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Re: undefined

#371

Post by post_below »

JohnJamesRambo wrote: post #133
post_below wrote: post #28

A bit more info: https://www.nbcnews.com/health/health-news/man-dies-after-in... Also happening in Nigeria: https://www.democracynow.org/2020/3/23/headlines/two_nigeria... Note that there doesn't appear to be any evidence yet that chloroquine is effective in COVID-19 treatment. So far it has been studied only for other types of coronavirus.

>Note that there doesn't appear to be any evidence yet that chloroquine is effective in COVID-19 treatment. So far it has been studied only for other types of coronavirus. https://www.ncbi.nlm.nih.gov/pubmed/32173110 That's incorrect. I don't know how these people died from taking chloroquine phosphate, it is quite safe when taken in normal dosages. What they had may have been contaminated (since it seems to be for a…

"In vitro"

It seems like a promising treatment, but in vitro effectiveness often doesn't translate to actual effectiveness.

I'm not saying they shouldn't use it, in an emergency sometimes experimental therapies make sense.

In these times, though, I think rational science is also important. We do not yet have studies of it's effectiveness in treating COVID-19.

Also from your link:

>CONCLUSIONS: There is rationale, pre-clinical evidence of effectiveness and evidence of safety from long-time clinical use for other indications to justify clinical research on chloroquine in patients with COVID-19. However, clinical use should either adhere to the Monitored Emergency Use of Unregistered Interventions (MEURI) framework or be ethically approved as a trial as stated by the World Health Organization. Safety data and data from high-quality clinical trials are urgently needed.

I genuinely think it's valuable (in our post fact world) to be able to tell the difference between the concepts of "evidence to support further study" and evidence of effectiveness in a particular application.

Edit: New thread here at HN: https://news.ycombinator.com/item?id=22671404

Re: undefined

#372

Post by tim333 »

fabian2k wrote: post #22

I wasn't able to find a reliable source on short notice, but the ones I found indicate a therapeutic index of around 4-8 for chloroquine. The therapeutic index is the ratio between the dose that is effective and the lethal dose. So in this case if you take 4-8 times the dose that actually works you're in the range where it could kill you. I'd be really interested in more robust sources on this. But from the bits I've…

The lethal dose is about 3-5g in an adult. The amount used for treatment varies. The highest was the Chinese taking 2x500mg per day for coronavirus. They reported no adverse effects but it seems a little close.

Others I think have used 500mg once per day.

This link has some info http://www.maripoisoncenter.com/wp-content/uploads/2015/03/C... Says 20mg/kg toxic, 40mg/kg usually fatal without invervention.

Re: undefined

#373

Post by [deleted] »

cameldrv wrote: post #353
shadowprofile77 wrote: post #121

The recommended dosage of chloroquine for treatment of an active malaria infection is 1000 milligrams per day on the first day, followed by an additional 500 mg 6 to 8 hours later followed by 500 mg per day for three days afterwards. There are slight variations of this regimen recommended by different clinical sites. The point here being that if this man and his wife both became critically ill less than an hour after…

They said it was a teaspoon of Chloroquine Phosphate. I can't find what the density of Chloroquine Phosphate is anywhere, but if it were only as dense as water, that would be 5 grams, which is 5x the first day dose for treating Malaria.

[deleted]

Re: undefined

#374

Post by tim333 »

tree3 wrote: post #350
refurb wrote: post #262

Earlier quoted context omitted.

Seems completely reasonable to me. He says "have a real chance". He's not promising they work and stating that he and the FDA are doing everything they can to find treatments.

"be put in use IMMEDIATELY"

Here's a story where it was put in use immediately and saved the guys life. "Coronavirus Victim, 52, Said Good-Bye To Family, Prepared to Die; Says Hydroxychloroquine Saved His Life" https://www.dailywire.com/news/coronavirus-victim-52-said-go...

It can be a mistake to avoid helpful medication because one idiot kills himself with fish tank cleaner.

It can actually be used immediately at a doctors discretion - it's just not officially recommended yet in the US.

Re: undefined

#375

Post by totalZero »

refurb wrote: post #262
anigbrowl wrote: post #25

A relevant data point. I don't think this is a good way to share public health information. @realdonaldtrump 7:13 AM - 21 Mar 2020 HYDROXYCHLOROQUINE & AZITHROMYCIN, taken together, have a real chance to be one of the biggest game changers in the history of medicine. The FDA has moved mountains - Thank You! Hopefully they will BOTH (H works better with A, International Journal of Antimicrobial Agents)..... ....be put…

Seems completely reasonable to me. He says "have a real chance". He's not promising they work and stating that he and the FDA are doing everything they can to find treatments.

