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Chloroquine, past and present

blogs.sciencemag.org

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Re: Chloroquine, past and present

#51

Post by altcognito »

throwaway894345 wrote: post #38
Wowfunhappy wrote: post #33

Earlier quoted context omitted.

> There's still no explanation (afaik) for why they rolled their own test instead of using the WHO's test The explanation is obvious, isn't it? "We thought our test would work, and it would be better." It was stupid, to be sure. It would have been a stupid risk even if it had paid off—although in that case, few would be chastising them, and many would be thankful.

Agree, and that's kind of my point. Being "fully funded" wasn't the problem--it was hubris/mismanagement.

So, I think this is the most frustrating part of living in this political era. I did start this off with "funding", but it wasn't just funding, it was cutting qualified staff. It's that even the best qualified staff aren't moving fast enough or adapting and looking at cases beyond our own borders. Even in a reduced regulation environment, the FDA is likely hampering response time.

The US has regressed to an early 19th century model of government (loosely federated) at a time we're more tightly coupled than we ever have been due to moderinity.

Re: Chloroquine, past and present

#52

Post by icelancer »

Munky-Necan wrote: post #46

Until there's a double blind placebo trial I will take this type of report with a truck load of salt. We want randomized control trials in medicine. We want highly vetted research in medicine. Lacking either is a bad idea. I am also not holding my breath about a vaccine. We tried making a vaccine with SARS-CoV with a significant amount of the animal models dying from cytokine storm after viral exposure. Drug trials a…

>> Until there's a double blind placebo trial I will take this type of report with a truck load of salt.

You're welcome to. The remainder of the world should have the choice. Some people can't - or don't - want to wait for an RCT with a sample size in the thousands before taking a cheap and well-known drug with well-tolerated side effects.

Re: Chloroquine, past and present

#54

Post by icelancer »

altcognito wrote: post #7
AdmiralBumbleB wrote: post #3

This chloroquinine rush is already out of control. My pharmacy is already out of it and is unable to procure from other pharmacies (which are also out already!) My pharmacist placed orders for all her patients to prefill prescriptions (where possible) for the next few months. I can understand a shortage when there's a clear evidence-based need, but the rumour-mill hasn't even ramped to full bore yet and it's already…

This is where having a fully funded CDC and pandemic team in the US pays off. They would have been paying very close attention for weeks on end in China, Italy and South Korea and many approaches could have been already dead-ended before it even significantly reached out shores. To say nothing of actually being in the process of ramping up medications that HAVE shown to be effective. It feels like we are starting fro…

>> fully funded CDC

Is there evidence that more money would have solved the constant CDC problems and incompetencies that are coming up? It seems like a throwaway obvious statement, but plenty of government agencies - and private companies - don't operate a lot more effectively with more money.

Re: Chloroquine, past and present

#55

Post by hannob »

brucer wrote: post #15

I was intrigued by the results from the recent quick french study: https://www.mediterranee-infection.com/wp-content/uploads/20... I read through the paper, and it's not immediately obvious, but if you look at the two graphs at the bottom, the hydroxychloroquine is 75% effective in the first chart, but only 50% in the second one. That's because the actual test was: Control: 16 hydroxychloroquine: 14 hydroxychloroquin…

The study wasn't randomized. It tells you basically nothing.

I really don't understand why anyone approves such studies. They could've done something useful and we'd know a little bit now.

Re: Chloroquine, past and present

#56

Post by icelancer »

uwuhn wrote: post #25
AdmiralBumbleB wrote: post #3

This chloroquinine rush is already out of control. My pharmacy is already out of it and is unable to procure from other pharmacies (which are also out already!) My pharmacist placed orders for all her patients to prefill prescriptions (where possible) for the next few months. I can understand a shortage when there's a clear evidence-based need, but the rumour-mill hasn't even ramped to full bore yet and it's already…

I bought aquarium chloroquine to use as a last-ditch resort if I basically have to choose between taking it or dying due to hospital overcapacity. No harm to patients there IMO. I spent $60 for the 10 grams recommended for a course (.5 g a day). That was last week, and it's so much more expensive now.

