Covid-19 – a case for medical detectives", by WOLFGANG WODARG, 2-May-2020
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The Nigerian dead in Sweden
I was aware of such a case with the same puzzling symptoms, which had been described in 2014 by Swedish pneumologists in a young patient from Nigeria who had died of the disease. At that time, an enzyme deficiency was suspected and actually found to be a possible cause after death, which occurs in many regions of Africa in 20 - 30% of the population.
It is the so-called glucose-6-dehydrogenase deficiency, or "G6PD deficiency", one of the most common genetic peculiarities, which can lead to threatening haemolysis (dissolution of red blood cells), mainly in men, when certain drugs or chemicals are taken. The following map shows the distribution of this deficiency (Source and explanations here).
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This hereditary trait is particularly common among ethnic groups living in areas with malaria. The modified G6PD gene offers advantages in the tropics. It makes its carriers resistant to malaria pathogens. However, G6PD deficiency is also dangerous if those affected come into contact with certain substances found in, for example, field beans, currants, peas and a number of medicines.
These include acetylsalicylic acid, metamizole, sulfonamides, vitamin K, naphthalene, aniline, malaria drugs and nitrofurans. The G6PD deficiency then leads to a disruption of the biochemical processes in the red blood cells and – depending on the dose – to mild to life-threatening haemolysis. The debris of the burst erythrocytes subsequently leads to microemboli, which block small vessels throughout the organs. What had caused the illness and death of the young man from Nigeria remained unclear at the time.
An alarming discovery
I looked at the drugs that can cause severe hemolysis in G6PD deficiency and got really scared. One of the substances that is called very dangerous in all forms of this enzyme deficiency is the anti-malarial drug hydroxychloroquine (HCQ).
But this is precisely the substance that Chinese researchers in Wuhan have been recommending against SARS since 2003. Along with the virus from Wuhan, HCQ now came back to us as one of the therapeutic options and was accepted as such. At the same time, HCQ was recommended as a promising agent against Covid-19 for further clinical trials with the support of WHO and other agencies.
According to reports, production of this drug is to be increased in Cameroon, Nigeria and other African countries. India is the largest producer of HCQ and exports it to 55 countries. Werner Baumann, Chairman of the Board of Management of Bayer AG, announced at the beginning of April that "various investigations in laboratories and clinics" had provided first indications that chloroquine might be suitable for the treatment of corona patients. The company then provided several million tablets.
There are now hundreds of trials worldwide, planned or ongoing by different sponsors, in which HCQ is used alone or together with other drugs. When I looked at some large studies to see if patients with G6PD deficiency were excluded, I found no evidence of this in most study plans. In the USA, for example, a large multi-center study with 4,000 volunteers from healthy medical staff is being prepared. Here, however, the term "hypersensitivity" is only used in general terms, as is the case with all drugs with regard to allergic reactions. In a chloroquine/hydroxychloroquine study by Oxford University (NCT04303507) with a planned 40,000 participants, the risk of G6PD deficiency is also not mentioned. In another large study by the Pentagon, though, there is an explicit warning to exclude G6PD deficiency patients from the study.
The following graph, based on information from the WHO database, shows how many studies on Covid-19 and HCQ have been initiated – and how few of them take enzyme deficiency into account.
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Mostly only the cardiac complications of chloroquine or hydroxychloroquine are mentioned, which in Brazil led to the premature termination of a study with 11 deaths of 81 subjects. However, it seems that worldwide little attention is paid to this further serious side effect. In addition, due to the lack of alternatives, HCQ has been tolerated and massively applied in many countries since the beginning of the year as part of a so-called "compassionate use". In medicine, compassionate use refers to the use of not yet approved drugs in emergency situations.
Conspicuous clusters
During this research, more and more results of more precise evaluations of the deaths in especially affected cities were received. In New York and other cities in the USA, it was reported that the vast majority of fatalities were African Americans – twice as many as could be expected based on the proportion of the population.
Also from England, where the mortality data from Euromomo shows an increasing death rate since the beginning of April, it was reported that 35% of about 2000 seriously ill people, twice as many as expected, came from ethnic "minorities" ("black, Asian or other ethnic minority"), including doctors and medical staff.
A major doctor's death in Italy remains in urgent need of clarification. The death of about 150 doctors and only a few female doctors is associated with Covid-19. Although age may have played a role in many of these cases, it should be noted that a high prevalence of G6PD deficiency has also been described for some regions of Italy and that in Italy up to 71% of those who tested positive with PCR, as well as the staff, had a prophylactic high level of HCQ. The same applies to Spain. Among the first 15 Covid-19 deaths in Sweden, there were 6 younger migrants from Somalia.
