5 ms·

I guess that's the end of the road for hydroxychloroquine/chloroquine as a treatment for COVID-19.

danans 6y ago
Yes it's probably the end medically, but it's not the end of its use as a political wedge. To people who believe the current political rhetoric promoting hydroxychloroquine, a study in a medical journal doesn't change anything, as their interest in it was never based its medical efficacy, but rather as a symbol used to rally around their leader and their movement. Just look at the anti-vaccination movement, which continues despite being debunked for years. And we shouldn't so quickly dismiss this phenomenon. We underestimate the power of that kind of fictional narrative group-think to our peril. The only way to fight falsehood based narrative is truth based narrative. The dry statistical or scientifically derived truth that eggheads like most of us wish would prevail is largely powerless. Stories are what ultimately wins.
- puranjay 6y ago
  It's been absurd that I have people on my Twitter feed attributing the low death rate in India to India's "widespread daily use of HCQ". 31 years in India and I've never even heard of it!
  - rsynnott 6y ago
    I suspect this was people thinking “chloroquine is a malaria drug and India has malaria, therefore it’s used in India”. Which sounds vaguely convincing at first glance, but malaria in India has been immune for decades.
    - puranjay 6y ago
      Don't even get me started on the people hoarding tonic water because it has quinine in it
  - rurban 6y ago
    Easy to explain. HCQ as treatment is questionable. Always was. Even the Chinese retracted their recommendation in End of February. But it is still recommended as prevention, and there is a Indian study confirming its suitability as prevention. That's how it always worked. India is also the sole manufacturer of it, for their malaria problem. It's still in widespread use there. Europeans were extra stupid to try it as treatment. If you read the early original Chinese reports they always mentioned that it worked as prevention, Lupus patients had an advantage. And those two disliked presidents always promoted its usage as prevention, not treatment. But reading is apparently a rare skill.
- hn_throwaway_99 6y ago
  Exactly. What, you think these hucksters like Laura Ingraham are going to apologize for their dangerous bullshit (spoiler - no: https://www.thedailybeast.com/laura-ingraham-trashes-promising-coronavirus-treatment-remdesivir-to-promote-hydroxychloroquine https://www.thedailybeast.com/laura-ingraham-trashes-promisi... )? Of course not. Apologies are for losers, instead when the facts are against you, you just double down and demonize those who try to convince you with those facts as nefarious enemies. Those of us who live in the world of reality need to realize the only way to fight this "demon haunted world" is to make a scarier demon, not try to fight with facts.
- eloff 6y ago
  It goes both ways. There are studies showing it is a statistically and clinically significant treatment [1]. Whether those results are reproducible or not remains to be seen. Most of these studies you never hear about because many people on the left want Trump to be wrong or have a knee jerk reaction to anything he says. It even has a name: Trump derangement syndrome. Irrational behavior in both directions is indefensible. [1] https://www.medrxiv.org/content/10.1101/2020.05.02.20080036v1 https://www.medrxiv.org/content/10.1101/2020.05.02.20080036v... [2] https://pubmed.ncbi.nlm.nih.gov/32335560/ https://pubmed.ncbi.nlm.nih.gov/32335560/
  - deleted 6y ago
    [deleted]
  - danans 6y ago
    > Irrational behavior in both directions is indefensible. Agreed that any political side is capable of false narratives, but that's hardly what's going on here. Nobody with the fundamental desire for a treatment for themselves and those they care about should they fall severely ill would want any proven effective treatment to be dismissed for political reasons, whether that is hydroxychloroquine or anything else. The problem is that what should have been left as an investigation into a medication with no political colors was turned into a political wedge by the US president who seemingly aspired to use it to regain relevance during this crisis. The same thing has also happened for the various promotions of very preliminary vaccines, or of a fictional nationally deployed testing website that was claimed by POTUS to be under development by Google. This follows the basic principle guiding this administration and its leader that there is no such thing as bad publicity. And to a certain extent, they might even be right. Time will tell.
