Reply
 
Thread Tools Display Modes
  #1  
Old 03-25-2020, 07:12 AM
Jim Peebles is offline
Guest
 
Join Date: Jul 2017
Posts: 647

Legality of Nevada malaria treatment ban


From:
https://www.usnews.com/news/best-sta...virus-patients
"Sisolak [the Governor if Nevada] signed an emergency order earlier Tuesday barring the use of anti-malaria drugs for someone who has the coronavirus. The order restricting chloroquine and hydroxychloroquine came after President Donald Trump touted the medication as a treatment and falsely stated that the Food and Drug Administration had just approved the use of chloroquine to treat patients infected with coronavirus. Sisolak said in a statement that there’s no consensus among experts or Nevada doctors that the drugs can treat people with COVID-19."
Is this even legal? What about the "right to try" law? What about off label use of an FDA drug approved for something else? Is the Nevada Governor practicing medicine without a license? Can anyone harmed or whose family members are harmed from not being able to use the drugs to treat Covid-19 sue him? How can he be removed from office?
  #2  
Old 03-25-2020, 05:13 PM
Melbourne is offline
Guest
 
Join Date: Nov 2009
Posts: 6,011
Here's the text of the NYC ban:

Quote:
No pharmacist shall dispense hydroxychloroquine or chloroquine except when written as prescribed for an FDA-approved indication; or as part of a state approved clinical trial related to COVID-19 for a patient who has tested positive for COVID-19, with such test result documented as part of the prescription. No other experimental or prophylactic use shall be permitted, and any permitted prescription is limited to one fourteen day prescription with no refills.
https://www.governor.ny.gov/news/no-...ster-emergency

Nevada is generally the same, I think Ohio is another, and I don't know how many other states.

I think the article you quote misrepresents what Trump literally said about FDA approval: they are welcome to their opinion, but it won't win any converts in the "Trump vs liberal media" war
  #3  
Old 03-25-2020, 05:29 PM
Qadgop the Mercotan's Avatar
Qadgop the Mercotan is offline
Charter Member
 
Join Date: Apr 2000
Location: Slithering on the hull
Posts: 27,903
Quote:
No pharmacist shall dispense hydroxychloroquine or chloroquine except when written as prescribed for an FDA-approved indication; or as part of a state approved clinical trial related to COVID-19 for a patient who has tested positive for COVID-19, with such test result documented as part of the prescription. No other experimental or prophylactic use shall be permitted, and any permitted prescription is limited to one fourteen day prescription with no refills.
It seems to me that's a mostly reasonable limitation to be enacted in a time of emergency on a regulated/prescription-only substance which has great medical use but is currently being blatantly misused despite recommendations to the contrary, and is now dangerously scarce for legitimate use.

I worry about the "14 day no refills" language though, and hope that doesn't prevent folks with rheumatologic diseases from getting their prescriptions refilled. I just started a new lupus patient on it the other week and he'll need it daily, perhaps for life (and yes, it's often lupus and House is an idiot who deservedly got kicked out of my alma mater).

Last edited by Qadgop the Mercotan; 03-25-2020 at 05:30 PM.
  #4  
Old 03-25-2020, 05:32 PM
Exapno Mapcase is offline
Charter Member
 
Join Date: Mar 2002
Location: NY but not NYC
Posts: 32,202
Quote:
Originally Posted by Jim Peebles View Post
From:
https://www.usnews.com/news/best-sta...virus-patients
"Sisolak [the Governor if Nevada] signed an emergency order earlier Tuesday barring the use of anti-malaria drugs for someone who has the coronavirus. The order restricting chloroquine and hydroxychloroquine came after President Donald Trump touted the medication as a treatment and falsely stated that the Food and Drug Administration had just approved the use of chloroquine to treat patients infected with coronavirus. Sisolak said in a statement that there’s no consensus among experts or Nevada doctors that the drugs can treat people with COVID-19."
Is this even legal? What about the "right to try" law? What about off label use of an FDA drug approved for something else? Is the Nevada Governor practicing medicine without a license? Can anyone harmed or whose family members are harmed from not being able to use the drugs to treat Covid-19 sue him? How can he be removed from office?
Shouldn't you prove that the drugs have any positive effect on coronavirus before you advocate using them? You can't, though. There is no proof.

And you are misunderstanding the "right to try" law.

Quote:
Right-to-try laws are U.S. state laws and a federal law that were created with the intent of allowing terminally ill patients access to experimental therapies (drugs, biologics, devices) that have completed Phase I testing but have not been approved by the Food and Drug Administration (FDA).
Basically, whenever you try to call for something that in your own cite says was "falsely stated " you're starting from deep in a hole.
  #5  
Old 03-25-2020, 05:50 PM
RioRico is online now
Guest
 
Join Date: Sep 2019
Location: beyond cell service
Posts: 2,432
Those questioning the constitutionality or legality of emergency orders are welcome to file suit in appropriate courts. Have (m)any such suits been filed? What are the outcomes?
  #6  
Old 03-25-2020, 05:51 PM
psychobunny is online now
Guest
 
Join Date: May 2000
Posts: 2,791
Here and here are just two stories of people being unable to get their medications for Sjogren's and lupus because of shortages caused by hoarding. Several pharmacy boards have sent out notices to pharmacies not to fill prescriptions without a valid doctor patient relationship because so many doctors were writing prescriptions for themselves, friends and family. It's not an easy call. People with autoimmune diseases are presumably at higher risk for complications from Covid 19 especially since the alternatives to hydroxychloroquine are strong immunosuppressive medications. Word is that the local pharmacies are all out anyway.
Oh, and if this were the pit I would have some choice words about Kaiser in that second link telling a patient she would have to stop her plaquenil and thanking her for her sacrifice.
__________________
I'm not really an insane rabbit, but I play one on the net.