Deadly combination
Therefore the frightening result of my research is that typical severe courses with haemolysis, microthrombi and shortness of breath without typical signs of pneumonia occur more frequently where two factors come together:
Many patients with ancestors from malaria countries with G6PD deficiency
Prophylactic or therapeutic use of high-dose HCQ
This is exactly what is to be expected in Africa, and this is already the case everywhere where migration is causing a large proportion of the population coming from malaria countries. The following diagram shows the process flow schematically.
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Cities such as New York, Chicago, New Orleans, London, or even large cities in Holland, Belgium, Spain and France are such centers. If the test is widely used in these migration hotspots and is expected to be positive in about 10 to 20% of the population, many people from the G6PD countries will also be among them. If they are then treated with high-dose HCQ, either prophylactically or as part of a "compassionate" use, as planned, then those severe clinical pictures will also be evoked in young people, as has been presented to us by the sensational press, and which keep our fear of Covid-19 alive.
It is unknown how many times this deadly combination has already led to victims. There has been no discussion of the issue among those responsible in the WHO and in governments. There is also a frightening lack of knowledge and sense of responsibility among doctors who are accountable for the treatment of Covid-19 patients or for the staff treating them.
Once again: This connection applies not only to Africa, but also to large parts of Asia, South and Central America, Arabia and the Mediterranean region.
However, the cases mentioned have nothing to do with Covid-19 disease. A PCR test result leading to the prophylactic prescription of HCQ is sufficient to cause severe disease in up to one third of the people from high-risk populations treated in this way.
HCQ treatment for G6PD deficiency is a dangerous malpractice
This could be remedied immediately if all treating physicians worldwide were informed about the contraindication of HCQ. However, the WHO, the CDC, the ECDC, the Chinese SARS specialists, the medical associations, the drug authorities and the German government and its advisors are carelessly neglecting to inform the public. In view of the ongoing programmes, this appears to be gross negligence.
It is a malpractice to treat people with G6PD deficiency with high-dose chloroquine derivatives or other drugs known to be dangerous for them. Under the WHO label "'Solidarity' clinical trial for COVID-19 treatments", healthy people are exposed in a hurry to authorised, life-threatening experiments. Hundreds of clinical trials, mostly worthless observational studies with parallel approaches, very often also run with HCQ as one of the alternatives.
German drug legislation prohibits the use of unauthorised drugs, but the government still encourages this. A non-validated test that is not approved for diagnostic purposes provides the pretext for the use of life-threatening medication – given an infectious disease where there is still no evidence that it poses serious risks beyond the risk of the annual flu epidemic.
At full throttle into the catastrophe
The dangers of this epidemic are presented with the help of scientific imposture. An unsuitable test from Berlin provides the pretext for deadly measures all over the world. The consequences of these mistakes lead to emergencies in many regions, which are attributed to an epidemic. This creates precisely the wave of fear so many in business and politics are now riding and which threatens to bury our fundamental rights.
The public, the media and the medical community hardly seem to be surprised that in New York and other centres more than twice as many "African Americans" die as would be expected due to their population share. Even in the studies of deaths in the USA and elsewhere, the risk posed by G6PD deficiency is almost always ignored or forgotten.
When sought-after virologists and other experts have been announcing for a long time that there will be a wave of deaths and terrible conditions in the cities in Africa, do they know about these connections? Or are there other provable reasons that justify such momentous prophecies? Finally: Is all this just a matter for science or also for public prosecutors and courts?
Note from the editor: Further information and graphics can be found on the author's website.
About the author: Dr. med. Wolfgang Wodarg, born in 1947, is an internist and pulmonary physician, specialist for hygiene and environmental medicine as well as for public health and social medicine. After his clinical activity as an internist, he was, among other things, a public health officer in Schleswig-Holstein, Germany for 13 years, at the same time lecturer at universities and technical colleges and chairman of the expert committee for health-related environmental protection at the Schleswig-Holstein Medical Association; in 1991 he received a scholarship at the Johns Hopkins University, Baltimore, USA (epidemiology).
As a member of the German Federal Parliament from 1994 to 2009, he was initiator and speaker in the Enquête Commission "Ethics and Law of Modern Medicine", member of the Parliamentary Assembly of the Council of Europe, where he was chairman of the Subcommittee on Health and deputy chairman of the Committee on Culture, Education and Science. In 2009, he initiated the Committee of Inquiry into WHO's role in H1N1 (swine flu) in Strasbourg, where he remained as a scientific expert after leaving Parliament. Since 2011 he has been working as a freelance university lecturer, doctor and health scientist and was a volunteer member of the board and head of the health working group at Transparency International Germany until 2020.
