0 33 minuti 3 anni

MedEthica 1/2022

[1]

Publication planning and ghost writing are the two main systems, closely intertwined with each other, by means of which the pharmaceutical industry controls, de facto (and often fraudulently), international medical science.[2] There are already many scandals in which the illegitimate and perverse use of these tools came to light through judicial inquiries. There are also the alarms raised by medical journals worried about the unreliability that plagues medical science due to these practices of the pharmaceutical industry.

Sergio Sismondo and Scott Howard Nicholson describe publication planning in this way:

«Publication planning is the sub-industry to the pharmaceutical industry that does the organizational and practical work of shaping pharmaceutical companies’ data and turning it into medical journal articles. Its main purpose is to create and communicate scientific information to support the marketing of products».[3]

This definition does not explicitly reference some important elements of this trading technique or strategy. For example:

  • that it is often done by paying distinguished experts, mostly academics, to put their signature on the articles produced by pharmaceutical companies’ ghost writers so as to conceal their conflict of interest and to deceive the public into believing that the articles are the product of independent scientific studies;
  • that article orders are tailored from pharmaceutical companies to sub-industries so that they serve the commercial purposes of the product launch, such as extolling off-label uses that could not otherwise be advertised, hiding negative effects, praising positive effects, or inventing non-existent scientific results;
  • that publication planning is often done well in advance and in a subtle way with respect to future commercial launches in order to prepare the market and possibly ruin potential competition. For example, publication planning could try to convince doctors that there is an unsatisfied pharmacological need or that current drugs are not sufficient or that they have negative effects on certain diseases.

Here I do not intend to dwell on these almost always immoral (and often illegal) strategies used by pharmaceutical companies or on the incalculable damage they cause to the credibility and reliability of medical science.[4] I only intend to apply the publication planning mechanism on a presumptive basis to what has happened over the past two years with regard, on the one hand, to early treatments and, on the other, to the latest pharmacological innovations for the treatment of COVID-19.

  1. The Early Treatment Narrative is Now Convenient

It is now in the public domain that pharmaceutical companies have recently marketed, with the authorization of the competent drug agencies, some super antiviral pills—Molnupiravir-Lagevrio (Merck)[5] and Paxlovid (Pfizer)[6]—for the early treatment of COVID-19. These super pills have now been added to other drugs already previously granted emergency approval or authorization (depending on each legal system’s formal terminology).[7]

For my purposes, we must pay attention to two facts: a) that these drugs are antivirals, and b) that they require immediate use on patients when the first symptoms of the disease appear

Now, anyone who has followed the debate on the early treatments of COVID-19 since the beginning of the pandemic will immediately recognize that these are the two main assumptions of the action of those doctors all over the world who have tried to promptly treat their patients before the worsening of the disease. In fact, the idea has always been to prevent the sick from ending up in the hospital, because hospitalization marks the moment when the disease becomes a dangerous infection of internal organs.

The SARS-Cov-2 virus, in other words, is not dangerous in and of itself, but because of subsequent cascade of complications that are no longer directly tied to viral replication. The hospitalized patients do not die from the virus as such, but because their body’s internal organs have deteriorated and are unable to recover. The disease, like all similar viral infections, must therefore be managed to avoid complications. And the treatment mainly involves the immediate use of antivirals and antiseptics (in addition to other elements of good medical practice such as resting, checking that the temperature does not rise too much, providing vitamin supplements, etc.).[8]

In fact, many doctors who belong to medical associations and who have consulted at the international level have developed treatment protocols based on the conventional medical practice for this type of disease and on the effectiveness of various traditional products with proven track records, whose positive and negative effects are well known. The effectiveness of these products has been observed both in the daily events of relationships with patients and in various clinical studies.[9]

2. Discreditation of Off-Label Use and Early Care Drugs

In this regard, it should be remembered that the doctor is not a mere dispenser of drugs authorized by the drug agencies. The doctor has a professional competence that depends above all on the relationship with the patient and on medical practice. It is for this reason, for example, that it is permissible for the doctor to use drugs even for uses not authorized by the agencies. This is called off-label use and comprises up to 50% of the world drug market. In other words, almost half of the time doctors prescribe drugs for uses not included in the scientific studies that led to the approval of the drugs themselves; this is not only legitimate, but in accordance with the primary and ultimate meaning of medical science.[10]

