By Donald Pompan, MD, and Michael M. Jacobs, MD, MPH
December 3, 2020
The Senate Homeland Security Committee convened a hearing on 19 November 2020 Chaired by Senator Ron Johnson (R-WI) to examine “Early Outpatient Treatment: An Essential Part of a COVID-19 Solution.” This hearing was not televised nationally and was sparsely attended, even by its own Committee members. The meeting provided essential insight into why our country has failed miserably in the medical management of COVID-19, especially with high-risk patients. Rather than embracing early treatment, which is how most illnesses are managed, the medical establishment (academia, federal health agencies) has actively suppressed the evidence for early outpatient treatment of COVID-19 illness. The 2-hour and 30-minute hearing is essential viewing for all Americans given that around 275,000 (as of December 1, 2020) of our citizens have died and many aspects of our society are devastated by lockdowns.
There were three physician-scholars supporting early outpatient treatment of symptomatic COVID-19 illness in high-risk patients: Dr. Peter McCullough of Baylor University Medical Center, Dr. Harvey Risch of Yale University, and Dr. George Fareed, Medical Director at Pioneers Medical Center, Brawley, California. Dr. Ashish Jha of Brown University presented the opposing viewpoint.
Dr. Peter McCullough, who treats COVID patients, described his scholarly article published in the American Journal of Medicine (August 2020) titled “Pathophysiological Basis and Rationale for Early Outpatient Treatment of SARS-CoV-2 (COVID-19) Infection.” In his testimony, Dr. McCullough described the “four pillars of pandemic response” including “Contagion Control,” “Early Home Treatment,” “Hospitalization,” and “Vaccination.” He emphasized that our collective medical response and media portrayal has ignored early treatment. He then described the stages of COVID-19 illness to include viral replication, cytokine storm, and microthrombosis. He discussed how early outpatient treatment is a multidrug regimen to disrupt viral replication, thereby reducing the risk of progression to high-morbidity cytokine storm and microthrombosis. Hydroxychloroquine (HCQ), the drug most known to the public, is one of several drugs in Dr. McCullough’s published algorithm to not only disrupt viral replication and packaging but to treat the ravaging effects of cytokine storm and microthrombosis.
Dr. Harvey Risch presented his analysis of the research involving early treatment, focusing on the outpatient use of hydroxychloroquine because it is the most studied drug. Dr. Risch emphasized outpatient treatment of symptomatic high-risk patients within the first 5 to 7 days of illness with the “HCQ cocktail,” consisting of HCQ in combination with zinc and an antibiotic, azithromycin or doxycycline. Dr. Risch has published a paper in the American Journal of Epidemiology analyzing the data. His conclusion, drawn from established powerful and informative statistical methods such as meta-analyses, is that early treatment of symptomatic high-risk COVID-19 patients is both safe and dramatically effective.
Dr. George Fareed, who practices in the epicenter of the COVID-19 pandemic in California, presented his clinical experience with outpatient treatment of hundreds of high-risk COVID-19 patients with the “HCQ cocktail.” He works alongside other physicians who collectively have treated a few thousand patients. Dr. Fareed noted that he and his colleagues have seen dramatic outcomes with minimal side-effects, few hospitalizations, and no deaths with early outpatient treatment. Dr. Fareed, who has a background at the National Institutes of Health as a virologist, noted that his treatment is in accordance with the science and pathophysiology as described by Dr. McCullough. Like Dr. McCullough, Dr. Fareed’s treatment regimen extends well-beyond the use of HCQ in managing devastating sequelae of COVID-19 illness.