    - eloff 6y ago
      Every reference I've seen to Hydroxychloroquine in the media is quick to denounce it as a dangerous, discredited treatment. So I think this is not just irrationality on the part of the left, but an example of the gated institutional narrative suppressing ideas. Not to take away from the irrationality of blind faith in anything Trump says seen on the right. If you look at the experts, they're still designing studies to test it, and there are some papers suggesting it does work. The jury is very much still out on this subject.
imglorp 6y ago
The end of the science road perhaps, but there's still political obstacles to setting it aside. It's not obvious why Trump is pushing it so hard. https://www.vox.com/2020/4/7/21211872/trump-coronavirus-hydroxychloroquine-covid19-drugs-sanofi-owns https://www.vox.com/2020/4/7/21211872/trump-coronavirus-hydr...
rsynnott 6y ago
Unfortunately, probably not; the general public won’t read this, and some people won’t believe it when they see news media’s take on it. There was an article the other day that interviewed someone who’d been on long-term treatment with the drug (for lupus) they were shocked when they got covid, because they believed that the drug was a prophylactic. No reputable scientist ever claimed that, as far as I know; it was a popular myth encouraged by unscrupulous news outlets, which won’t go away just because of a study or two.
eloff 6y ago
Not necessarily. Some discussions[1] of potential mechanism focuses on hydroxychloroquine working as an ionophore to drive zinc into cells - so this potentially only works when given in conjunction with zinc. There are a few studies that suggest it is effective used that way. Whether those results hold up over time is an open question. [1] (video) https://fast.wistia.net/embed/medias/td0v8taipc https://fast.wistia.net/embed/medias/td0v8taipc
- rurban 6y ago
  The effective use is applying it 3 weeks before the infection. Not two days after. That's not enough time to fill up the cells with zinc.
throwablePie 6y ago
"We included patients hospitalised between Dec 20, 2019, and April 14, 2020, with a positive laboratory finding for SARS-CoV-2" It may be the end of the road for hospitalized patients with heavy viral loads but, considering the fact that zinc is mentioned nowhere in the full text, it is not the end of the road for prophylaxis. Early action before hospitalization is necessary... see below. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31180-6/fulltext https://www.thelancet.com/journals/lancet/article/PIIS0140-6... Zinc does the hard work of inhibiting viral replication; HCQ is the zinc ionophore that lights the pathway. "First used in 1967, the term ionophore refers to the molecule’s ability to bind a metal ion and facilitate its transport across cellular membranes." In order to inhibit viral replication, zinc must enter the cell... HCQ and other zinc ionophores can facilitate this. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4896753/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4896753/ Pasting my previous comment below with slight modifications: Hydroxychloroquine is just one of several zinc ionophores that inhibit viral replication. "Zinc Ionophores Pyrithione Inhibits Herpes Simplex Virus Replication" https://pubmed.ncbi.nlm.nih.gov/23867132/ https://pubmed.ncbi.nlm.nih.gov/23867132/ "... the virus replicative cycle can be divided into 10 steps (Fig. 52-1): (1) adsorption, (2) penetration, (3) uncoating, (4) early transcription, (5) early translation, (6) replication of the viral genome, (7) late transcription, (8) late translation, (9) assembly, and (10) release of new virus particles." If using HCQ as a zinc ionophore which targets replication, "antiviral drug treatment should be started early, before irreversible tissue damage occurs. Such timely treatment is not possible without early and accurate diagnosis, which is difficult for many viral infections (such as infections of the respiratory tract)" https://www.ncbi.nlm.nih.gov/books/NBK8119/ https://www.ncbi.nlm.nih.gov/books/NBK8119/