Yet, in this pandemic emergency, the relationship between doctors and drugs has been turned upside down, as if there were some benefit in doctors not being free to deal with the epidemic as they see fit. One early attack on conventional medical procedure was the ban on autopsies, which could have saved thousands of lives, and which had no scientific or common-sense basis. The elimination of autopsies remains a mystery to be solved.[11] The second deadly attack on medicine was the constant attempt to block the freedom of doctors by trying to subject them to impersonal protocols (such as that of the Italian government “Paracetamol and watchful waiting”),[12] and to prevent them from freely using commonly used drugs as if suddenly off-label use had become contrary to medicine.

It is a self-evident fact that doctors who argued that it was possible and important to intervene promptly at the home level to avoid the onset and worsening of infections were considered literally insane and constantly insulted in public and in the mainstream media and even threatened with suspension, marginalization, and disciplinary measures.[13] “There is no cure for COVID,” was the slogan. Demolishing, ostracizing, demonizing, and blocking doctors who thought they could help patients were among the main demagogic techniques. Another technique was “scientific” and consisted of a daily media pounding on the fact that every possible remedy proposed by these “esoteric” or “witch” doctors was deemed contrary to science, ridiculous, or harmful.[14]

I remember a fanatical journalist who, after having invited one of these doctors to speak on his show, turned off the audio before his guest could even express his point of view. The trigger for this psychotic reaction from the journalist was that this doctor dared to start by saying that he followed science. It was this very idea, namely that such a “crazy” and “ignorant” doctor could say he was following science, which triggered the blind fury of the journalist who said that there was a limit to everything and that he could not allow such a person (whom the journalist himself had invited and who had not yet explained his view on medical science) to speak on his broadcast. This is an example of the atmosphere in which we have been breathing over the past two years, in which the vaccines had to appear to be the only possible solution and in which any doctor who dared to say that the disease had to be treated immediately at home, at the first sign of symptoms with antiviral and anti-inflammatory therapies to combat the virus, was literally censored, insulted, and marginalized by civil society.

3. Discrediting of Cheap Available Drugs

Let’s recall among others the case of hydroxychloroquine which was discredited globally especially through an article that appeared on May 22, 2020, in the famous medical journal The Lancet.[15] The impact of that article was disruptive. Ongoing clinical trials were stopped for fear that the “guilty drug” would harm the health of the participants.[16] A real media and professional persecution began against all doctors who believed it was useful and right to continue using that drug, now condemned by global public communication.

The World Health Organization (WHO), also based on a study promoted by the Bill Gates Foundation with the university that was trying to produce the AstraZeneca vaccine (therefore in obvious conflict of interest), removed it from the list of recommended drugs.[17] The Italian Medicines Agency (AIFA), which like many other similar agencies, seems to have among its unofficial institutional tasks that of protecting the business of pharmaceutical companies, did not miss the opportunity and even went so far as to prohibit off label use of hydroxychloroquine. Of course, TV experts, often in obvious conflict of interest, joined the chorus against this dangerous drug.[18] Fortunately, in this case, the Italian judges recognized that this was an undue violation of the autonomy of doctors and suspended AIFA’s infamous decision.[19]

The ad hoc study produced by the Gates/Oxford collaboration in obvious conflict of interest—called the Recovery Study—made use (more or less like the Who’s Solidarity trial) of a brilliant stratagem; it had used the drug in late stages of COVID, when the antiviral effect could not prevent the degeneration of the disease into infection.[20] This same trick was used by the so-called Tsunami Study to discredit the use of hyperimmune plasma (also beneficial as an antiviral only if used before the development of infections).[21] But hydroxychloroquine had two other irremediable defects: it was very inexpensive, and it undermined the requirement of the lack of alternatives necessary for the emergency approval of vaccines.

The Lancet article, which had such a dramatic effect on science and medical practice was based on false data and was almost immediately retracted, on June 4, 2020 to be precise.[22] The commercial advantage of Big Pharma, however, thanks also to Recovery, had already been reached. Hydroxychloroquine had now been discredited thanks also to the essential contribution of the Gates Foundation and the creators of the AstraZeneca vaccine.