Do you have a source for it? I've had to buy through underground labs; could not find any Avaclor.

Re: Chloroquine, past and present

#57

Post by mymacbook »

patrickbuckley wrote: post #34
hprotagonist wrote: post #2

And so to today. As I said yesterday, I find the reports of chloroquine/hydroxychloroquine activity against the coronovirus very interesting, but preliminary. There has as yet been no well-controlled trial, and unfortunately the effects seen are still the sort of thing that can look exciting but disappear when you look closely. I mean that. It happens all the time – ask anyone else who does drug research for a living…

This is a great reminder, thank you for pointing it out. Interestingly during the 1918 Spanish flu aspirin was a new drug and was given to people in an effort to reduce fever. The problem is they gave it in doses that we now know is toxic. There is some evidence that patients treated in hospitals with aspirin had a 30x!!! deathrate vs those treated "homeopathically". This YouTube video goes into the history and conte…

Those that did not take aspirin during the Spanish flu had far lower morbidity rates. Fever is not something I rush to suppress with drugs until I exceed 104.0 - same for my family and even when our daughter was a little tiny thing.

Preliminary unpublished information shows concerns on accelerating progression of SARS-CoV-2 virus to COVID-19 illness for ALL NSAIDs (not just aspirin). However, even with non-NSAIDs I exercise extreme caution when using (e.g. acetaminophen - Tylenol - 4000mg is considered VERY TOXIC for liver).

Re: Chloroquine, past and present

#58

Post by nordsieck »

guiriduro wrote: post #48

Is there not an argument that given chloroquine's apparent efficacy, albeit statistically weakly or improperly demonstrated (so far), along with its long history of relative safety in anti-malarial prophylaxis (with known caveats), set against an exponential growth in dangerous pneumonia - it is therefore rational to want to at least offer it to all suspected cases and healthworkers in balance of the serious risks th…

> Is there not an argument that given chloroquine's apparent efficacy, albeit statistically weakly or improperly demonstrated (so far), along with its long history of relative safety in anti-malarial prophylaxis (with known caveats), set against an exponential growth in dangerous pneumonia - it is therefore rational to want to at least offer it to all suspected cases and healthworkers in balance of the serious risks they face?

The term is "compassionate use". It's drug approval for patients where the drug is not fully tested.

It almost certainly wouldn't be approved for healthcare workers, but it might be approved for people who need ventilators.

The basic idea is that the situation is so dire - all of the normal medical options have been exhausted - that patients are legally allowed to essentially experiment on themselves.

Re: Chloroquine, past and present

#59

Post by altcognito »

icelancer wrote: post #54
altcognito wrote: post #7

Earlier quoted context omitted.

This is where having a fully funded CDC and pandemic team in the US pays off. They would have been paying very close attention for weeks on end in China, Italy and South Korea and many approaches could have been already dead-ended before it even significantly reached out shores. To say nothing of actually being in the process of ramping up medications that HAVE shown to be effective. It feels like we are starting fro…

>> fully funded CDC Is there evidence that more money would have solved the constant CDC problems and incompetencies that are coming up? It seems like a throwaway obvious statement, but plenty of government agencies - and private companies - don't operate a lot more effectively with more money.

Totally agree, and in one of my other responses I recognize the shortcomings of how I put it. Thanks for the good faith response.

Re: Chloroquine, past and present

#60

Post by jdkee »

blhack wrote: post #29
throwaway894345 wrote: post #27

Earlier quoted context omitted.

I really hope this virus prompts our disaster management agencies to get their shit together, and specifically to consider supply chain security as part of their threat model (and no, we don't meaningfully do this or we wouldn't have such a pitiful national reserve of respirators and other respiratory treatment devices following SARS and MURS). Not sure exactly what this would look like, but identifying key partners…

How could our disaster management agencies have gotten their shit together to anticipate a run on an old anit-malaria drug?

As a previous commentator noted, the Chinese were providing guidance on chloroquine a month ago.
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