20 ms·

We definitely want more studies, but IMO we're reaching a tipping point. We have anecdotal evidence from China and South Korea, and this quite flawed, but at l

We definitely want more studies, but IMO we're reaching a tipping point. We have anecdotal evidence from China and South Korea, and this quite flawed, but at least data-containing study from France. Chloroquine's safety profile isn't great, but the safety profile of COVID is way worse. If you look at Chemotherapy for example, one would never take any of those drugs unless you had cancer. COVID isn't quite as bad as cancer, but Chloroquine, especially for a short course, isn't anywhere near as bad as most chemo drugs. Many people take it for years as prophylaxis -- not even to treat an existing disease.

stcredzero 7y ago
> COVID isn't quite as bad as cancer, but Chloroquine, especially for a short course, isn't anywhere near as bad as most chemo drugs. For certain individuals who just happen to have a bad reaction, COVID could well be just as fatal as cancer. In terms of how fast it can kill people, in certain cases, it can be worse than a lot of cancers.
- caycep 7y ago
  use hydroxochloroquine then?
- cameldrv 7y ago
  Do you mean COVID is as fatal as cancer or Chloroquine is?
  - gnulinux 7y ago
    COVID. For >70 y.o. individuals mortality rate is 30%. If you're >70 y.o. have heart condition and have diabetes (all risk factors) COVID is clearly more deadly than some (most?) cancers, not to mention it kills in the order of weeks, when cancer kills in the order of months or years.
    - cameldrv 7y ago
      Right. OTOH in the Chinese treatment guidelines, they say not to give it for >65 y.o. Unfortunately that's exactly the population it would potentially benefit the most. I'm guessing there must be some reason that's in there, but I'd like to see numbers.
    - mcguire 7y ago
      "For >70 y.o. individuals mortality rate is 30%." Where are you getting this number? It is significantly higher than any I have seen. https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e2.htm https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e2.htm - TABLE. Hospitalization, intensive care unit (ICU) admission, and case–fatality percentages for reported COVID–19 cases, by age group —United States, February 12–March 16, 2020 https://www.worldometers.info/coronavirus/coronavirus-age-sex-demographics/ https://www.worldometers.info/coronavirus/coronavirus-age-se... - Age of Coronavirus Deaths
    - tveita 7y ago
      https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e2.htm https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e2.htm gives a CFR of 4.3–10.5% for age group 75-84 and 10.4–27.3% for age group ≥85. Your number is over that by quite a bit, where is it from?
wolco 7y ago
The half life is 2 months. Any bad reaction will linger. Compared to antibiotics with a 8 hour half life. Lets stay home instead.
- _red 7y ago
  >Lets stay home instead. For a couple of weeks, fine. However on the other end of this spectrum is "Millions starve". At some point we need to ask is that fair to the youth? (note: I'm an old fart)
  - wolco 7y ago
    The recovering youth are getting breathing problems that aren't going away as well. It would be in their interest not to get it. It's also resetting our global warming clock. Something youth were keen about getting the world to do. If they can't handle staying at home for an extended time then global warming might not be that important after all.
    - gpm 7y ago
      This isn't resetting the global warming clock. Atmospheric CO2 is still going up not down. It's a temporary and small reduction in CO2 output coupled with a much more severe and much longer term reduction in scientific output that might actually solve global warming, and a much longer term and much more severe economic recession that limits our options to (further) hurt the economy to switch to greener means of energy production.
      - DataWorker 7y ago
        Agree. This will ultimately be horrible for the environment. Environmental regulations will fall by the wayside and look at the price of oil.
      - wolco 7y ago
        Not sure you can have it both ways. Either shutting down all Chinese factories for a period of time reduced CO2. Or they made no difference and we can run those factories without fear. Wouldn't a global recession/depression reduce production? Increased funding for scientific output or more climate models isn't going to make a difference. People have to buy and use less. You can't have it both ways here either.
gumby 7y ago
> Chloroquine's safety profile isn't great, but the safety profile of COVID is way worse. If you look at Chemotherapy for example, one would never take any of those drugs unless you had cancer. The FDA's Office of new drugs is split into divisions (dermatology, oncology etc) and the different divisions have different approval criteria as you mention. From my Onco friends' PoV, cancer patients are pretty much assumed to be dying anyway so the standard of risk is quite different from, say, Derm, whose patients don't really die of anything except cancers. Note: I have presented to the FDA and have written clinical trial requests (e.g. IND) which have been approved, but I have never done a submission to OOD. However my friends who do really talk about the approval path in a different way than I used to. Don't self-medicate with chloroquine. It's very hepatotoxic.
