5 ms·

From the article: "The Brazil study was undertaken with 81 patients at a hospital in Manaus, in Amazonas state. As well as chloroquine, patients were also give

From the article: "The Brazil study was undertaken with 81 patients at a hospital in Manaus, in Amazonas state. As well as chloroquine, patients were also given azithromycin, an antibiotic also being used in the U.S., often paired with chloroquine. However, higher dose use of chloroquine (600 milligrams as opposed to 450 milligrams) was stopped after just six days, after 11 of patients who were given the greater dose died." So they canceled a test with higher doses, not tests with regular doses. Meanwhile they touched several times on the fact that Trump touted the drug. If trump recommended hugs, the media would write an article about how choking people is bad.

nick_kline 7y ago
It's not that trump said he likes to breath air, so everyone became fixated on that. It's that this is one of many (dozens at least) of things he has said were solutions, cures, miracles that would deal with covid-19. These went through the fox news world and now my elderly relatives are fixated on getting it (they are otherwise healthy). Because fox news and all these other non-medical people keep harping on it, the elderly people, the same ones preyed upon by certain news sources get the wrong idea about this.
- complianceowl 7y ago
  Wrong (Trump Voice)
- ghostpepper 7y ago
  There are two stories here: One is whether one of the most promising drugs to stop the pandemic is actually dangerous, and the other is what Trump said and whether he was right to say it blah blah blah. Thanks to the inclusion of Trump in this article by National Post, anyone who has strong views about Trump (most people in North America) are now focused on the second story, instead of the first.
  - m0zg 7y ago
    Best I can tell, the article doesn't even mention the cause of death. :-) Did they die because they were given HCQ or did they die in spite of being given HCQ? We'll never know. And the paper itself (https://web.archive.org/web/20200413181618/https://www.medrxiv.org/content/10.1101/2020.04.07.20056424v1.full.pdf https://web.archive.org/web/20200413181618/https://www.medrx...) doesn't say that either, and mentions that this study's randomization was flawed in that older patients with heart disease were assigned to the high dosage arm of the experiment.
    - tehjoker 7y ago
      They saw people were getting heart arrhythmias in the original Brazil study. Anecdotally, a doctor I know has been seeing an increase in arrhythmias on patients treated with HCQ at lower doses if they already have a pre-existing circulatory problem. What is really irking me is that we still don't even know if it's really doing anything. At the same time, my elderly parent is taking HCQ for arthritis and appears to think she is invincible, going to the store each day in the middle of Queens, the world epicenter. She tried to send me links to Trump's touted Dr. Zelenko about how it's a miracle cure.
      - m0zg 7y ago
        We don't even know if eggs and butter are "good for you" so I'm not surprised we know jack squat about HCQ beyond anecdotal evidence, which most studies you will find in the press seem to either ignore, or set their studies up s.t. they fail. In particular, per anecdotal evidence HCQ+Zpak+Zinc is the most effective combination, and only if given at the onset of symptoms. Yet routinely we see either just HQ or HCQ alone, or HCQ (with or without Zpak) given to patients that are so far gone it's unlikely to make any difference. Just read the original study fer chrissakes, it's publicly accessible. Sure it's not "randomized" or "principled", but at the very least _try_ what Raoult did in the first place, maybe? Exactly as he did it?
        tehjoker 7y ago
        It looks like Azithromycin is for clearing bacterial pneumonia. Certainly this is a possible and probably common complication of viral pneumonia caused by COVID-19, but I'm sure doctors are well aware of ways to treat secondary bacterial pneumonia. Just looking at what doctors are saying about Zinc, it seems like there could be something to it, especially if an individual is Zinc deficient, but it's not at all clear it's anything like a silver bullet. https://www.medicinenet.com/script/main/art.asp?articlekey=228691 https://www.medicinenet.com/script/main/art.asp?articlekey=2... We have no idea what the mechanism of action if for HCQ. My doctor friend tried looking it up and it seemed like there are many possible pathways, many of which are still being researched, that modify immune response. There was one statement that speculated if HCQ could act directly on viral particles by changing pH near a key molecule. My attitude is, great if it works, but we still are very far from knowing that for certain. One thing that I think is worth keeping in mind is that if a medicine kills 1% of the people we give it to, and we give it to a large number of people relatively indiscriminately, it's about as bad as COVID, which kills 1-5% of victims (though as much as 15% for high risk patients).
- addicted44 7y ago
  Any high level official recommending it is a bad thing in itself. The major issue is that there isn't enough evidence there for drug companies to put in money to ramp up supply. Heck, there wasn't enough evidence for Trump, who had just signed a trillion dollar stimulus, to divert a few tens of millions of dollars to ramp up supply. Yet, you are telling a bunch of people who may never be able to make use of it to go buy the existing supply on the market. This existing supply exists because there are people who have actual proven needs of the drug, and as a result now you've also made the drug unavailable for uses where it's actually been proven to work.
