7 ms·

HCQ is an off-patent drug that is produced in every major country in the world. In fact, many countries have stockpiles of it because of its efficacy at prevent

HCQ is an off-patent drug that is produced in every major country in the world. In fact, many countries have stockpiles of it because of its efficacy at preventing malaria. If there’s a risk of a supply run, it would definitely not last very long. For many people there’s alternatives for treating arthritis and lupus. If it’s shown even to improve the patient’s outcome by even just 10% or more (as this study suggests), every country should be ramping up production of it right now instead of letting it be politicized.

rozab 7y ago
Face masks have been shown to be effective at controlling pandemics, and apparently no one (in many western countries) thought to stockpile those.
- 3fe9a03ccd14ca5 7y ago
  Facemasks are only produced in a handful of countries. In fact we basically don’t even have the skill set or machinery here to convert factories to producing facemask even if we wanted to. Garment work was moved offshore decades ago. Unlike off-patent prescription drugs.
  - URSpider94 7y ago
    Which handful are you thinking of? We do make them here in the US... https://www.wired.com/story/surreal-frenzy-inside-us-biggest-mask-maker/ https://www.wired.com/story/surreal-frenzy-inside-us-biggest...
  - perl4ever 7y ago
    Unlike...? "Covid-19 Could Bring Generic Drug Manufacturing Back to the U.S., Analyst Writes" https://www.barrons.com/articles/covid-19-could-bring-generic-drug-manufacturing-back-to-u-s-51586267074 https://www.barrons.com/articles/covid-19-could-bring-generi...
- Piezoid 7y ago
  During the H1N1 crisis France made a strategic reserve. Latter governments reduced the inventory. It was not renewed in the end.
  - goatinaboat 7y ago
    The US likewise had a reserve until it was depleted in 2009 and never replaced https://www.bloomberg.com/news/articles/2020-03-18/hospital-makes-face-masks-covid-19-shields-from-office-supplies https://www.bloomberg.com/news/articles/2020-03-18/hospital-...
- adventured 7y ago
  > Face masks have been shown to be effective at controlling pandemics, and apparently no one (in many western countries) thought to stockpile those. You're dropping the context of the hard decisions nations and governments actually deal in day to day, year to year when it comes to budgets. That's why not a single country had a proper stockpile of N95 masks for a pandemic like this. That isn't an exaggeration: literally not one nation had enough of a stockpile for this scenario, that includes South Korea, Japan, China. To say that nobody thought to do it is outlandish. As one example Congress set aside funds in 2006 to stockpile 100 million N95 masks. That's not strange, as many people were aware of the need to maintain such a stockpile. There is a big difference between being aware of the need, proposing plans and spending for it, and actually getting billions of dollars on a recurring basis to maintain the necessary proper stockpile perpetually with no event to push it with (yeah but we had a flu pandemic in 1957! try selling that premise). That's the actual reality of budgets and governments. It's expensive to maintain a persistent minimum stockpile of 1 billion non-expired N95 masks to cover the US population and the demand the US has seen. If it's a year-long pandemic, a billion masks isn't enough. You need several billion masks in that scenario. Coming out of the great recession, that is a very hard budget decision for all nations. And the fact is, most nations can't afford to do it at all. The easy retort of course is to say, well, look at the damage from this virus compared to that cost for masks. That's purely hindsight spouting that tries to pretend a comprehensive reality doesn't exist and that people who make budgets don't have to deal with difficult decisions every single year (while not factoring in every possible bad scenario every time they make a budget). And let's not pretend it's enough to stockpile masks, regarding spending allocations. If we're doing hindsight fantasy, let's be correct about it. You need to constantly maintain a lot of other gear and training for a pandemic, costing large sums of money. In an ideal scenario a nation the size of the US should probably have over a million ventilators stockpiled, just in case. We should probably maintain 2x or 3x the ICU capacity we have, on a persistent basis and at a large cost. This isn't an argument against being more prepared. Of course every nation should have a vast magical stockpile of N95 masks that never depletes, even the ~140 poor nations of the world that can't afford to do it. The point is, it's difficult to convince any nation to do it at the required persistent scale, and most can't afford to do it regardless.
  - 7y ago
DangerousPie 7y ago
Then why are lupus patients struggling to get HCQ right now? Sure in the long run it may be relatively easy to manufacture enough HCQ. But right now stocks are running extremely low because people are trying to use it for COVID without any scientific basis.
- renewiltord 7y ago
  They’re struggling because you have chosen this regulatory regime. Generics factories are pumping it out right now.
  - DangerousPie 7y ago
    How is this about regulation? Factories and supply chains can't just suddenly ramp up their production by an order of magnitude or more. You need to build new machines, hire new workers, source new supplies, and figure out how to distribute it all. That can't just happen from one day or another, no matter how little regulation there is on the product.
    - renewiltord 7y ago
      You’re overestimating the difficulty of this. But don’t trust me. Go talk to a generics drug manufacturer in India yourself.
      - DangerousPie 7y ago
        So that's why it's so hard to find things like flour or toilet paper right now? Nothing to do with supply chains and manufacturing, just too much regulation? Can't wait until we repeal the 4-ply rule!
        renewiltord 7y ago
        I haven’t looked at why flour or toilet paper have shortages and don’t know the primary factors there[1]. I’ve done all I that I care to to inform you. 1: It’s probably the bullwhip effect and hysteresis in the supply chain but that’s speculation on my part.
URSpider94 7y ago
It's already been politicized, it's too late. The minute that politicians started advocating for a treatment before there was any scientific backing, that ship sailed. Also, this study does NOT suggest that patient outcome is improved by 10% or more. Not in any way. Fewer patients died within the timeframe of this study, but more patients on the drug experienced ARDS; not to mention that 9 patients had to be removed from the study due to cardiac effects of the drug.
- taborj 7y ago
  > It's already been politicized, it's too late. The minute that politicians started advocating for a treatment before there was any scientific backing, that ship sailed. In general, that doesn't mean we should simply abandon all attempts to de-politicize it. In fact, it means just the opposite - we should put aside any political aspects and focus on objective data.
  - URSpider94 7y ago
    Agreed, of course. The difficulty is when one side of the argument is saying "take this medicine, it will help you," and the other side is saying "no, we don't know that yet." So, effectively, one side of the argument is arguing not to politicize the issue, the other side is doubling down on focusing on anecdotal data.
pdkl95 7y ago
> If there’s a risk of a supply run, it would definitely not last very long. For many people there’s alternatives for treating arthritis. As of the last time I talked to her a couple days ago, my mother still hasn't been able to fill her hydroxychloroquine prescription that she has used to treat lupus for over 30 years. The alternative medications are steroids such as prednisone, which have previously caused dangerous side effects. Due to the useless panic buying, she's is now at severe risk of a bad autoimmune reaction if anything activates her immune system (even from a mild cold; covid-19 would be fatal). > every country should be ramping up production of it right now instead of letting it be politicized Yes, they should, but before that happens while supplies are limited, there are people that need the drug for well-established reasons.
filleduchaos 7y ago
> In fact, many countries have stockpiles of it because of its efficacy at preventing malaria. The world largely moved past quinine for battling malaria quite a while ago. In fact, chloroquine is all but banned in my country now.

