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Post Dave...I DID Aaron Scott
Dave Dorsey wrote:
I am sure you are correct that people make their thinking subservient to their political views. In fact, I think I have encountered this very recently.

However, Shaun has done nothing but give you logic and evidence. It is fallacious, embarrassing, and uncalled for to attempt to project that onto him rather than answering him with logic and evidence in return. It makes it look like you do not have any logic or evidence to respond with.



I DID answer him with logic and evidence.

Did you not read what I posted? How I advised that that was referencing an article in the a respected medical journal? This is not some fly-by-night person. This is not a doctor that the press can make fun of because she dares to believe in demons and the such.

This is a YALE PROFESSOR OF EPIDEMIOLOGY.

Dave, with respect, I didn't see you flying to defend Perry Stone--a man who, despite any flaws, is still far better than me. Strangely silent.

But when I say something, you are ready to defend and call it all terribly embarrassing and the such.

You might want to review your priorities on this.

You might find that you are upset with me because I'm taking a position you disagree with (but without good reason).
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8/1/20 4:23 pm


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Post Dave Dorsey
Yes, and Shaun explained to you with extreme patience why the evidence you presented did not support your claim and was not comparable to double-blind RCTs. And rather than continuing to engage, you ran to the cognitive escape pod and said, well, you probably just think this because you don't like Trump. Now 67% friendlier!
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8/1/20 4:26 pm


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Post Dave...bless your heart Aaron Scott
Dave Dorsey wrote:
Yes, and Shaun explained to you with extreme patience why the evidence you presented did not support your claim and was not comparable to double-blind RCTs. And rather than continuing to engage, you ran to the cognitive escape pod and said, well, you probably just think this because you don't like Trump.



Dave,

I never once said that it was equal or better than a double-blind study. I simply tried to make it clear that it was a valid piece of work, done by someone who is a top-shelf player in the medical field.

What say that you and I quit bantering on about this?

You're not changing my mind; I'm not changing yours.

To my knowledge, I don't know that I've ever posted once about hydro-stuff. But when I read the article, saw the credentials of the writer, saw that it appeared in a peer-reviewed magazine, etc., I thought it carried a tremendous amount of weight.

If you want to want for a double-blind study, then, I trust that if you catch COVID-19, or anyone in your church or family does, you will suitably warn them of the great danger of taking this stuff without a double-blind study.

And as for me, if I catch it, I'll be happy to take it first thing.

Let's call it quits. I don't have an endless capacity to hear you go on and on about my supposed failure, while you remain strangely silent and receptive when someone has something negative to post about Perry Stone.
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8/1/20 4:46 pm


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Post shaunbwilson
Aaron Scott wrote:
Shaun, did you note that he was referencing an article he had written in the American Journal of Epidemiology? That is, he was referring to a medical journal article. That's like saying that it's an opinion to reference a scientific article, and is only science if it IS the article. However, agreed, Newsweek has it as "Opinion." But just know that's really not.

This is why I was asking you to which article you were referring. I genuinely was not sure when you said "the article" which article you meant. When I asked if you were referring to the opinion piece, this wasn't intended to be a dismissal of the article; it was a genuine clarifying question. Thank you for clarifying.

As this article thoroughly points out (without bringing politics into the equation), the article in the American Journal of Epidemiology (AJE) is a scientifically questionable opinion article. The "Early Outpatient Treatment of Symptomatic, High-Risk Covid-19 Patients that Should be Ramped-Up Immediately as Key to the Pandemic Crisis" (AJE) article itself clearly states "Editor’s Note: The opinions expressed in this article are those of the authors and do not necessarily reflect the views of the American Journal of Epidemiology" on page 1.[1] The respectfulinsolence.com article also points out that "Prof. Risch is on the editorial board of AJE, a fact conveniently not mentioned in his Newsweek op-ed that is highly relevant, given that editorial board members can exercise a lot of influence on what gets published in a journal."[2][3] Risch even makes it a point in his AJE article to state that the "star" study which is part of his opinion "meta-analysis" is "controlled but not randomized or blinded, and involved 42 patients in Marseilles, France."[4] He is highlighting himself that this study does not meet scientific standards, including statistical significance, randomization, and blinding. The AJE has even published an article stating that Risch's article has "a major error."[5] To be clear, the AJE—of which Dr. Risch is on the editorial board—approved a publication stating that Risch's original work had a major error which must be considered when reading his opinion article.