Last edited by psychobunny; 03-25-2020 at 05:56 PM.
  #7  
Old 03-25-2020, 06:34 PM
Mama Zappa is offline
Charter Member
 
Join Date: Feb 2003
Posts: 12,697
Quote:
Originally Posted by Qadgop the Mercotan View Post
It seems to me that's a mostly reasonable limitation to be enacted in a time of emergency on a regulated/prescription-only substance which has great medical use but is currently being blatantly misused despite recommendations to the contrary, and is now dangerously scarce for legitimate use.

I worry about the "14 day no refills" language though, and hope that doesn't prevent folks with rheumatologic diseases from getting their prescriptions refilled. I just started a new lupus patient on it the other week and he'll need it daily, perhaps for life (and yes, it's often lupus and House is an idiot who deservedly got kicked out of my alma mater).
A friend and her adult daughter are both on this for an autoimmune disorder (dunno if it is lupus specifically) - and they are very, very worried about having enough. One of them had run out and they were sharing the other prescription, hoping they would be able to get more before that ran out too.
  #8  
Old 03-25-2020, 06:47 PM
bobot's Avatar
bobot is online now
Member
 
Join Date: Jan 2009
Location: Chicago-ish
Posts: 9,772
Hey this is from another thread, from a long time ago, like 2 weeks.
Quote:
Originally Posted by Jim Peebles View Post
I think Vegas would be a bad vacation. But I am not changing any of my plans for coronavirus. I think it is an overblown run of the mill virus.
I asked you for a response there, but it looks like you aren't subscribed to that thread. So what do you think today about the overblown run of the mill virus?
  #9  
Old 03-25-2020, 07:06 PM
Jim Peebles is offline
Guest
 
Join Date: Jul 2017
Posts: 647
I'm not worried about it, but one is considered a public health threat if one says that. I'm convinced the antimalarial drugs work (when combined with zinc and azithromycin), and on the off chance I get a serious case I would ask my doctor for it. I don't see how it is legal for a governor to tell doctors they cant give antimalarials to patients with serious cases of coronavirus.
  #10  
Old 03-25-2020, 07:12 PM
Snowboarder Bo's Avatar
Snowboarder Bo is offline
Member
 
Join Date: May 2005
Location: Las Vegas
Posts: 28,952
Quote:
Originally Posted by Jim Peebles View Post
I'm not worried about it, but one is considered a public health threat if one says that.
Not true.
Quote:
Originally Posted by Jim Peebles View Post
I'm convinced the antimalarial drugs work (when combined with zinc and azithromycin)


Are you stocking up on Forsythia? You totally should.
  #11  
Old 03-25-2020, 07:14 PM
Jim Peebles is offline
Guest
 
Join Date: Jul 2017
Posts: 647
Quote:
Originally Posted by Snowboarder Bo View Post
Not true.

Are you stocking up on Forsythia? You totally should.
Maybe. Can you convince me to?
  #12  
Old 03-25-2020, 07:35 PM
Telemark's Avatar
Telemark is offline
Charter Member
 
Join Date: Apr 2000
Location: Just outside of Titletown
Posts: 23,785
Quote:
Originally Posted by Jim Peebles View Post
Maybe. Can you convince me to?
It seems like the bar is pretty low on that.
  #13  
Old 03-25-2020, 08:02 PM
bobot's Avatar
bobot is online now
Member
 
Join Date: Jan 2009
Location: Chicago-ish
Posts: 9,772
Quote:
Originally Posted by Jim Peebles View Post
... I'm convinced the antimalarial drugs work (when combined with zinc and azithromycin), ...
OK, so , like, why?
  #14  
Old 03-25-2020, 08:08 PM
Darren Garrison's Avatar
Darren Garrison is offline
Guest
 
Join Date: Oct 2016
Posts: 13,325
Quote:
Originally Posted by Snowboarder Bo View Post
Are you stocking up on Forsythia? You totally should.
I have some of tbose in my yard. Should I eat the branches, too, or just the leaves and flowers?
  #15  
Old 03-25-2020, 08:23 PM
nearwildheaven is online now
Guest
 
Join Date: Apr 2013
Posts: 13,806
I just saw that Nevada's 14-day limit is for NEW (hydroxy)chloroquine patients, and in addition, the pharmacist must call the prescriber AND SPEAK DIRECTLY TO THEM, get the patient's ICD-10 diagnosis, and document it.

