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The much-touted report into hydroxychloroquine offers only comical relief

6 June 2020

9:00 AM

6 June 2020

9:00 AM

For 25 years, Richard Horton, hard-left polemicist, has been editor-in-chief of the Lancet, the stately old Florence Nightingale of medical journals. Yet despite a string of political scandals during his tenure, it remains second in influence only to the New England Journal of Medicine (NEJM). Horton’s causes célèbres include publishing an inflated Iraq War death toll, a letter on Gaza from pro-Hamas doctors and calling for physicians to join Extinction Rebellion. Since then, climate combat has morphed seamlessly into Covid war. Once again we are being browbeaten to listen to ‘the experts’ and railroaded into economic vandalism by scientists brandishing models and warning that vast numbers of lives will be lost if we don’t do as they say — not as they do. The WHO, rather than the IPCC, is the arbiter of the orthodoxy which cannot be challenged, and social media platforms are the self-appointed censors. Dissenting ideas are too dangerous even to be heard. Lockdown sceptics are deleted from YouTube. Virtuous celebrities call for wet markets in Indonesia to be closed, for fear of embarrassing China. Horton is a vocal advocate for the WHO where he has held a number of high-profile jobs and praised China’s handling of the pandemic. So, it was ironic that a Lancet editorial last month exhorted Americans to ‘put a president in the White House… who will understand that public health should not be guided by partisan politics.’ Horton is in the front line of the most pitched partisan battle of the pandemic; the fight — to the death — to crown a cure for Covid-19. His latest improvised explosive device is an observational study of hydroxychloroquine (HCQ), published in the Lancet on 22 May. It used machine learning to analyse the records of 96,032 patients in 671 hospitals on six continents and claimed that the mortality rate for patients taking HCQ was double that of those that took nothing. As one Colombia University statistician wrote, ‘Not many drugs are that good at killing people.’ Horton’s Molotov cocktail was manna from heaven for progressives who revelled in headlines trumpeting that the drug ‘touted by Trump’ was killing people. Dr Fauci, the administration’s most senior infectious diseases expert grinned as he told CNN that the study showed that HCQ was ineffective, even though he had previously dismissed observational studies as purely anecdotal when they supported the use of HCQ. The WHO immediately halted its international random controlled trials (RCT), perhaps worried that they might yet provide evidence in support of HCQ. France went further and banned the use of HCQ in any Covid-19 treatment. Yet many countries, including Morocco, Algeria, Nigeria, Turkey, Armenia, Russia, India, Indonesia, Malaysia, South Korea, Switzerland, Spain and Holland, told the WHO that early-intervention HCQ had dramatically reduced mortality rates and they were sticking with a winner.

It was quickly apparent that there were big problems with the big data created by a company called Surgisphere. Worse, it provided no evidence of patient consent and deemed ethical approval of its practices unnecessary. More than 140 leading scientists and physicians wrote to the Lancet protesting the secrecy and pointing to numerous concerns. The huge mortality rate had not shown up in any other study and seemed to be related not to the drug but to the practice in the US and Europe of giving HCQ to only the sickest patients. The dosage frequently exceeded that prescribed by the Food and Drug Administration (FDA). The data had been so manipulated that there was no discernible difference between the continents. And the Australian data was just plain wrong. The study said it had analysed 600 Covid-19 patients in five hospitals of whom 73 had died by 21 April. Yet only 71 deaths had occurred at that date, spread across more than 28 hospitals and two aged care facilities. The authors responded that they had suddenly ‘discovered’ that a new hospital had joined the registry on April 1 and ‘self-designated as belonging to the Australasia continental designation,’ but ‘this hospital had a nearly 100 per cent composition of Asian race and a relatively high use of chloroquine compared to non-use in Australia,’ so the researchers decided that it ‘should have more appropriately been assigned to the Asian continental designation.’ The Lancet’s comically named ‘Department of Error’ obliged but Peter Ellis, chief data scientist for the Nous group said, ‘there is simply no plausible way I can think of that the data are real.’ The company, which was put into liquidation in 2015, seems as dodgy as its data. Its founder, Sapan Desai, a co-author of the study, was named in three medical malpractice lawsuits filed in 2019. He told the Scientist that he couldn’t comment except to say that any lawsuit naming him was ‘unfounded.’ Thomas Koenigsberger, the Science Editor (actually the Scoence editor, which hardly inspires confidence about his editing skills) has been dead since March 2018, according to his obituary. Perhaps he is a ghost editor. And the Director of Sales and Marketing has experience in modelling lingerie rather than pandemics, according to Models Mayhem, where she lists her services.

Despite the furore, Horton refused to concede any problems. In this he has form, once waiting 12 years to retract a damaging article on vaccines and autism. Not so the NEJM. It had published a far less controversial article based on Surgisphere data last month, but this week asked the authors to prove their data was reliable and published an expression of concern about their conclusions. Hours later, Horton crumbled and followed suit.

The campaign to destroy hydroxychloroquine has been waged relentlessly, both by competitor pharmaceutical companies and those who want to destroy the US economy to advance their political agenda. It is shocking that it has cost hundreds of thousands of lives and billions of taxpayer dollars. But although the corruption of science for political and/ or financial gain has become a defining characteristic of our age, it is not a new story.

In 2009, Marcia Angell, wrote, ‘It is simply no longer possible to believe much of the clinical research that is published,’ adding, ‘I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of the NEJM.’ In 2015, Horton echoed her: ‘much of the scientific literature, perhaps half, may simply be untrue… Afflicted by… flagrant conflicts of interest, together with an obsession for pursuing fashionable trends of dubious importance, science has taken a turn towards darkness,’ adding that editors ‘aid and abet the worst behaviours’ and ‘our love of “significance” pollutes the literature with many a statistical fairy-tale.’ Lancet-gate, it seems, is just the latest chapter.

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