Aaron Scott wrote:
Because as the article says, there is a lot of politics affecting matters. If you are against Trump, you might have a vested interest in not wanting him to be right.

Thanks for sharing that you consider politics to be a major part of the scientific method; however, I do not share this belief. I am not against Trump; I just do not find politics to have a place in the scientific method. I don't care about what Trump thinks about HCQ any more than I care about what Sean Hannity, Anderson Cooper, The (Dixie) Chicks, or The Rock think about it. Medical science should always be done agnostic of politics. I am engaging with the scientific literature. If you want to talk about politics, I'm afraid I'm not your guy.

Aaron Scott wrote:
shaunbwilson wrote:
If RCTs have had enough time to show that HCQ is ineffective, what additional time do you believe is needed to prove [in an RCT] that it does work?

That's just it: They did NOT show it was ineffective in early treatment of high-risk patients. To show that it is not working it late-stage COVID-19 is to say that a wet towel won't put out a skillet fire after it has caught the rest of the house on fire.

This is technically correct, but not factually correct. If you are truly interested in a layman's understanding of why we cannot say that HCQ is effective in the early treatment of high-risk COVID-19 patients, please see the respectfulinsolence.com article. It outlines why the studies that Risch referenced in his "meta-analysis" opinion piece in the AJE do not prove this.

Aaron Scott wrote:
shaunbwilson wrote:
If so many doctors have found it to be so effective, why have they not started a double-blind randomized controlled trial while also continuing to treat their patients with HCQ? [(Is this because the doctors also do not want Trump to be proven correct?)]

I don't know. Maybe they have started one. That doesn't negate the author's point.

The author's point has already been negated and is not related to my question. The United States government bought 60,000,000 doses of HCQ anticipating that it would be helpful as a COVID-19 prophylaxis.[6] HCQ manufacturers have an ongoing interest in continuing to sell HCQ to countries that continue to use it and to expand the number of countries in which they can sell it as a prophylaxis for COVID-19. Despite the US government and Big Pharma having a vested interest in proof that HCQ works, no one seems to be able to show it as effective using the scientific method's gold standard in pharmacology: the randomized controlled trial.

As to the scientific literature about treating COVID-19 with HCQ that is based on randomized controlled trials, there are five published and two pre-published of which I am aware. They all say the same thing: HCQ is not effective.
  1. Hydroxychloroquine with or without Azithromycin in Mild-to-Moderate Covid-19 - Published conclusion: Among patients hospitalized with mild-to-moderate Covid-19, the use of hydroxychloroquine, alone or with azithromycin, did not improve clinical status at 15 days as compared with standard care.

  2. A Randomized Trial of Hydroxychloroquine as Postexposure Prophylaxis for Covid-19 - Published conclusion: After high-risk or moderate-risk exposure to Covid-19, hydroxychloroquine did not prevent illness compatible with Covid-19 or confirmed infection when used as postexposure prophylaxis within 4 days after exposure.

  3. Hydroxychloroquine in patients with mainly mild to moderate coronavirus disease 2019: open label, randomised controlled trial - Published conclusion: Administration of hydroxychloroquine did not result in a significantly higher probability of negative conversion than standard of care alone in patients admitted to hospital with mainly persistent mild to moderate covid-19. Adverse events were higher in hydroxychloroquine recipients than in non-recipients.

  4. A Cluster-Randomized Trial of Hydroxychloroquine as Prevention of Covid-19 Transmission and Disease - Published conclusion: There was no significant difference in the primary outcome of PCR-confirmed, symptomatic Covid-19 disease (6.2% usual care vs. 5.7% HCQ; risk ratio 0.89 [95% confidence interval 0.54-1.46]), nor evidence of beneficial effects on prevention of SARS-CoV-2 transmission (17.8% usual care vs. 18.7% HCQ).

