CoronaVirus and Forced Vaccination Manipulation

Common Law VS Jackboot Rules

https://www.bitchute.com/video/O3yBYj6b7xCb/
Considering they tell us what they are doing before they do it and this ritual clearly shows the virus emerging from the millimeter wave masts from nearly the beginning, still leads me to the conclusion this five gee technology has everything to do with this nwo cornholio hoax.
From the oxygen molecules being compromised and historical evidence of molecule disruption with new frequency exposure.
Human separation for targeting of waves.
The nanobot vaccine will guarantee total control over the populace with the 5g surveilance matrix.

https://m.dw.com/en/germany-45-officers-injured-at-berlin-rally-against-coronavirus-curbs/a-54402885


The people are unhappy.

Chloroquine & Hydroxychloroquine: Side Effects, Toxicity, and Safety Concerns

After seeing all the recent hype over Chloroquine and Hydroxychloroquine, I did a little searching on PubMed.

What I found was that both these drugs are extremely toxic, have a host of side effects, and from what I can tell, have never been tested for long term use other than what they were originally prescribed for; "Chloroquine (CQ) is used to prevent and treat malaria and amebiasis, while hydroxychloroquine (HCQ), a less toxic metabolite of chloroquine, is used to treat rheumatic diseases such as systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), juvenile idiopathic arthritis (JIA) and Sjogren's syndrome."

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From Wikipedia:

Adverse effects
The most common adverse effects are nausea, stomach cramps, and diarrhea. Other common adverse effects include itching and headache.[4] The most serious adverse effects affect the eye, with dose-related retinopathy as a concern even after hydroxychloroquine use is discontinued.[2] Serious reported neuropsychiatric adverse effects of hydroxychloroquine use include agitation, mania, difficulty sleeping, hallucinations, psychosis, catatonia, paranoia, depression, and suicidal thoughts.[4] In rare situations, hydroxychloroquine has been implicated in cases of serious skin reactions such as Stevens–Johnson syndrome, toxic epidermal necrolysis, and Drug reaction with eosinophilia and systemic symptoms.[4] Reported blood abnormalities with its use include lymphopenia, eosinophilia, and atypical lymphocytosis.[4]

For short-term treatment of acute malaria, adverse effects can include abdominal cramps, diarrhea, heart problems, reduced appetite, headache, nausea and vomiting.[2] Other adverse effects noted with short-term use of HCQ include low blood sugar and QT interval prolongation.[3] Idiosyncratic hypersensitivity reactions have occurred.[4]

For prolonged treatment of lupus or rheumatoid arthritis, adverse effects include the acute symptoms, plus altered eye pigmentation, acne, anemia, bleaching of hair, blisters in mouth and eyes, blood disorders, cardiomyopathy,[3] convulsions, vision difficulties, diminished reflexes, emotional changes, excessive coloring of the skin, hearing loss, hives, itching, liver problems or liver failure, loss of hair, muscle paralysis, weakness or atrophy, nightmares, psoriasis, reading difficulties, tinnitus, skin inflammation and scaling, skin rash, vertigo, weight loss, and occasionally urinary incontinence.[2] Hydroxychloroquine can worsen existing cases of both psoriasis and porphyria.[2]

Children may be especially vulnerable to developing adverse effects from hydroxychloroquine.[2]

Eyes
Main article: Chloroquine retinopathy
One of the most serious side effects is retinopathy (generally with chronic use).[2][20] People taking 400 mg of hydroxychloroquine or less per day generally have a negligible risk of macular toxicity, whereas the risk begins to increase when a person takes the medication over five years or has a cumulative dose of more than 1000 grams. The daily safe maximum dose for eye toxicity can be computed from a person's height and weight.[21] Macular toxicity is related to the total cumulative dose rather than the daily dose. Regular eye screening, even in the absence of visual symptoms, is recommended to begin when either of these risk factors occurs.[22]

Toxicity from hydroxychloroquine may be seen in two distinct areas of the eye: the cornea and the macula. The cornea may become affected (relatively commonly) by an innocuous cornea verticillata or vortex keratopathy and is characterized by whorl-like corneal epithelial deposits. These changes bear no relationship to dosage and are usually reversible on cessation of hydroxychloroquine.

The macular changes are potentially serious. Advanced retinopathy is characterized by reduction of visual acuity and a "bull's eye" macular lesion which is absent in early involvement.

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Here are five studies and documents I found that underscore the dangers and valid concerns of these two drugs:

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Prevalence of hydroxychloroquine-induced side-effects in dermatology patients: A retrospective survey of 102 patients

Abstract
Aim: Our aim was to assess the prevalence of adverse effects (AEs) pertaining to the use and withdrawal of hydroxychloroquine (HCQ) in dermatological outpatients.

Patients and methods: We conducted a retrospective study between January 2013 and June 2014 that included consecutive patients currently or previously receiving HCQ seen in our department. AEs were collated using a standardized questionnaire and validated by clinical and laboratory examination. Drug causality was evaluated using the updated French drug reaction causality assessment method. The main evaluation criterion was the prevalence of AEs in which HCQ had an intrinsic imputability score of I>2.

Results: We included 102 patients (93 of whom were women, with a median age of 44.5; range: 22-90years). HCQ was given for cutaneous lupus in most cases (n=70). At least one AE was reported for 55 patients. Among the 91 reported AEs, 59 (65%) had an HCQ intrinsic imputability score I>2. AEs were responsible for permanent HCQ discontinuation in 19 cases. Of these, 8 were unrelated to HCQ based on imputability score. The most common AEs associated with HCQ were gastrointestinal and cutaneous signs. Of the 8 patients diagnosed with retinopathy, only 3 were confirmed after reevaluation.

Conclusion: AEs associated with HCQ were reported for over 50% of patients and were responsible for permanent HCQ discontinuation in one-third of cases. A more in-depth evaluation of imputability seems necessary, particularly regarding ophthalmological symptoms, since in two thirds of cases the reasons for discontinuation were not related to HCQ.