These drugs ARE allowed to be used for hospitalized patients.
  #16  
Old 03-25-2020, 08:31 PM
bobot's Avatar
bobot is online now
Member
 
Join Date: Jan 2009
Location: Chicago-ish
Posts: 9,772
Quote:
Originally Posted by bobot View Post
OK, so , like, why?
Jim. Jim Peebles. Calling Jim Peebles, did you somehow miss this question? I mean, I'll ask again, repeatedly, I don't mind. You there, Jim Peebles?
  #17  
Old 03-25-2020, 08:52 PM
Jim Peebles is offline
Guest
 
Join Date: Jul 2017
Posts: 647
Quote:
Originally Posted by bobot View Post
OK, so , like, why?
This recent research paper has been all over the news:
https://www.mediterranee-infection.c...t-of-covid-19/
And doctors seem to believe it, to the point they are being accused of prescribing it to themselves and their families:
https://www.yahoo.com/news/states-do...190038095.html

Last edited by Jim Peebles; 03-25-2020 at 08:53 PM.
  #18  
Old 03-25-2020, 10:07 PM
Exapno Mapcase is offline
Charter Member
 
Join Date: Mar 2002
Location: NY but not NYC
Posts: 32,202
Let's make this simple. Passing along links that you've haven't checked out and probably just lifted from some right-wing blog isn't going to work in any place where people are going to look beyond the headlines.

What is the reality of "Hydroxychloroquine and azithromycin as a treatment of COVID-19"? Slim to none.

There are hundreds of news articles explaining this if you cared to look. I'll link to just one, from Contagion, "a fully integrated news resource covering all areas of infectious disease." It has an interview with "Jason Pogue, PharmD, BCPS, BCIDP, clinical professor of infectious diseases, at the University of Michigan College of Pharmacy, [who] speaks with Contagion®’s Senior Editor Michaela Fleming to share his thoughts on the recently published study “Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open label non-randomized clinical trial.”

Bottom line. I'll make this short, too.
Quote:
Contagion®: So final thoughts on this, should patients be receiving this combination therapy then?

Pogue: Yeah, so simply put, my answer would be no. But I think that I have to elaborate on that a little bit. Although these data look good on the surface, I think there are a number of limitations to this data set that we need to talk about. Again, we have to be able to critically assess these data as they come out.

The first thing that I would comment on is this. Remember I said at the beginning that there were 20 patients in the hydroxychloroquine group, and 16 patients who got standard of care. But, if you actually look at the methods in the study, you'll see that there were actually 26 patients who got hydroxychloroquine. For this analysis, remember, the primary thing was eradication at day 6. In order to be assessable, they still have to be analyzable at day 6. There were actually 6 patients in the hydroxychloroquine group that dropped out of the study because they were no longer assessable.

I think it's important for viewers to note that if you actually look in the methods, these 6 patients, there were 3 of them that were taken out of the study because they decompensated and went to the ICU. Every single one of those patients was still PCR positive.
You will, of course, ask me why all those doctors are hoarding it if it doesn't work. My cynical opinion is that most of them seem to be from red states, people who are similarly in thrall to Trump's delusions. COVID-19 is a science issue, which means you can only pay attention to what liberals say on the subject. You don't have to believe me, though. These drugs are being torn apart in a dozen other threads in this forum you're not reading, and none of the scorn is coming from me in those.

Again, I'll make this simple.

Never believe a word Trump says.
Never believe a word Trump says.
Never believe a word Trump says.
Never believe a word Trump says.
Never believe a word Trump says.

Avoid anyone who does.
Avoid anyone who does.
Avoid anyone who does.
Avoid anyone who does.
Avoid anyone who does.

Last edited by Exapno Mapcase; 03-25-2020 at 10:09 PM.
  #19  
Old 03-25-2020, 10:26 PM
Jim Peebles is offline
Guest
 
Join Date: Jul 2017
Posts: 647
Quote:
Originally Posted by Exapno Mapcase View Post
Let's make this simple. Passing along links that you've haven't checked out and probably just lifted from some right-wing blog isn't going to work in any place where people are going to look beyond the headlines.

What is the reality of "Hydroxychloroquine and azithromycin as a treatment of COVID-19"? Slim to none.

There are hundreds of news articles explaining this if you cared to look. I'll link to just one, from Contagion, "a fully integrated news resource covering all areas of infectious disease." It has an interview with "Jason Pogue, PharmD, BCPS, BCIDP, clinical professor of infectious diseases, at the University of Michigan College of Pharmacy, [who] speaks with Contagion®’s Senior Editor Michaela Fleming to share his thoughts on the recently published study “Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open label non-randomized clinical trial.”

Bottom line. I'll make this short, too.


You will, of course, ask me why all those doctors are hoarding it if it doesn't work. My cynical opinion is that most of them seem to be from red states, people who are similarly in thrall to Trump's delusions. COVID-19 is a science issue, which means you can only pay attention to what liberals say on the subject. You don't have to believe me, though. These drugs are being torn apart in a dozen other threads in this forum you're not reading, and none of the scorn is coming from me in those.

Again, I'll make this simple.

Never believe a word Trump says.
Never believe a word Trump says.
Never believe a word Trump says.
Never believe a word Trump says.
Never believe a word Trump says.

Avoid anyone who does.
Avoid anyone who does.
Avoid anyone who does.
Avoid anyone who does.
Avoid anyone who does.
Nope. You are the one turning a scientific issue into a political issue.
  #20  
Old 03-26-2020, 12:38 AM
Banksiaman is offline
Guest
 
Join Date: Apr 2012
Location: Straya
Posts: 1,271
Quote:
Originally Posted by Jim Peebles View Post
Nope. You are the one turning a scientific issue into a political issue.
Okay, even if you discounted the political bits of Exapno Mapcase's reply, what is your response to the sciency bit, which says that the trial is basically meaningless?