  5. Hydroxychloroquine for Early Treatment of Adults with Mild Covid-19: A Randomized-Controlled Trial - Published conclusion: No significant differences were found in the mean reduction of viral load at day 3 (-1.41 vs. -1.41 Log10 copies/mL in the control and intervention arm, respectively; difference 0.01 [95% CI -0.28;0.29]) or at day 7 (-3.37 vs. -3.44; d –0.07 [-0.44;0.29]). This treatment regimen did not reduce risk of hospitalization (7.1%, control vs. 5.9%, intervention; RR 0.75 [0.32;1.77]) nor shortened the time to complete resolution of symptoms (12 days, control vs. 10 days, intervention; p = 0.380). No relevant treatment-related AEs were reported.

  6. Hydroxychloroquine in Nonhospitalized Adults With Early COVID-19: A Randomized Trial - Conclusion: Of 491 patients randomly assigned to a group, 423 contributed primary end point data. Of these, 341 (81%) had laboratory-confirmed infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or epidemiologically linked exposure to a person with laboratory-confirmed infection; 56% (236 of 423) were enrolled within 1 day of symptoms starting. Change in symptom severity over 14 days did not differ between the hydroxychloroquine and placebo groups (difference in symptom severity: relative, 12%; absolute, −0.27 points [95% CI, −0.61 to 0.07 points]; P = 0.117). At 14 days, 24% (49 of 201) of participants receiving hydroxychloroquine had ongoing symptoms compared with 30% (59 of 194) receiving placebo (P = 0.21). Medication adverse effects occurred in 43% (92 of 212) of participants receiving hydroxychloroquine versus 22% (46 of 211) receiving placebo (P < 0.001). With placebo, 10 hospitalizations occurred (2 non–COVID-19–related), including 1 hospitalized death. With hydroxychloroquine, 4 hospitalizations occurred plus 1 nonhospitalized death (P = 0.29).

  7. Effect of Hydroxychloroquine in Hospitalized Patients with COVID-19: Preliminary results from a multi-centre, randomized, controlled trial. - Conclusion: In patients hospitalized with COVID-19, hydroxychloroquine was not associated with reductions in 28-day mortality but was associated with an increased length of hospital stay and increased risk of progressing to invasive mechanical ventilation or death.


I appreciate your interaction in this conversation, but it seems that we have different approaches when it comes to reviewing scientific literature. I don't know that you can move forward with this conversation without mixing science with politics, and I know that I cannot move forward with this conversation by mixing politics into the science. I hope and pray that God continues to bless both of us by keeping us and those we love from contracting COVID-19, and I wish you only the best as you continue to review the scientific literature that's out there as the complex intricacies of this novel and mysterious disease continue to be unraveled by scientific researchers.
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Post Shaun.... Aaron Scott
Please know that I fully understand that politics and science/medicine do not mix. However, it seems that both sides of this have allowed that to play a role.

One side often believes that if Trump says it, it's the truth.

The other side often believes that if Trump said it, it's clearly false.

My point was not to say that YOU were doing that. However, if a person is against Trump, I find that they often interpret the same things very differently. For instance, those against Trump see that move of the embassy to Jerusalem as a terrible thing for the Palestinians.

It make all the sense in the world to have a strong border the prevents illegal entry to a greater degree. Unless you are against Trump, in which case we don't need no stinkin' wall, and we should open wide our arms for the huddled masses, yearning to breathe free.

See what I mean?

Trump was a DISASTER in the COVID-19 thing. But the news portrays him as trying to get people to drink bleach, etc. He did not such thing.

THAT was the point I was making.

To me the Hydro-stuff reviews seems to make it a very good option to have available. I would not recommend that no other measures be taken, but that is certainly one that SHOULD be taken.

