0:247 - Dr. Moorjani shares his "war zone" experience in treating patients with COVID 19 in New Rochelle, New York with Dr. Rashid. New York is the Epicenter for COVID 19 in the USA.

1:26 - Dr. Rashid introduces the episode, "A Delicate Balance" that doctors and healthcare providers are facing the controversial issue of treating COVID 19 with Hydroxychloroquine and Azithromycin without solid clinical evidence through randomized clinical trials.

4:24 - New Governor Andrew Cuomo expresses solemnly the high death rate New York is facing especially those that are more vulnerable to the novel Coronavirus 2019. Dr. Rashid explains the public health crisis that the healthcare system New York is facing due to COVID 19.

5:59 - Dr. Moorjani shares exclusive clinical pearls with his experience in treating COVID 19. In his anecdotal evidence, he shares that early treatment of COVID 19 with Hydroxychloroquine and Azithromycin was found to be successful. Dr. Moorjani goes into further detail about the physiology and pharmacology of why the combination may work in decreasing the viral load of COVID 19.

10:44 - Dr. Rashid explains the history of Chloroquine and Hydroxychloroquine from World War 2 in treating malaria. Dr. Rashid shares the recent research results from Marseille, France. It was found when both Hydroxychloroquine and Azithromycin are used together, there is a significant decrease in the COVID 19 viral load.

11:38 - US President Trump praises the the use of Hydroxychloroquine calling it a "tremendous breakthrough".

12:07 - Dr. Rashid explains how doctors are facing "A Delicate Balance" between clear scientific evidence vs. anecdotal evidence.

13:21 - NIAID Director Dr. Anthony Fauci shares the distinction between giving a patient a drug with clear scientific evidence vs. anecdotal evidence and that "These two things are really not incompatible."

14:05 - Dr. Moorjani shares the controversial aspects of Hydroxychloroquine and Azithromycin. He shares his further information about the dosing and time of intervention in treating patients with COVID 19. He shares his thoughts on the French study as well as the studies performed in South Korea and Taiwan. Side effects of the combination are discussed into further detail.

25:08 - Dr. Rashid shares the second study the same group of French experts performed on the combination which also showed promising results.

25:38 - Dr. Rashid shares that "A Delicate Balance" is experienced from the medical and economical level that Americans and the world is currently experiencing with regards to social distancing and currently being in lockdown.

27:11 - Queen Elizabeth II shares her public speech giving hope during these trying times and that "We will meet again."

27:50 - Dr. Rashid concludes the episode and shares contact information for the show.

TWEETABLES

"And I've never seen anything like it. I now characterize it as a war zone."

"It's frightening. It's disturbing that amount of loss."

"In honor of the first responders and health care workers, the iconic Empire State Building will glow red heart beat lights during this pandemic."

"Testing has become rapid, the turnaround time is less than 24 hours."

"Once the symptoms start, you have five to six days to intervene."

"They recover fast, they go home, they're afebrile, and they can go back to their normal life after they have tested negative...."

"The study had found a significant reduction of the COVID 19 viral load when a combination of Hydroxychloroquine is used with Azithromycin."

"This could be a tremendous breakthrough, tremendous breakthrough."

"The delicate balance is between giving a promising drug with the hope that it will be effective from anecdotal evidence versus clear scientific evidence from randomized clinical trials that assures drug effectiveness."

"There are those who lean to the point of giving hope and saying give that person the option of having access to that drug. And then you have the other group, which is my job as a scientist, to say my job is to ultimately prove without a doubt that a drug is not only safe, but that it actually works."

"The dosing of Hydroxychlooquine and Zithromax is something that's controversial. What we are doing is a dose of 800 to 1200 mg loading on day 1 of Hydroxychloroquine and then 400 day after that."

"If the QT interval is more than 500 we are either not initiating this or we are stopping the protocol if the patient is on it."

"So if Hydroxychloroquine works and it stops the virus from multiplying, it allows the immune system to gain the upper hand."

"Zithromax we finish the 5 day course."

"I think in our own opinion, right now in the early stages, very good success rates with this intervention protocol that we have."

"And they showed that this combination of Hydroxychloroquine and Azithromycin cleared the PCR much more rapidly than with no treatment or with Hydroxychloroquine alone."

"It does stop the virus from multiplying, it stops the virus from getting into the ACE 2 receptor cell where it attaches to so it prevents that attachment."

"Azithromycin as I said before possibly acts synergistically or additively by down regulating the ACE 2 receptor, which the virus uses to get into the cell."

"Hydroxychloroquine does have cardiac toxicity."

"So a clinical trial to understand the nuances of this intervention is absolutely necessary. And so I applaud Governor Cuomo for launching the trial on a statewide basis for trying to address and answer some of these questions."

"Doctors and scientists rapidly racing around the globe are faced with giving treatment that has promise, but not enough scientific data. It is a delicate balance that they face. And at the same token, we all are facing this."

"In many ways, life and death has always been a delicate balance."

"We will succeed and that success will belong to every one of us."

LINKS MENTIONED

New York's Epicenter

Governor Andrew Cuomo - New York's High Death Rate

Empire State Building - Heartbeat Lights

Hydroxychloroquine And Azithromycin Physiology And Pharmacology

First Research Study Results From Marseille, France

US President Trump - Remarks On Hydroxychloroquine

NIAID Dr. Anthony Fauci - Hydroxychloroquine's Anecdotal Evidence Vs. Clinical Trials

Side Effects Of Hydroxychloroquine And Azithromycin For COVID 19

Second Research Study Results From Marseille, France

The Economic Toll Americans Face With Lockdown

Queen Elizabeth II - Message Of Hope

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Disclosures

Dr. Susan Rashid reports no relevant financial disclosures. Rashid Media Productions report no relevant financial disclosures.

Citation

Moorjani, H., Rashid, S. “5: A Delicate Balance." Secrets of Survival (S.O.S.) - An Informative And Historical Podcast - The Capstone Project for the Media and Medicine Program At Harvard Medical School, Produced With Rashid Media Productions. https://secrets-of-survival-s-o-s.simplecast.com/episodes/inside-the-warzone. Originally Published on April 8, 2020. Currently Under Construction with the Media and Medicine Program At Harvard Medical School.

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