling or infected with the virus, get called dying from COVID. But in fact, in the CDC’s own review slides, they say COVID-associated deaths.
They’re not even saying what they’re from. They’re just leaving it to the reviewer to try to figure out what they mean. In fact, a study that came out earlier this year showed that among hospitalized children with COVID, about half were there because of the COVID, and half were there that happened to have COVID. So, we take the 490 and divide by two, we’re down to about 245, something like that, that might’ve died with COVID.
I think that it’s not just five-to-11s. I think that that’s zero to 12, that number. But the point of that is that among these 200 or 240, almost all of those have chronic conditions, either diabetes or obesity. Or they have immunocompromised because they’ve had cancer or other chronic conditions that put them at very high mortality risk from COVID because of their conditions. Healthy children, probably zero or very close to zero of that number.
Marty Makary at Johns Hopkins reported on the study from his institution of 48,000 children. He asserted that no healthy children in that study had died from COVID. So, that’s the real bottom line. Are we talking about zero or one or five across the country, or 10? We don’t really know exactly, but those numbers are smaller than the number of children who’ve died from influenza each year in past years when we’ve had flu epidemics, as we usually do, except for last year.
It’s a tenth of the number that die from traffic accidents. It’s lower than the number who get hit by lightning, and certainly lower than what flu does. So, why are we potentially forcing all children to get vaccinated to save approximately zero, since we know, we can tell who are the high-risk children? Why aren’t we vaccinating the high-risk children?
Why aren’t we letting parents and doctors decide who’s at high risk, and letting them choose whether to be vaccinated or not? There’s pros and cons for that discussion, and I’m not going to argue either side because it’s a real discussion.
The real discussion is, however, that all children across the country do not need to be vaccinated because they’re not protecting anyone. They’re not protecting adults from the illness. They’re not protecting elderly. They’re not protecting other children. They’re not protecting teachers by getting vaccinated, and they’re not protecting themselves because healthy children don’t need it for themselves.
People will argue every one of the things that I just said, but in fact, it’s very clear that children do perfectly well with this illness when they get it. Either they’re asymptomatic or they have a headache, they’re a little tired, they sleep a little long for a day or two, and that’s about it. That’s the extent of COVID in young children.
It’s not much different than a light flu or a cold in children, and that is probably how the illness is essentially meant to be manifested in a society where all children get it as little children, get through it without a big ruckus, and go on. Then everybody’s protected after that, and adults don’t have to worry about it because they all had it as children.
That’s most likely how this whole thing would work, but what happened now is we as immunologically naïve adults are exposed to this and react totally differently because we didn’t get it as children, and we don’t have that immunity. Well, some people do.
You have to explain why 75 percent, plus or minus, of people who’ve had COVID had it asymptomatically. That’s the adults who have had COVID. There’s a lot of immunity in the population because of all these people who’ve had it asymptomatically.
Mr. Jekielek: Okay. I just wanted to stop on that 75 percent of all adults. This is a study you’re talking about specifically, yes?
Dr. Risch: There’s been two or three studies mostly done by CDC, where they’ve sampled blood samples in blood banks to test for COVID over time and compared that to the number of individuals who have been PCR tested or symptomatic who’ve been symptomatic of COVID.
What they found is in the first study in early to mid 2020, approximately sevenfold the number of people who’ve actually had COVID by testing is seven times the number who actually were symptomatic with COVID. Now, in the recent year with the Delta strain, that’s come down to more like three to one. So, it’s somewhere in that range.
What that means is, when a state for example, reports that it’s had 200,000 cases per million, the people with COVID, that’s by testing. So, it’s either symptomatic or people who were screened and got tested. Two hundred thousand cases per million is 20 percent of the population has had COVID by testing or symptomatic. That means if you multiply that by five, essentially, everybody’s had COVID.
If that number is five, between three and seven, I’m just saying if it’s approximately five, then that’s the ballpark for estimating where the real immunity is, and that’s why you see states like North Dakota, South Dakota, other states that have minimal or no lockdowns, where everybody mixed, lots of people got COVID early.
People didn’t get very sick because they had relatively young, healthy populations that were doing most of the mixing, that they built up large amounts of population immunity, what we call herd immunity early on, and so they were largely done.