If something is outright false, then whether you're on the board or not, it's not going to be published. Well, except those ones that "proved" that hydro-stuff DIDN'T work...and then had to be withdrawn. That's the sort of politics that I'm referring to: A rush to print anything contrary to Trump, and to diminish anything in his favor.

In any case, God bless you and keep you.
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8/2/20 11:24 am


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Post Dave Dorsey
Aaron... curious. Not trying to give you a hard time.

Did you click even one of the links Shaun gave you?
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8/2/20 11:26 am


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Post Dave...no` Aaron Scott
No, I simply reviewed what Shaun had posted (either his own synopsis or the study's synopsis). To me, it appears that these studies do not exactly address what the professor was saying. Let me explain....

As I understand it, the professor is claiming that early use of HCQ in very effective for nfected people who are at HIGH-RISK due to certain morbidity factors. He is not making a blanket claim that HCQ is the solution to any sickness.

As best I can tell, none of these studies particularly address that set of circumstances. However, there were some interesting facts in what Shaun provided:
Quote:

Hydroxychloroquine in Nonhospitalized Adults With Early COVID-19: A Randomized Trial - Conclusion: Of 491 patients randomly assigned to a group, 423 contributed primary end point data. Of these, 341 (81%) had laboratory-confirmed infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or epidemiologically linked exposure to a person with laboratory-confirmed infection; 56% (236 of 423) were enrolled within 1 day of symptoms starting. Change in symptom severity over 14 days did not differ between the hydroxychloroquine and placebo groups (difference in symptom severity: relative, 12%; absolute, −0.27 points [95% CI, −0.61 to 0.07 points]; P = 0.117). At 14 days, 24% (49 of 201) of participants receiving hydroxychloroquine had ongoing symptoms compared with 30% (59 of 194) receiving placebo (P = 0.21). Medication adverse effects occurred in 43% (92 of 212) of participants receiving hydroxychloroquine versus 22% (46 of 211) receiving placebo (P < 0.001). With placebo, 10 hospitalizations occurred (2 non–COVID-19–related), including 1 hospitalized death. With hydroxychloroquine, 4 hospitalizations occurred plus 1 nonhospitalized death (P = 0.29).

Effect of Hydroxychloroquine in Hospitalized Patients with COVID-19: Preliminary results from a multi-centre, randomized, controlled trial. - Conclusion: In patients hospitalized with COVID-19, hydroxychloroquine was not associated with reductions in 28-day mortality but was associated with an increased length of hospital stay and increased risk of progressing to invasive mechanical ventilation or death.

Notice that the synopsis, assuming the authors give us what we need to kno, does not tell us if it was administered early...nor whether it was administered early to high-risk patients.

For what it's worth, I have never argued that HCQ was "the cure" or even largely the cure for COVID-19. I simply believe that it is showing promise in those at especially high-risk, IF administered early on.

As any number of my posts will show, I stand open to correction, and have changed course a number of times over the years. But on this one, in the particular cases to which HCQ applies, I think we can all go home feeling like HCQ is NOT a worthwhile medication for COVID-19...AND...that it IS a worthwhile medication for COVID-19 (in the cases mentioned).

Either way, good discussion.






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8/2/20 3:01 pm


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Post Dave Dorsey
Okay, thanks. Figured as much but thought it would be good to be sure. Now 67% friendlier!
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8/2/20 5:02 pm


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Post Dave... Aaron Scott
Dave Dorsey wrote:
Okay, thanks. Figured as much but thought it would be good to be sure.



Did you feel that I needed to read each link...or that I could not trust Shaun to give me a true synopsis?
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8/3/20 9:17 am


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Post Dave Dorsey
Well, if you did read his summaries, you didn't engage with any of them in your reply.

With respect, it just seems like you have a religious-like belief in the efficacy of HCQ and you aren't even entertaining the overwhelming evidence Shaun is presenting that your belief is not sound.
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Post Um, actually, Dave... Aaron Scott
Dave Dorsey wrote:
Well, if you did read his summaries, you didn't engage with any of them in your reply.

With respect, it just seems like you have a religious-like belief in the efficacy of HCQ and you aren't even entertaining the overwhelming evidence Shaun is presenting that your belief is not sound.


