6 ms·

This is this the more toxic variant though right? It’s meant to be hydroychloroquine

simtel20 7y ago
Here in Brazil, for whatever reason, the president has been talking up chloroquine, while Trumps talking point is hydroxychloroquine. I don't know how people who have no medical training or experience who are actively trying to undermine their advisors with such experience determine which of these medicines they're going to place their bets on, but given the lack of good results in either, it seems like either bet is as bad as the other.
- goldcd 7y ago
  Like Pepsi and Coke?
  - jcrubino 7y ago
    Like Coke and Diet Coke and Coke Zero
- merpnderp 7y ago
  China had more luck treating COVID with chloroquine phosphate (which is more toxic), but hydrochloroquine sulfate is more available in the US.
  - addicted44 7y ago
    COVID-19 kills anywhere between 0.7-4% of the people it infects. (Some countries like Italy saw a much higher mortality rate, nearing 15% in Italy, I believe, but that was due to the breakdown of the overwhelmed health services). How would one even tell if any of the chloroquinine derivatives have been effective without a systematic study when 96 out of 100 people (at worst) would have recovered anyways? That's another thing that makes the 20 person French study which kicked off all this so much more ridiculous. There was a 44% chance that they would have all recovered without any intervention. But it was probably higher for this group since they did have intervention, and they clearly had a high level of medical assistance.
    - rootusrootus 7y ago
      > COVID-19 kills anywhere between 0.7-4% of the people it infects. (Some countries like Italy saw a much higher mortality rate, nearing 15% in Italy, I believe, but that was due to the breakdown of the overwhelmed health services). That is mixing up IFR and CFR. We don't have any good way of knowing IFR yet, and it may be quite a while before we can get a good estimate. The denominator in CFR is confirmed cases, so Italy's inflated CFR could be (and probably is) entirely related to the lack of sufficient testing.
      - rurban 7y ago
        Italy has a very high IFR of 1%, the same rate as their every year flu epidemic. Or better very two years. The flu comes every two years. Italy has traditionally the highest flu death rates in the world. This year, with COVID-19, it is still lower than in a bad flu year. When you read 15% this might be the CFR, the case fatality rate. But only about a tenth is getting tested. So it means nothing. You can only look the death numbers, and after it settled down at the excess death rate. From there you get the real IFR. So far we are at an IFR of 0.3 - 0.6. A little bit higher than the flu, but in absolute numbes lower than a bad flu year.
        rootusrootus 7y ago
        IIRC, Italy had a health care professional study that put their IFR at something around .35% or so. Similar for Germany, and the CDC just did a study of HCP's here and came up with 0.26% IFR (but the sample was 75% women).
      - imustbeevil 7y ago
        The CFR is 21% [0]. We're already assuming the IFR is 10x lower. [0] https://www.worldometers.info/coronavirus/ https://www.worldometers.info/coronavirus/
        shadowprofile77 7y ago
        Please check your calculations more carefully before posting a number. the 21% mortality rate represents a percentage of all closed cases in the worldmeters data, not the sum total of all cases both active and closed either through fatality or recovery. The CFR from worldmeters based on total cases counted so far and total deaths counted so far sits at about 6% (and bear in mind that the total count of cases on the site is far, far off from the probable real number of cases.
- deleted 7y ago
  [deleted]
- jankassens 7y ago
  Experts that say that a solution in form of vaccine is 1 year out don't offer immediate help. If some self-appointed expert claims to have a solution, a politician might take a bet on that solution and either later claim they were first to bet big on the solution or just move on to the next bet or blaming of someone else later.
jcrubino 7y ago
A small hydroxychloroquine Study was just published. Equivical results found with some patients discontinued for ECG irregularities. Source: https://www.medrxiv.org/content/10.1101/2020.04.10.20060699v1.full.pdf https://www.medrxiv.org/content/10.1101/2020.04.10.20060699v... Discussion: https://news.ycombinator.com/item?id=22879361 https://news.ycombinator.com/item?id=22879361
- DoreenMichele 7y ago
  Discussion: https://news.ycombinator.com/item?id=22879361 https://news.ycombinator.com/item?id=22879361
ineedasername 7y ago
Toxicity is relative. I came across one mention that said it's 40% less cytotoxic. Overall, both drugs are supposed to be relatively safe at careful dosing levels, but both have significant risk if the dosing is just a little bit too high, and a therapeutic index for covid-19 has yet to be determined. Near as I can tell from a quick lit review, there's risk of blindness and also renal failure if renal systems are already weakened. Liver toxicity can also (but rarely) be a problem-- however, the cocktail proposed using antibiotics makes that more problematic, as antibiotics can also adversely impact liver function. Considering both liver risks are small at careful dosing, that may not be an issue if the risk is additive, but if it's potentiating then there's a real problem and we really need to understand if there are more at-risk people for those issues that will die from the cocktail than will die from covid-19 complications. This is why the larger scale trials are necessary, and doctors should be extremely cautious in using any of these drugs unless the covid-19 trajectory looks to be trending towards death anyway. Outside of studies, they should probably not be prescribed for low or medium severity cases. *Foot note: I'm not a doctor or medical professional. I'm well informed on these matters, but a little knowledge is dangerous. Take the above in that context.
scared2 7y ago
According to Donald Trump cloroquine can also be referred to as hydroxy chloroquine. You can watch here https://youtu.be/3GuNbGC2D_8 https://youtu.be/3GuNbGC2D_8
- pdonis 7y ago
  > It is the same one. No, it isn't. Chloroquine and hydroxychloroquine are not the same drug.
  - nnq 7y ago
    > According to Donald Trump We need to invent a drug that increases people's ability to detect irony.
  - scared2 7y ago
    I am not a doctor but according to the US president's press briefing both words can be used interchangeably (link above).
    - deleted 7y ago
      [deleted]
    - ska 7y ago
      He's not in any way medically or chemically trained either, and has a well established history of sometimes saying things that are not factually correct during briefings. Why would you rely on that as a source?
    - adrianmonk 7y ago
      According to Trump's own words on the coronavirus, you can call it "a flu". During one of his daily press briefings, he listed off things you can call it, and that was on the list. Influenza and coronaviruses are both categories of virus, but they are very different categories. They are not only not the same family, they are also not the same order, class, or phylum. That's like if we were being attacked by horses, and Trump said, "You can call these horses many names... including octopus."
droithomme 7y ago
> This is this the more toxic variant though right? It’s meant to be hydroychloroquine Hydroxychloroquine has fewer side effects than chloroquine which has fewer side effects than quinine which has fewer side effects than the bark it's made from that contains a bunch of other compounds including quinidine. All quinine class drugs produce heart arrhythmia as a side effect in some patients, more so with increasing doses, and all come with warnings that they should not be used or should be used with caution in patients with heart conditions. These contraindications of these widely used drugs have been known for decades.