Now, Delta came. Some of the people, some of that natural immunity might have been not quite enough to deal with the Delta, so they’ve had a very small, low-level bump over the last few months that is probably going down also. But nothing like the states that locked down like Vermont and Hawaii and so on that spent all their time locked down, and with very severe curtailments of mixing.
And now are having these waves of pandemic that are bigger than what they first saw in early 2020 because it was misguided to try to suppress something that was going to be endemic no matter what anybody did.
The realization of when you take measures that just prolong the pandemic, it just gives it more time to build up, and you have more and more waves. If you let the pandemic go through the society in a controlled, safe way in the first waves, and you control how people respond to that infection in a way that minimizes their damage, their personal damage, you get through it, and that was the exact opposite.
That was what we were trying to say early on in April, May, June of 2020. You have to let this get through the population and develop natural immunity, and that is how we would solve it. That didn’t happen because of financial interests for selling products to deal with it instead of letting it happen on its own.
Mr. Jekielek: There’s something called let it rip, which Jay Bhattacharya says … I’m talking about focused protection. This is not let it rip. What are you talking about, the focus protection?
Dr. Risch: Yes. So, how do you do it safely? That’s focused protection. Did we know how to protect people in June of 2020 when people were dying in nursing homes because the infected people we were putting back in the nursing homes? It wasn’t just New York. It happened in Jersey and Connecticut also. Sixty percent of the mortality in the first months of the pandemic in Connecticut was in Connecticut nursing homes.
Did people know how to deal with that? Yes and no. It wasn’t the right thing to do, but did they know what tools they might’ve had to set up shelters for infected elderly people instead of putting them back in nursing homes? I don’t know that people knew that was something they could do. They didn’t do that, but at the same time, we weren’t using the medications that could have been used that would’ve saved those people.
Elderly people have frail immune systems, and Dr. George Fareed in Southern California recognized early on that you can’t just give hydroxychloroquine and zinc and vitamin D and antibiotics day four or five, which works for middle-aged people perfectly well. Doesn’t work for frail elderly because the virus has had no immune system growing to try to suppress it because of their age and disabilities.
In them, you have to give it on day one. How do you give it on day one? It means you have to screen them daily. You screen them for a fever and pulse oximeters, the little toys that you buy at the Walgreens for $30, and you can test your blood oxygen levels, and doing that twice a day.
When those people, their oxygens were dropping but they weren’t otherwise symptomatic. Then you found that they already had a fever that you wouldn’t have recognized. You start treating them, and that’s what he did in nursing homes. He was very effective in saving the lives of people in nursing homes because he was getting to them on day one, and this kind of aggressive, safe method of treating people is what works and should’ve been done.
But it requires people who are willing to use what they know in classic medical practice, the way doctors were classically trained, which is each one is the Sherlock Holmes doctor of figuring out what you’re supposed to do and how it works and the best you can do, and treat the patients.
Not formulaic things that your hospital board or your medical practice board says, “These are the drugs you must use, and you can’t veer from this, and we’re telling you how to practice medicine.” Okay? That’s destroyed medicine.
Mr. Jekielek: A couple of things I’m thinking. One of them is to do what you just described, as this doctor did with the nursing homes. You also had to realize that you’re bucking the entire system because the system is telling you a radically different thing. Right?
Dr. Risch: Yes.
Mr. Jekielek: For a lot of people, that’s a big step.
Dr. Risch: Yes. You’re really driving out something that everybody’s wondered about in this whole pandemic, which is why the people who’ve stood up to the narrative have stood up to the narrative.
What aspect of personality has made people who think they’re right stand up for what they think is right in spite of the narrative, of social penalties, potential economic penalties and career penalties? Why they foolishly and naively, like me, have stood up just because I’m not going to lie about what nature says when I’m the middleman.
Nature says something to me, and I just translate that into English. I’m not going to misrepresent that saying that nature is saying something else because it’s just not in my person, I guess, to lie about something like that. I wouldn’t be a scientist.
What’s the point of doing science if you’re going to just be a tool for some company to misrepresent nature, to say it says something else? Then why would I have spent a whole career taking a low-pay job as a scientist when I could’ve been making a lot more practicing medicine or in the private sector doing something?