Ivermectin had a similar fate, despite the fact that its positive efficacy studies against COVID 19 have always far exceeded its negative ones.[23]

4. They Had Been Working on It for Some Time Behind the Scenes

But now everything has changed. The antivirals to be taken immediately, at home and pre-hospitalization, have been placed on the market by the same pharmaceutical companies that produced the so-called anti-COVID vaccines. The issue here is not only to highlight that, according to the logic of publication planning, the public narrative on early treatments can now change because these drugs are finally part of the full-price product line sold by pharmaceutical companies. The issue is also that if these miracle pills have now already been approved, it means that the pharmaceutical companies were working on them and on the logic of early home treatments from the very beginning. It means that those same principles that guided the work of heroic general practitioners willing to go against the tide, risking public ostracism and their license or job, were valid and were, in fact, being studied by pharmaceutical companies.

The antivirals already in circulation, however, were already widely tested and low-cost because they were no longer covered by the exclusive rights of the pharmaceutical companies. Now the antivirals in circulation are brand new, still experimental, and can be marketed at exorbitant prices.

You don’t have to be a genius to notice that these new drugs cannot be guaranteed to be as safe as the old ones because they have been hastily approved with emergency approvals that, by definition, cannot follow the usual safety protocols that are supposed to take around five years. Older drugs, albeit in off-label use with respect to COVID (like nearly all drugs with respect to any disease), had been tested within ordinary timeframes and had been in use for decades, which made them extremely safe from the point of view of science and medical practice—or, at least, it makes their adverse event profile well known.

It is a paradox that these drugs today are advertised without doubts of any kind by the media and politics[24] while the previous ones were so easily questioned and attacked based on alleged scientific truths churned out weekly, coincidentally, always with the help of a “favor vaccini” principle—like the “favor rei” which implies the more favorable application of the rules for the defendant. The sudden change from the public narrative on early treatments and antivirals confirms the logic and power of publication planning by pharmaceutical companies, also based on their economic power to hire journalists, doctors, politicians, and news agencies.[25]

5. But Do the Conditions for Emergency Authorization Exist?

The logic we are talking about is even more perverse. In fact, it must be remembered that one of the prerequisites for the emergency authorization of drugs is that there are no valid and effective alternatives for the cure or treatment of a certain pathology. It was therefore necessary, in the process that aimed at the emergency authorization (with sure billionaire profits) of the anti-COVID super pills, to sufficiently discredit any other products already on the market. The drug agencies had to have a plausible, credible, and easily accepted excuse to present to the authorities and the public. Up to the emergency authorizations it was therefore necessary to demolish both the existing alternatives and the doctors who tried to use and promote them, even if this resulted in the loss of human life. In the pharma trade war, innocent lives lost are side effects, like civilians who die when bombs are dropped.

It is very important to ask oneself if the legal, ethical and medical conditions exist for the current emergency approvals of these new products, remembering that the essential feature of emergency authorizations is the reduction of safety protocols for the benefit of the efficacy of a drug with respect to which there are no valid and safe alternatives.

Unfortunately, one of the effects (probably desired and coveted) of the COVID pandemic emergency was precisely that of the abatement, not only of the safety protocols, but also of the appropriate attention and prudence to be used regarding the emergency authorization of drugs. By now the agencies have in this regard a sort of license to arbitrary approval, being sure of public demagogic acceptance of any emergency decision aimed at combatting COVID-19.

Among the prerequisites for emergency authorizations, the existence of which must always be verified, is the very state of a health emergency. It is almost under everyone’s eyes, in fact, that in many countries, if not all, the emergency is over, and the Omicron variant is not only comparable to the influenza of 2017-2018, but also a positive step toward obtaining real herd immunity against SARS-Cov-2.[26]

In an ethical and legal system that works, the justification for emergency authorizations against COVID, especially the various mandates, should now be stopped, not only with respect to specific assumptions such as the lack of alternatives and efficacy, but also with respect to the general requirement of responding to a real state of emergency.