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Hydroxychloroquine side-effects raise concerns for rheumatology patients

The hype surrounding hydroxychloroquine (HCQ) as a potential treatment for COVID-19 has led to problems for patients who use the drug to treat conditions like lupus, leading to shortages in pharmacies and worries about potentially dangerous side-effects, according to rheumatologists.

Following preliminary reports in March that the antimalarial drug could be effective in treating COVID-19—and a strong endorsement from US President Donald Trump—prescriptions of the drug spiked. In the USA, for example, prescriptions increased by more than 2000% in the 10-week period between Feb 16 and April 25 this year, compared with the same period last year.

Similar increases in HCQ prescriptions in Europe led to temporary shortages of the drug for rheumatology patients, says Nathalie Costedoat-Chalumeau, a rheumatologist at Cochin Hospital in Paris, France. “We had issues with delivering treatment, our patients couldn't find it in the pharmacy,” she says, although the problem has now been mostly resolved. Thomas Dörner, a rheumatologist at the Charité University Hospital in Berlin, says that in Germany, rheumatology patients were given preferential access to HCQ, which ensured shortages were short-lived.

A bigger problem is that the extensive news coverage of the side-effects of HCQ has left some rheumatology patients worried about the safety of a drug that they take every day. Multiple studies on the use of HCQ in patients with COVID-19 have highlighted the risk of cardiac complications for those using the drug, especially when taken in combination with the antibiotic azithromycin. The drug combination has been linked to an abnormal heart rhythm, in the form of a prolonged QT interval, in small observational studies in France and the USA. In addition one observational study of more than 1400 COVID-19 patients in New York City-area hospitals found that those who were given HCQ and azithromycin were more than twice as likely to suffer a heart attack as those who were not.

The first randomised controlled clinical trial of HCQ found no serious side-effects, but that was to be expected given that the participants were relatively young and healthy, and the study excluded people with pre-existing cardiac issues, says David Boulware, an infectious disease physician at the University of Minnesota in Minneapolis (MN, USA) who led the study. More importantly, the study showed that the drug was ineffective as a post-exposure prophylactic for COVID-19.

These concerns over safety, and a lack of evidence of any benefit, have led the US National Institutes of Health, the US Food and Drug Administration, and the American College of Physicians to recommend against use of HCQ to treat COVID-19 unless it is part of a clinical trial.

“The evidence is really insufficient that it helps, and in many cases it seems to hurt,” says Jacqueline Fincher, president of the American College of Physicians. “Continuing clinical trials will help to strengthen the evidence of whether the drug works or not, and ensure that anyone taking it is being properly monitored for the risks,” she says.

One study, published in The Lancet, that found an increased risk of death among COVID-19 patients treated with HCQ prompted WHO to temporarily suspend the HCQ arm of its global SOLIDARITY clinical trial. But the veracity of the data in that study was widely questioned and heavily criticised, and the article has since been retracted.

All the attention on the potential cardiac side-effects now has rheumatology patients wondering if it is safe to continue using the drug. “The heart issue is a new one. We never discussed it with patients because it was so rare, but what they have been seeing on social media is crazy,” says Costedoat-Chalumeau. “I start all my appointments talking about it now.”

Dörner and Costedoat-Chalumeau both say the risk to rheumatology patients is very low. The dose used in patients with COVID-19 is much higher, double or even triple what is given to those with lupus, and COVID-19 is itself associated with cardiac complications, which the drug could exacerbate. “This is something that may be specific to COVID-19 and the higher doses,” says Costedoat-Chalumeau.

David Holtgrave, dean of public health at the State University of New York at Albany (Albany, NY, USA) who worked on the study that found a link with heart attacks, agrees that the cardiac risks seen in patients with COVID-19 should not be extrapolated to other patients. “Our patients were hospitalised, and many were quite ill,” he says. “It's very different than using these drugs for other conditions.”

Boulware says it is too early to completely cast aside HCQ for COVID-19—he has two more trials underway looking at pre-exposure prophylaxis and early treatment—but he also says the results are not looking very promising. Many researchers and physicians now feel it is time to move on to other ideas.

“It was not a bad idea to try, but now all the evidence is against using it to treat this condition,” says Costedoat-Chalumeau.

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Safety considerations for chloroquine and hydroxychloroquine in the treatment of COVID-19