He says it should be put in use immediately. Are we reading the same material? How do you come to the conclusion that this is reasonable?

Sometimes, "reasonable" is a word that people use to verbally dance their way out of indefensible positions. Don't do that.

Re: undefined

#376

Post by totalZero »

tim333 wrote: post #374
tree3 wrote: post #350

Earlier quoted context omitted.

"be put in use IMMEDIATELY"

Here's a story where it was put in use immediately and saved the guys life. "Coronavirus Victim, 52, Said Good-Bye To Family, Prepared to Die; Says Hydroxychloroquine Saved His Life" https://www.dailywire.com/news/coronavirus-victim-52-said-go... It can be a mistake to avoid helpful medication because one idiot kills himself with fish tank cleaner. It can actually be used immediately at a doctors discretion - it's ju…

The Daily Wire is Ben Shapiro's right-wing fake news infotainment website. It's overtly political and puts opinion above fact.

The man in the story says he was also given benadryl and a drug he didn't recognize. So please don't pretend that one drug saved the man's life. For all we know, he was going to recover anyway, or one of the other drugs (which he doesn't even know what they are) helped him.

Re: undefined

#377

Post by pbreit »

et2o wrote: post #284
pbreit wrote: post #276

Earlier quoted context omitted.

It's been confirmed effective against SARS CoV in vitro [1]. Before you say it, yes, I know treatments in vitro do not always work in vivo. Reports from China, South Korea and France have suggested efficacy in humans against COVID-19. 1: https://www.ncbi.nlm.nih.gov/pubmed/15351731

Actually they rarely translate. Chloroquine is a particularly funny example because they have already tried it as an antiviral drug several times without any efficacy.

Can you point to evidence that in vitro efficacy rarely translates to in vivo?

I've seen the one situation of chloroquine showing promise in vitro against SARS CoV but no others. Is there literature on others?

Re: undefined

#378

Post by pbreit »

et2o wrote: post #295
pbreit wrote: post #287

Earlier quoted context omitted.

There is absolutely evidence of effectiveness against COVID-19 in humans from China, South Korea & France.

Please let me and the CDC know of these well-conducted trials of chloroquine for COVID. I take it you are not familiar with epidemiology, clinical evaluation of drug efficacy, or medical statistics. That’s fine! No one is saying you need to be. But you shouldn’t be extremely confident of your conclusions when experts are telling you that you’re wrong. The French chloroquine+azithromycin trial was terrible and no one…

One died.

I am not extremely confident in what is not even a conclusion. I am simply shocked at the pushback and resistance to a promising treatment with minimal downsides.

Medecine appears to be the only profession in the world that only accepts one form of evidence. That is what is maddening.

Re: undefined

#379

Post by anigbrowl »

refurb wrote: post #345
amazingman wrote: post #338

Earlier quoted context omitted.

It seems completely reasonable to you for the president to tweet out unqualified medical advice during a pandemic?

It's not medical advice. It's "hey, these drugs look promising, so the FDA is fast tracking things". How could anyone construe that as medical advice? If the president said "hey, the FDA just approved a great new cancer drug", is that medical advice for cancer patients? Of course not.

People on HN might not, uneducated people easily could. Why do you think pharmaceutical commercials include so many warnings?

Re: undefined

#380

Post by anigbrowl »

AmericanChopper wrote: post #341
anigbrowl wrote: post #233

Earlier quoted context omitted.

Now now, there are multiple quotations on this thread showing that not to be true.

There is not a single one showing this not to be true, trump has: * Instructed the FDA to perform a clinical trial * Said the FDA has approved it for treatment of Coronavirus in “compassionate use” circumstances * Said he thinks it will be effective * Said he can’t be sure how it will turn out All of his quotes on the topic can be put into one of those categories. The first two are simply statements of fact, the seco…

Trump has made absolutely no statements at all saying:

This will certainly work out*

"But the nice part is, it’s been around for a long time, so we know that if it — if things don’t go as planned, it’s not going to kill anybody."

Full quote in https://news.ycombinator.com/item?id=22669656

Look, I know you want to nuance your way out of this, but it's not gonna fly because remarks like the above are taken at face value by foolish people and that's something that public figures have a responsibility to take into account. As I keep pointing out, that's why pharma ads have to have so many warnings in them. You think they wouldn't rather just say 'try this, it'll cure what ails ya!' But bitter experience has shown that people need to reminded about side effects and safe dosage and listening to their doctor over and over and over again.

In case you follow up on this thread, please listen to this - an interview with the woman whose husband died, describing how they came to try the medication: https://twitter.com/VaughnHillyard/status/124225399700566425...

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