Here in Brazil, for whatever reason, the president has been talking up chloroquine, while Trumps talking point is hydroxychloroquine. I don't know how people who have no medical training or experience who are actively trying to undermine their advisors with such experience determine which of these medicines they're going to place their bets on, but given the lack of good results in either, it seems like either bet is as bad as the other.

goldcd 7y ago
Like Pepsi and Coke?
- jcrubino 7y ago
  Like Coke and Diet Coke and Coke Zero
merpnderp 7y ago
China had more luck treating COVID with chloroquine phosphate (which is more toxic), but hydrochloroquine sulfate is more available in the US.
- addicted44 7y ago
  COVID-19 kills anywhere between 0.7-4% of the people it infects. (Some countries like Italy saw a much higher mortality rate, nearing 15% in Italy, I believe, but that was due to the breakdown of the overwhelmed health services). How would one even tell if any of the chloroquinine derivatives have been effective without a systematic study when 96 out of 100 people (at worst) would have recovered anyways? That's another thing that makes the 20 person French study which kicked off all this so much more ridiculous. There was a 44% chance that they would have all recovered without any intervention. But it was probably higher for this group since they did have intervention, and they clearly had a high level of medical assistance.
  - rootusrootus 7y ago
    > COVID-19 kills anywhere between 0.7-4% of the people it infects. (Some countries like Italy saw a much higher mortality rate, nearing 15% in Italy, I believe, but that was due to the breakdown of the overwhelmed health services). That is mixing up IFR and CFR. We don't have any good way of knowing IFR yet, and it may be quite a while before we can get a good estimate. The denominator in CFR is confirmed cases, so Italy's inflated CFR could be (and probably is) entirely related to the lack of sufficient testing.
    - rurban 7y ago
      Italy has a very high IFR of 1%, the same rate as their every year flu epidemic. Or better very two years. The flu comes every two years. Italy has traditionally the highest flu death rates in the world. This year, with COVID-19, it is still lower than in a bad flu year. When you read 15% this might be the CFR, the case fatality rate. But only about a tenth is getting tested. So it means nothing. You can only look the death numbers, and after it settled down at the excess death rate. From there you get the real IFR. So far we are at an IFR of 0.3 - 0.6. A little bit higher than the flu, but in absolute numbes lower than a bad flu year.
      - rootusrootus 7y ago
        IIRC, Italy had a health care professional study that put their IFR at something around .35% or so. Similar for Germany, and the CDC just did a study of HCP's here and came up with 0.26% IFR (but the sample was 75% women).
    - imustbeevil 7y ago
      The CFR is 21% [0]. We're already assuming the IFR is 10x lower. [0] https://www.worldometers.info/coronavirus/ https://www.worldometers.info/coronavirus/
      - shadowprofile77 7y ago
        Please check your calculations more carefully before posting a number. the 21% mortality rate represents a percentage of all closed cases in the worldmeters data, not the sum total of all cases both active and closed either through fatality or recovery. The CFR from worldmeters based on total cases counted so far and total deaths counted so far sits at about 6% (and bear in mind that the total count of cases on the site is far, far off from the probable real number of cases.
deleted 7y ago
[deleted]
jankassens 7y ago
Experts that say that a solution in form of vaccine is 1 year out don't offer immediate help. If some self-appointed expert claims to have a solution, a politician might take a bet on that solution and either later claim they were first to bet big on the solution or just move on to the next bet or blaming of someone else later.