Based on a demonstrated in vitro effect on SARS-CoV-2 and its known safety profile, both chloroquine and hydroxychloroquine (CQ/HCQ) are currently being used off label to treat COVID-19 [1]. However, although the safety of CQ/HCQ is well established in malaria or autoimmune disease, COVID-19 patients could be more vulnerable to side effects because of their advanced age, comorbidities (such as diabetes, obesity and cardiovascular disease), and subsequent co-medication [2]. Both agents are metabolized via the liver and the kidney. Critically ill patients may have an altered metabolism due to changes in hepatic and renal function, which could increase the risk of adverse reactions. Additionally, there may be interactions with co-medication normally not taken together with CQ/HCQ. Both drugs have long half-lives (approximately 1–2 months) and distribute poorly in fat tissue [3]. Therefore, long-term monitoring for adverse reactions is recommended. Importantly, CQ/HCQ have narrow therapeutic ranges, and toxic effects are closely related to the ingested dose. A one-time dose of 20 mg/kg CQ has been described to be toxic, and doses of 30 mg/kg CQ have resulted in case fatalities [4]. Apart from the general safety profile of CQ/HCQ, there are adverse reactions that may interfere with the clinical picture of COVID-19 due to their similarity to the symptoms of the illness. In particular, this holds for cardiovascular, neuropsychiatric and gastrointestinal adverse drug reactions. Table 1 illustrates the five most commonly reported suspected adverse drug reactions in these organ classes, as reported to the global pharmacovigilance database of the WHO (VigiAccessTM) [5]. This global database provides insight into spontaneous post-marketing case safety reports on suspected adverse reactions. The data should be interpreted with caution as the number of reports may be influenced by many different factors, including patients' baseline characteristics, extent of exposure, and nature of adverse reactions. Reported cardiac side effects of CQ/HCQ include conduction disturbances (bundle-branch block, incomplete or complete atrioventricular block, QT prolongation and subsequent torsade de pointes) and cardiomyopathy (hypertrophy and congestive heart failure). Due to their systemic infection and comorbidities, COVID-19 patients appear to have a higher risk of cardiac arrhythmia, QT prolongation and myocardial damage a priori [6]. This could result in the cardiotoxicity of CQ/HCQ being of particular importance, especially when given in combination with other QT-prolonging agents like azithromycin [7]. Neurological and psychiatric side effects have also been reported following CQ/HCQ treatment. Neurological side effects include muscular weakness, diplopia, dyskinesia, seizures, myasthenic syndrome, and (with long-term use) neuromyopathy. Psychiatric side effects include sleeplessness, agitation, psychosis, depression, anxiety, aggressiveness and confusion; psychiatric side effects start within a few days after the beginning of treatment and improve after cessation of treatment. COVID-19 patients suffer from dyspnoea, which may in turn lead to anxiety and sleeplessness, symptoms that may be aggravated by potential psychiatric side effects of CQ/HCQ. Finally, gastrointestinal symptoms (nausea and diarrhoea) have been reported and are the presenting complaint in some cases. In 393 patients admitted to two hospitals in New York, diarrhoea and nausea or vomiting were reported in 23.7% and 19.1% of patients, respectively. To these patients, treatment with drugs having potential gastrointestinal side effects could be problematic [2].

In conclusion, it is likely that some of the commonly reported adverse effects of CQ/HCQ will hamper successful treatment of patients suffering from COVID-19. Thus, until adequately powered randomized controlled trials (RCTs) provide more information on the efficacy and safety of CQ/HCQ use in the treatment of patients with COVID-19, it is very important that the potential benefits of these agents are weighed against the potential risks. Furthermore, clinical trials should also evaluate the long-term (e.g. 3–6 months post-therapy) (side) effects of the use of CQ/HCQ in COVID-19, such as cardiomyopathy, muscle weakness, anxiety, sleeplessness and gastrointestinal disorders. Preferably, until data from RCTs become available, the off-label use of CQ/HCQ should be reserved only for COVID-19 patients treated in context of clinical trials in order to improve our knowledge on safety and efficacy.

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Chloroquine and hydroxychloroquine: side effect profile of important therapeutic drugs

Abstract
Precise knowledge of the undesirable effects of chloroquine and hydroxychloroquine allows better exploitation of their therapeutic effects. Retinopathy can be avoided by observing a maximum daily dosage of 3.5-4 mg/kg ideal body weight for chloroquine and 6-6.5 mg/kg for hydroxychloroquine. In this way, both can be used for long-term therapy. The pharmacokinetics of chloroquine (storage in deep compartments with long plasma half-life) means that it can cumulate, especially with higher dosages and in the presence of renal or hepatic insufficiency. A high plasma concentration reinforces the side-effects without reinforcing the therapeutic effects. Besides subjective symptoms (e.g. anorexia, diarrhoea, nausea), the following undesirable reactions are significant. On the skin exanthema, hyperpigmentation and photodynamic reactions can develop. The hair can become white in blonde and red-haired men. In the eye, chloroquine deposits in the cornea and disturbances of accommodation can occur, besides retinopathy. Neuromyopathy and central nervous system disturbances (e.g. psychosis) are rare, as is impairment of auditory function or blood cells. During pregnancy there is a risk of potential fetal damage (hearing loss, abortion). An acute overdose is extremely dangerous: the lethal dose is 1 g for children and 4 g for adults. As death occurs rapidly, chloroquine has to be stored where it is absolutely inaccessible to children.

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Chloroquine And Hydroxychloroquine Toxicity

Introduction
Chloroquine (CQ) is used to prevent and treat malaria and amebiasis,[1] while hydroxychloroquine (HCQ), a less toxic metabolite of chloroquine, is used to treat rheumatic diseases such as systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), juvenile idiopathic arthritis (JIA) and Sjogren's syndrome.[2] Both medications can cause corneal deposits, posterior subcapsular lens opacity, ciliary body dysfunction, and most important, irregularity in the macular pigmentation in the early phase, a ring of macular pigment dropout in the advanced stage, and peripheral bone spicule formation, vascular attenuation, and optic disc pallor in the end-stage. Ocular symptoms of retinopathy include blurred and partial loss of central vision, side vision and in the later stage, night vision.  Symptoms of corneal deposits include haloes and glare.  Clinical research has resulted in precise screening protocols and safe dosing guidelines to prevent ocular toxicity and detect retinal damage at an early stage.

Etiology
Chloroquine and hydroxychloroquine bind to melanin in the retinal pigment epithelium (RPE) and cause damage to the macular cones outside of the fovea.  The drugs inhibit RPE lysosome activity, reduce phagocytosis of shed photoreceptor outer segments causing an accumulation of outer receptor segments.  In response, pigment-containing RPE cells migrate into the outer nuclear and outer plexiform layers of the retina resulting in irreversible photoreceptor loss and RPE atrophy.[3]  HCQ has a long half-life (about one month) and takes about half a year to achieve full elimination from the body; this is significant when managing minor side effects such as itching and corneal deposits and major ones such as retinal toxicity and explains continued maculopathy even after discontinuation of the medication.  Corneal deposits (called vortex keratopathy or corneal verticillata) result from binding to cellular lipids and deposition of the drug in the basal epithelial layer of the cornea.  Discontinuation of the drug usually causes the deposits to disappear over time.

