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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

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's incredibly reckless to go 'it's over the counter so it's fine'. A healthy person taking a reasonable dose as a malaria countermeasure is not the same as a person on a ventilator in the ICU. Their immune system is in a different condition, so is their heart.

m0zg 7y ago
> 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/malaria/travelers/drugs.html https://www.cdc.gov/malaria/travelers/drugs.html
- tptacek 7y ago
  I think we can all intuitively see the distinction in risk tolerance between table salt consumption and HCQ consumption.
  - m0zg 7y ago
    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.
    - tptacek 7y ago
      You mean, like, that I'll have an infarction because of Q-T disruption, probably won't do anything to ward off C19, and, if I'm dosing it "over the counter" "like candy", might not have even had C19 in the first place? Seems like I can distinguish the risks between that and table salt too.
  - xienze 7y ago
    > I think we can all intuitively see the distinction in risk tolerance between table salt consumption and HCQ consumption. Good thing we have doctors that can decide the best course of treatment via HCQ then.
    - tptacek 7y ago
      I completely agree.
    - Fjolsvith 7y ago
      > Good thing we have doctors that can decide the best course of treatment via HCQ then. Except in New York.
      - Fjolsvith 7y ago
        Asked about the progress of the trials at his daily press briefing, Cuomo noted that state officials have allowed use of the drug hydroxychloroquine in combination with the antibiotic Zithromax in hospitals “at their discretion.” He said the federal government would increase supplies to New York pharmacies, but that New York has imposed a 14-day limit to protect the supplies for people who rely on it to treat other medical conditions. [1] It would suck to be one of the 200+ people dying daily [2] who didn't have a chance to try this combination to save their life because of a 14 day limit. 1. https://thehill.com/homenews/state-watch/491358-cuomo-use-of-antimalarial-drug-in-new-york-hospitals-anecdotally https://thehill.com/homenews/state-watch/491358-cuomo-use-of... 2. https://news.ycombinator.com/item?id=22805612 https://news.ycombinator.com/item?id=22805612 and https://news.ycombinator.com/item?id=22787800 https://news.ycombinator.com/item?id=22787800
- threeseed 7y ago
  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.
  - xienze 7y ago
    > So we don't know the implications of rolling it out to millions of people worldwide. It’s 70+ years old. It’s a well-understood drug. It’s an experimental treatment, not an experimental medicine. It’s also frequently prescribed to grandmas with rheumatoid arthritis.
    - threeseed 7y ago
      > It’s a well-understood drug For treating the issues it was designed for. Not for treating COVID-19.
      - xienze 7y ago
        You could technically say that about Tylenol, but I doubt there’d be anyone jumping up and down about how dangerous it would be for a Covid 19 patient to take 500mg of it daily as part of a treatment regimen. There’s literally NO drugs approved specifically for Covid 19, but there are drugs, like HCQ, which are promising and well-understood in general.
        kevingadd 7y ago
        Tylenol is an odd choice of example here given that it poses a risk of liver damage and for some subsets of the population it's actively dangerous to take it. We literally lace some drugs with Tylenol to make them "abuse-deterrent" because we know taking too much of it would harm you.
        Fjolsvith 7y ago
        500mg of Tylenol daily poses a risk of liver damage?
Mountain_Skies 7y ago
Is it being used as a treatment for those already on a ventilator? My impression is that it is being used as a way to help prevent patients from getting to the point of needing a ventilator.
- kevingadd 7y ago
  I should have been more precise - even if you're not already on a ventilator, your respiratory system is under some stress that isn't going to be equivalent to the experience of most people taking HCQ under normal circumstances. There are also various reports of COVID stressing the heart which is another potentially scary thing that could change the safety of the drug. As Derek notes in the article, "Many people are saying that perhaps it will work best if taken early in the course of infection" - so at that point your lungs and heart are probably doing great, so the risks aren't quite as severe if we're talking about early intervention... but in the event that it doesn't help and your condition worsens, now you've got HCQ in your system getting up to its side effect business while the virus goes to town on your cells. Ultimately if a doctor is prescribing this stuff as an early preventative measure or attempting to use it to help patients who are in bad shape, best of luck to them - I hope it works. But it's really depressing to see laymen telling each other that it's safe to just take this drug.
xienze 7y ago
> A healthy person taking a reasonable dose as a malaria countermeasure is not the same as a person on a ventilator in the ICU. Well I don’t think a person on a ventilator is in any position to self medicate, a doctor who presumably knows what they’re doing would be the one to direct the course of treatment. What’s the problem with that? There’s literally no “established” treatment for Covid 19 other than “hope we can keep you alive long enough for your immune system to beat it”, so under a doctor’s care I really don’t think there’s a lot of downside to trying to establish the efficacy of certain drugs in lieu of a long trial process.