6. The Case for Preferring Existing Antivirals

From the point of view of both ethical and scientific prudence, I am convinced that we must currently prefer existing drugs to the new super pills approved in an emergency, overcoming the psychological effect of the unjust denigration they have suffered. The new super pills, in fact, are still being tested and do not provide sufficient guarantees of their safety. There is no real emergency reason or lack of plausible alternatives that, in this case, could legitimize the sacrifice of security. The risk-benefit ratio must in fact always be calculated, weighing, on the one hand, the state of emergency and the lack of alternatives, and, on the other, the acceptance of unpredictable future risks.

The state of emergency is no longer current and it is necessary to recover tranquility and psychological normality with respect to COVID-19. There are alternatives and they are widely known. These are drugs approved in an ordinary way, that is, after the complete period of experimentation, and which have been in use for many years, enough years to give doctors considerable peace of mind in predicting their effects and benefits. The fact that some drugs have been part of world medical practice for a long time is one of the best guarantees as opposed to calculating the risk-benefit ratio of novel super pills. There are also other natural or physiological remedies that should not be underestimated and that have no contraindications.[27]

Frankly, it is not clear why there should be emergency authorizations of experimental antivirals against COVID in the current context. This is obviously a marketing scam resulting from a perverse publication planning operation that must be understood and unmasked. An emergency must always be evaluated in a timely manner, and the alternatives must be carefully considered, including in regard to off-label uses.

Let me clarify. One of the tricks used by publication planning and drug agencies is to evaluate existing alternatives solely with respect to drugs authorized specifically for the relevant pathology, in the present case SARS-Cov-2/COVID-19. In applying such an approach, however, pharmacological alternatives for the cure or treatment of new pathologies will always be lacking. No drug can be authorized in the past for future diseases. If you use this perverse and fallacious logic, you can approve any drug by saying that it is specifically designed to target a certain pathology. In this way, it would even be superfluous to discredit already existing drugs which, of course, could not have been specifically approved for a disease that did not exist before. This is inadmissible. The off-label uses of drugs are part of existing medical alternatives and must be evaluated with honesty and detachment from the billionaire interests of pharmaceutical companies. 

The very dangerous drift of the total abatement of drug safety protocols using the preferential COVID emergency highway must be firmly opposed.

Fulvio Di Blasi, Ph.D., is a practicing lawyer and an expert in ethics and natural law theory. He is the author of God and the Natural Law (2003), Ancient Wisdom and Thomistic Wit: Happiness and the Good Life (2017), From Aristotle to Thomas Aquinas (2021), The Death of the Phronimos: Faith and Truth about Anti Covid Vaccines (2021), and Vaccination as an Act of Love? Epistemology of Ethical Choice in Times of Pandemics (Italian version January 2022; English version forthcoming March 2022).


[1] I thank Marisa Gatti-Taylor Ph.D. and Steven Millen Taylor Ph.D.—as well as a friend who needs to remain anonymous to avoid possible negative employment repercussions—for their editorial help with this article.

[2] See F. Di Blasi, The Death of the Phronimos: Faith and Truth About Anti Covid Vaccines (Phronesis Editore: Palermo, 2021).

[3] See S. Sismondo, S. H. Nicholson, “Publication planning 101,” Journal of Pharmaceutical Sciences (J Pharm Sci), 2009, 12(3):273-9, doi: 10.18433/j3ww2r, PMID: 20067704.

[4] For an in-depth study of these aspects, refer to my book The Death of the Phronimos: Faith and Truth About Anti Covid Vaccines, op. cit.