- berryjerry 7y ago
  Sorry to say but this sounds like a Darwin award. People always worry about the stupidest in society but if it wasn't one thing it would be another for them. If the danger of something is that stupid people act stupidly then I don't see it as a danger at all. This is why people can sell cure all homeopathic drinks that only succeed in making you relieve your bowels or "cleanse your body" as they would say. In this case the people are doubly stupid because not only do they believe something wrong, but they believe it wrong not from a lie, but because they are interpreting "promising trials" as something already working.
- giardini 7y ago
  nick_kline>"and now my elderly relatives are fixated on getting it(HCQ/CQ)." Do you think Trump and Fox News are your elderly relatives only source of information? Do you think this behavior is limited to your elderly relatives? You can't shake an MD today w/o HCQ/CQ, zinc and ZPAK pills falling out of their pockets. Why is that? Firstly, because it works. Secondly, doctors (and dentists, and everyone who could write prescriptions and wasn't living in Tibet) spread the word of using HCQ/CQ+ZINC+ZPAK as a prophylactic measure among themselves. They wrote prescriptions for themselves and theirs, so much so that for awhile they sucked up all the HCQ/CQ in the supply chain. If you think your "elderly relatives" are "fixated", then you must also think that most MDs are also "fixated".But maybe your "elderly relatives" know something you don't know. Perhaps you're the "fixated" one - fixated on false ideas of how to best judge from social behavior in the heat of possible disaster what most likely works and what does not work. In this situation "doing what the doctors are doing" makes sense. The poor lost soul by the side of the road, waving a red flag and saying "But what about randomized controlled double-blind trials? I must have real science!" is the person that Darwin's theories will leave behind.
xiphias2 7y ago
It was a multi-drug combination therapy without real control arm as far as I saw. Also the 95% confidence intervals were overlapping, and the probablity of the high dosage being more lethal is not published.
- brokensegue 7y ago
  So you think they were mistaken to stop the trial? Or what?
  - xiphias2 7y ago
    No, when we are talking about taking away human lives, even with a little bit of data it’s immoral to continue a human trial. The problem is with the binary reporting that doesn’t get into the nuances of the data that we’re getting. People are getting confused and disappointed, because it looks like there’s a new miracle cure every day. And at the end cynical people are wright when it comes to this kind of binary reporting. And then cynism can lead to bad decisions.
rdtsc 7y ago
> Meanwhile they touched several times on the fact that Trump touted the drug. I did notice that. There were articles and some research before and everyone seemed interested and noticed as soon as he mentioned it the majority opinion almost immediately switched to "it's dangerous", "let's avoid it", "it probably won't work" while all the other alternatives seem to be still "interesting" and "worth studying" etc.
- outworlder 7y ago
  > I did notice that. There were articles and some research before and everyone seemed interested and noticed as soon as he mentioned it the majority opinion almost immediately switched to "it's dangerous", "let's avoid it", "it probably won't work" while all the other alternatives seem to be still "interesting" and "worth studying" etc. The fact that a politician is pushing an (yet) unproven drug has to be viewed with skepticism. The flip side is that it caused a cascade of reactions from other governments trying to control the drug's supply. They may have reasoned that a world leader has information they do not. And other governments (see this article) started pushing it as a treatment too. Additionally, now people are pushing the drug as a political issue. By people, I mean the average joe. This is damaging. Regardless, science is doing its thing. Trials are ongoing, as this article shows. But politicians should refrain from making baseless statements about subjects they know zero about.
  - dmix 7y ago
    Notably on Feb 4th China announced their researchers were recommending testing chloroquine, about a month and a half(?) before Trump mentioned it: http://www.whiov.ac.cn/kyjz_105338/202002/t20200204_5497136.html?from=groupmessage http://www.whiov.ac.cn/kyjz_105338/202002/t20200204_5497136.... https://www.nytimes.com/2020/02/06/health/coronavirus-treatments.html https://www.nytimes.com/2020/02/06/health/coronavirus-treatm... https://www.nature.com/articles/s41422-020-0282-0 https://www.nature.com/articles/s41422-020-0282-0 This was the original study which I believe influenced the French study and Dr. Zelenko (who seemed to be the nexus to Trump). The UK banned export of CQ around Feb 26th (I believe the first country to do so): https://ihsmarkit.com/research-analysis/uk-bans-parallel-export-of-two-covid19-treatment-candidates.html https://ihsmarkit.com/research-analysis/uk-bans-parallel-exp... From Google's custom date searches is looks like Trump first mentioned it in a press conference on March 19th: https://twitter.com/cspan/status/1240672025989001221 https://twitter.com/cspan/status/1240672025989001221