Epidemiology
The advance of spectral domain optical coherence tomography (SD-OCT) and multifocal electroretinography (mf-ERG) technology has allowed for better detection of retinopathy.[4]  These advances, combined with the increased clinical availability of SD-OCT and, to a lesser degree mf-ERG, has increased reported incidence and prevalence of toxicity over the last decade.

The incidence of HCQ retinal toxicity was found to be 0.38% in a 2003 study of 526 patients.[5]  A 2010 study of approximately 4000 patients found a higher overall incidence of toxicity of 0.68%.  This study also found that the incidence increased sharply after 5 to 7 years of HCQ use from close to 0% to about 1%.[6]  Based on this study the American Academy of Ophthalmology recommended new screening guidelines in 2011.  The same study revealed that the most important predictor of toxicity was the duration of use (cumulative dose) and that age, the daily dose, and patient weight did not correlate significantly with HCQ toxicity.  One reaches a cumulative dose of 1000 grams (1 kilogram) at 7 years when taking the most commonly prescribed dose of 400 mg a day.  A new study then focused on those patients that had taken HCQ over 5 years.  This study revealed a much higher overall risk of 7.5% retinal toxicity among the 2361 patients studied.[7]  A daily dose over 5 mg/kg body weight increased the odds 5.7 times and taking HCQ over 10 years increased the odds by 3.2 times of developing retinopathy.  As long as patients received a dose of less than 5 mg/kg for less than 10 years, the incidence was still relatively low at 2%.  However, this risk went up to 20% for those patients who had taken HCQ over 20 years.  For those patients without retinopathy after 20 years of usage, the risk of developing toxicity in each subsequent year is around 4%.  Therefore, this study revealed that dose matters as well.  This study found that kidney disease and tamoxifen therapy increased the risk of retinopathy by 2.1 and 4.6 fold, respectively.  

A report in 2015 described that pericentral maculopathy without the classic parafoveal (Bull's eye) retinopathy is common in Asian (50%) compared to Caucasian (2%) patients,[8] and Asian patients should, therefore, receive adapted screening tests such as a wider angle threshold visual field test.

Pathophysiology
In malaria, chloroquine and hydroxychloroquine act as chemotherapeutic agents against erythrocytic forms of the Plasmodium parasites. Absorption of the drug increases the pH of the acidic food vacuoles of the parasite while it is inside the erythrocyte, which interferes with vesicle function and the development and asexual reproduction of the parasite.[9] The drugs also inhibit parasite growth by interfering with the conversion of toxic heme, released from the parasite digestion of hemoglobin to the non-toxic hemozoin.[10]  As a treatment for rheumatic disease, HQ/HCQ increases the pH in the lysosomes of antigen-presenting cells.  This blocks toll-like receptors (TLR) on dendritic cells, reduces the activation of these cells and reduces inflammation by inhibiting the production of rheumatoid factor and acute phase reactants. The drugs also accumulate in white blood cells, and by stabilizing lysosomal membranes inhibit the activity of enzymes that cause cartilage breakdown such as collagenase and protease.  TLR 9 recognizes DNA-containing immune complexes and inhibition by CQ/HCQ leads to inhibition of anti-DNA auto-inflammatory processes, such as occur in SLE.[11]

Histopathology
SD-OCT testing visualizes the retinal layers in as much detail as microscopic examination and in CQ/HCQ retinopathy a loss of the photoreceptor inner-outer segment junction (the IS/OS line, also called the ellipsoid zone or the photoreceptor integrity line (PIL)) and a thinning of the outer nuclear layer of the retina are observed.[12]

Toxicokinetics
Both chloroquine and hydroxychloroquine have excellent oral absorption and bioavailability.  Both have a long and variable plasma elimination half-life because of a high volume of distribution, an extended mean residence time (HCQ 1300 hours and CQ 900 hours) and with about half the drug metabolites undergoing unmodified renal clearance.  Both drugs are modified by cytochrome P450 in the liver.[13] chloroquine and hydroxychloroquine can pass through the placenta, but do not appear to cause harm to the baby and likely is beneficial to both mother and baby by an improved pregnancy outcome.[14]  Both drugs are excreted in breast milk.  Studies of pregnant mice revealed that the drug accumulates in the fetal retina. However, this accumulation is not permanent, and no reports of permanent harm exist.[15]

History and Physical
History should include the medical condition(s) that prompted CQ or HCQ therapy, the time since the start of therapy and the daily dose in mg per kilogram of the patient's actual weight.  Ideal weight was the preferable measure in the past but can cause overdosing of thin patients, and the patient's actual weight is now the preferred measure.[16]  Record whether the patient is Asian as it increases the risk for peripheral retinopathy.[8]   Perform a review of systems with specific questions about kidney and concurrent liver disease.  A comprehensive medication review should emphasize the following concurrent medications: tamoxifen therapy increases the risk for retinal toxicity, antacids, and kaolin clay reduce the activity of CQ/HCQ, and the patient should take the medicines 4 hours apart.  CQ/HCQ reduces ampicillin activity and increases cyclosporin activity.  CQ/HCQ increases the risk of convulsions in patients taking mefloquine (another drug to treat malaria).[17]  An ocular history should include specific questions regarding any pre-existing retinal disease.  Ask questions regarding central acuity and whether the patient has noticed fading out of the region right next to fixation.  Ask questions regarding the ability to focus on near objects and glare as well.  One may use a questionnaire such as the systemic lupus erythematosus disease activity index to measure the effectivity of the therapy.[18]  Ask questions about non-ocular side effects as well.  Only two third of patients comply with therapy,[19] and most non-adherence to therapy are in patients under 80 kilograms in weight, likely because of an increased incidence of side effects.  Common, nonocular, side effects of chloroquine and hydroxychloroquine include pruritus, headaches, dizziness, and gastrointestinal upset.  Less frequent side effects include discoloration of the oral cavity, nails, skin and hair and rash.  HCQ myopathy is uncommon and presents with proximal muscle weakness and rarely ventilatory failure.  In these cases, a muscle biopsy can determine characteristic pathological findings.[20]