With Pogue's concerns about the value of the data, which appear to be reasonable expectations about getting reliable results, is there anything left that you can point to that says using this is better than scoffing a mixture of bleach and gravel, on the basis that bleach kills germs and rocks are effective deterrents?

Actually proving that specific drugs work on specific conditions effectively enough to market them is a multi-million dollar business because its hard to actually do to the level necessary to risk peoples' lives in case you get it wrong. At some point you need to choose whether to believe the science or people who are spouting random things sourced from their own ignorance because, at heart, they believe any words are better than considered silence.
  #21  
Old 03-26-2020, 12:40 AM
Jim Peebles is offline
Guest
 
Join Date: Jul 2017
Posts: 647
Quote:
Originally Posted by Banksiaman View Post
Okay, even if you discounted the political bits of Exapno Mapcase's reply, what is your response to the sciency bit, which says that the trial is basically meaningless?

With Pogue's concerns about the value of the data, which appear to be reasonable expectations about getting reliable results, is there anything left that you can point to that says using this is better than scoffing a mixture of bleach and gravel, on the basis that bleach kills germs and rocks are effective deterrents?

Actually proving that specific drugs work on specific conditions effectively enough to market them is a multi-million dollar business because its hard to actually do to the level necessary to risk peoples' lives in case you get it wrong. At some point you need to choose whether to believe the science or people who are spouting random things sourced from their own ignorance because, at heart, they believe any words are better than considered silence.
India appears to believe in Trump Pills, it has banned their export according to:
https://news.yahoo.com/india-bans-ex...031443401.html
  #22  
Old 03-26-2020, 01:17 AM
Banksiaman is offline
Guest
 
Join Date: Apr 2012
Location: Straya
Posts: 1,271
Quote:
Originally Posted by Jim Peebles View Post
India appears to believe in Trump Pills, it has banned their export according to:
https://news.yahoo.com/india-bans-ex...031443401.html
I'm not getting the link, but it might be because India has more than a million malaria cases p.a. [2015 most recent I can find], and would rather treat its own malaria-affected citizens than the anxious non-malarial families of doctors in heartland America.
  #23  
Old 03-26-2020, 02:00 AM
nelliebly is offline
Guest
 
Join Date: Jul 2017
Location: Washington
Posts: 2,816
Jim Peebles, I have lupus. I was on hydroxychlorquine for years. It helped suppress the symptoms of the disease, and unlike other lupus meds, it didn't KO my immune system. Unfortunately, docs found it damaged my retinas and yanked me off of it. I still have friends with lupus who rely on it, though.

So I'm going to say this to all of those who demand some of the limited supply of this medication, one that has not been credibly proven to cure or prevent COVID-19 but is needed by lupus sufferers and others: shame on you. Seriously. You should be ashamed.
  #24  
Old 03-26-2020, 03:10 AM
Harrington is offline
Guest
 
Join Date: Nov 2017
Posts: 189
Quote:
Originally Posted by Banksiaman View Post
I'm not getting the link, but it might be because India has more than a million malaria cases p.a. [2015 most recent I can find], and would rather treat its own malaria-affected citizens than the anxious non-malarial families of doctors in heartland America.
The article doesn't expressly state why India is withholding Hydroxychloroquine, but it is implied they are doing it for health concerns.

Quote:
"Chloroquine has demonstrated toxicity in certain patients," Dinesh Dua, chairman of the Pharmaceuticals Export Promotion Council of India, told Reuters. "You have to tread with caution because there is no comprehensive data to prove it works."
And also operational disruptions due to sickness, lockdown, and fears.

Quote:
The group said India, the world's largest supplier of generic drugs, was not short of the drug but that companies were acutely short of staff to run operations.
Quote:
"It is impossible to maintain operations due to lockdown, because employees don't want to come (to work)," Dua said.
There is nothing that suggests India is hording the medication because of Trump's excited utterance.

However, in this article, an Indian drug manufacturer states that the country is using it prophylactically.

Quote:
For now, the company does not expect to be able to export. “As the things stand today, we can not export the API hydroxychloroquine sulphate, as well as it’s formulations, unless exemptions are given on a case to case basis on humanitarian grounds,” Harish Kamath, the IPCA corporate counsel wrote us. He noted that the Indian government recently permitted prophylactic use of hydroxychloroquine tablets for health care workers as well as people who were in close contact with coronavirus patients — and because of this there could be increased demand and an immediate shortage in the country.
  #25  
Old 03-26-2020, 03:19 AM
Melbourne is offline
Guest
 
Join Date: Nov 2009
Posts: 6,011
Quote:
Originally Posted by Qadgop the Mercotan View Post
It seems to me that's a mostly reasonable limitation to be enacted in a time of emergency on a regulated/prescription-only substance which has great medical use but is currently being blatantly misused despite recommendations to the contrary, and is now dangerously scarce for legitimate use.