I read all the he posted. AND, as you will see about two or three posts above, I indicated what I felt was the missing piece of these studies.

I have no problem agreeing that the studies are valid. However, you will note that while they address usages of HCQ, they do not apparently specifically address what was referenced in the article I posted; namely, early use in high-risk patients.

I highlighted portions of two of them that I felt showed interesting information. See below:


Quote:
At 14 days, 24% (49 of 201) of participants receiving hydroxychloroquine had ongoing symptoms compared with 30% (59 of 194) receiving placebo (P = 0.21). Medication adverse effects occurred in 43% (92 of 212) of participants receiving hydroxychloroquine versus 22% (46 of 211) receiving placebo (P < 0.001). With placebo, 10 hospitalizations occurred (2 non–COVID-19–related), including 1 hospitalized death. With hydroxychloroquine, 4 hospitalizations occurred plus 1 nonhospitalized death (P = 0.29).



I found this one interesting because, as I understand it, after 14 days of use, only 24% using HCQ had ongoing symptoms, compared with 30% of those getting a placebo.

Further, with the placebo, there were 10 hospitalizations and one death; with HCQ, there were only 4 hospitalizations and one death.

I thought that was significant. So I highlighted them in my response.





Quote:
Effect of Hydroxychloroquine in Hospitalized Patients with COVID-19: Preliminary results from a multi-centre, randomized, controlled trial. - Conclusion: In patients hospitalized with COVID-19, hydroxychloroquine was not associated with reductions in 28-day mortality but was associated with an increased length of hospital stay and increased risk of progressing to invasive mechanical ventilation or death.


Notice that the synopsis, assuming the authors give us what we need to know, does not tell us if it was administered early...nor whether it was administered early to high-risk patients. For instance, if HCQ was administered late to high-risk or low-risk patients, it appears to have little affect.

For what it's worth, I have never argued that HCQ was "the cure" or even largely the cure for COVID-19. However, as best I can tell, it has shown dramatic promise for those especially high-risk, IF administered early on.

With respect, Dave, I didn't think needed to read all of those articles (which Shaun many not have read either, for all I know), since I trusted Shaun to give me a true summary (either copied from these studies or by his own reading of them).
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8/3/20 10:03 am


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Post Re: Um, actually, Dave... shaunbwilson
Aaron Scott wrote:
Notice that the synopsis, assuming the authors give us what we need to know, does not tell us if it was administered early...nor whether it was administered early to high-risk patients. For instance, if HCQ was administered late to high-risk or low-risk patients, it appears to have little affect.


Just as an FYI, I only posted results and/or conclusions, not the full abstract. The information you are wondering about is in the sources. For example:

In study 2 ("A Randomized Trial of Hydroxychloroquine as Postexposure Prophylaxis for Covid-19"), "Participants had known exposure (by participant report) to a person with laboratory-confirmed Covid-19, whether as a household contact, a health care worker, or a person with other occupational exposures. . . . Trial enrollment began on March 17, 2020, with an eligibility threshold to enroll within 3 days after exposure; the objective was to intervene before the median incubation period of 5 to 6 days. . . . We included participants who had household or occupational exposure to a person with confirmed Covid-19 at a distance of less than 6 ft for more than 10 minutes while wearing neither a face mask nor an eye shield (high-risk exposure) or while wearing a face mask but no eye shield (moderate-risk exposure)." From the conclusion that I posted: "After high-risk or moderate-risk exposure to Covid-19, hydroxychloroquine did not prevent illness compatible with Covid-19 or confirmed infection when used as postexposure prophylaxis within 4 days after exposure."
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8/3/20 10:47 am


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Post Shaun... Aaron Scott
shaunbwilson wrote:
Aaron Scott wrote:
Notice that the synopsis, assuming the authors give us what we need to know, does not tell us if it was administered early...nor whether it was administered early to high-risk patients. For instance, if HCQ was administered late to high-risk or low-risk patients, it appears to have little affect.