jcrubino 7y ago

A small hydroxychloroquine Study was just published. Equivical results found with some patients discontinued for ECG irregularities. Source: https://www.medrxiv.org/content/10.1101/2020.04.10.20060699v1.full.pdf https://www.medrxiv.org/content/10.1101/2020.04.10.20060699v... Discussion: https://news.ycombinator.com/item?id=22879361 https://news.ycombinator.com/item?id=22879361

DoreenMichele 7y ago
Discussion: https://news.ycombinator.com/item?id=22879361 https://news.ycombinator.com/item?id=22879361

ineedasername 7y ago

Toxicity is relative. I came across one mention that said it's 40% less cytotoxic. Overall, both drugs are supposed to be relatively safe at careful dosing levels, but both have significant risk if the dosing is just a little bit too high, and a therapeutic index for covid-19 has yet to be determined. Near as I can tell from a quick lit review, there's risk of blindness and also renal failure if renal systems are already weakened. Liver toxicity can also (but rarely) be a problem-- however, the cocktail proposed using antibiotics makes that more problematic, as antibiotics can also adversely impact liver function. Considering both liver risks are small at careful dosing, that may not be an issue if the risk is additive, but if it's potentiating then there's a real problem and we really need to understand if there are more at-risk people for those issues that will die from the cocktail than will die from covid-19 complications. This is why the larger scale trials are necessary, and doctors should be extremely cautious in using any of these drugs unless the covid-19 trajectory looks to be trending towards death anyway. Outside of studies, they should probably not be prescribed for low or medium severity cases. *Foot note: I'm not a doctor or medical professional. I'm well informed on these matters, but a little knowledge is dangerous. Take the above in that context.

scared2 7y ago

According to Donald Trump cloroquine can also be referred to as hydroxy chloroquine. You can watch here https://youtu.be/3GuNbGC2D_8 https://youtu.be/3GuNbGC2D_8

pdonis 7y ago
> It is the same one. No, it isn't. Chloroquine and hydroxychloroquine are not the same drug.
- nnq 7y ago
  > According to Donald Trump We need to invent a drug that increases people's ability to detect irony.
- scared2 7y ago
  I am not a doctor but according to the US president's press briefing both words can be used interchangeably (link above).
  - deleted 7y ago
    [deleted]
  - ska 7y ago
    He's not in any way medically or chemically trained either, and has a well established history of sometimes saying things that are not factually correct during briefings. Why would you rely on that as a source?
  - adrianmonk 7y ago
    According to Trump's own words on the coronavirus, you can call it "a flu". During one of his daily press briefings, he listed off things you can call it, and that was on the list. Influenza and coronaviruses are both categories of virus, but they are very different categories. They are not only not the same family, they are also not the same order, class, or phylum. That's like if we were being attacked by horses, and Trump said, "You can call these horses many names... including octopus."

droithomme 7y ago

> This is this the more toxic variant though right? It’s meant to be hydroychloroquine Hydroxychloroquine has fewer side effects than chloroquine which has fewer side effects than quinine which has fewer side effects than the bark it's made from that contains a bunch of other compounds including quinidine. All quinine class drugs produce heart arrhythmia as a side effect in some patients, more so with increasing doses, and all come with warnings that they should not be used or should be used with caution in patients with heart conditions. These contraindications of these widely used drugs have been known for decades.