[5] The U.S. Food and Drug Administration (FDA), after a negative vote by its independent scientific committee on November 30, 2021, issued an EUA for the use of Molnupiravir on December 23, 2021: see FDA News Release, “Coronavirus (COVID-19) Update: FDA Authorizes Additional Oral Antiviral for Treatment of COVID-19 in Certain Adults,” December 23, 2021, URL: https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-additional-oral-antiviral-treatment-covid-19-certain. The European Medicines Agency (EMA) did not authorize it but only advised it, leaving the decisions to the governments of the individual states: see EMA News, “EMA issues advice on use of Lagevrio (molnupiravir) for the treatment of COVID-19,” November 19, 2021, URL: https://www.ema.europa.eu/en/news/ema-issues-advice-use-lagevrio-molnupiravir-treatment-covid-19. On November 4, 2021, the UK Medicines and Healthcare products Regulatory Agency (MHRA) granted a conditional drug authorization for Great Britain and a temporary drug regulation (pending judgment by the EMA) for the ‘Northern Ireland: see UK Government, “Regulatory approval of Lagevrio (molnupiravir),” November 4, 2021, URL: https://www.gov.uk/government/publications/regulatory-approval-of-lagevrio-molnupiravir. On December 30, 2021, the Italian Medicines Agency (AIFA) authorized the use of the drug: see, AIFA Press Release, “Availability of molnupiravir and remdesivir in the treatment of patients not hospitalized for COVID-19 and at high risk of serious illness,” December 30, 2021, URL: https://www.aifa.gov.it/-/disponibilit%C3%A0-molnupiravir-e-remdesivir-trattamento-pazienti-non-ospedalizzati-covid-19-1. Other states, such as Australia, New Zealand and Bangladesh have also recently authorized its use.

[6] The FDA granted the Paxlovid EUA on December 22, 2021: see FDA News Release, “Coronavirus (COVID-19) Update: FDA Authorizes First Oral Antiviral for Treatment of COVID-19,” December 22, 2021, URL: https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-first-oral-antiviral-treatment-covid-19. EMA granted conditional authorization for the drug on January 28: see EMA, “Paxlovid,” January 28, 2022, URL: https://www.ema.europa.eu/en/medicines/human/EPAR/paxlovid. Great Britain granted conditional clearance on December 31st: see UK Government, “Regulatory approval of Paxlovid,” December 31, 2021, URL: https://www.gov.uk/government/publications/regulatory-approval-of-paxlovid. In Italy, AIFA defined the conditions for using the drug on January 28: see, AIFA, “AIFA defines how to use Paxlovid soon available in Italy,” January 28, 2022, URL: https://www.aifa.gov.it/-/comunicato-stampa-n.-684.

[7] See FDA, “Emergency Use Authorization – Drugs and Non-Vaccine Biological Products,” URL: https://www.fda.gov/emergency-preparedness-and-response/mcm-legal-regulatory-and-policy-framework/emergency-use-authorization#coviddrugs; EMA, “COVID-19 treatments,” URL: https://www.ema.europa.eu/en/human-regulatory/overview/public-health-threats/coronavirus-disease-covid-19/treatments-vaccines/covid-19-treatments. In Europe, the current emergency authorization of Covid drugs is called “conditional approval” and it has analogous legal requirements to the American EUA.

[8] The Covid-19 Early Treatment Fund (CETF) has a useful presentation page of early care with links to various successful protocols developed and used in various parts of the world: see CETF, “Promising drugs,” URL: https://www.treatearly.org/promising-drugs.

[9] See A. Donzelli, “Medicines Against Covid-19 in the Early Stages: Which Ones Should Be Avoided?,” Fondazione Allineare Sanità e Salute, November 20, 2021, URL: https://cmsindipendente.it/sites/default/files/2022-01/Slide_Conf_Stampa20nov21_paracetamolo_IPP_cLDL_Donzelli.pdf.

[10] On these aspects of medical science see F. Di Blasi, Vaccination as an Act of Love? The Epistemology of Ethical Choice in Times of Pandemics (Phronesis Publisher: Palermo, 2022 (Italian version); English version forthcoming in February 2022); F. Di Blasi, The Death of the Phronimos: Faith and Truth about Anti Covid Vaccines, op. cit.