For me, there’s no roadblock other than having to fight off the little stings that come around in the periphery to deal with saying what I think is the truth. I said early on in this when I had only some of the evidence for hydroxychloroquine, “This is a very strong evidential signal, and if any study comes out that’s a valid study done properly that gives a very different answer to this, I will reevaluate because I’m a scientist.”
That’s what scientists do. You get new study, new data, new opinion, new theory, work from that, support that, refute that. That’s how science works. It’s always evolving. So, that was my paradigm.
However, I already knew that I would be very astonished had there been a study, a valid study, that showed that the drug didn’t work. In fact, after that, five more studies came out, every one stronger than the previous one, showing how good this drug and its combinations work for preventing hospitalization, preventing death.
So, it didn’t surprise me that more studies were coming out. It gratified me to think that I had more evidence to say what I’d been saying all along because you do take some degree of risk when you purport that nature is speaking a certain way with limited evidence. But I was secure enough to think that this was very strong evidence, even when I started.
Why other people have stood up to this, why Dr. Fareed stood up? Because he believes in his experience. He treated enough patients to know that this was the way the world works. He’s Harvard Med School educated. He’s a very smart person. He’s a very caring physician.
He spent half of his career in the lab doing science, and the second half of his career treating patients, and he’s a very other-directed person. He wants to do good by each and every person that comes to him.
That’s what medicine really is about at that level, and why he’s a clinician on the front lines and not an academic physician in some university who’s never seen a COVID patient and is pontificating about how COVID patients should be treated when they’ve never treated a COVID patient.
There’s an academic disdain for local docs in general, that academics think that they are at the top of the medical/intellectual world because they’re doing their research, their clinical research. In some respects, it’s good, and for those areas that they actually study, that’s fine.
But for diseases on the front line, the doctors on the front line who are exploring, who are saying, “Well, this treatment works, but maybe I’ll try this in this patient, and that seemed to work a little better. Maybe I’ll try it in a few more patients,” and gradually accrete knowledge about how to treat things is the classical model for how diseases on the front line are managed.
That’s what worked for the doctors who are willing to do that in this pandemic, like all illnesses have dealt with in the past. That’s what brought the realm of knowledge to how we have treatment regimens.
Mr. Jekielek: This is very interesting to me too because I’m not entirely a stranger to medicine. I have medical doctors in the family, but it wasn’t entirely obvious to me that the doctor-patient relationship is sacrosanct. It’s a one-on-one thing.
Using a repurposed drug is perfectly reasonable if you believe, as a doctor based on the evidence, that you should use it, that you can try it, that you could help save someone’s life. I imagine that there was some kind of bigger influence or board or organization that would be setting such things. This has been my own learning process.
Dr. Risch: For all of us, actually.
Mr. Jekielek: You know?
Dr. Risch: Right. Well, I think that part of the problem is that the whole society evolves, and we evolve by little steps of decline so that each one of them is not really perceptible. We take it for granted. We accept a slight lessening of the quality until suddenly you wake up thinking, “How did we get to rigidified medicine?”
How did we get to doctors who can’t practice the way they think? Who are corporate doctors and almost automatons—robots following the recipes that their institutions require them to use? How do we get there, and how did doctors lose their independence and their ability to think for themselves and so on?
Those are economic forces that people weren’t paying attention to because they succumbed little by little as the temperature on the pot kept rising, and the frog—that’s us—inside the pot kept trying to swim and cope with it until the frog got boiled. That our society has been like that, probably in multiple aspects that we don’t pay attention to, but certainly in regard to the quality of medical care, and it’s sad, unfortunately.
Mr. Jekielek: Well, it’s interesting because a lot of… We’ve been doing this series of interviews at this Brownstone Institute Inaugural Conference, and this has been coming up again and again—the idea of rude awakenings that these last few years have provided, a rude awakening in multiple areas. This isn’t one that I had considered before that you just described. That’s fascinating, and frankly, important that we realize this.
Dr. Risch: I had a couple of email groups of mostly doctors. Though the first one—it started including other people—lawyers, scientists and professionals and so on, got to more than 2,500. I was getting 300 emails a day that I couldn’t possibly cope with. So, I left that. I am accessible by email. People email me directly, I respond.