Vortex keratopathy (corneal verticillata) rarely causes vision complaints. In some advanced cases, patients may notice haloes and glare. The deposits occur within the sub-epithelium, do not stain, and are non-irritating.  Verticillata appears as bilateral fine, golden-brown or gray opacities in the inferior cornea that branch out from a central whorl.[21]

Evaluation
Three reports from the American Academy of Ophthalmology (AAO) in 2002, 2011, and 2016 have provided clinicians with evidence-based guidelines for screening patients on CQ/HCQ therapy.[22]  Baseline testing within the first year of starting therapy should include a dilated fundus exam to document pre-existing retinal pathology.  While the latest recommendations do not require it, automated visual field (VF) testing and spectral domain optical coherence tomography (SD-OCT) are often done at this visit as well.  Guidelines recommend a 10-2 threshold VF except for Asian patients where a wider angle test such as a 24-2 or 30-2 VF protocol will pick up the 50% that develop retinopathy outside the central 20 degrees of VF.  Additional recommended screening tests include SD-OCT, fundus autofluorescence (FAF), and the most sensitive test of all, multifocal electroretinography (mf-ERG).  For Asian patients, wide-field SD-OCT and FAF should be performed.  Tests no longer recommended include baseline retinal photography, time-domain OCT, full-field ERG, electro-oculography, fluorescein angiography, color vision, and Amsler grid tests.

The guidelines recommend starting annual screening after 5 years unless additional risk factors are present that include small stature, obesity, liver or kidney disease, and retinal disease.  In these cases, test on an annual basis from the start.  Since mf-ERG, is the most sensitive test but not as readily available, some protocols recommend introducing it at a later stage.[22]  These guidelines recommend doing SD-OCT/FAF and VF tests first and to introduce mf-ERG only when these tests suggest retinopathy.

Interpretation of results is:

Visual field: defects are most likely to occur at 5 degrees from the center, except in Asian patients where the defect may be over 10 degrees from the center.  Use statistical analysis to determine the significance of the data.
SD-OCT: will reveal parafoveal thinning of the photoreceptor integrity line and the outer nuclear layer of the retina; this results in a "flattening" of the foveal depression and the "flying saucer sign" where the outer nuclear layer in the fovea's center is unaffected, and just around it this layer is much thinner (the edge of the saucer).
FAF: reveals in early maculopathy, a ring of hyperfluorescence (caused by the accumulation of lipofuscin) and in later stages, a ring of hypofluoresence (caused by the loss of photoreceptor and retinal pigment epithelial layers).[23]
mf-ERG: amplitude reduction is most common in ring 2, followed by ring 3, 4 and 1.  Delayed implicit times are less common.[23]
The dilated fundus exam: 2016 recommendations indicate that with better dosing guidelines and earlier detection, end-stage bull's eye maculopathy presents less often.  However, the clinician should have familiarity with the fundus appearance of irregularity in the macular pigmentation in the early phase, a ring of macular pigment dropout in the advanced stage, and peripheral bone spicule formation, vascular attenuation, and optic disc pallor in the end-stage.  

Treatment / Management
The clinician needs to be well-versed in the reasons to prescribe chloroquine and hydroxychloroquine and dosing recommendations to detect those patients at increased risk.

Chloroquine has a long history in the treatment of malaria caused by Plasmodium vivax, ovale, malariae, and falciparum in regions where P. falciparum has not developed resistance to it (mainly in North Africa).  It also has utility in treating amebiasis, especially the extra-intestinal forms.  For malaria prophylaxis in adults, start 500 mg CQ phosphate once a week from 2 weeks before until 8 weeks after travel to an endemic area.  The adult dose for active infection of malaria is a total dose of 2500 mg divided over 3 days for patients over 60 kg and for those less than 60 kg, 41.7 mg/kilogram of divided over 3 days.  Give patients with amebiasis a 1 gram loading dose for two days followed by 500 mg of CQ phosphate for 2-3 weeks.  Chloroquine is often part of a multi-drug regimen with other anti-parasitic medications.  A cumulative dose of over 460 g or a daily dose of 2.3 mg/kg body weight/day is high risk.[24][25]  The latest studies show that using the patient's real weight instead of ideal weight correlates better with safe dosing.  Chloroquine is rarely an option for rheumatic diseases over hydroxychloroquine.

HCQ treats rheumatic conditions as mentioned previously in this article. It also has utility in the treatment or prevention of malaria. For malaria prophylaxis in adults, start 400 mg HCQ once a week from 2 weeks before until 8 weeks after travel to an endemic area.  The adult dose for the treatment of malaria is a total dose of 2000 mg divided over 3 days for patients over 60 kg and for those less than 60 kg, 25 mg/kilogram divided over 3 days.  For rheumatic diseases, the most common dose is 400 mg per day.  In 2016, the previous guideline to keep the daily dose of HCQ under 6.5 mg/kilogram of ideal bodyweight was adjusted to 5 mg/kilogram of the actual body weight to keep the risk of retinopathy within acceptable levels.

Previous guidelines using ideal weight protect short stature, obese patients, while the new guidelines using actual weight appear to protect short stature thin patients from receiving a dose that is too high.[26]  While overdose is a concern for maculopathy, it also results in poor medication compliance because of immediate side effects.  Ask patients about common side effects of CQ/HCQ therapy that include pruritus, headaches, dizziness and gastrointestinal upset to detect those that are non-compliant and those that are receiving a dose that is too high.  Non-compliance significantly increases the risk for morbidity from the disease the CQ/HCQ treats and several tools have been tested to improve compliance.[16]  These tools include patient access to online blood results and web-based education.[27]

Convincing evidence of toxicity should result in the drug's discontinuation in consultation with the prescribing physician.  Because of the long half-life of both drugs, retinopathy can continue for over 6 months, and studies have shown ongoing changes for up to 20 years after cessation of the drugs.[28]  The goal is to detect early indications of retinal toxicity while the patient is still asymptomatic.