nick_kline 7y ago

It's not that trump said he likes to breath air, so everyone became fixated on that. It's that this is one of many (dozens at least) of things he has said were solutions, cures, miracles that would deal with covid-19. These went through the fox news world and now my elderly relatives are fixated on getting it (they are otherwise healthy). Because fox news and all these other non-medical people keep harping on it, the elderly people, the same ones preyed upon by certain news sources get the wrong idea about this.

complianceowl 7y ago
Wrong (Trump Voice)
ghostpepper 7y ago
There are two stories here: One is whether one of the most promising drugs to stop the pandemic is actually dangerous, and the other is what Trump said and whether he was right to say it blah blah blah. Thanks to the inclusion of Trump in this article by National Post, anyone who has strong views about Trump (most people in North America) are now focused on the second story, instead of the first.
- m0zg 7y ago
  Best I can tell, the article doesn't even mention the cause of death. :-) Did they die because they were given HCQ or did they die in spite of being given HCQ? We'll never know. And the paper itself (https://web.archive.org/web/20200413181618/https://www.medrxiv.org/content/10.1101/2020.04.07.20056424v1.full.pdf https://web.archive.org/web/20200413181618/https://www.medrx...) doesn't say that either, and mentions that this study's randomization was flawed in that older patients with heart disease were assigned to the high dosage arm of the experiment.
  - tehjoker 7y ago
    They saw people were getting heart arrhythmias in the original Brazil study. Anecdotally, a doctor I know has been seeing an increase in arrhythmias on patients treated with HCQ at lower doses if they already have a pre-existing circulatory problem. What is really irking me is that we still don't even know if it's really doing anything. At the same time, my elderly parent is taking HCQ for arthritis and appears to think she is invincible, going to the store each day in the middle of Queens, the world epicenter. She tried to send me links to Trump's touted Dr. Zelenko about how it's a miracle cure.
    - m0zg 7y ago
      We don't even know if eggs and butter are "good for you" so I'm not surprised we know jack squat about HCQ beyond anecdotal evidence, which most studies you will find in the press seem to either ignore, or set their studies up s.t. they fail. In particular, per anecdotal evidence HCQ+Zpak+Zinc is the most effective combination, and only if given at the onset of symptoms. Yet routinely we see either just HQ or HCQ alone, or HCQ (with or without Zpak) given to patients that are so far gone it's unlikely to make any difference. Just read the original study fer chrissakes, it's publicly accessible. Sure it's not "randomized" or "principled", but at the very least _try_ what Raoult did in the first place, maybe? Exactly as he did it?
      - tehjoker 7y ago
        It looks like Azithromycin is for clearing bacterial pneumonia. Certainly this is a possible and probably common complication of viral pneumonia caused by COVID-19, but I'm sure doctors are well aware of ways to treat secondary bacterial pneumonia. Just looking at what doctors are saying about Zinc, it seems like there could be something to it, especially if an individual is Zinc deficient, but it's not at all clear it's anything like a silver bullet. https://www.medicinenet.com/script/main/art.asp?articlekey=228691 https://www.medicinenet.com/script/main/art.asp?articlekey=2... We have no idea what the mechanism of action if for HCQ. My doctor friend tried looking it up and it seemed like there are many possible pathways, many of which are still being researched, that modify immune response. There was one statement that speculated if HCQ could act directly on viral particles by changing pH near a key molecule. My attitude is, great if it works, but we still are very far from knowing that for certain. One thing that I think is worth keeping in mind is that if a medicine kills 1% of the people we give it to, and we give it to a large number of people relatively indiscriminately, it's about as bad as COVID, which kills 1-5% of victims (though as much as 15% for high risk patients).
addicted44 7y ago
Any high level official recommending it is a bad thing in itself. The major issue is that there isn't enough evidence there for drug companies to put in money to ramp up supply. Heck, there wasn't enough evidence for Trump, who had just signed a trillion dollar stimulus, to divert a few tens of millions of dollars to ramp up supply. Yet, you are telling a bunch of people who may never be able to make use of it to go buy the existing supply on the market. This existing supply exists because there are people who have actual proven needs of the drug, and as a result now you've also made the drug unavailable for uses where it's actually been proven to work.
berryjerry 7y ago
Sorry to say but this sounds like a Darwin award. People always worry about the stupidest in society but if it wasn't one thing it would be another for them. If the danger of something is that stupid people act stupidly then I don't see it as a danger at all. This is why people can sell cure all homeopathic drinks that only succeed in making you relieve your bowels or "cleanse your body" as they would say. In this case the people are doubly stupid because not only do they believe something wrong, but they believe it wrong not from a lie, but because they are interpreting "promising trials" as something already working.
giardini 7y ago
nick_kline>"and now my elderly relatives are fixated on getting it(HCQ/CQ)." Do you think Trump and Fox News are your elderly relatives only source of information? Do you think this behavior is limited to your elderly relatives? You can't shake an MD today w/o HCQ/CQ, zinc and ZPAK pills falling out of their pockets. Why is that? Firstly, because it works. Secondly, doctors (and dentists, and everyone who could write prescriptions and wasn't living in Tibet) spread the word of using HCQ/CQ+ZINC+ZPAK as a prophylactic measure among themselves. They wrote prescriptions for themselves and theirs, so much so that for awhile they sucked up all the HCQ/CQ in the supply chain. If you think your "elderly relatives" are "fixated", then you must also think that most MDs are also "fixated".But maybe your "elderly relatives" know something you don't know. Perhaps you're the "fixated" one - fixated on false ideas of how to best judge from social behavior in the heat of possible disaster what most likely works and what does not work. In this situation "doing what the doctors are doing" makes sense. The poor lost soul by the side of the road, waving a red flag and saying "But what about randomized controlled double-blind trials? I must have real science!" is the person that Darwin's theories will leave behind.