- stevespang 7y ago
  >"Chloroquine's safety profile isn't great, but the safety >profile of COVID is way worse. If you look at Chemotherapy >for example, one would never take any of those drugs unless >you had cancer". EXACTLY - - and chemotherapy has MUCH WORSE side effects than simple chloroquine, used for >70 years, never "recalled".
- cameldrv 7y ago
  I appreciate an expert opinion here. What do you think is the actual rate of adverse events from Chloloroquine, and of what severity?
  - jennyyang 7y ago
    One of the comments in the article: I prescribe Plaquenil extensively in patients with autoimmune conditions.The safety profile of this drug is excellent. It is also still used for malaria prophylaxis in healthy individuals .it is not a new drug. I don’t see the reason of labeling it as dangerous. The question is : does it work for Covid19 prevention and treatment? The answer is “the current limited evidence suggests that it does”. What i can tell you that I am aware of a number of doctors in the US who are currently infected or waiting for results who are taking the drug. And I cannot blame them.
arrrg 7y ago
The study from France seems to suck, though. Not very valuable data. They measured virus, not outcomes, they measured virus in the throat, not the lungs, the starting point was not the start of the disease but some later (more arbitrary) point in time, the two groups were not randomly assigned and the study wasn’t really blind. It could be that they just happened to compare two groups where the treatment group was further along in the illness – especially since they try to sell that as a disadvantage for them, but that could honestly be an advantage for them. We know that virus in the throat decreases as the illness progresses. (Virus in the lungs is much more relevant and also dangerous here, better would probably be outcomes.) Not really evidence, sorry.
- mytailorisrich 7y ago
  On the 26th February, in an interview, one of the researchers behind the French study said that he wasn't worried about Covid-19 and that it was just a flu...
  - tasogare 7y ago
    I wanted to write this comment. The researcher is indeed a specialist from what I read on the internet but given his total turn about concerning Covid I would personally not put any trust in his work. He participated in the crisis the country is facing right now, by saying on social networks there was no real danger about the virus.
    - ggm 7y ago
      Scientists make mistakes. Scientists change their mind in the light of the evidence. Your distrust of this scientist is distrust of science. Please, don't do this.
      - jfkebwjsbx 7y ago
        What? There was more than enough evidence. They are the ones anti-science.
gus_massa 7y ago
> but at least data-containing study from France. Are you are talking about the study that was trendy yesterday? The control group is not randomized, and most of it was in others hospitals. They are not counting the 6 patients that they lost in the treatment group (1 just leave, 1 had too much nausea, 3 where transfer to ICU, 1 die). It is more strange that they didn't lost any patient in the control group.
takinola 7y ago
I don't know about the efficacy of Chloroquine in treating COVID-19 but I would imagine that we already know a lot about the safety of dosing people with the drug. Any one growing up in the tropics during the 70s or 80s took regular doses for malaria treatment. The main adverse reaction that often happened was a crazy amount of itching (it would last for 3 days and would not let up even when you were trying to fall asleep)
- alkibiades 7y ago
  from what dr fauci said, they wanted to be sure there weren’t any adverse affects for people who already have covid. But that they know it’s safe under normal circumstances
- jussij 7y ago
  I remember taking malaria tables in preparation for a holiday trip to the tropics. I would have been 12 or 13 years of age and this would have been in mid 70s. As part of that same preparation I also had 2 jabs (I think for Yellow Fever and Cholera) and if I remember correctly I had to take one malaria tablet a day, for a period of two weeks prior to the start of the trip. I honestly don't remember any side effects from taking those malaria tablets, but I do remember the 2 days of numbing pain in my arm, which I assumed was caused by the two jabs.
pbreit 7y ago
Agree with all except wondering what you mean by the safety profile being not great? It's been around for 70 years, taken by millions over very long periods of time with relatively minimal negative side effects.
- barbs 7y ago
  Do you have sources for that? Would like to know the numbers.
  - throwaway4787 7y ago
    Idk you could google it? But as anecdotal evidence I had to take it as a kid as a prophylactic against malaria. So did literally everyone I knew back then.

