4 ms·

More on chloroquine/azithromycin and on Dr. Raoult

45 points by hprotagonist 7y ago

Leary 7y ago
More likely to work early on in the infection, I doubt any anti-viral would be very effective once the patient experiences ARDS.
woliveirajr 7y ago
> Now, it would be a more simple world if assholes were always wrong about things, and I am not yet prepared to say that Dr. Raoult is wrong about hydroxychloroquine and azithromycin. But neither does he seem to be the sort of person who is always a reliable source, either. I do not take pleasure in this. But I am less hopeful about this work than I was when I first read about it, and I can only wonder what direction those hopes will take in the weeks to come. In weeks to come there'll be people living and people dying. I'm not sure in which group I'll be. But all discussions about the Dr. Raoult personality doesn't add up to the big question: does it work or not ?
- hprotagonist 7y ago
  we don't know; the data that personality generated isn't helpful! See here: https://sciencebasedmedicine.org/hydroxychloroquine-and-azithromycin-versus-covid-19/ https://sciencebasedmedicine.org/hydroxychloroquine-and-azit... the results are so uninterpretable as to not help the SNR on the issue.
jojo2000 7y ago
In those troubled times, a lot of people are just critisizing instead of doing something useful. There is a bibliography studying the effects of chloroquine and derivates to fight viruses. As scientists, the base of our work is to read papers and search for bibliography. Targeting people with ad hominem attacks is plain lame. Do some science FFS, and act swiftly in times of war. https://www.sciencedirect.com/science/article/pii/S0924857920300996 https://www.sciencedirect.com/science/article/pii/S092485792... https://aac.asm.org/content/53/8/3416 https://aac.asm.org/content/53/8/3416 https://www.sciencedirect.com/science/article/pii/S0006291X0401839X https://www.sciencedirect.com/science/article/pii/S0006291X0... https://link.springer.com/article/10.1186/1743-422X-2-69 https://link.springer.com/article/10.1186/1743-422X-2-69 https://www.sciencedirect.com/science/article/pii/S0166354207004597 https://www.sciencedirect.com/science/article/pii/S016635420... https://www.sciencedirect.com/science/article/pii/S1473309903008065 https://www.sciencedirect.com/science/article/pii/S147330990... https://www.sciencedirect.com/science/article/pii/S0166354213001150 https://www.sciencedirect.com/science/article/pii/S016635421... https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(06)70361-9/fulltext https://www.thelancet.com/journals/laninf/article/PIIS1473-3... https://link.springer.com/article/10.1007/s00535-009-0132-9 https://link.springer.com/article/10.1007/s00535-009-0132-9 https://link.springer.com/article/10.1186/1743-422X-3-39 https://link.springer.com/article/10.1186/1743-422X-3-39
- hprotagonist 7y ago
  That Didier Raoult appears to have a history of image manipulation is not an ad hominem, and is apparently true. His 2006 offense was sufficiently bad as to be banned from publication for a time in a leading journal in his field. That is also not an ad hominem. You also completely fail to engage with the first 2/3 of the text, which has any number of impersonal methodological critiques which are not addressed through a literature search.
  - jojo2000 7y ago
    You point the exact problem here. As a scientist the first test is intuition. The second test is having people getting better with treatment. The third test is conducting a full, deep study with the utmost scientific rigor. So now there is a dilemna. People die in front of you. You try something. It seems to work. It uses a widely-used set of molecules (Hydroxychloroquine + azythromycine (+Zinc in some protocols). Will you try it, or will you make a double-blind study with half the people at risk of dying ? History of aviation. People just couldn't believe that it was possible. http://www.wright-brothers.org/History_Wing/Aviations_Attic/They_Wouldnt_Believe/They_Wouldnt_Believe_the_Wrights_Had_Flown.htm http://www.wright-brothers.org/History_Wing/Aviations_Attic/... "Not wishing to be miserly with his information, Root sent an eye-witness account of what the Wrights were doing to the Scientific American, with a letter telling the editor he was free to use it. But the editor was not to be taken in and made no effort to investigate what Root had dropped into his lap. Though the Scientific American printed in 1905 many articles about flying, nearly all were about devices that maybe ought to be tried." I don't fail in anything, I just don't need to engage in endless debates about methodology. Half of the studies in psychology fail to replicate. There are problems everywhere in science, because geniuses are still rare and now ostracized because they produce new researched and are judged by lords of the old order. If you scratch hard, you can always find something. Some people criticize, others just act. The people who create are always going to be the targets of the people who spend their time criticizing. Now it's time to act. Not pull over waiting for some authority to decide for yourself. The list of publications is here to show that this available treatment doesn't come from a magical hat.
beagle3 7y ago
With all the known cases (e.g. 100k in the US) and about 0.5-1% taking HCQ continuously already for lupus and other diseases, if these people are underrepresented, we have a big clue that it works, almost to the point of proof (need to show that it's not the underlying condition that stops the virus, a-la sickle cell anemia vs malaria). If they are equally represented, it's discouraging, but not proof that it doesn't work (again because of underlying being a confounder). This information should readily be available to the CDC or whoever else is tracking the cases. What am I missing? Why do you have to wait for double-blind trials?
- hprotagonist 7y ago
  hipaa, nonstandard data recording systems, time, confounds of preexisting medical conditions, scattershot testing, and the overall saturation of the healthcare system are going to make that signal more or less invisible.
  - beagle3 7y ago
    We are talking about the confirmed positive cases, these people are all potential spreaders and are supposed to be closely monitored. This is a standard CDC playbook (lots of people I’ll, find out what’s common to them). The list you gave, if true, is total incompetence of e CDC to a level which has never been demonstrated before - in fact, the CDC has generally done well with their playbook even if it was a couple of weeks late (and we’re 10 weeks since I heard from a friend who works with the CDC that they’re watching it)