xiphias2 7y ago

It was a multi-drug combination therapy without real control arm as far as I saw. Also the 95% confidence intervals were overlapping, and the probablity of the high dosage being more lethal is not published.

brokensegue 7y ago
So you think they were mistaken to stop the trial? Or what?
- xiphias2 7y ago
  No, when we are talking about taking away human lives, even with a little bit of data it’s immoral to continue a human trial. The problem is with the binary reporting that doesn’t get into the nuances of the data that we’re getting. People are getting confused and disappointed, because it looks like there’s a new miracle cure every day. And at the end cynical people are wright when it comes to this kind of binary reporting. And then cynism can lead to bad decisions.

rdtsc 7y ago

> Meanwhile they touched several times on the fact that Trump touted the drug. I did notice that. There were articles and some research before and everyone seemed interested and noticed as soon as he mentioned it the majority opinion almost immediately switched to "it's dangerous", "let's avoid it", "it probably won't work" while all the other alternatives seem to be still "interesting" and "worth studying" etc.

outworlder 7y ago
> I did notice that. There were articles and some research before and everyone seemed interested and noticed as soon as he mentioned it the majority opinion almost immediately switched to "it's dangerous", "let's avoid it", "it probably won't work" while all the other alternatives seem to be still "interesting" and "worth studying" etc. The fact that a politician is pushing an (yet) unproven drug has to be viewed with skepticism. The flip side is that it caused a cascade of reactions from other governments trying to control the drug's supply. They may have reasoned that a world leader has information they do not. And other governments (see this article) started pushing it as a treatment too. Additionally, now people are pushing the drug as a political issue. By people, I mean the average joe. This is damaging. Regardless, science is doing its thing. Trials are ongoing, as this article shows. But politicians should refrain from making baseless statements about subjects they know zero about.
- dmix 7y ago
  Notably on Feb 4th China announced their researchers were recommending testing chloroquine, about a month and a half(?) before Trump mentioned it: http://www.whiov.ac.cn/kyjz_105338/202002/t20200204_5497136.html?from=groupmessage http://www.whiov.ac.cn/kyjz_105338/202002/t20200204_5497136.... https://www.nytimes.com/2020/02/06/health/coronavirus-treatments.html https://www.nytimes.com/2020/02/06/health/coronavirus-treatm... https://www.nature.com/articles/s41422-020-0282-0 https://www.nature.com/articles/s41422-020-0282-0 This was the original study which I believe influenced the French study and Dr. Zelenko (who seemed to be the nexus to Trump). The UK banned export of CQ around Feb 26th (I believe the first country to do so): https://ihsmarkit.com/research-analysis/uk-bans-parallel-export-of-two-covid19-treatment-candidates.html https://ihsmarkit.com/research-analysis/uk-bans-parallel-exp... From Google's custom date searches is looks like Trump first mentioned it in a press conference on March 19th: https://twitter.com/cspan/status/1240672025989001221 https://twitter.com/cspan/status/1240672025989001221