stcredzero 7y ago

> COVID isn't quite as bad as cancer, but Chloroquine, especially for a short course, isn't anywhere near as bad as most chemo drugs. For certain individuals who just happen to have a bad reaction, COVID could well be just as fatal as cancer. In terms of how fast it can kill people, in certain cases, it can be worse than a lot of cancers.

caycep 7y ago
use hydroxochloroquine then?
cameldrv 7y ago
Do you mean COVID is as fatal as cancer or Chloroquine is?
- gnulinux 7y ago
  COVID. For >70 y.o. individuals mortality rate is 30%. If you're >70 y.o. have heart condition and have diabetes (all risk factors) COVID is clearly more deadly than some (most?) cancers, not to mention it kills in the order of weeks, when cancer kills in the order of months or years.
  - cameldrv 7y ago
    Right. OTOH in the Chinese treatment guidelines, they say not to give it for >65 y.o. Unfortunately that's exactly the population it would potentially benefit the most. I'm guessing there must be some reason that's in there, but I'd like to see numbers.
  - mcguire 7y ago
    "For >70 y.o. individuals mortality rate is 30%." Where are you getting this number? It is significantly higher than any I have seen. https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e2.htm https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e2.htm - TABLE. Hospitalization, intensive care unit (ICU) admission, and case–fatality percentages for reported COVID–19 cases, by age group —United States, February 12–March 16, 2020 https://www.worldometers.info/coronavirus/coronavirus-age-sex-demographics/ https://www.worldometers.info/coronavirus/coronavirus-age-se... - Age of Coronavirus Deaths
  - tveita 7y ago
    https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e2.htm https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e2.htm gives a CFR of 4.3–10.5% for age group 75-84 and 10.4–27.3% for age group ≥85. Your number is over that by quite a bit, where is it from?

wolco 7y ago

The half life is 2 months. Any bad reaction will linger. Compared to antibiotics with a 8 hour half life. Lets stay home instead.

_red 7y ago
>Lets stay home instead. For a couple of weeks, fine. However on the other end of this spectrum is "Millions starve". At some point we need to ask is that fair to the youth? (note: I'm an old fart)
- wolco 7y ago
  The recovering youth are getting breathing problems that aren't going away as well. It would be in their interest not to get it. It's also resetting our global warming clock. Something youth were keen about getting the world to do. If they can't handle staying at home for an extended time then global warming might not be that important after all.
  - gpm 7y ago
    This isn't resetting the global warming clock. Atmospheric CO2 is still going up not down. It's a temporary and small reduction in CO2 output coupled with a much more severe and much longer term reduction in scientific output that might actually solve global warming, and a much longer term and much more severe economic recession that limits our options to (further) hurt the economy to switch to greener means of energy production.
    - DataWorker 7y ago
      Agree. This will ultimately be horrible for the environment. Environmental regulations will fall by the wayside and look at the price of oil.
    - wolco 7y ago
      Not sure you can have it both ways. Either shutting down all Chinese factories for a period of time reduced CO2. Or they made no difference and we can run those factories without fear. Wouldn't a global recession/depression reduce production? Increased funding for scientific output or more climate models isn't going to make a difference. People have to buy and use less. You can't have it both ways here either.

gumby 7y ago

> Chloroquine's safety profile isn't great, but the safety profile of COVID is way worse. If you look at Chemotherapy for example, one would never take any of those drugs unless you had cancer. The FDA's Office of new drugs is split into divisions (dermatology, oncology etc) and the different divisions have different approval criteria as you mention. From my Onco friends' PoV, cancer patients are pretty much assumed to be dying anyway so the standard of risk is quite different from, say, Derm, whose patients don't really die of anything except cancers. Note: I have presented to the FDA and have written clinical trial requests (e.g. IND) which have been approved, but I have never done a submission to OOD. However my friends who do really talk about the approval path in a different way than I used to. Don't self-medicate with chloroquine. It's very hepatotoxic.

