I think this drug has become too politicized to be able to have a factual scientific debate.
Someone went really nuts with flagging and downvoting these comments.
Hydroxychloroquine Probably Isn’t the Answer
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Re: Hydroxychloroquine Probably Isn’t the Answer
#82Re: Hydroxychloroquine Probably Isn’t the Answer
#83Earlier quoted context omitted.
It's resistance to people who are clearly out of their lane. He is not a medical doctor, yet he's recommending people take it. It's unremarkable that he's incompetent to give this advice, because most people are incompetent to give such advice. I am incompetent to give such advice. What is remarkable is he clearly thinks he's competent to give such advice, and that it's appropriate for him to give it without any qual…
A fair amount of doctors tend to believe it is promising [1]. If I was in the hospital, of course I would want to take it regardless of how anecdotal the evidence is. [1] https://www.washingtontimes.com/news/2020/apr/2/hydroxychlor...
> A fair amount of doctors tend to believe it is promising
There are a couple of red flags about that article. No peer-reviewed (or otherwise) papers are mentioned and no clinical trials are discussed. The article does not even attempt to evaluate the truth of whether it's an effective therapy.
Even judged on its own terms, the article is a weak. After looking at that survey they're flogging, it'd be pretty interesting to hear from Spanish doctors, since that's where most of the enthusiasm seems to be coming from, but they don't even attempt to talk to anyone. Well... it's the Washington Times.
> of course I would want to take it
"Of course?" I hope you would at least consider the opinion of the physician treating you.
Re: Hydroxychloroquine Probably Isn’t the Answer
#84Why is this flagged? It seems like an interesting article from a reputable source.
I'm guessing it's because the organization has been praised by a number of well-known people on the right (e.g., Steve Forbes, Ben Carson). And because the question of whether or not this drug works, or even should be used at all, seems to have become highly politicized. I think I read that at least one US governor threatened to pull the medical license of any doctor that used it. I don't have any idea whether this d…
US state governors don't have the authority to pull medical licenses.
Re: Hydroxychloroquine Probably Isn’t the Answer
#85Earlier quoted context omitted.
Seems like those statistics would be pretty easily explained by Marseille being a week or two behind other areas in France on the epidemic curve. Pennsylvania: 11510 cases, 150 deaths, mortality rate 1.3% Is Pennsylvania also using HCQ systematically on all cases? I don't think these crude CFRs are useful.
That's the most interesting rebuttal I've heard but I don't think it's true. Everything else being equal, you could estimate the stage of the epidemic by the number of cases per capita. The Marseille department, Bouches-du-Rhône, has 3% of the French population and about 4% of cases. Also, in your example, the crude CFR for the US is 2.9% right now, so only 2.2x that of Pennsylvania. We're talking about 8+ here.
You didn't finish the comparison for cases for capita.
Bouches-du-Rhône has ~3% of the French population and ~4% of the covid-19 hospitalizations.
The department of Paris has ~3% of the French population and ~10% of the hospitalizations.
That seems to indicate that Bouches-du-Rhône is behind Paris.
(used hospitalizations instead of cases only because I couldn't find a good source for case breakdown by department. numbers from https://dashboard.covid19.data.gouv.fr/)
Re: Hydroxychloroquine Probably Isn’t the Answer
#86Prevent Senior in Brazil, an health operator with mosts of its patients on risk groups (60+ yo) are using hydroxychloroquine on all its COVID-19 patients with tremendous success. Right now I choose to believe on MD in front line rather then in Health Societies, FDA, WHO and those bureaucrats who let the virus spread all around due to its incompetence
Doctors and clinicians on front lines in NYC and greater NYC area say it's not helping at all, that they've by and large given up on using it. So I could reply that right now I choose to believe these MDs and ARNPs on front lines rather than commenters on HN. But that's not helpful compared to research. This one is a mess, and the tiny sampling of articles we have are not definitive. // Disclaimer: Lived in Africa fo…
Cuomo just said he is confident about hidroxychloroquine as NYC may see a plateau soon
Re: Hydroxychloroquine Probably Isn’t the Answer
#87Earlier quoted context omitted.