[11] Especially in Europe, in the early months of the pandemic, the authorities advised against and effectively prevented autopsies to avoid presumed risks of contagion. Scholars have referred to this as a “science lockdown”, which involved America as well. See, e.g., M. Salerno, F. Sessa, A. Piscopo, A. Montana, M. Torrisi, F. Patanè, P. Murabito, G. Li Volti, C. Pomara, “No Autopsies on COVID-19 Deaths: A Missed Opportunity and the Lockdown of Science, Journal of Clinical Medicine, 2020, Published: 14 May 2020, 9(5):1472, https://doi.org/10.3390/jcm9051472: “The time is now to shout out against this terrible lockdown of science: autopsy, autopsy, autopsy!” See also A. Tzankov, D. Jonigk, “Unlocking the Lockdown of Science and Demystifying COVID-19: How Autopsies Contribute to Our Understanding of a Deadly Pandemic,” Virchows Archiv: an international journal of pathology, 2020, 477(3), 331–333, https://doi.org/10.1007/s00428-020-02887-5; J. Gale, “Covid Has Killed 5 Million People, But Only Hundreds Have Been Autopsied”, Bloomberg Businessweek, November 5, 2021, URL: https://www.bloomberg.com/news/articles/2021-11-05/perform-more-autopsies-on-covid-victims-to-understand-virus-scientists-say: “Authorities were concerned in the panic-stricken early months of the pandemic that dissecting coronavirus-infected patients could spread the infection, resulting in at least half of the autopsy units in the U.S. being shut down, according to L. Maximilian Buja, a professor of pathology and laboratory medicine at the University of Texas’s McGovern Medical School in Houston […] Hamburg forensic pathologist Klaus Puschel defied Germany’s official recommendation to avoid autopsies, permitting 80 comprehensive post-mortem exams on fatal cases in March and April 2020. The findings showed SARS-CoV-2 can spread beyond the respiratory tract to affect the heart, kidney, liver, and brain.”

[12] In Italy, both the National Medicines Agency and the Ministry of Health indicated that in the event of infection, patients would just have to stay at home and wait, possibly taking paracetamol. Doctors were de facto advised not to treat their patients with any type of therapy. Many doctors challenged these directives but, although the first instance judges recognized that the directives violated the freedom of doctors, the appellate judges defended the government’s positions.

[13] See, e.g., M. Nass, “The extraordinary story of how patient access to COVID treatments was denied, eventually involving witch hunts of physicians who dared to treat patients”, Meryl’s COVID Newsletter, 11/02/2022, URL: https://merylnass.substack.com/p/the-extraordinary-story-of-how-patient.

[14] The journalistic literature on these things is endless. it is enough to do a short online search to realize this. See, e.g., H. Wetzler, “Opinion: We should be questioning the global suppression of early treatment options for COVID-19,” Clark County Today, May 27, 2021, URL: https://www.clarkcountytoday.com/opinion/opinion-we-should-be-questioning-the-global-suppression-of-early-treatment-options-for-covid-19/.

[15] C. Funck-Brentano, J.-E. Salem, “RETRACTED: Chloroquine or hydroxychloroquine for COVID-19: why might they be hazardous?,” The Lancet, Published: May 22, 2020, DOI: https://doi.org/10.1016/S0140-6736(20)31174-0.

[16] See E. Mahase, “Covid-19: WHO Halts Hydroxychloroquine Trial to Review Links with Increased Mortality Risk,” BMJ,2020, 369:m2126, doi:10.1136/bmj.m2126.

[17] See WHO, “WHO discontinues hydroxychloroquine and lopinavir/ritonavir treatment arms for COVID-19,” July 4, 2020, URL: https://www.who.int/news/item/04-07-2020-who-discontinues-hydroxychloroquine-and-lopinavir-ritonavir-treatment-arms-for-covid-19. It is interesting that the WHO’s own trial, the results of which were published in The New England Journal of Medicine, was based on hospitalized patients, and therefore not on the early stages of the disease: see WHO, “WHO COVID-19 Solidarity Therapeutics Trial”, URL: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/global-research-on-novel-coronavirus-2019-ncov/solidarity-clinical-trial-for-covid-19-treatments.

[18] See, e.g., Affari Italiani, “Coronavirus, Bassetti: “Hydroxychloroquine does not Work. On Trump Used Heparin,”” 04/11/2020, URL: https://www.affaritaliani.it/coronavirus/coronavirus-bassetti-l-idrossiclorochina-non-funziona-su-trump-usata-eparina-703871.html?refresh_ce.

[19] Cfr., Affari Italiani, “Hydroxychloroquine, Green Light from the State Council. “Defeated” Aifa,” December 11, 2020, URL: https://www.affaritaliani.it/coronavirus/idrossiclorochina-via-libera-dal-consiglio-di-stato-sconfessata-l-aifa-711163.html?refresh_ce.