stevespang 7y ago
>"Chloroquine's safety profile isn't great, but the safety >profile of COVID is way worse. If you look at Chemotherapy >for example, one would never take any of those drugs unless >you had cancer". EXACTLY - - and chemotherapy has MUCH WORSE side effects than simple chloroquine, used for >70 years, never "recalled".
cameldrv 7y ago
I appreciate an expert opinion here. What do you think is the actual rate of adverse events from Chloloroquine, and of what severity?
- jennyyang 7y ago
  One of the comments in the article: I prescribe Plaquenil extensively in patients with autoimmune conditions.The safety profile of this drug is excellent. It is also still used for malaria prophylaxis in healthy individuals .it is not a new drug. I don’t see the reason of labeling it as dangerous. The question is : does it work for Covid19 prevention and treatment? The answer is “the current limited evidence suggests that it does”. What i can tell you that I am aware of a number of doctors in the US who are currently infected or waiting for results who are taking the drug. And I cannot blame them.

arrrg 7y ago

The study from France seems to suck, though. Not very valuable data. They measured virus, not outcomes, they measured virus in the throat, not the lungs, the starting point was not the start of the disease but some later (more arbitrary) point in time, the two groups were not randomly assigned and the study wasn’t really blind. It could be that they just happened to compare two groups where the treatment group was further along in the illness – especially since they try to sell that as a disadvantage for them, but that could honestly be an advantage for them. We know that virus in the throat decreases as the illness progresses. (Virus in the lungs is much more relevant and also dangerous here, better would probably be outcomes.) Not really evidence, sorry.

mytailorisrich 7y ago
On the 26th February, in an interview, one of the researchers behind the French study said that he wasn't worried about Covid-19 and that it was just a flu...
- tasogare 7y ago
  I wanted to write this comment. The researcher is indeed a specialist from what I read on the internet but given his total turn about concerning Covid I would personally not put any trust in his work. He participated in the crisis the country is facing right now, by saying on social networks there was no real danger about the virus.
  - ggm 7y ago
    Scientists make mistakes. Scientists change their mind in the light of the evidence. Your distrust of this scientist is distrust of science. Please, don't do this.
    - jfkebwjsbx 7y ago
      What? There was more than enough evidence. They are the ones anti-science.

gus_massa 7y ago

> but at least data-containing study from France. Are you are talking about the study that was trendy yesterday? The control group is not randomized, and most of it was in others hospitals. They are not counting the 6 patients that they lost in the treatment group (1 just leave, 1 had too much nausea, 3 where transfer to ICU, 1 die). It is more strange that they didn't lost any patient in the control group.

takinola 7y ago

I don't know about the efficacy of Chloroquine in treating COVID-19 but I would imagine that we already know a lot about the safety of dosing people with the drug. Any one growing up in the tropics during the 70s or 80s took regular doses for malaria treatment. The main adverse reaction that often happened was a crazy amount of itching (it would last for 3 days and would not let up even when you were trying to fall asleep)

alkibiades 7y ago
from what dr fauci said, they wanted to be sure there weren’t any adverse affects for people who already have covid. But that they know it’s safe under normal circumstances
jussij 7y ago
I remember taking malaria tables in preparation for a holiday trip to the tropics. I would have been 12 or 13 years of age and this would have been in mid 70s. As part of that same preparation I also had 2 jabs (I think for Yellow Fever and Cholera) and if I remember correctly I had to take one malaria tablet a day, for a period of two weeks prior to the start of the trip. I honestly don't remember any side effects from taking those malaria tablets, but I do remember the 2 days of numbing pain in my arm, which I assumed was caused by the two jabs.

pbreit 7y ago

Agree with all except wondering what you mean by the safety profile being not great? It's been around for 70 years, taken by millions over very long periods of time with relatively minimal negative side effects.

barbs 7y ago
Do you have sources for that? Would like to know the numbers.
- throwaway4787 7y ago
  Idk you could google it? But as anecdotal evidence I had to take it as a kid as a prophylactic against malaria. So did literally everyone I knew back then.