Just as an FYI, I only posted results and/or conclusions, not the full abstract. The information you are wondering about is in the sources. For example:

In study 2 ("A Randomized Trial of Hydroxychloroquine as Postexposure Prophylaxis for Covid-19"), "Participants had known exposure (by participant report) to a person with laboratory-confirmed Covid-19, whether as a household contact, a health care worker, or a person with other occupational exposures. . . . Trial enrollment began on March 17, 2020, with an eligibility threshold to enroll within 3 days after exposure; the objective was to intervene before the median incubation period of 5 to 6 days. . . . We included participants who had household or occupational exposure to a person with confirmed Covid-19 at a distance of less than 6 ft for more than 10 minutes while wearing neither a face mask nor an eye shield (high-risk exposure) or while wearing a face mask but no eye shield (moderate-risk exposure)." From the conclusion that I posted: "After high-risk or moderate-risk exposure to Covid-19, hydroxychloroquine did not prevent illness compatible with Covid-19 or confirmed infection when used as postexposure prophylaxis within 4 days after exposure."



I think we may be using "high-risk" in two different ways.

As I understand it, the professor's study particularly was speaking not about high-risk EXPOSURE, but rather a person with COVID-19 that has a high-risk health profile--e.g., diabetes, obesity, etc., if I recall right.

The claim being that if a person who would typically have an especially hard time with COVID-19 is treated early on with HCQ, it has been shown to be very effective in that particular sort of case.

If I was not clear about this notion of "high-risk," or if I am misunderstanding you, I apologize.
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8/3/20 1:13 pm


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Post A WHOSOEVER QUESTION.... Aaron Scott
IF the original article is telling the truth about results, what do you think is being missed in the interpretation or the medication that apparently invalidates the article? Hon. Dr. in Acts-celeratology
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8/3/20 1:22 pm


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Post Eddie Robbins
Forget it, fellas. You’re wasting your valuable time. The one true statement he made was “I can stand in the middle of Fifth Avenue and shoot somebody and I still would not lose voters.“ I had hopes that most Christians would come to see that he is only pandering to them. But, I was wrong. Acts-pert Poster
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8/3/20 2:33 pm


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Post Eddie, Eddie, Eddie Aaron Scott
Eddie Robbins wrote:
Forget it, fellas. You’re wasting your valuable time. The one true statement he made was “I can stand in the middle of Fifth Avenue and shoot somebody and I still would not lose voters.“ I had hopes that most Christians would come to see that he is only pandering to them. But, I was wrong.



This is not about what Trump said. It's what a leading epidemiologist said. I don't give it credence because Trump said it--especially when, at first, pretty much everyone was saying otherwise.

But it's MY view that, yeah, HCQ has a role to play.

But on a side note, to doubt everything that Trump says is probably not much better than to believe everything he says.

OK, gotten run--Andy Stanley's coming on (somewhere, I'm sure).
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8/3/20 3:51 pm


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Post Re: Eddie, Eddie, Eddie Eddie Robbins
Aaron Scott wrote:
Eddie Robbins wrote:
Forget it, fellas. You’re wasting your valuable time. The one true statement he made was “I can stand in the middle of Fifth Avenue and shoot somebody and I still would not lose voters.“ I had hopes that most Christians would come to see that he is only pandering to them. But, I was wrong.



This is not about what Trump said. It's what a leading epidemiologist said. I don't give it credence because Trump said it--especially when, at first, pretty much everyone was saying otherwise.

But it's MY view that, yeah, HCQ has a role to play.

But on a side note, to doubt everything that Trump says is probably not much better than to believe everything he says.

OK, gotten run--Andy Stanley's coming on (somewhere, I'm sure).



😎
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8/3/20 4:38 pm


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Post That's the problem Richard L Shores
Eddie Robbins wrote:
The one true statement he made was “I can stand in the middle of Fifth Avenue and shoot somebody and I still would not lose voters.“



That's the problem with the Never-Trumpers. They take everything the man says as being serious when he is clearly being tongue-in-cheek.
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