I worry about the "14 day no refills" language though, and hope that doesn't prevent folks with rheumatologic diseases from getting their prescriptions refilled. I just started a new lupus patient on it the other week and he'll need it daily, perhaps for life (and yes, it's often lupus and House is an idiot who deservedly got kicked out of my alma mater).
I didn't find the Nevada declaration, but I saw discussion that it had a 31 day limit instead. No help if you're from another state, unless you're willing to drive interstate and the dispenser is willing to accept an out-of-state prescription.
  #26  
Old 03-26-2020, 05:46 AM
Monty's Avatar
Monty is offline
Straight Dope Science Advisory Board
 
Join Date: Feb 1999
Location: Beijing, China
Posts: 24,169
Quote:
Originally Posted by Jim Peebles View Post
I'm not worried about it, but one is considered a public health threat if one says that. I'm convinced the antimalarial drugs work (when combined with zinc and azithromycin), and on the off chance I get a serious case I would ask my doctor for it. I don't see how it is legal for a governor to tell doctors they cant give antimalarials to patients with serious cases of coronavirus.

Where did you get your medical and/or pharmacological training? Oh, I see you are in Las Vegas. Luckily for you you're not in Singapore.

And it's legal for a governor to tell doctors to, get this, follow the laws relating to medicines. That's kind of a no-brainer, one would think.
  #27  
Old 03-26-2020, 07:05 AM
Left Hand of Dorkness's Avatar
Left Hand of Dorkness is offline
Charter Member
 
Join Date: May 1999
Location: at the right hand of cool
Posts: 42,383
Quote:
Originally Posted by Jim Peebles View Post
And doctors seem to believe it, to the point they are being accused of prescribing it to themselves and their families:
https://www.yahoo.com/news/states-do...190038095.html
Q. What do you call the med student who graduated at the bottom of their class?
A. Doctor.

There are over a million physicians in the United States. They're gonna run the gamut in terms of intelligence, gullibility, and ideological zealotry.

If only the dumbest, most gullible, most hardcore Trump-worshipping 5% of doctors--a tiny minority of doctors--are stockpiling drugs based on the president's unqualified and ignorant opinion, that's 50,000 doctors acting like assholes here.

The fact that some doctors seem to believe Trump's bloviating is completely unsurprising. In no way does it provide evidence to support that bloviating.
  #28  
Old 03-26-2020, 07:25 AM
dropzone's Avatar
dropzone is offline
Charter Member
Charter Member
 
Join Date: May 2000
Location: Bedlam
Posts: 30,632
Quote:
Originally Posted by Qadgop the Mercotan View Post
(and yes, it's often lupus and House is an idiot who deservedly got kicked out of my alma mater).
Gee thanks, doc. Cut a lame wiseass off at the knees. Just see if I hand you any straight lines in the future.
  #29  
Old 03-26-2020, 07:28 AM
Qadgop the Mercotan's Avatar
Qadgop the Mercotan is offline
Charter Member
 
Join Date: Apr 2000
Location: Slithering on the hull
Posts: 27,903
Quote:
Originally Posted by dropzone View Post
Gee thanks, doc. Cut a lame wiseass off at the knees. Just see if I hand you any straight lines in the future.
Two other famous alums of my alma mater:
1) Dr. Hannibal Lector
2) Dr. Julius Hibbert
  #30  
Old 03-26-2020, 08:45 AM
Ann Hedonia's Avatar
Ann Hedonia is offline
Guest
 
Join Date: Apr 2009
Posts: 3,919
Quote:
Originally Posted by Jim Peebles View Post
This recent research paper has been all over the news:
https://www.mediterranee-infection.c...t-of-covid-19/
And doctors seem to believe it, to the point they are being accused of prescribing it to themselves and their families:
https://www.yahoo.com/news/states-do...190038095.html
The other study, not so much. The other study, conducted in China, showed that it didn’t work.

https://www.bloomberg.com/news/artic...-care-in-study

Someone else upthread mentioned some of the issues with the French study, specifically the patients that didn’t complete the trial. The other issue I see is that the trial wasn’t randomized.

The doctors want their medicine to be proven to work. When they are selecting which patients get which treatment it is possible that, subconsciously or even consciously, they gave the “good” treatment to patients that had a better chance of recovery.

The other thing that works against the hydroxychloroquine as miracle drug theory is that there isn’t a clear cut theory for a mechanism of action. All you have is some anecdotal idea that an anti-parasitic drug and and antibiotic (two classes of drugs that are generally not considered effective against viruses) may work against this particular virus.

Dr. Trump’s statement that hydroxychloroquine should work because it is a powerful drug against malaria is ignorant, because malaria doesn’t have jack shit in common with coronavirus.

And, to repeat, the Chinese study showed it didn’t work. I suspect this treatment is just one other gem that comes out of Trump’s pinhole - like the Google website- that is just going to fade into obscurity because it was largely based on lies.

But if you are intent in your belief that Dr. Trump is infallible in his medical knowledge, you can buy the chemical on Amazon in aquarium supplies, unless other idiots got it all first.

This is all reminding me of when I worked with cancer support groups, trying to dissuade people from throwing their hopes behind the latest experimental drug or natural remedies. Which literally NEVER panned out. And it was always the conservatives that had the propensity towards magical thinking. They were so easily conned it was scary. Nothing’s changed.