45 points by hprotagonist 7y ago

More likely to work early on in the infection, I doubt any anti-viral would be very effective once the patient experiences ARDS.

woliveirajr 7y ago

> Now, it would be a more simple world if assholes were always wrong about things, and I am not yet prepared to say that Dr. Raoult is wrong about hydroxychloroquine and azithromycin. But neither does he seem to be the sort of person who is always a reliable source, either. I do not take pleasure in this. But I am less hopeful about this work than I was when I first read about it, and I can only wonder what direction those hopes will take in the weeks to come. In weeks to come there'll be people living and people dying. I'm not sure in which group I'll be. But all discussions about the Dr. Raoult personality doesn't add up to the big question: does it work or not ?

hprotagonist 7y ago
we don't know; the data that personality generated isn't helpful! See here: https://sciencebasedmedicine.org/hydroxychloroquine-and-azithromycin-versus-covid-19/ https://sciencebasedmedicine.org/hydroxychloroquine-and-azit... the results are so uninterpretable as to not help the SNR on the issue.

jojo2000 7y ago

In those troubled times, a lot of people are just critisizing instead of doing something useful. There is a bibliography studying the effects of chloroquine and derivates to fight viruses. As scientists, the base of our work is to read papers and search for bibliography. Targeting people with ad hominem attacks is plain lame. Do some science FFS, and act swiftly in times of war. https://www.sciencedirect.com/science/article/pii/S0924857920300996 https://www.sciencedirect.com/science/article/pii/S092485792... https://aac.asm.org/content/53/8/3416 https://aac.asm.org/content/53/8/3416 https://www.sciencedirect.com/science/article/pii/S0006291X0401839X https://www.sciencedirect.com/science/article/pii/S0006291X0... https://link.springer.com/article/10.1186/1743-422X-2-69 https://link.springer.com/article/10.1186/1743-422X-2-69 https://www.sciencedirect.com/science/article/pii/S0166354207004597 https://www.sciencedirect.com/science/article/pii/S016635420... https://www.sciencedirect.com/science/article/pii/S1473309903008065 https://www.sciencedirect.com/science/article/pii/S147330990... https://www.sciencedirect.com/science/article/pii/S0166354213001150 https://www.sciencedirect.com/science/article/pii/S016635421... https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(06)70361-9/fulltext https://www.thelancet.com/journals/laninf/article/PIIS1473-3... https://link.springer.com/article/10.1007/s00535-009-0132-9 https://link.springer.com/article/10.1007/s00535-009-0132-9 https://link.springer.com/article/10.1186/1743-422X-3-39 https://link.springer.com/article/10.1186/1743-422X-3-39

hprotagonist 7y ago
That Didier Raoult appears to have a history of image manipulation is not an ad hominem, and is apparently true. His 2006 offense was sufficiently bad as to be banned from publication for a time in a leading journal in his field. That is also not an ad hominem. You also completely fail to engage with the first 2/3 of the text, which has any number of impersonal methodological critiques which are not addressed through a literature search.
- jojo2000 7y ago
  You point the exact problem here. As a scientist the first test is intuition. The second test is having people getting better with treatment. The third test is conducting a full, deep study with the utmost scientific rigor. So now there is a dilemna. People die in front of you. You try something. It seems to work. It uses a widely-used set of molecules (Hydroxychloroquine + azythromycine (+Zinc in some protocols). Will you try it, or will you make a double-blind study with half the people at risk of dying ? History of aviation. People just couldn't believe that it was possible. http://www.wright-brothers.org/History_Wing/Aviations_Attic/They_Wouldnt_Believe/They_Wouldnt_Believe_the_Wrights_Had_Flown.htm http://www.wright-brothers.org/History_Wing/Aviations_Attic/... "Not wishing to be miserly with his information, Root sent an eye-witness account of what the Wrights were doing to the Scientific American, with a letter telling the editor he was free to use it. But the editor was not to be taken in and made no effort to investigate what Root had dropped into his lap. Though the Scientific American printed in 1905 many articles about flying, nearly all were about devices that maybe ought to be tried." I don't fail in anything, I just don't need to engage in endless debates about methodology. Half of the studies in psychology fail to replicate. There are problems everywhere in science, because geniuses are still rare and now ostracized because they produce new researched and are judged by lords of the old order. If you scratch hard, you can always find something. Some people criticize, others just act. The people who create are always going to be the targets of the people who spend their time criticizing. Now it's time to act. Not pull over waiting for some authority to decide for yourself. The list of publications is here to show that this available treatment doesn't come from a magical hat.

beagle3 7y ago

With all the known cases (e.g. 100k in the US) and about 0.5-1% taking HCQ continuously already for lupus and other diseases, if these people are underrepresented, we have a big clue that it works, almost to the point of proof (need to show that it's not the underlying condition that stops the virus, a-la sickle cell anemia vs malaria). If they are equally represented, it's discouraging, but not proof that it doesn't work (again because of underlying being a confounder). This information should readily be available to the CDC or whoever else is tracking the cases. What am I missing? Why do you have to wait for double-blind trials?

hprotagonist 7y ago
hipaa, nonstandard data recording systems, time, confounds of preexisting medical conditions, scattershot testing, and the overall saturation of the healthcare system are going to make that signal more or less invisible.
- beagle3 7y ago
  We are talking about the confirmed positive cases, these people are all potential spreaders and are supposed to be closely monitored. This is a standard CDC playbook (lots of people I’ll, find out what’s common to them). The list you gave, if true, is total incompetence of e CDC to a level which has never been demonstrated before - in fact, the CDC has generally done well with their playbook even if it was a couple of weeks late (and we’re 10 weeks since I heard from a friend who works with the CDC that they’re watching it)