But I started another one with just … Supposed to be just doctors, but it has a few others. But now it’s about 250. It’s a little bit more manageable. I only get 100 emails a day to deal with.
These doctors, a number of them were all complaining about how their ability to practice medicine had been declining. One in particular in Connecticut who, at the beginning of 2021, was actively treating COVID outpatients—prescribing hydroxychloroquine, ivermectin, antibiotics, other things.
Being very aggressive, measuring antibody levels and T cells and so on, and really doing proper medical care for people who were at risk. Then his practice was bought out by one of the Connecticut corporate medical practices who immediately told him he cannot use hydroxychloroquine and ivermectin.
Mr. Jekielek: Wow.
Dr. Risch: He had to stop treating patients that way. He can still use steroids a little bit, aspirin and anticoagulants, and Tylenol. It’s put a big damper on his ability to practice the medicine that he wants to practice. So, I’ve had to stop referring patients to him and to find other patients in Connecticut for local people.
I refer people who ask me all the time. I get emails from patients all across the country, and actually from the world, saying, “How do I find a doctor who will treat me? I’ve got COVID,” and there are not lots of resources. Our website, earlycovidcare.org, we set up to provide information on the evidence behind various treatments.
We have maybe a dozen now, including hydroxychloroquine, ivermectin, favipiravir, fluvoxamine, steroids, antibiotics, vitamins, zinc, and everything you could find. Also listing some doctors and telemedicine groups. We refer to that page and provide, if they’re local, information to people who are looking for care.
I’ve had maybe hundreds of people who’ve emailed me back saying, “I felt like I was at death’s door when I emailed you. When you gave me this information, I went to them and I got treated, and I recovered in two or three days.” When you use these medications, that’s how well they work. Maybe it wasn’t 100 percent, but people knew they were getting better, that they were substantially better in that timeframe. That’s very gratifying to me at this stage of my career.
The science is great and I love the science that I’ve done. I’ve got some really good papers out there that I like. But it’s not personally gratifying to know that you’ve saved people’s lives or contributed to saving people’s lives. Even for me, not practicing medicine, and not having that tangible feel of relating to patients so directly that my clinical colleagues have. But still, getting a taste of that at this stage of my career has been very gratifying.
Mr. Jekielek: When we’re talking about using these therapeutic treatments, including one called the kitchen sink, which is, I guess, a whole bunch of these things mixed together, some prominent personalities have gotten that, Joe Rogan or Tim Pool, and it’s always met with kind of a bizarre backlash. Right?
Dr. Risch: Well, I think the backlash is because of the idea that they actually got treated, and that they’re a public persona. They’re saying, “I took early treatment, then it worked.” Not to mention I didn’t even say monoclonal antibodies. That’s another component of early treatment that contributes very dramatically, along with all the other medications.
The real problem is that as we’ve learned from AIDS, viral illnesses are difficult to treat by single medications. They require two or three to clobber the virus in different ways, and one of the things that that means is that all the studies that test single drugs, like this tested hydroxychloroquine versus placebo, is an almost useless study because that’s not enough to really damage the virus and its replication.
Now, what that also means is we don’t know whether two is enough. So, doctors are willing to throw everything into the patient as long as they think it’s safe. If a patient starts to have adverse events, they start throwing up, feel bad, or whatever, they have to back off. But until you know you’ve saved the patient, you’re going to do everything that you can, and so it’s better to be conservative and use more as long as you believe it’s safe.
Now, variants of these medications are extremely safe, and that’s why they’ve been used. The really interesting thing about this is that the new medications that have been developed that are under FDA approval review are all things that target the virus, and that means when the virus mutates, as it will, that that targeting will become less and less effective, whereas hydroxychloroquine and ivermectin and other medications do not target the virus.
They target the host, the person. They make the person less amenable to being infected by the virus in a general way. That means it doesn’t much matter what the spike protein does and mutates in the virus.
It’s still going to be blocked from getting into cells by the hydroxychloroquine and zinc, and the replication enzyme that replicates the virus is going to be blocked by that, ivermectin, and other molecules that do this. They target the host, the body, the person, and that isn’t going to change, isn’t going to mutate in the same way.