Last edited by Ann Hedonia; 03-26-2020 at 08:48 AM.
  #31  
Old 03-26-2020, 10:02 AM
Exapno Mapcase is offline
Charter Member
 
Join Date: Mar 2002
Location: NY but not NYC
Posts: 32,202
Quote:
Originally Posted by Jim Peebles View Post
Nope. You are the one turning a scientific issue into a political issue.
Dude. The President of the United States turned this into a political issue. I'm just reporting the facts.
  #32  
Old 03-26-2020, 10:54 AM
Exapno Mapcase is offline
Charter Member
 
Join Date: Mar 2002
Location: NY but not NYC
Posts: 32,202
I saw in another thread that politics are supposed to be kept out of this forum, which I somehow had missed, so I will refrain from any more comments along that line.
  #33  
Old 03-26-2020, 02:24 PM
DocCathode's Avatar
DocCathode is online now
Guest
 
Join Date: Jul 2000
Location: Philladelphia-Mummer city
Posts: 11,854
Quote:
Originally Posted by Ann Hedonia View Post

But if you are intent in your belief that Dr. Trump is infallible in his medical knowledge, you can buy the chemical on Amazon in aquarium supplies, unless other idiots got it all first.
I can't remember where in the USA this was. But, there's already been one death in the news caused by a human ingesting tablets meant to be dissolved in an aquarium.

to Qadgop The Mercotan

Besides the worry of the virus breaking out in the prison you work in, you must be constantly barraged by folks asking you about Corona virus. This has got to be a tough time for you.

To the OP

I don't know what to say that hasn't already been said by actual doctors.
__________________
Nothing is impossible if you can imagine it. That's the wonder of being a scientist!
Prof Hubert Farnsworth, Futurama
  #34  
Old 03-26-2020, 03:21 PM
nearwildheaven is online now
Guest
 
Join Date: Apr 2013
Posts: 13,806
Quote:
Originally Posted by Ann Hedonia View Post
This is all reminding me of when I worked with cancer support groups, trying to dissuade people from throwing their hopes behind the latest experimental drug or natural remedies. Which literally NEVER panned out. And it was always the conservatives that had the propensity towards magical thinking. They were so easily conned it was scary. Nothing’s changed.
Did any of them see Dr. Donald Trump? (Yes, he's a real person.)

https://en.wikipedia.org/wiki/Donald_L._Trump

(Couldn't resist.)
  #35  
Old 03-26-2020, 05:19 PM
Ann Hedonia's Avatar
Ann Hedonia is offline
Guest
 
Join Date: Apr 2009
Posts: 3,919
Quote:
Originally Posted by DocCathode View Post
I can't remember where in the USA this was. But, there's already been one death in the news caused by a human ingesting tablets meant to be dissolved in an aquarium.
That’s what I was referring to. I probably shouldn’t have done that. It was sarcasm, but I keep forgetting how gullible some people are.
  #36  
Old 03-27-2020, 05:02 AM
Iggy is offline
Guest
 
Join Date: Jun 2012
Location: somewhere else
Posts: 5,460
The use of Chloroquine/hydroxychloroquine as part of a treatment for SARS (caused by a different coronavirus than COVID-19) was tried in the earlier 2002-2004 SARS outbreak. In vitro testing showed apparent efficacy at glycosylation inhibition, helping to disrupt the viral replication process. Cite from The Lancet from 2006

Chloroquine shows strong anti-viral properties for both therapeutic and prophylactic roles.
Cite from 2005 from the Virology Journal: Chloroquine is a potent inhibitor of SARS coronavirus infection and spread from a study in primates cell cultures.

And so on. There is reasonable scientific reasons to think that Chloroquine/hydroxychloroquine may prove effective in treatment of the current coronavirus outbreak. While a fully blind study would be ideal, such may prove difficult in the current climate.
  #37  
Old 03-27-2020, 05:42 AM
Ruken is offline
Charter Member
 
Join Date: May 2003
Location: DC
Posts: 8,180
Quote:
Originally Posted by Iggy View Post
While a fully blind study would be ideal, such may prove difficult in the current climate.
Already been done, with no difference from placebo. Also underpowered though.
  #38  
Old 03-27-2020, 08:27 AM
Ann Hedonia's Avatar
Ann Hedonia is offline
Guest
 
Join Date: Apr 2009
Posts: 3,919
To put in succinctly, the much touted study was apparently a manipulated piece of crap, done by a doctor who appears to be as credible and professional as Trump’s personal physician. ETA - Does Trump shop for doctors at Grateful Dead concerts?

https://forbetterscience.com/2020/03...from-covid-19/

It was a 14 day study that, through some manipulation of time and space, was conducted in 10 days.
Peer review was done in less than 24 hours by an associate of the “scientist”.

Even though the stated endpoints were days 1, 7 and 14, the only data used was the day 6 data. This is called cherry-picking the endpoints and it’s a common way to cheat in drug trials.

Here’s how it works. You are testing a drug. You have a heavily tested interest in the drug being successful. Yiu design a test with a 14 day endpoint. You give the drugs to a bunch of patients for two weeks and the results at the end of two weeks are minimal or non-existent. But you tested every patient every day. So at the end of the two weeks you comb through the data and find that many of your patients improved a little bit on Day 9, even if it didn’t stick.
So your published result is “promising new drug shows results after 9 days”.

The patient groups also appeared to be cherry-picked and the control group was, on the average, about 15 years older than the group that got the drug. Plus, they weren’t treated at the same location and they were tested using different methods. And they declined to release certain clinical results (whether the patient got better), releasing only viral load data.

Their main concern seemed to be getting these results to Fox News. And that Trump sucking asshat Dr. Oz actually went on national TV with the opinion that this doctor was a great genius and it would be unethical not to give these drugs to millions of people.

It’s really mind-boggling stupidity, and very harmful to people that have conditions that these drugs actually work against.