m0zg 7y ago

> 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/malaria/travelers/drugs.html https://www.cdc.gov/malaria/travelers/drugs.html

tptacek 7y ago
I think we can all intuitively see the distinction in risk tolerance between table salt consumption and HCQ consumption.
- m0zg 7y ago
  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.
  - tptacek 7y ago
    You mean, like, that I'll have an infarction because of Q-T disruption, probably won't do anything to ward off C19, and, if I'm dosing it "over the counter" "like candy", might not have even had C19 in the first place? Seems like I can distinguish the risks between that and table salt too.
- xienze 7y ago
  > I think we can all intuitively see the distinction in risk tolerance between table salt consumption and HCQ consumption. Good thing we have doctors that can decide the best course of treatment via HCQ then.
  - tptacek 7y ago
    I completely agree.
  - Fjolsvith 7y ago
    > Good thing we have doctors that can decide the best course of treatment via HCQ then. Except in New York.
    - Fjolsvith 7y ago
      Asked about the progress of the trials at his daily press briefing, Cuomo noted that state officials have allowed use of the drug hydroxychloroquine in combination with the antibiotic Zithromax in hospitals “at their discretion.” He said the federal government would increase supplies to New York pharmacies, but that New York has imposed a 14-day limit to protect the supplies for people who rely on it to treat other medical conditions. [1] It would suck to be one of the 200+ people dying daily [2] who didn't have a chance to try this combination to save their life because of a 14 day limit. 1. https://thehill.com/homenews/state-watch/491358-cuomo-use-of-antimalarial-drug-in-new-york-hospitals-anecdotally https://thehill.com/homenews/state-watch/491358-cuomo-use-of... 2. https://news.ycombinator.com/item?id=22805612 https://news.ycombinator.com/item?id=22805612 and https://news.ycombinator.com/item?id=22787800 https://news.ycombinator.com/item?id=22787800
threeseed 7y ago
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.
- xienze 7y ago
  > So we don't know the implications of rolling it out to millions of people worldwide. It’s 70+ years old. It’s a well-understood drug. It’s an experimental treatment, not an experimental medicine. It’s also frequently prescribed to grandmas with rheumatoid arthritis.
  - threeseed 7y ago
    > It’s a well-understood drug For treating the issues it was designed for. Not for treating COVID-19.
    - xienze 7y ago
      You could technically say that about Tylenol, but I doubt there’d be anyone jumping up and down about how dangerous it would be for a Covid 19 patient to take 500mg of it daily as part of a treatment regimen. There’s literally NO drugs approved specifically for Covid 19, but there are drugs, like HCQ, which are promising and well-understood in general.
      - kevingadd 7y ago
        Tylenol is an odd choice of example here given that it poses a risk of liver damage and for some subsets of the population it's actively dangerous to take it. We literally lace some drugs with Tylenol to make them "abuse-deterrent" because we know taking too much of it would harm you.
        Fjolsvith 7y ago
        500mg of Tylenol daily poses a risk of liver damage?

Mountain_Skies 7y ago

Is it being used as a treatment for those already on a ventilator? My impression is that it is being used as a way to help prevent patients from getting to the point of needing a ventilator.

kevingadd 7y ago
I should have been more precise - even if you're not already on a ventilator, your respiratory system is under some stress that isn't going to be equivalent to the experience of most people taking HCQ under normal circumstances. There are also various reports of COVID stressing the heart which is another potentially scary thing that could change the safety of the drug. As Derek notes in the article, "Many people are saying that perhaps it will work best if taken early in the course of infection" - so at that point your lungs and heart are probably doing great, so the risks aren't quite as severe if we're talking about early intervention... but in the event that it doesn't help and your condition worsens, now you've got HCQ in your system getting up to its side effect business while the virus goes to town on your cells. Ultimately if a doctor is prescribing this stuff as an early preventative measure or attempting to use it to help patients who are in bad shape, best of luck to them - I hope it works. But it's really depressing to see laymen telling each other that it's safe to just take this drug.

xienze 7y ago

> A healthy person taking a reasonable dose as a malaria countermeasure is not the same as a person on a ventilator in the ICU. Well I don’t think a person on a ventilator is in any position to self medicate, a doctor who presumably knows what they’re doing would be the one to direct the course of treatment. What’s the problem with that? There’s literally no “established” treatment for Covid 19 other than “hope we can keep you alive long enough for your immune system to beat it”, so under a doctor’s care I really don’t think there’s a lot of downside to trying to establish the efficacy of certain drugs in lieu of a long trial process.