> but without a randomized control trial, there is no way the success can reliably be attributed to the medications That's non-sense, if everyone that had cancer got cured by a miracle drug, would you still demand a randomized control trial?
Unless you did such a trial, you cannot be sure it actually was the drug that helped. But if everyone gets cured, such a trial should be easy to set up. Unfortunately, things are not that easy in real life. There is no miracle drug.
But you already have a control which is a statistic called "survival rate after x years". If you beat it with a large enough treatment group, then you can prove it works.
Re: Hydroxychloroquine Probably Isn’t the Answer
#88Earlier quoted context omitted.
> The idea is that any treatment that slows the progress of the infection will also buy the patient's immune system more time to fight the infection. Is there any serious trial that shows that Hydroxychloroquine has any effect at all?
https://www.medrxiv.org/content/10.1101/2020.03.22.20040758v... Note that it is not peer reviewed
Thanks for the link, it looks good.
This part is strange:
> Normalization and mitigation criteria included the following: a. Body temperature ≤ 36.6 °C on the surface, ≤ 37.2 °C under the armpit and mouth or ≤ 37.8 °C in the rectum and tympanic membrane;
Is this a standard criteria? Why didn't they agree to use the same measurement method in all the study?
The part about counting coughs is not convincing for me, it looks too difficult to measure accurately. I prefer to ignore it.
But this part looks really interesting:
> Notably, a total of 4 of the 62 patients progressed to severe illness, all of which occurred in the control group not receiving HCQ treatment. For adverse effects, it should be noted that there were two patients with mild adverse reactions in the HCQ treatment group, one patient developed a rash, and one patient experienced a headache, none severe side effects appeared among them.
Re: Hydroxychloroquine Probably Isn’t the Answer
#89Earlier quoted context omitted.
Yes! I want to be sure that this miracle drug is 100% to eliminate all the other drugs that has nasty side effects and have a lower effectivity. Let's pick some terminal ill patients. I think cancer metastasis in the brain has a very bad prognosis, like less than a year of life expectancy [1]. Let's make a one year trial: 100 patients in the control group that receive the usual treatment and a placebo. 100 patients i…
So you have a cancer that normally has a 90% fatality rate after a year. Someone gives you evidence that they gave this drug to everyone with this cancer in their hospital, and 70/73 survived for a year. Not properly randomized, not properly controlled. Would you really reject their data and find it unconvincing?
If the results are so good it would be impressive. But it will be necessary to take a look at the data. Dollar to doughnuts they have a horrible methodological mistake, like a bad classification of the patients, or using a weird definition of cure [1], or cherrypicking the patients that get cured.
[1] We have a big announcement of a miracle cure in Argentina in 1986. It was crotoxina [links bellow] that is a part of the venom of some snakes. One of the problems was that they were comparing CT from different angles and finding fake reductions in the size of the tumors. (Other parts of the study were just frauds.)
https://translate.google.com/translate?sl=auto&tl=en&u=https...
https://translate.google.com/translate?hl=&sl=es&tl=en&u=htt...
https://translate.google.com/translate?hl=&sl=es&tl=en&u=htt...
Re: Hydroxychloroquine Probably Isn’t the Answer
#90Earlier quoted context omitted.
Yes! I want to be sure that this miracle drug is 100% to eliminate all the other drugs that has nasty side effects and have a lower effectivity. Let's pick some terminal ill patients. I think cancer metastasis in the brain has a very bad prognosis, like less than a year of life expectancy [1]. Let's make a one year trial: 100 patients in the control group that receive the usual treatment and a placebo. 100 patients i…
Unfortunately, you cannot correct nasty side effects for patients who die from lack of treatment.
Note that some cancers kill you very fast and other kill you in a very long time, so you have a chance of die from another cause.
If the study in a small group proves that the miracle drug is ineffective and moreover it reduces the life expectancy to 1/2, then by not giving it to everyone avoid the nasty effect of reducing the life expectancy of a lot of people.
Take a look at some "miracle" cures of cancer of the past, like https://theincidentaleconomist.com/wordpress/the-rise-and-fa...
Also, since a few years in Prostate Cancer the recommendation is not to treat all cases after detection https://en.wikipedia.org/wiki/Prostate_cancer#Management