Last edited by Ann Hedonia; 03-27-2020 at 08:31 AM.
  #39  
Old 03-27-2020, 09:37 AM
Ruken is offline
Charter Member
 
Join Date: May 2003
Location: DC
Posts: 8,180
A good way to boost your reported success rate is to remove people from the treatment group if they get sent to the ICU or if they die.
  #40  
Old 03-27-2020, 10:58 AM
Exapno Mapcase is offline
Charter Member
 
Join Date: Mar 2002
Location: NY but not NYC
Posts: 32,202
"Junk science" is unfortunately a real thing, and there is no field in which it's as prevalent as medicine.

I wrote the first major books about lactose intolerance. To do so I spent endless hours in the basement of the med school library, where the old medical journals were stored, reading literally every study every published about the problem that they had available.

I'm not a doctor, but I did go as far as grad school statistics and worked professionally in survey research (FORTRAN on punch cards!), so I had a basic understanding of how to conduct a study and meaningfully process the results.

Out of all the hundreds of peer-reviewed journal articles I read, shockingly few gave information that was useful to me in advising people about how LI worked and what to do if you had it. The vast majority were quickie, small-scale studies done for apparently no reason other than to get something published and move on to the next quickie, small-scale study. Most did no more than gather a group small enough to fit in a room, feed them some lactose, and have them self-report symptoms.

There is a much quoted line that reads "At least one study found that the average academic article is read by about 10 people, and half of these articles are never read at all." Ironically, that statement itself is junk. Trying to trace it back led to an editor at a journal who inserted it into somebody else's article based on a memory of something he heard in college. I found another unsourced claim that 44% of all articles are never cited. That one I can believe.

What happened here was that people suddenly raced back to the literature to find anything that might possibly be useful, with the result that old junk that never should have been unearthed hit the media. It's still junk, though. This is a good lesson for anyone willing to pay attention.
  #41  
Old 03-27-2020, 11:43 AM
UltraVires is online now
Guest
 
Join Date: Jul 2007
Location: Bridgeport, WV, US
Posts: 16,793
Isn't this practice done all of the time? Oh, yes it is: https://en.wikipedia.org/wiki/Off-label_use

So could someone with medical expertise convince me that this just isn't a middle finger to Trump? Sure, maybe it does not work, but could it be harmful? Any more harmful than side effects of other medications?

As long as my doctor gives me the full information as to the possible negatives, why shouldn't I be able to take it with the blessing of my doctor?
  #42  
Old 03-27-2020, 12:07 PM
Exapno Mapcase is offline
Charter Member
 
Join Date: Mar 2002
Location: NY but not NYC
Posts: 32,202
Quote:
Originally Posted by UltraVires View Post
Isn't this practice done all of the time? Oh, yes it is: https://en.wikipedia.org/wiki/Off-label_use

So could someone with medical expertise convince me that this just isn't a middle finger to Trump? Sure, maybe it does not work, but could it be harmful? Any more harmful than side effects of other medications?

As long as my doctor gives me the full information as to the possible negatives, why shouldn't I be able to take it with the blessing of my doctor?
It has extremely severe side effects, including blindness. It is just as extremely unethical to prescribe a medication for off-label use which has exactly zero proof that it is in any way effective but would certainly hurt many patients needlessly.
  #43  
Old 03-27-2020, 12:29 PM
Ann Hedonia's Avatar
Ann Hedonia is offline
Guest
 
Join Date: Apr 2009
Posts: 3,919
Quote:
Originally Posted by UltraVires View Post
Isn't this practice done all of the time? Oh, yes it is: https://en.wikipedia.org/wiki/Off-label_use

So could someone with medical expertise convince me that this just isn't a middle finger to Trump? Sure, maybe it does not work, but could it be harmful? Any more harmful than side effects of other medications?

As long as my doctor gives me the full information as to the possible negatives, why shouldn't I be able to take it with the blessing of my doctor?
Off-label use happens all the time, yes. In many cases it’s still a shady practice, simply because frequently the drug is used off-label because it couldn’t pass the clinical trial for the condition.

Sometimes it’s not a shady practice. Frequently a drug found effective against one type of solid tumor cancer will be used off-label for other similar solid tumor cancers. Because there’s a pretty good case that these tumors respond similarly to similar medications. Myself, I occasionally take a prescription antihistamine off-label for anxiety.

But there are strict laws against the drug companies PROMOTING these drugs for off-label use. The pharmaceutical companies employ or pay doctors to promote off-label uses of medication to other doctors. They also frequently ghost write articles for medical journals and pay doctors to put their name on them. I find this to be a shady practice although pharmaceutical companies have their own talking points justifying such practices.

I’m not sure about the legality of an untrained person who happens to be the President of the United States promoting a virtually untested drug to millions of people. Probably one of those laws we don’t have because no one thought we needed it. I think it’s immoral, though.

The biggest issue in this case isn’t the practice of off-label prescribing.

It’s that the one preliminary study appears to be garbage.

Last edited by Ann Hedonia; 03-27-2020 at 12:32 PM.
  #44  
Old 03-27-2020, 12:47 PM
UltraVires is online now
Guest
 
Join Date: Jul 2007
Location: Bridgeport, WV, US
Posts: 16,793
Quote:
Originally Posted by Exapno Mapcase View Post
It has extremely severe side effects, including blindness. It is just as extremely unethical to prescribe a medication for off-label use which has exactly zero proof that it is in any way effective but would certainly hurt many patients needlessly.
Then why would any doctor give it to a patient to treat Covid-19?

