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Efficacy of hydroxychloroquine in patients with Covid-19: a randomized trial

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Re: Efficacy of hydroxychloroquine in patients with Covid-19: a randomized trial

#61
post #45

Earlier quoted context omitted.

The President shouldn't be recommending unproven drugs, he should be communicating what we know and what to do now.

That's still not a partisan issue.

Then criticizing the President for promoting drugs that haven't been shown to work is non-partisan as well. Can't have it both ways.

I find the "political" vs "non-political" distinction facile anyways.

Re: Efficacy of hydroxychloroquine in patients with Covid-19: a randomized trial

#62
post #11

I wish the current U.S. administration hadn't tried to turn this into a partisan issue.

It absolutely did not. The press did. The mainstream US media has become a one-sided partisan cheerleading squad for the Democrats, and most Americans are sick of it. We'll see how that works out in November.

Your bias is showing. I could say "most Americans are sick of a lying, inept administration that can't be trusted". But I would be accused of being a biased democrat. I suspect the reality is the administration is totally inept or rendered inept due to the rotten top. The misinformation or biased information on either side's media outlet does not let the people see the real truth. Strange times indeed.

Re: Efficacy of hydroxychloroquine in patients with Covid-19: a randomized trial

#63

Earlier quoted context omitted.

How did they turn it into a partisan issue? Trump announced in a press conference that hydroxychoroquine held promise as a potential therapy based on anecdotal evidence being shared by physicians in Asia and Europe. Everyone, Democrats, the media, and individuals jumped on him as promoting snake oil and having no basis for his claims. It was barely news when he announced it. Some of the same evidence he was referenci…

He heard something about these two drugs, and without any scientific evidence he announced it, causing a panic-grab for the drugs. Unfortunately even the CDC was saying we don't have evidence supporting it.

> He heard something about these two drugs, and without any scientific evidence he announced it, causing a panic-grab for the drugs.

And? As I said, there has been some anecdotal evidence coming from countries like China, SK, and France indicating it could help. It shouldn't be a strike against a government official for sharing potentially important information. At a certain point we need to stop blaming people in positions of authority for the stupidity that exists among individuals in society. I'd rather my government be open and transparent than hide information from me because the more idiotic portions of the population may react poorly.

Its also worth noting that Hydroxychloroquine is unavailable in the US without a prescription. The "panic-grab" you are seeing is entirely due to physicians buying for themselves and their family/friends. Definitely sleazy, but they are hardly uninformed.

> Unfortunately even the CDC was saying we don't have evidence supporting it.

The CDC has proven itself to be conservative and slow to the point of harmful ineptitude. A huge part of the reason the situation in the US has diverged so much from countries that have managed to successfully clamp down on the disease (like SK) is because they insisted that testing rely on their own, overengineered procedures, and because they've insisted (for at least a decade now) that masks are only beneficial for HCPs, despite numerous studies to the contrary and the advice of nations like those in East Asia. Now, after the cat is well out of the bag, they've opened up testing to private companies and other testing procedures, and are now beginning to say that regular people should in fact be using masks to prevent the spread of the disease.

An appeal to authority is a fallacy on the best of days. Its even worse when said authority is in the midst of the most incompetent moment in its history.

Re: Efficacy of hydroxychloroquine in patients with Covid-19: a randomized trial

#64
post #11

I wish the current U.S. administration hadn't tried to turn this into a partisan issue.

Look in the mirror to see how this became a partisan issue. The president made absolutely no partisan statements when mentioning his hope for the drug. It was those looking through dirt colored glasses that took things down that path.

It's not "partisan statements," it's the strategy of trying to take ownership of one particular treatment. It shouldn't be a political issue.

It's hard to see the president's statements as anything but an effort to promote himself by tying himself to this treatment. It should be non-partisan.

Previous administrations didn't try to set up "I win" scenarios in times of crisis. We need to be able to evaluate the treatment without it being clouded by the issue of whether one side or the other was right.

Re: Efficacy of hydroxychloroquine in patients with Covid-19: a randomized trial

#65
post #53

Earlier quoted context omitted.

> Face it, HCQ is an old and cheap drug that doesn't fit Big Pharma profit visions. That seems like a non sequitur... Do you think HCQ knows that, and is therefore making itself less effective, just to stick it to Trump? The reality is, HCQ is not without adverse side-effects, and we have reason to be cautious. There have been several examples in the past where early results of HCQ testing looked promising against va…

We can check efficacy claim of HCQ by doing Randomised trail in US under FDA supervision instead of just relying on Chinese studies, But main benefit of HCQ if it found to be effective would be that it is already a widely used approved drug. We know it's side effects, Getting a new drug approved and check for its side effects itself is very time consuming and expensive exercise. Here only randomised large scale trail…

Nothing is preventing them, that is why there are several large scale trials taking place in the United States right now... (mostly in New York, as well as at least one in Washington).