rozab 7y ago

Face masks have been shown to be effective at controlling pandemics, and apparently no one (in many western countries) thought to stockpile those.

3fe9a03ccd14ca5 7y ago
Facemasks are only produced in a handful of countries. In fact we basically don’t even have the skill set or machinery here to convert factories to producing facemask even if we wanted to. Garment work was moved offshore decades ago. Unlike off-patent prescription drugs.
- URSpider94 7y ago
  Which handful are you thinking of? We do make them here in the US... https://www.wired.com/story/surreal-frenzy-inside-us-biggest-mask-maker/ https://www.wired.com/story/surreal-frenzy-inside-us-biggest...
- perl4ever 7y ago
  Unlike...? "Covid-19 Could Bring Generic Drug Manufacturing Back to the U.S., Analyst Writes" https://www.barrons.com/articles/covid-19-could-bring-generic-drug-manufacturing-back-to-u-s-51586267074 https://www.barrons.com/articles/covid-19-could-bring-generi...
Piezoid 7y ago
During the H1N1 crisis France made a strategic reserve. Latter governments reduced the inventory. It was not renewed in the end.
- goatinaboat 7y ago
  The US likewise had a reserve until it was depleted in 2009 and never replaced https://www.bloomberg.com/news/articles/2020-03-18/hospital-makes-face-masks-covid-19-shields-from-office-supplies https://www.bloomberg.com/news/articles/2020-03-18/hospital-...
adventured 7y ago
> Face masks have been shown to be effective at controlling pandemics, and apparently no one (in many western countries) thought to stockpile those. You're dropping the context of the hard decisions nations and governments actually deal in day to day, year to year when it comes to budgets. That's why not a single country had a proper stockpile of N95 masks for a pandemic like this. That isn't an exaggeration: literally not one nation had enough of a stockpile for this scenario, that includes South Korea, Japan, China. To say that nobody thought to do it is outlandish. As one example Congress set aside funds in 2006 to stockpile 100 million N95 masks. That's not strange, as many people were aware of the need to maintain such a stockpile. There is a big difference between being aware of the need, proposing plans and spending for it, and actually getting billions of dollars on a recurring basis to maintain the necessary proper stockpile perpetually with no event to push it with (yeah but we had a flu pandemic in 1957! try selling that premise). That's the actual reality of budgets and governments. It's expensive to maintain a persistent minimum stockpile of 1 billion non-expired N95 masks to cover the US population and the demand the US has seen. If it's a year-long pandemic, a billion masks isn't enough. You need several billion masks in that scenario. Coming out of the great recession, that is a very hard budget decision for all nations. And the fact is, most nations can't afford to do it at all. The easy retort of course is to say, well, look at the damage from this virus compared to that cost for masks. That's purely hindsight spouting that tries to pretend a comprehensive reality doesn't exist and that people who make budgets don't have to deal with difficult decisions every single year (while not factoring in every possible bad scenario every time they make a budget). And let's not pretend it's enough to stockpile masks, regarding spending allocations. If we're doing hindsight fantasy, let's be correct about it. You need to constantly maintain a lot of other gear and training for a pandemic, costing large sums of money. In an ideal scenario a nation the size of the US should probably have over a million ventilators stockpiled, just in case. We should probably maintain 2x or 3x the ICU capacity we have, on a persistent basis and at a large cost. This isn't an argument against being more prepared. Of course every nation should have a vast magical stockpile of N95 masks that never depletes, even the ~140 poor nations of the world that can't afford to do it. The point is, it's difficult to convince any nation to do it at the required persistent scale, and most can't afford to do it regardless.
- 7y ago