[20] See D. Pawar, D. Raoult, N. Yamaguchi, J. Bertoglio, A. Palamidese, V. Soresi, J. Hancke, M. Rango, G. Cordeddu, D. Gammella, “Recovery Trial and Hydroxychloroquine,” International Medical Journal, Published September 29, 2020, Volume 25, Issue 09, 3237-44, URL: https://www.seronijihou.com/article/recovery-trial-and-hydroxychloroquine

[21] On this, see the excellent report of the Le Iene investigation broadcast of April 27, 2021, “The News on Hyperimmune Plasma and Monoclonal Antibodies”, URL: https://www.iene.mediaset.it/video/plasma-iperimmune-e-anticorpi-monoclonali_1039930.shtml?r=q2-b586c122359ed11672d0fbe1d277d4bef0356aa6db48d33d703a4ad933ac43e6. In this case too, the demagogic contribution of TV experts in probable conflict of interest is evident. 

[22] On this see, e.g., S. Boseley, M. Davey, “Covid-19: Lancet Retracts Paper that Halted Hydroxychloroquine Trials,” June 4, 2020, The Guardian, URL: https://www.theguardian.com/world/2020/jun/04/covid-19-lancet-retracts-paper-that-halted-hydroxychloroquine-trials; C. Piller, K. Servick, “Two Elite Medical Journals Retract Coronavirus Papers Over Data Integrity Questions,” Science, June 4, 2020, URL: https://www.science.org/content/article/two-elite-medical-journals-retract-coronavirus-papers-over-data-integrity-questions; J. Wise, “Data Transparency: “Nothing Has Changed Since Tamiflu”, BMJ, June 9, 2020, URL: https://www.bmj.com/content/bmj/369/bmj.m2279.full.pdf.

[23] See, e.g., FLCCC Alliance, “Ivermectin in COVID-19,” constantly updated, URL: https://covid19criticalcare.com/ivermectin-in-covid-19/; IVMMETA, “Ivermectin for COVID-19: Real-Time Meta Analysis of 78 Studies,” February 2, 2022, Version 175, URL: https://ivmmeta.com/; P. Kory, G. U. Meduri, J. Varon, J. Iglesias, P. E. Marik, “Review of the Emerging Evidence Demonstrating the Efficacy of Ivermectin in the Prophylaxis and Treatment of COVID-19,” American Journal of Therapeutics, May/June 2021, Volume 28, Issue 3, p. e299-e318, doi: 10.1097/MJT.0000000000001377; A. Bryant, T. A. Lawrie, T. Dowswell, E. J. Fordham, S. Mitchell, S. R. Hill, T. C. Tham, “Ivermectin for Prevention and Treatment of COVID-19 Infection: A Systematic Review, Meta-analysis, and Trial Sequential Analysis to Inform Clinical Guidelines,” American Journal of Therapeutics, July/August 2021, Volume 28, Issue 4, p. e434-e460, doi: 10.1097/MJT.0000000000001402; M. Nass, “The extraordinary story of how patient access to COVID treatments was denied, eventually involving witch hunts of physicians who dared to treat patients”, op. cit.

[24] On the possible negative effects of Molnupiravir see, e.g., L. Goldstein, “Molnupiravir: mutagenic, carcinogenic, authorized in the UK,” TrialSite News, 2021, URL: https://trialsitenews.com/molnupiravir-mutagenic-carcinogenic-authorized-in-the-uk/.

[25] See, e.g., P. Gulisano, “Here comes the superpill, now we can talk about early treatments,” La Nuova Bussola Quotidiana, February 5, 2022, URL: https://lanuovabq.it/it/arriva-la-superpillola-ora-si-puo-parlare-di-cure-domiciliari.

[26] See C. J. L. Murray, “COVID-19 will continue but the end of the pandemic is near,” The Lancet, Published January 19, 2022, DOI: https://doi.org/10.1016/S0140-6736(22)00100-3.

[27] See, A. Donzelli, “Medicines Against Covid-19 in the Early Stages: Which Ones Should Be Avoided?,” cit.

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