Re: Efficacy of hydroxychloroquine in patients with Covid-19: a randomized trial

#66
post #11

I wish the current U.S. administration hadn't tried to turn this into a partisan issue.

How did they turn it into a partisan issue? Trump announced in a press conference that hydroxychoroquine held promise as a potential therapy based on anecdotal evidence being shared by physicians in Asia and Europe. Everyone, Democrats, the media, and individuals jumped on him as promoting snake oil and having no basis for his claims. It was barely news when he announced it. Some of the same evidence he was referenci…

Welcome to the club. The over-the-top reactions to events like this are what's going to get this guy re-elected.

Re: Efficacy of hydroxychloroquine in patients with Covid-19: a randomized trial

#67

Earlier quoted context omitted.

It absolutely did not. The press did. The mainstream US media has become a one-sided partisan cheerleading squad for the Democrats, and most Americans are sick of it. We'll see how that works out in November.

No, most Americans are sick of Trump and his mindless anti science supporters and their endless lies. Yeah. We are going to see in November. You aren’t going to like the outcome for your racist draft dodging business failure tax cheating rapist impeached serial liar with early dementia but restoring adults to leadership will suit the rest of us well.

"restoring adults to leadership"

with Biden (or any of the dems)? Hah! Good luck with that...

Re: Efficacy of hydroxychloroquine in patients with Covid-19: a randomized trial

#68

The sample size is 62 and the mortality rates are between 0% and 7% depending primarily on age and co-morbidities. I don't think we can draw any meaningful conclusions from this other than what we already know: seems worth looking into HCQ more.

They weren't looking at the effects on mortality. They looked at TTCR ("the return of body temperature and cough relief, maintained for more than 72 h") and radiological changes. They found a decently large effect in both of these.

The meaningful conclusion is "Considering that there is no better option at present, it is a promising practice to apply HCQ to COVID-19 under reasonable management."

Re: Efficacy of hydroxychloroquine in patients with Covid-19: a randomized trial

#69
post #12

Seems relevant: https://twitter.com/SquawkCNBC/status/1245669685267439616 Not sure they've been doing proper studies and such because they're so slammed, but it seems they've been trying it in Italy and... maybe it helps some, but doesn't seem like it works miracles.

In combination with antibiotics and (it seems) zinc it looks quite effective. A doctor in NY has treated with that combination and is up to almost 700 COVID-19 patients without one dying _or needing a ventilator_. Some relevant quotes: >Dr. Zelenko said the whole treatment costs only $20 over a period of 5 days with 100% success. He defines success as “Not to die.” Dr. Zelenko first posted his Facebook video message…

This news story raises several big red flags.

This story was reported by Laura Ingraham on Fox News. Her tweet promoting this as a "cure" was immediately withdrawn by Twitter as "misleading". The 40 minute video interview with Zelenko, again on Fox News, was conducted not by a medical reporter, but by Rudy Giuliani. Zelenko goes on to make numerous huge dire public health predictions -- none of which a family practitioner has any business suggesting, especially in public on a national news outlet.

As always, consider the source of the information.

It's also very important to note that Zelenko was treating 700 unhospitalized patients; these were not cases severe enough to admit to a hospital. He treated them from his home (since he lost a lung to cancer years ago). So he never actually physically met with any of those 700 patients to monitor their progress.

In fact it's likely that many of these patients never tested positive, but simply self-reported as positive, further diluting the 'trial'.

And because 80% of positive COVID-19 cases are minor or even asymptomatic, the number of his patients that really _needed_ treatment falls from 700 down to, at most, 140 (20% of 700). That's a much smaller treatment effect that a large number like 700 would suggest.

It's also important to note that, apparently, Dr Zelenko treated sick people with medications that were NOT approved for the target disease. And he did so apparently without approval from any higher public health authority. In short, it appears that he experimented on his patients without authorization to do so from a public health or research authority.

Zelenko is a family medicine doctor, not a specialist in infectious disease or research. Thus it's very unlikely he wrote up an experimental design with proper safeguards, much less got it approved. With such poor experimental controls, it's impossible to interpret his results. What's more, if any of his patients later incur harm (like heart attacks from the chloroquine), such a laissez-faire approach to medicine will invite lawsuits galore.

No. Anecdotal evidence alone is NEVER enough.

Re: Efficacy of hydroxychloroquine in patients with Covid-19: a randomized trial

#70

The sample size is 62 and the mortality rates are between 0% and 7% depending primarily on age and co-morbidities. I don't think we can draw any meaningful conclusions from this other than what we already know: seems worth looking into HCQ more.

They weren't looking at the effects on mortality. They looked at TTCR ("the return of body temperature and cough relief, maintained for more than 72 h") and radiological changes. They found a decently large effect in both of these. The meaningful conclusion is "Considering that there is no better option at present, it is a promising practice to apply HCQ to COVID-19 under reasonable management."

Also, you don't need to decrease mortality to have a huge benefit from a treatment. If you just get people recovering faster, you've probably indirectly saved many lives!
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