Differential Diagnosis
The differential diagnosis for CQ/HCQ vortex keratopathy (VK, also called corneal verticillata) includes:

Sub-epithelial deposition of other medications:  A good medical history should reveal the medication responsible.  Amiodarone most commonly is the cause of vortex keratopathy, followed by CQ, HCQ, indomethacin, and phenothiazines.  The appearance of the verticillata caused by these different medications is similar in appearance.[29]
Fabry disease: Verticillata from Fabry disease is similar in appearance to those caused by medications. Fabry disease presents with retinal vessel tortuosity and cataracts as well.  Other findings include pain of the extremities and angiokeratomas of the skin.  Cardiovascular, renal and cerebrovascular disease are late manifestations.[30]
Iron lines: Caused by iron deposition from the tear film into the basal epithelium layer.[31]
Hudson Stahli line: Tends to be more linear and usually horizontal and at the junction of the lower one third and upper two-third of the cornea.
Fleisher ring: This is present in moderate to advanced cases of keratoconus.  The inferior portion of the ring may be present in less advanced cases and can be confused with VK.
Corneal irregularity from refractive procedures such as radial keratotomy:  The deposits are within the irregularities caused by the surgery (for example, within the radial keratotomy incisions).
Stocker's line: The iron line is found next to the head of a pterygium.
Ferry's line: The iron line is found next to a glaucoma filtering bleb.
Gout: Uric acid crystal deposition in Bowman's membrane appears as a dust-like brown type of band keratopathy.  In an early stage, it can be confused with VK.[32]
Corneal chrysiasis: Caused by deposition of gold in the corneal stroma.  A good medical history should reveal a history of treatment with intramuscular injections of gold salts.  The deposition is more granular in appearance and more diffusely distributed throughout the surface of the cornea.[33]
The differential for CQ/HCQ retinopathy includes:

Age-related macular degeneration: Geographic atrophy (GA) in the absence of drusen and choroidal neovascularization and CQ/HCQ retinopathy can present similarly.  Both present with thinning of the photoreceptor integrity line and the outer nuclear layer of the retina and atrophy of the choriocapillaris on SD-OCT.[34]  However, GA does not appear in a parafoveal ring (bull's eye) pattern.  Conversely, especially in Asian patients, CQ/HCQ retinopathy does not present in the typical bull's eye pattern either, and the clinician will need to use other clinical criteria to differentiate the two conditions.  One study revealed that reticular drusen are visualized in all patients with GA by SD-OCT and FAF and their presence can be a valuable tool to differentiate GA from CQ/HCQ retinopathy [35]  mf-ERG reveals a typical paracentral reduction in CQ/HCQ retinopathy that is not present in GA.

Central areolar choroidal dystrophy (CACD): CACD can appear in a bull's eye pattern.  However, it develops between age 20-40 years old, usually too young of an age to have been on CQ/HCQ for over 20 years and to be at high risk of CQ/HCQ retinopathy.  It progresses through 4 stages, each associated with characteristic retinal and choroidal findings.  A speckled FAF pattern is present in 85% of patients with CACD and can be used to differentiate CACD from GA and CQ/HCQ retinopathy.[35]

Stargardt disease: Presence of irregular, pisciform, yellow flecks, at the RPE level in the macula with a possible extension into the periphery differentiates Stargardt disease from CQ/HCQ maculopathy.  The commonest age of onset is in the 2nd decade of life; the classic "beaten bronze" appearance and positive genetic testing for the ABCA4 mutation are additional ways to differentiate the two conditions.  Finally, the classic "silent choroid" found in patients with Stargardt disease when tested with fluorescein angiography is not present in patients with CQ/HCQ retinopathy.[36] Conversely, a recent study of eight patients with Stargardt disease revealed an almost complete overlap of SD-OCT, FAF, mf-ERG, and fundus findings with CQ/HCQ retinopathy.[37]

Cone-rod dystrophy (CRD): CRD can present with bull's eye maculopathy. CRD occurs in childhood and causes loss of central vision and photophobia in the early stage, followed by central scotomas, loss of color vision, and peripheral vision.  Night blindness is a present in the early stage.  Photopic and scotopic ERG testing is precise in differentiating CRD from CQ/HCQ retinopathy.[38]

Benign concentric annular dystrophy (BCAD): This rare disorder is characterized by a bull's eye macular pigmentary change while visual acuity is well-preserved.[39]

Prognosis
When the clinician that detects early retinopathy does not discontinue CQ/HCQ therapy, the prognosis is a progressive loss of paracentral vision followed by loss of central vision and night blindness.  Even when the clinician discontinues therapy, retinopathy can progress for many years.  Progression of vortex keratopathy (VK) causes increasing haloes and blur but is fully reversible upon discontinuation of therapy.

Complications
Even when the clinician and patient adhere to screening guidelines and retinopathy is detected in a sub-clinical stage, discontinuation of chloroquine or hydroxychloroquine therapy may not stop the progression of retinopathy to a stage where the patient loses vision.

Deterrence and Patient Education
As discussed in previous sections, a thorough knowledge of the latest screening guidelines, last amended in 2016, and clear communication on the risks and benefits of CQ/HCQ therapy are essential in reducing toxicity while maintaining the extensive benefits of CQ/HCQ treatment of certain parasitic and rheumatic diseases.

Enhancing Healthcare Team Outcomes
To reduce the incidence of chloroquine and hydroxychloroquine toxicity, health care providers (HCP's) that prescribe these medications and those that screen for ocular toxicity have developed clear dosing and screening protocols that have reduced the risk of end-stage disease; bull's eye maculopathy and central vision loss (Level I).