So, these medications are much more likely to last through variations in the virus that occur because of selection because anytime you give something to a virus that mutates a lot, that only suppresses some of the virus. The virus that gets around the vaccine, that gets around the immune system, that gets around the medication then becomes the one that multiplies out and becomes infective to the next person, that it evades the immunity.
It evades the suppression, and even though the suppression suppresses all boats, it lowers the water for everything, but some of the boats get around that and get out, and that’s the problem. That’s why using vaccines in the middle of a pandemic promotes generation of mutant strains that evade the vaccines, and why in general it’s not a good idea to do that unless the vaccines work so well that they reduce the ability of the virus to spread.
So, yes, they might make mutant strains, but the strains can’t quite get out to the next person to infect a larger number because getting out is also a step that the virus has to accomplish. Not just multiplying in a person, but being coughed or sneezed or breathed out to the next person.
Also, it’s like sperm trying to get into the ovum. You start with 300 million sperm, and you end up with one that actually gives you the fertilized egg. It’s because each step along the way cuts by 1,000 the ability of the next step to work. The same is true for the virus—getting from one person to the next cuts it by 1,000 or a million or whatever to be able to get out. So, even if you make mutant strains, they may or may not succeed.
All of that has to be accomplished, and a vaccine that makes the immunity so strong that even though you can make some mutant strains, they don’t quite get out, is enough. That’s the level of what we call sterilizing. That’s enough. But these vaccines don’t come close enough to that.
When you hear 90 or 95 percent effective, that’s the optimal in the period between two weeks and four months. It goes up then comes back down, and that’s the optimal, and 90 percent isn’t enough.
It would have to have been 99 percent in order to get there. Ninety percent is enough to help people who would otherwise might have gotten sick. There’s the benefit of those vaccines for the people who didn’t have adverse events, that they do get helped in the short-term.
We don’t know anything about the long-term consequences, but that’s a totally separate discussion for next year or the year after. The vaccines do help in that short timeframe, but not enough to keep … We’ve seen in Israel, for example, with the booster—the case numbers dropped dramatically. We know in the short term that they work.
Do they work enough? That’s the real question, and the answer is we don’t know yet because that booster is going to wear out in another three months. then we have to see what comes back there too, and we really do not want to live in what’s called subscription model of vaccination where people have to get these vaccines every three or four or six months.
We already know there’s evidence from Public Health UK that the vaccination reduces by a small increment the ability of the immune system to cope with infections in general. For most people, middle-age or younger, they have good immune systems and are able to cope. You cut it by a little bit, it doesn’t have that much damage.
But if that happens each time you get vaccinated, and you have to get vaccinated every six months, by the time three or four years have passed, now you may have made a sizeable amount of damage across the population to people for other illnesses—flu, respiratory syncytial virus, other coronaviruses, maybe even the common cold.
We don’t know what’s going to happen to people’s immune response to that after this long-term buildup of minor increments of damage. So, these are all the virologists’ considerations as to how to manage the pandemic, and why the vaccination strategy was a very simplistic idea at first. Why it was what I call in the range of plausibility argument, not scientific arguments, that the whole pandemic has been forced on people’s acceptance based on plausibility.
Vaccine, that sounds plausible. We’ll go with that without understanding the real scientific ramifications of it, which were suppressed. Our government agencies suppressed that and so on, as early treatment was suppressed because of plausibility arguments.
Well, hydroxychloroquine, even though it’s been safely used in hundreds of millions of people, now we’ve got COVID. We don’t know it’s safe in COVID. Even though we know it’s safe for all those tens of millions of people in malaria and rheumatoid diseases and autoimmune diseases and so on, safe for them, but not safe for COVID.
What evidence is there not safe for COVID? None because we actually didn’t let you use it for outpatients because we blocked that in March of 2020 before it really had a chance to be widely used in official capacity. So, you have to ask where all this malfeasance came from and why it left plausibility arguments driving people’s social acceptability of these messages.
Mr. Jekielek: Fascinating. I’ve seen this comparison made often. I wanted to get you to comment on it, but the idea of booster shots every however many months. Isn’t that analogous to getting a flu shot every year or something like this?