Yes it's probably the end medically, but it's not the end of its use as a political wedge. To people who believe the current political rhetoric promoting hydroxychloroquine, a study in a medical journal doesn't change anything, as their interest in it was never based its medical efficacy, but rather as a symbol used to rally around their leader and their movement. Just look at the anti-vaccination movement, which continues despite being debunked for years. And we shouldn't so quickly dismiss this phenomenon. We underestimate the power of that kind of fictional narrative group-think to our peril. The only way to fight falsehood based narrative is truth based narrative. The dry statistical or scientifically derived truth that eggheads like most of us wish would prevail is largely powerless. Stories are what ultimately wins.

puranjay 6y ago
It's been absurd that I have people on my Twitter feed attributing the low death rate in India to India's "widespread daily use of HCQ". 31 years in India and I've never even heard of it!
- rsynnott 6y ago
  I suspect this was people thinking “chloroquine is a malaria drug and India has malaria, therefore it’s used in India”. Which sounds vaguely convincing at first glance, but malaria in India has been immune for decades.
  - puranjay 6y ago
    Don't even get me started on the people hoarding tonic water because it has quinine in it
- rurban 6y ago
  Easy to explain. HCQ as treatment is questionable. Always was. Even the Chinese retracted their recommendation in End of February. But it is still recommended as prevention, and there is a Indian study confirming its suitability as prevention. That's how it always worked. India is also the sole manufacturer of it, for their malaria problem. It's still in widespread use there. Europeans were extra stupid to try it as treatment. If you read the early original Chinese reports they always mentioned that it worked as prevention, Lupus patients had an advantage. And those two disliked presidents always promoted its usage as prevention, not treatment. But reading is apparently a rare skill.
hn_throwaway_99 6y ago
Exactly. What, you think these hucksters like Laura Ingraham are going to apologize for their dangerous bullshit (spoiler - no: https://www.thedailybeast.com/laura-ingraham-trashes-promising-coronavirus-treatment-remdesivir-to-promote-hydroxychloroquine https://www.thedailybeast.com/laura-ingraham-trashes-promisi... )? Of course not. Apologies are for losers, instead when the facts are against you, you just double down and demonize those who try to convince you with those facts as nefarious enemies. Those of us who live in the world of reality need to realize the only way to fight this "demon haunted world" is to make a scarier demon, not try to fight with facts.
eloff 6y ago
It goes both ways. There are studies showing it is a statistically and clinically significant treatment [1]. Whether those results are reproducible or not remains to be seen. Most of these studies you never hear about because many people on the left want Trump to be wrong or have a knee jerk reaction to anything he says. It even has a name: Trump derangement syndrome. Irrational behavior in both directions is indefensible. [1] https://www.medrxiv.org/content/10.1101/2020.05.02.20080036v1 https://www.medrxiv.org/content/10.1101/2020.05.02.20080036v... [2] https://pubmed.ncbi.nlm.nih.gov/32335560/ https://pubmed.ncbi.nlm.nih.gov/32335560/
- deleted 6y ago
  [deleted]
- danans 6y ago
  > Irrational behavior in both directions is indefensible. Agreed that any political side is capable of false narratives, but that's hardly what's going on here. Nobody with the fundamental desire for a treatment for themselves and those they care about should they fall severely ill would want any proven effective treatment to be dismissed for political reasons, whether that is hydroxychloroquine or anything else. The problem is that what should have been left as an investigation into a medication with no political colors was turned into a political wedge by the US president who seemingly aspired to use it to regain relevance during this crisis. The same thing has also happened for the various promotions of very preliminary vaccines, or of a fictional nationally deployed testing website that was claimed by POTUS to be under development by Google. This follows the basic principle guiding this administration and its leader that there is no such thing as bad publicity. And to a certain extent, they might even be right. Time will tell.
  - eloff 6y ago
    Every reference I've seen to Hydroxychloroquine in the media is quick to denounce it as a dangerous, discredited treatment. So I think this is not just irrationality on the part of the left, but an example of the gated institutional narrative suppressing ideas. Not to take away from the irrationality of blind faith in anything Trump says seen on the right. If you look at the experts, they're still designing studies to test it, and there are some papers suggesting it does work. The jury is very much still out on this subject.

imglorp 6y ago

The end of the science road perhaps, but there's still political obstacles to setting it aside. It's not obvious why Trump is pushing it so hard. https://www.vox.com/2020/4/7/21211872/trump-coronavirus-hydroxychloroquine-covid19-drugs-sanofi-owns https://www.vox.com/2020/4/7/21211872/trump-coronavirus-hydr...

rsynnott 6y ago

Unfortunately, probably not; the general public won’t read this, and some people won’t believe it when they see news media’s take on it. There was an article the other day that interviewed someone who’d been on long-term treatment with the drug (for lupus) they were shocked when they got covid, because they believed that the drug was a prophylactic. No reputable scientist ever claimed that, as far as I know; it was a popular myth encouraged by unscrupulous news outlets, which won’t go away just because of a study or two.

eloff 6y ago

Not necessarily. Some discussions[1] of potential mechanism focuses on hydroxychloroquine working as an ionophore to drive zinc into cells - so this potentially only works when given in conjunction with zinc. There are a few studies that suggest it is effective used that way. Whether those results hold up over time is an open question. [1] (video) https://fast.wistia.net/embed/medias/td0v8taipc https://fast.wistia.net/embed/medias/td0v8taipc

rurban 6y ago
The effective use is applying it 3 weeks before the infection. Not two days after. That's not enough time to fill up the cells with zinc.

throwablePie 6y ago

"We included patients hospitalised between Dec 20, 2019, and April 14, 2020, with a positive laboratory finding for SARS-CoV-2" It may be the end of the road for hospitalized patients with heavy viral loads but, considering the fact that zinc is mentioned nowhere in the full text, it is not the end of the road for prophylaxis. Early action before hospitalization is necessary... see below. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31180-6/fulltext https://www.thelancet.com/journals/lancet/article/PIIS0140-6... Zinc does the hard work of inhibiting viral replication; HCQ is the zinc ionophore that lights the pathway. "First used in 1967, the term ionophore refers to the molecule’s ability to bind a metal ion and facilitate its transport across cellular membranes." In order to inhibit viral replication, zinc must enter the cell... HCQ and other zinc ionophores can facilitate this. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4896753/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4896753/ Pasting my previous comment below with slight modifications: Hydroxychloroquine is just one of several zinc ionophores that inhibit viral replication. "Zinc Ionophores Pyrithione Inhibits Herpes Simplex Virus Replication" https://pubmed.ncbi.nlm.nih.gov/23867132/ https://pubmed.ncbi.nlm.nih.gov/23867132/ "... the virus replicative cycle can be divided into 10 steps (Fig. 52-1): (1) adsorption, (2) penetration, (3) uncoating, (4) early transcription, (5) early translation, (6) replication of the viral genome, (7) late transcription, (8) late translation, (9) assembly, and (10) release of new virus particles." If using HCQ as a zinc ionophore which targets replication, "antiviral drug treatment should be started early, before irreversible tissue damage occurs. Such timely treatment is not possible without early and accurate diagnosis, which is difficult for many viral infections (such as infections of the respiratory tract)" https://www.ncbi.nlm.nih.gov/books/NBK8119/ https://www.ncbi.nlm.nih.gov/books/NBK8119/