The best approach to maintaining excellent patient care and minimizing risk is a team approach involving nurses, nurse practitioners, physician assistants, and physicians. [Level V]

6 Types of COVID-19 Lawsuits That Will Be Coming Down the Pike

WHAT YOU NEED TO KNOW ABOUT POLIO AND OTHER SCAMS

THE GERM THEORY - THE NEW STATE RELIGION-DR. TIM O'SHEA

Turns out it is all about their “globe” lie and punishing those who do not abide by their climate change bullshit.

I like David Icke in general, especially for speaking up for our rights in Covid hoax times, but for someone so into truth-seeking, it's very odd he never mentions the flat earth or fake NASA. You would think that by now, he'd be all over it - don't you all think?? I'm very suspicious:

https://freedomplatform.tv/rose-icke-v-the-answer/?vgo_ee=Q5LHL%2FEfFQ029GuMyBcHAL35hO7C%2FF3J%2FgQB9Uu3XAY%3D

I think, because of his draconus/moon base conspiracy, that David Icke doesn't want to undermine all the 'work' hes done. His theories are based off the ball earth/space lies. And to admit the FE he would have to dismiss all his previous 'theories'. To be honest, I think even if he came out about FE, he would end up muddying the waters because he's controlled opposition. I don't hate him though. I actually think he's spot on about certain things.

GERMANY NOT TAKIN SHIT FROM THE BOLSHEVIKS AGAIN!!

ok great, thanks!

:

OY VEY

Realearth wrote:It appears your information is misinformation, see Doctors below that have been using HCQ cure for years.
SILENCED FRONTLINE DOCTORS HOLD CAPITOL HILL PRESS CONFERENCE TO CHALLENGE BIG TECH
https://www.bitchute.com/video/auRQYQvr3vsw/

Doctors are strangers claiming positions of authority that promote the use of unknown drugs and chemical cocktails
Anyone promoting the use of cure-alls is most likely a shill, go sell your snake oil somewhere else

Russian Blue Cat wrote:

Realearth wrote:It appears your information is misinformation, see Doctors below that have been using HCQ cure for years.
SILENCED FRONTLINE DOCTORS HOLD CAPITOL HILL PRESS CONFERENCE TO CHALLENGE BIG TECH
https://www.bitchute.com/video/auRQYQvr3vsw/

Doctors are strangers claiming positions of authority that promote the use of unknown drugs and chemical cocktails
Anyone promoting the use of cure-alls is most likely a shill, go sell your snake oil somewhere else

Legitimize the Freemasonic BS germ theory of Pasteur.
White coats of the Medical Industrial Complex.

UFO-Like Object Spotted Aboard US Aircraft Carrier (+Video)
Have seen videos pointing out these TR-3B triangle craft over the explosion.
Also have been seen over cali fires and other chaos.
Pfft, masonic triangle freaks.

Vaccinate or Terminate – Mandatory Vaccination As Workplace Policy
Tuesday, July 28, 2020
The discovery, testing and mass deployment of a COVID-19 vaccine are welcome developments in potentially ending the Coronavirus pandemic. A safe and widely available vaccine will also allow employees to return to the physical workplace. The benefits of an inoculated (and presumably safe and healthy) workforce are obvious. Employees immune from COVID-19 will experience fewer absences because they are healthy and so are the people that they care for (or that care for them). Offices and other facilities will avoid pandemic-related closures and disruptions associated with deep cleaning and other infection control measures. Inoculated individuals will be able to travel and participate in service, customer and other people-facing positions without fear of becoming ill or perpetuating an outbreak and making others ill. And while less obvious, incidents of mental health disorders and other very real but debilitating anxiety-related illnesses should wane in the face of actual progress in fighting the pandemic. If a fully or near fully inoculated workforce could materially reduce and even eliminate the direct threat the pandemic poses to the workplace, it seems natural to implement a mandatory vaccination program as soon as a COVID-19 vaccine is widely available – after health care workers, first responders and others at high risk are vaccinated – to ensure employee health and safety.

While the benefits of a fully immune workforce seem clear, what is less obvious are the legitimate objections that employees may have regarding a mandatory vaccination program and the legal basis for those objections. If a vaccine makes most individuals immune, then the fact that some unvaccinated individuals may carry or potentially transmit the virus does not create the same direct and wide threat the current pandemic inarguably poses now to the greater population that is largely susceptible and not immune. In addition, some individuals may be medically unable to be vaccinated or they may have sincere religious objections – both of which grounds may provide a legal basis upon which to refuse vaccination. As a result, private employers considering making COVID-19 vaccination a gatekeeping employment condition should proceed with caution.

Mandatory Vaccination and Disability and Religious-Related Issues
The EEOC first tackled mandatory vaccination in 2009 in response to the H1N1 (“swine flu”) pandemic and incorporated into its guidance established law concerning medical testing and religious objections. In its publication Pandemic Preparedness for the Workplace, the EEOC provided guidance regarding disability-related medical inquiries and medical examinations that might be relevant in a pandemic. As part of the 2009 guidance, the EEOC unequivocally concluded that both the ADA and Title VII prohibited an employer from compelling its employees to be vaccinated for influenza regardless of their medical condition or religious beliefs – even during a pandemic.

The 2009 EEOC guidance counseled, in accordance with the ADA, that an employee with underlying medical conditions should be entitled to an exemption from mandatory vaccination (if one was requested) for medical reasons. Similarly, Title VII, according to the 2009 guidance, protects employees with sincerely held religious beliefs from being forced to undergo vaccination if vaccination legitimately offends an employee’s religious beliefs. Accommodation for those individuals could include, for example, minimizing interactions with other employees or the general public, or otherwise examining ways in which the individual could perform their work without coming into contact with others, such as virtual or home-working arrangements. But in the event an accommodation is required, the interactive process requires that a discussion about those accommodations actually takes place.