Dr. Risch: Well, yes and no. We’ve known for a few decades that flu shots are safe, almost entirely safe. That they maybe don’t work as well as we’d like, if at all, in some people. But aside from that, if something is really proven to be safe and not damaging to the immune system in other respects, then it’s like what I said early on for hydroxychloroquine. Even if we don’t know that it works, we know that it’s safe. There’s no downside. There can only be an upside.
The only downside would be that you gave it instead of giving something else that might’ve been better, and since we didn’t have anything that we knew was better at the time, there couldn’t have been a downside.
The same is true for the flu vaccine, and every year we have a new flu vaccine, in theory, made to combat the new strain of the illness, of the virus, whereas now we’re giving year-and-a-half-old boosters. Would you take a year-and-a-half-old flu vaccine? No. Why would you take a year-and-a-half-old COVID vaccine? Well, the argument is that it works partially, or it works well for some people, or it works well enough.
I don’t know how to evaluate the “well enough” aspect of things. I’m an epidemiologist because I don’t really like virology or basic science, or do it well enough to be professional in that. I’m a professional epidemiologist where I take all that and see what happens in people. To me, the bottom line is what happens in people when we do studies of people to see what actually matters.
I think that it’s clear that the vaccines have been beneficial in large degree for at least short periods of time. We don’t know the damage that they’re doing in a longer timeframe, and we don’t know how long they actually do work.
Now we’re getting information that they work on the order of six months, maybe, plus or minus, for different aspects—for reduction of infection, reduction of mortality risk, and hospitalization risk—different outcomes. Each one has to be studied on its own. So, we are still evolving in knowledge.
Mr. Jekielek: You’ve touched on this already, but I guess as we finish up here, what does this whole reality of the fear and the reaction and corporate interest, what does this say about the medical professional as it stands of what needs to happen?
Dr. Risch: Without being too dramatic about this, there was an outstanding essay in Tablet Magazine from a few months ago written by Ashley Fernandez talking about why doctors in Germany in the 1930s became Nazis. The whole public health institution and the medical institution in Germany in the 1930s promoted the Nazi propaganda and messaging construed for how to manage public health.
At times of famine they decided that if this whole society couldn’t support food for everybody, that they would remove the people who needed the food the least—meaning helpless, handicapped, disabled young people, frail, elderly, and so on—who were expendable when the food had to go around to the people who needed it, whatever that meant.
They operationalized rational considerations without human moral considerations. Public health has the risk of doing that, and that’s what happened to us in our society. I was recognizing this more than a year ago. When you have big lies being propagated as propaganda through the media, through the government, through agencies, and so on, don’t believe your lying eyes.
All these doctors treating outpatients successfully, “oh, no, those drugs don’t work.” This was a big lie then. Why and who was purveying this? This is, I think, why Dr. Fernandez wrote this essay in the first place, because she was recognizing the commonalities to what was happening now when you have so much day in, day out propaganda, that people believe it because they’re bombarded with it through all of the major media.
They accept these messages, and they act on those messages instead of the truth, the reality of life and science and medicine. Doctors, I think, are just as frightened, just as anxious as everybody else, and maybe more so. Because they’ve invested so much time and effort into getting their careers going, they may feel they have more to risk even than just Joe Plumber or somebody else.
They went into their field because of stature and considerations of accomplishment and doing well for society and their patients and all of that. They may feel that they are at higher risk in some intangible way, I think.
They’re more likely to toe the line, and those lines have been enforced on them through the corruption of all the medical agencies, the medical review boards of all the states, largely. The pharmacy review boards have all pushed a top-down message coming from FDA, CDC, WHO.
I have to get in a comment about the FDA and its website. This is something that has made me the angriest over this last year-and-a-half. In July of 2020, the FDA mounted a website warning against hydroxychloroquine used for outpatients. The website’s still there.
It says, “Warning, hydroxychloroquine should not be used for outpatient treatments because of risk of cardiac adverse events,” and then in the small print, the fine print underneath that big, bold, black letter warning, it says, “We base this warning on adverse events that we have observed in hospital patients.” This is a fraud.
