Hydroxychloroquine Update for April 6 • Hacker News Board

Re: Hydroxychloroquine Update for April 6

#21

Post by m0zg » Mon, Apr 06, 2020, 11:06 PM UTC

tptacek wrote: post #15

m0zg wrote: post #9

Earlier quoted context omitted.

> doesn't mean it's universally safe _Table salt_ is not safe. Eat 100 grams of it and you will die. This does, however, mean that it's not as "dangerous" as the mainstream press wants you to believe. It's a 50 year old drug used all over the world. If it was "deadly", we'd know it by now. CDC itself recommends taking it _as a prophylaxis_ when heading to the areas where malaria might be present: https://www.cdc.gov/…

I think we can all intuitively see the distinction in risk tolerance between table salt consumption and HCQ consumption.

Now try to estimate the risk of _not_ consuming HCQ when you have C19 symptoms. Armchair virology and statistical studies are fun right up until the moment you get dry cough and shortness of breath.

Re: Hydroxychloroquine Update for April 6

#22

Post by tptacek » Mon, Apr 06, 2020, 11:06 PM UTC

war1025 wrote: post #17

My completely anecdotal experience with the Hydroxychloroquine story is that researchers keep pooh-poohing it and people in the field keep having success with it. All I know is that based on the aggregate of information I've seen thus far, if I come down with Coronavirus, I want to be prescribed that stuff.

Can you cite American clinical testimonials for HCQ? HCQ trials appear not to be controversial: they're being tried widely. Who's saying it's working?

Re: Hydroxychloroquine Update for April 6

#23

Post by kevingadd » Mon, Apr 06, 2020, 11:06 PM UTC

Mountain_Skies wrote: post #16

ck2 wrote: post #6

While other drugs are looking far more promising, there might be an obvious reason why despite lack of clear proof/results the president is pushing it so hard like everything else that motivates him: https://lawandcrime.com/covid-19-pandemic/major-producer-of-...

Is it possible to corner the market on a generic drug that is produced across the world?

Given the widespread shortages of the drug, you could operate on a 'rising tide lifts all boats' model here and if you're one of only 3 large scale suppliers you know that you and your competitors will all be selling more product.

I don't think it makes sense as a reasoning for boosting HCQ, though, and there are more obvious reasons why he'd promote it. If you want to make money this isn't how you do it.

Re: Hydroxychloroquine Update for April 6

#24

Post by benjohnson » Mon, Apr 06, 2020, 11:06 PM UTC

war1025 wrote: post #17

My completely anecdotal experience with the Hydroxychloroquine story is that researchers keep pooh-poohing it and people in the field keep having success with it. All I know is that based on the aggregate of information I've seen thus far, if I come down with Coronavirus, I want to be prescribed that stuff.

Quinine used to come from the bark of a tree - that bark is available as a nutritional supplement. It's also is used to make the bitter taste of Tonic Water.

Re: Hydroxychloroquine Update for April 6

#25

Post by csours » Mon, Apr 06, 2020, 11:07 PM UTC

war1025 wrote: post #17

My completely anecdotal experience with the Hydroxychloroquine story is that researchers keep pooh-poohing it and people in the field keep having success with it. All I know is that based on the aggregate of information I've seen thus far, if I come down with Coronavirus, I want to be prescribed that stuff.

Regression to the mean is a huge problem with anecdotes. Some people get better. It may be due to some treatment, or they may just get better. This is why we have structured studies.

Re: Hydroxychloroquine Update for April 6

#26

Post by threeseed » Mon, Apr 06, 2020, 11:07 PM UTC

m0zg wrote: post #9

kevingadd wrote: post #4

Earlier quoted context omitted.

The fact that you can buy the drug over the counter doesn't mean it's universally safe. The people being hospitalized here are already doing poorly so exposing them to additional risk is not something you should just do on a whim. As the linked post mentions, there are clear signs of potential risks associated with the use of HCQ. I hope for the patients being dosed with it now that it both works and is safe, but it'…

> doesn't mean it's universally safe _Table salt_ is not safe. Eat 100 grams of it and you will die. This does, however, mean that it's not as "dangerous" as the mainstream press wants you to believe. It's a 50 year old drug used all over the world. If it was "deadly", we'd know it by now. CDC itself recommends taking it _as a prophylaxis_ when heading to the areas where malaria might be present: https://www.cdc.gov/…

This drug is not administered to everyone though. It's only been tested and verified for people with I believe lupus and malaria. So we don't know the implications of rolling it out to millions of people worldwide.

That's why you do clinical trials.

Re: Hydroxychloroquine Update for April 6

#27

Post by bb88 » Mon, Apr 06, 2020, 11:07 PM UTC

m0zg wrote: post #3

Counterpoint: http://www.leparisien.fr/societe/sante/chloroquine-ne-perdon... You can do double blind studies until your patients are literally blue in the face, or you can try what works now. That is literally the choice at the moment. According to Peter Navarro, a good percentage of NYC patients are getting HCQ at the onset of symptoms now. Cuomo wants more of it, because it "appears to be working". Oklahoma is giv…

Any drug with a high efficacy should be seen in small sample sizes.

E.g. As a sample size of one, I know that consuming alcohol has a relaxing effect. And that's highly testable, one I wouldn't mind participating in.

If n=11 and there was no deviation from the normal expectation, it's possible that there was some undetectable effect, but it's far more likely there was no effect.

Re: Hydroxychloroquine Update for April 6

#28

Post by xienze » Mon, Apr 06, 2020, 11:07 PM UTC

ck2 wrote: post #6

While other drugs are looking far more promising, there might be an obvious reason why despite lack of clear proof/results the president is pushing it so hard like everything else that motivates him: https://lawandcrime.com/covid-19-pandemic/major-producer-of-...

It’s a decades-old generic drug that multiple companies produce. Literally anyone with the means to do so can make it. There’s not a lot of money to be made with a drug that costs $5 for a course of treatment. You might have a point if he was pimping some brand new drug that cost $5000 a month.

Re: Hydroxychloroquine Update for April 6

#29

Post by mirimir » Mon, Apr 06, 2020, 11:07 PM UTC

strken wrote: post #8

tptacek wrote: post #5

Earlier quoted context omitted.

Substantial numbers of C19 patients are being given HCQ in C19 trials, but more than that, substantial numbers of newly-diagnosed C19 patients are already taking HCQ , since it's part of the standard of care for widespread conditions like rheumatoid arthritis. And those patients will of course have had the HCQ intervention before acquiring C19, not late in the course of their illness. It doesn't look like anyone is r…

Dosages for arthritis are pretty low, though.

Based on my experience, the standard dosage for rheumatoid arthritis is 400 mg/day vs 600 mg/day for COVID-19. To start with, anyway. I opted for 200 mg/day, and my rheumatologist concurred.

Re: Hydroxychloroquine Update for April 6

#30

Post by pazimzadeh » Mon, Apr 06, 2020, 11:08 PM UTC

Taking Chloroquine too soon might promote viral infection by inhibiting the anti-viral response. https://sciencedirect.com/science/article/abs/pii/S016635421...

CQ is for patients who have uncontrolled inflammation in response to the virus, not to be taken as a prophylactic.