COVID 19 Updates to the 2009 Guidance
Since the onset of the Coronavirus pandemic, the EEOC has updated its Pandemic Preparedness in two ways relevant to mandatory COVID-19 vaccination: First, the EEOC acknowledged that the COVID-19 pandemic met the ADA’s “direct threat standard” that permits more extensive medical inquiries and controls in the workplace than the ADA previously allowed. A “direct threat finding” means that having someone with COVID-19 or symptoms of it in the workplace poses a “significant risk of substantial harm” to others in the workplace. That finding permits employers to put in place certain medical testing considerations and measures the ADA would not typically permit, such as taking employee temperatures, a measure that has been widely adopted since the pandemic’s onset.

Second, when the EEOC updated its prior guidance prohibiting mandatory vaccination, it noted the somewhat self-evident fact that as of its March 2020 update, when the guidance was updated, there was no COVID-19 vaccine available.

Given the reports that a fully deployed vaccine may be available as early as the end of this year (if not before), the EEOC may yet update this guidance concerning mandatory vaccination. But until that guidance is updated, employers should consider the present guidance as the basis for any mandatory COVID-19 vaccination program.

State Law Issues
Federal law does not provide the sole guidance regarding mandatory vaccination programs for the private, non-healthcare workforce. State law, which often raises the bar considerably above the Federal statutory floor, especially for small employers, should also be consulted before putting a mandatory vaccination program in place. The CDC lists many of the current state vaccination laws related to healthcare workers (who are generally required to undergo a variety of mandated vaccines) as well as educational requirements for students.

Political and Policy Considerations – The Anti-Vax Movement
Mandatory workplace vaccination programs not only implicate potential medical or religious objections, but they also implicate a significant but growing social movement against vaccination. Adherents to this movement – “anti-vaxxers” – believe that mandatory vaccination poses objectionable moral, ethical and public health issues. While the anti-vax movement largely currently focuses on mandatory vaccination of children for common childhood diseases, a natural migration to the private employment sphere might result in the face of COVID-19 vaccination programs as conditions of employment. Given the speed with which the COVID-19 vaccine is being developed and the natural inability to time-test its safety and efficacy, adherents to this movement may play a role in the development of public policy in the private workplace sphere. While a recent poll suggests 72% of Americans will readily be vaccinated, that means a fairly sizeable proportion would not (and apparently, that percentage is even higher among younger people).

Establishing a Legally Compliant “Mandatory” Vaccination Program
Absent further guidance from the EEOC, employers considering a mandatory COVID-19 vaccination program once the vaccine is considered safe and widely available as a condition to permitting employees to return to the physical office, for terminating employees from employment for refusing to be vaccinated, or for job applicants to begin employment, should consider some fundamental precepts prior to adopting such a program:

Vaccine costs, if not fully health insurance-funded, should be borne entirely by the employer to avoid financial barriers to employment;

The program should allow employees to opt out entirely if they have medical or religious objections to vaccination;

In the event of a medical or religious objection, an interactive dialog should be established with the objector to determine whether the individual’s objections can be accommodated in light of the positon for which the individual is applying or currently holds;

Fully trained human resources professionals should be responsible for this process, versus line managers who may lack such training;

Job descriptions should be updated to provide for essential functions, which may include travel, customer-facing positions, close interaction with other employees, or other factors that might compel mandatory vaccination;

Employers should pay particular attention to recordkeeping given the ADA mandate that medical records be kept separate from general personnel files and the importance of data integrity and limited internal access to medical information.

Employers should keep in mind that a vaccine is not a fail-safe for an employer’s general obligation to provide a safe working environment, and COVID-19 has taught some hard workplace lessons regarding the prevention against and mitigation of easily transmittable but hard to discern dangers such as viruses and bacteria in the workplace.

Summary
To some, a COVID-19 vaccine will be a welcome development that will permit employment to return to the pre-pandemic paradigm. Others, however, may legitimately believe that a vaccine threatens their health or spiritual well-being. A widely available vaccine that immunizes the population generally may well support individual opt-outs from vaccination, but these factors should be accounted for in designing and deploying a mandatory COVI- 19 workplace vaccination program.

Devon1 wrote:

DOD IMPLEMENTATION PLAN FOR FLU PANDEMIC

WHO Corona Virus Pandemic Simulation Exercise
Coronavirus disease (COVID-19) training: Simulation exercise
To support countries’ preparedness effort on the COVID-19 outbreak, WHO`s Department of Health Security and Preparedness has developed various COVID-19 tabletop exercise (SimEx) packages. This includes:

A Generic Covid19 SimEx to examine and strengthen existing plans, procedures and capabilities to manage an imported case of 2019-nCov and targets the health authorities at the national level.
A Health facility & IPC SimEx that is based on the Core Components of Infection Prevention and Control Programmes at the National and Acute Care Facility Level.
A Point of Entry (POE) SimEx to examine and strengthen existing plans, procedures and capabilities at the main airport (POE).
An Urban Covid19 SimEx to discuss critical issues in urban environments as the pandemic develops into an established infectious disease that may have periods of increased spread and number of persons affected.
The simulation package consists of different elements including:

PowerPoint presentations to support the facilitation of the exercise and its subsequent debriefing
A participants’ guide and a facilitators’ guide to explain what is expected from the different people involved in the preparation and running of the exercise.
A set of reference documents and technical guidance on 2019-nCov


The package highlights clearly where some minor adaptions are needed to make the simulation country-specific and more relevant to the participants.

If you need technical support to implement this exercise, please contact your WHO country office or regional office focal point.

I was reading through this thread today and saw a meme of the similarities between slave masks, punishment masks and then the Coronavirus mandatory masks. I’ve clicked back through all of the thread and can’t find which page number it’s on. Could someone tell me the date it was posted or repost for me please? Sorry to be a pain, I should’ve saved it when I saw it. Can’t find on google images.

Thankyou @BosnianFlatearther - appreciate it.

https://www.youtube.com/watch?v=L2bbzmNMW6c

The first part of the video is in german, the second part in english..

29.08.2020 the next protest is taking place in BERLIN