They used hospital disease, which all medical professionals recognize is a different disease, as I’ve said, than outpatient flu-like illness. That has stood up there. Everyone that says hydroxychloroquine can’t be used points to that website and says, “Here’s the reason why we can’t do it.” The states, the AMA, the pharmacy boards, they all point to that. Foreign countries, their governments all point to that, saying, “We can’t do it because the FDA says not to do it.”
I’ve railed against this in the media that we are a part of, and the way that the propaganda reacts to this is, “Ignore it. Ignore all of this.” I’m saying this now because the general public has to be the one that gets angry. The general public should be furious at the way people have been treated in the country by suppression of these drugs, by that kind of website that suppresses the ability of doctors to practice medicine.
This is what should’ve been done, and why people should be angry. They should be angry at their government. They should be angry at President Trump for not leading the fight in this when he was in power. They should be angry at the government now for not leading the fight to make these drugs available. These drugs work, there’s no question, and they should’ve been out there, whether or not vaccines are used. There’s a role for vaccines, and I’m not saying that.
There’s no role for universal vaccination, but there is a role for targeted vaccination for people who have reasons to do the risk-benefit analysis and see it’s in their benefit. There’s a reason why those people will still get COVID, because the vaccines are not 100 percent effective.
They still need to have treatment, and these drugs are the treatments of choice. This has to be there, and people need to be angry about this to see why these drugs have been suppressed from them for reasons that have nothing to do with the science and the medicine.
Mr. Jekielek: Okay. You’re given the opportunity to create policy at the level of the CDC or FDA. As our final question, what do you do?
Dr. Risch: You open up, you remove the FDA’s website. You apologize for it. You say that there’s a role for these medications to be used. You basically open the tap, as some states have done. Florida and Texas have been pretty free about allowing the prescription of the medications. There are other states where they are free, but quiet about it, and so you open those taps, and you let people become knowledgeable. You get them out.
We’ve still got 60 million doses of hydroxychloroquine in the Strategic National Stockpile that should be released. There’s no shortage of that. The drug can be made in about 15 minutes. It’s a very simple drug to make. The raw ingredients are plentiful, it’s made all over the world. That’s why it’s so inexpensive to make.
It can be supplied in very large quantities. Ivermectin can be made in large quantities. It takes a little longer to make it, but it’s still something that can be made relatively straightforwardly, and so you do that. You make those medications available.
You make the recipes for doing this available to doctors to know how to do it. There are countries where hydroxychloroquine and ivermectin are over the counter. So, you make this available everywhere. Prescription is better because doctors really need to be involved in helping people to fight this. It’s not a do-it-yourself thing at home. You make it available, practical, and easy to do, and you get people over it.
This does two things. Number one, it reduces the anxiety dramatically so people will live their normal lives and get everything back together. Secondly, the people who get COVID and get beyond it have natural immunity. Natural immunity is how we’re going to get out of this endemic disease. Vaccine immunity works, but it’s short-lived.
Natural immunity is much longer lived in spite of all the propaganda saying, “Well, we don’t know how long natural immunity is.” Well, do we know how long vaccine immunity is? Well, no. Natural immunity is better. It’s been better. There’s now 124 studies on the earlycovidcare.org website. It grows by a half a dozen studies a week, if not more, looking at natural immunity and how well it works.
This is virology 101. Natural immunity was known to the ancients, to the Greeks. They knew that people only got sick once from a disease and got over it and were immune to it when it came back. You can’t suddenly say that all human knowledge disappears because you have a vested interest in selling a product that can’t allow that to be true.
That’s how we end this pandemic, by having large amounts of natural immunity, which makes any subsequent waves into bumps, and bumps that are treatable bumps, and that’s how we get through it. We have to do that by opening the tap to the medications that work. Whether they’re new medications or old medications, expensive or cheap, we have to make them practical, safe, usable, and that’s what’s going to get us out of this. That’s the key.
Mr. Jekielek: Well, Dr. Harvey Risch, it’s such a pleasure to have you on.
Dr. Risch: Thank you. Great to be with you.
[Narration]: Our team reached out to the FDA, the U.S. Food and Drug Administration, but they did not respond to our request for comment.
This interview has been edited for clarity and brevity.