I have no medical training and therefore no opinion whatsoever about the efficacy of these drugs. Are some suggesting that my doctor might be such a MAGA Trump supporter that he would risk my life for no medical benefit because Trump said so?

If so, he would just be hurting Trump by having me go blind and not helping my illness would he not?
  #45  
Old 03-27-2020, 12:50 PM
Thudlow Boink's Avatar
Thudlow Boink is offline
Charter Member
 
Join Date: May 2000
Location: Lincoln, IL
Posts: 28,657
Quote:
Originally Posted by UltraVires View Post
Then why would any doctor give it to a patient to treat Covid-19?
WAG: Some doctors wouldn't, but some would just because the patient demanded it. Just like some doctors will prescribe antibiotics for a cold or flu because patients insist on them.
  #46  
Old 03-27-2020, 01:53 PM
Exapno Mapcase is offline
Charter Member
 
Join Date: Mar 2002
Location: NY but not NYC
Posts: 32,202
Quote:
Originally Posted by UltraVires View Post
Then why would any doctor give it to a patient to treat Covid-19?

I have no medical training and therefore no opinion whatsoever about the efficacy of these drugs. Are some suggesting that my doctor might be such a MAGA Trump supporter that he would risk my life for no medical benefit because Trump said so?

If so, he would just be hurting Trump by having me go blind and not helping my illness would he not?
There is no free market solution to prescribing medications. Take anything for any reason is not medicine but quackary.

Are some doctors quacks? Certainly. Since you now know better, if your doctor suggests this medication run out the door and contact your state medical association.
  #47  
Old 03-27-2020, 03:55 PM
Qadgop the Mercotan's Avatar
Qadgop the Mercotan is offline
Charter Member
 
Join Date: Apr 2000
Location: Slithering on the hull
Posts: 27,903
Quote:
Originally Posted by Thudlow Boink View Post
WAG: Some doctors wouldn't, but some would just because the patient demanded it. Just like some doctors will prescribe antibiotics for a cold or flu because patients insist on them.
I've evaluated and supervised my fellow doctors for decades.

Some of them just can't say no to patient requests. They're people pleasers who wilt under pressure. And it's difficult to break them of that character defect. I know, I've tried. It's ridiculous, but there it is. It takes close scrutiny and constant supervision to have a chance at changing some of them.
  #48  
Old 03-27-2020, 07:01 PM
UltraVires is online now
Guest
 
Join Date: Jul 2007
Location: Bridgeport, WV, US
Posts: 16,793
Quote:
Originally Posted by Qadgop the Mercotan View Post
I've evaluated and supervised my fellow doctors for decades.

Some of them just can't say no to patient requests. They're people pleasers who wilt under pressure. And it's difficult to break them of that character defect. I know, I've tried. It's ridiculous, but there it is. It takes close scrutiny and constant supervision to have a chance at changing some of them.
But aren't there some doctors that see some value in these treatments, even if it hasn't been fully vetted? Maybe there's some of this "That will shut the patient up" going on, but there have been several doctors in the media that are saying that there is nothing else that can treat this, so in certain circumstances, why not try this?

As I said, I know nothing about medicine, so I don't have an opinion, but I have clients wanting to bring a certain case, and I'll tell them that their chance of success is exceedingly poor, but if they want, I will try this pretty poor legal argument to see if it sticks. As long as I am being completely honest going in, and it is not just a purely insane and frivolous argument, what is wrong with letting the client/patient make the final decision? It's not going to kill anyone else if they take these drugs, right?
  #49  
Old 03-27-2020, 07:18 PM
DocCathode's Avatar
DocCathode is online now
Guest
 
Join Date: Jul 2000
Location: Philladelphia-Mummer city
Posts: 11,854
Quote:
Originally Posted by UltraVires View Post
But aren't there some doctors that see some value in these treatments, even if it hasn't been fully vetted?
Yes, they're idiots.

Years ago while working tech support, I came across the case of a doctor who had to get his floppy drive replaced because he'd shoved a 3.5 disk into a 5 inch drive. It's possible to be an MD and still be a mororn.

Quote:
Maybe there's some of this "That will shut the patient up" going on, but there have been several doctors in the media that are saying that there is nothing else that can treat this, so in certain circumstances, why not try this?
Because there is zero proof it would help, substantial proof it might harm, and there are patients out there who do need this drug.
  #50  
Old 03-27-2020, 07:25 PM
Musicat is offline
Charter Member
 
Join Date: Oct 1999
Location: Sturgeon Bay, WI USA
Posts: 21,811
I'm a bit disturbed by governors who apparently know so much about medicine that they overrule doctors.
Reply

Bookmarks

Thread Tools
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is Off
HTML code is Off

Forum Jump


All times are GMT -5. The time now is 09:25 PM.

Powered by vBulletin® Version 3.8.7
Copyright ©2000 - 2020, vBulletin Solutions, Inc.

Send questions for Cecil Adams to: cecil@straightdope.com

Send comments about this website to: webmaster@straightdope.com

Terms of Use / Privacy Policy

Advertise on the Straight Dope!
(Your direct line to thousands of the smartest, hippest people on the planet, plus a few total dipsticks.)

Copyright © 2019 STM Reader, LLC.

 
Copyright © 2017