DangerousPie 7y ago

Then why are lupus patients struggling to get HCQ right now? Sure in the long run it may be relatively easy to manufacture enough HCQ. But right now stocks are running extremely low because people are trying to use it for COVID without any scientific basis.

renewiltord 7y ago
They’re struggling because you have chosen this regulatory regime. Generics factories are pumping it out right now.
- DangerousPie 7y ago
  How is this about regulation? Factories and supply chains can't just suddenly ramp up their production by an order of magnitude or more. You need to build new machines, hire new workers, source new supplies, and figure out how to distribute it all. That can't just happen from one day or another, no matter how little regulation there is on the product.
  - renewiltord 7y ago
    You’re overestimating the difficulty of this. But don’t trust me. Go talk to a generics drug manufacturer in India yourself.
    - DangerousPie 7y ago
      So that's why it's so hard to find things like flour or toilet paper right now? Nothing to do with supply chains and manufacturing, just too much regulation? Can't wait until we repeal the 4-ply rule!
      - renewiltord 7y ago
        I haven’t looked at why flour or toilet paper have shortages and don’t know the primary factors there[1]. I’ve done all I that I care to to inform you. 1: It’s probably the bullwhip effect and hysteresis in the supply chain but that’s speculation on my part.

URSpider94 7y ago

It's already been politicized, it's too late. The minute that politicians started advocating for a treatment before there was any scientific backing, that ship sailed. Also, this study does NOT suggest that patient outcome is improved by 10% or more. Not in any way. Fewer patients died within the timeframe of this study, but more patients on the drug experienced ARDS; not to mention that 9 patients had to be removed from the study due to cardiac effects of the drug.

taborj 7y ago
> It's already been politicized, it's too late. The minute that politicians started advocating for a treatment before there was any scientific backing, that ship sailed. In general, that doesn't mean we should simply abandon all attempts to de-politicize it. In fact, it means just the opposite - we should put aside any political aspects and focus on objective data.
- URSpider94 7y ago
  Agreed, of course. The difficulty is when one side of the argument is saying "take this medicine, it will help you," and the other side is saying "no, we don't know that yet." So, effectively, one side of the argument is arguing not to politicize the issue, the other side is doubling down on focusing on anecdotal data.

pdkl95 7y ago

> If there’s a risk of a supply run, it would definitely not last very long. For many people there’s alternatives for treating arthritis. As of the last time I talked to her a couple days ago, my mother still hasn't been able to fill her hydroxychloroquine prescription that she has used to treat lupus for over 30 years. The alternative medications are steroids such as prednisone, which have previously caused dangerous side effects. Due to the useless panic buying, she's is now at severe risk of a bad autoimmune reaction if anything activates her immune system (even from a mild cold; covid-19 would be fatal). > every country should be ramping up production of it right now instead of letting it be politicized Yes, they should, but before that happens while supplies are limited, there are people that need the drug for well-established reasons.

filleduchaos 7y ago

> In fact, many countries have stockpiles of it because of its efficacy at preventing malaria. The world largely moved past quinine for battling malaria quite a while ago. In fact, chloroquine is all but banned in my country now.