I showed my brother, New York City physician Israel N. Kochin, Scott Adams's account of HCQ+Zinc prophylaxis as a risk management strategy for COVID-19.
I asked Dr. Kochin if he would prescribe HCQ+Zinc prophylaxis for a patient with no specific contraindications. Dr. Kochin said he would not, and explained why thus:
I remain concerned with physicians who advocate this treatment for COVID19- the limited published data still shows harm outweighing benefit (see my earlier post on the subject) in most studies. I hope I am wrong in my concern.
"WHO is actively following the ongoing clinical trials that are being conducted in response to COVID-19, including studies looking at the use of chloroquine and its derivative, hydroxychloroquine, for treatment and/or prevention. Currently, there is insufficient data to assess the efficacy of either of these medicines in treating patients with COVID-19, or in preventing them from contracting the coronavirus. In the context of the COVID-19 response, the dosage and treatment schedules for chloroquine and hydroxychloroquine that are currently under consideration do not reflect those used for treating patients with malaria. The ingestion of high doses of these medicines may be associated with adverse or seriously adverse health outcomes."
https://www.who.int/news-room/q-a-detail/malaria-and-the-covid-19-pandemic
COVID-19: "hydroxychloroquine (200 mg three times per day for 10 days)"
malaria prophylaxis: "400 mg once weekly"
Malaria Rx: "800 mg once, followed by 400 mg at 6, 24, and 48 hours after initial dose (total dose: 2 g)"
RA: "200 to 400 mg daily as a single daily dose or in 2 divided doses (Kumar 2013). Note: Due to the risk of retinal toxicity, most patients should not receive a daily dose >5 mg/kg/day using actual body weight or 400 mg, whichever is lower.."
https://www.uptodate.com/contents/hydroxychloroquine-drug-information
In my opinion, people who are considering they may take this medication if they develop COVID19 symptoms should be evaluated by their physician in advance for G6PD deficiency, which is the most common enzymatic deficiency in humans. This deficiency is particularly higher in those of African and Mediterranean (e.g. Sephardic) decent.
There are those advocating a lower dose, "The total 5 day dose (400 bid x 1 day then 200 bid for 5 days)." [source: Dr Jacob Teitelbaum], but I don't know where that dose originates from, but lower is certainly safer.
Some HCQ proponents are quite fanatical, it's not like they are going to let a little thing like reality dissuade them... some of them were posting in July new results about a study that was aborted in June. (Are they lying or simply willfuly ignorant?)
https://www.facebook.com/photo.php?fbid=10164060891315473&set=a.69381620472&type=3&eid=ARD6fygFusWLdYASNk2W1Qw_p9vgYWCcSrrJtTgD-_X7rCPA3kMDIA8CS-E0eajEbGQ7d4a7tXQwuCwu
Reality: This trial ended at the beginning of June due to a similar study showing "no efficacy in preventing COVID-19 for people exposed to the virus."
https://www.mitchellrepublic.com/newsmd/coronavirus/6523704-South-Dakotas-trial-of-a-controversial-COVID-19-drug-has-been-discontinued
https://www.keloland.com/top-stories/s-d-still-seeks-guidance-on-hydroxychloroquine/ also see https://www.goodrx.com/blog/coronavirus-medicine-chloroquine-hydroxychloroquine-as-covid19-treatment
Also American College of Cardiology remains concerned about fatalities from Arrhythmia https://www.acc.org/latest-in-cardiology/articles/2020/03/27/14/00/ventricular-arrhythmia-risk-due-to-hydroxychloroquine-azithromycin-treatment-for-covid-19 and they provide additional guidance here: https://mayoclinicproceedings.org/pb/assets/raw/Health%20Advance/journals/jmcp/jmcp_covid19.pdf
Furthermore, given the strong evidence for limited efficacy, research resources should probably focus on drugs with better preliminary results and/or novel pathways.
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