# Hydroxychloroquine study "does not meet the Society's expected standard." **URL:** \ **Category:** The Quarantine Zone\ **Tags:** covid-quarantine\ **Created:** [April 9, 2020, 4:55pm UTC](https://boards.straightdope.com/t/hydroxychloroquine-study-does-not-meet-the-societys-expected-standard/851443 "2020-04-09T16:55:54Z")\ **Posts on this page:** 20\ **Page:** 5
**Author:** ![Sage\_Rat](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/sage_rat/32/399_2.png) [@Sage\_Rat](https://boards.straightdope.com/u/Sage_Rat)\ **Post date:** [April 23, 2020, 4:54pm UTC](https://boards.straightdope.com/t/hydroxychloroquine-study-does-not-meet-the-societys-expected-standard/851443/81 "2020-04-23T16:54:59Z")
> [@Magiver](#): > > both of the last options offer the risk of a new drug but only one of them guarantees you will get the drug. And what they are trying to determine, through the trial, is whether the drug is more helpful, does nothing, or is **more harmful**. Once I go into ICU, say that I have a 99% chance of dying. There are 5 “medicines”, previous research makes it seem most likely that 1 will ensure that I die, 1 will raise my odds of surviving by +10%, and the other 3 will do bupkis. Though, there is a 20% chance that this assessment was wrong, in some completely unknowable fashion. 1. Should my doctor choose the medicine most likely to be the one that will help me? Randomly select one? Pick the one that is certain to kill me? Something else? 2. Knowing that my doctor has picked the medicine that is most liable to kill me, should I pick your option a, b, or c? 3. Knowing that my doctor has picked a medication randomly, should I pick your a, b, or c? 4. Realizing that my odds are, even in the best case, still pretty minimal and I have some amount of civic mindedness of trying to save other human lives, should I pick your a, b, or c? ---
**Author:** ![Fotheringay-Phipps](https://avatars.discourse-cdn.com/v4/letter/f/d9b06d/32.png) [@Fotheringay-Phipps](https://boards.straightdope.com/u/Fotheringay-Phipps)\ **Post date:** [April 23, 2020, 5:06pm UTC](https://boards.straightdope.com/t/hydroxychloroquine-study-does-not-meet-the-societys-expected-standard/851443/82 "2020-04-23T17:06:24Z")
I think the core of the disagreement is being omitted in the discussion here and people are talking past each other. Suppose you have something which suggests that a drug might be, on balance, a net benefit to people suffering from a certain illness. But you don’t have enough evidence (in the form of statistically significant studies etc.) to be completely confident that this is so. Do we let them take it, or not? The next question is whether or not this is - or at least was, at an earlier point (since it looks like recent evidence is going against it) - the case for the hydroxy. I would think everyone would agree that just because someone is dying of something you don’t just start pumping them with all sorts of random drugs just in case it might work. But my understanding is that there are drugs which are more likely than not to be effective that don’t get approved for use because approval requires a high degree of confidence, not just “more likely than not”. This is the area where there’s some question as to whether to relax the standards when there’s no alternative available and no time to do more rigorous studies. Next question is hydroxy specifically. I’m aware that the studies suggesting hydroxy efficacy have been challenged. What I’m not clear about is whether these criticisms amount to “these studies say nothing whatsoever about the likelihood that the drug is effective” or whether they’re merely saying “these studies don’t establish effectiveness with enough confidence to meet normal standards”. If the former, then all talk of “battlefield conditions” is moot. If the latter, then it enters a gray area, as above. ---
**Author:** ![Lance\_Turbo](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lance_turbo/32/6156_2.png) [@Lance\_Turbo](https://boards.straightdope.com/u/Lance_Turbo)\ **Post date:** [April 23, 2020, 5:16pm UTC](https://boards.straightdope.com/t/hydroxychloroquine-study-does-not-meet-the-societys-expected-standard/851443/83 "2020-04-23T17:16:36Z")
> [@Fotheringay-Phipps](#): > > Next question is hydroxy specifically. I’m aware that the studies suggesting hydroxy efficacy have been challenged. What I’m not clear about is whether these criticisms amount to “these studies say nothing whatsoever about the likelihood that the drug is effective” or whether they’re merely saying “these studies don’t establish effectiveness with enough confidence to meet normal standards”. If the former, then all talk of “battlefield conditions” is moot. If the latter, then it enters a gray area, as above. Some recent studies show that hydroxychloroquine may be actively harmful. [Study finds no benefit, higher death rate in patients taking hydroxychloroquine for Covid-19](https://www.cnn.com/2020/04/21/health/hydroxychloroquine-veterans-study/index.html) > [@](#): > > In the study of 368 patients, 97 patients who took hydroxychloroquine had a 27.8% death rate. The 158 patients who did not take the drug had an 11.4% death rate. ---
**Author:** ![Chisquirrel](https://avatars.discourse-cdn.com/v4/letter/c/6bbea6/32.png) [@Chisquirrel](https://boards.straightdope.com/u/Chisquirrel)\ **Post date:** [April 23, 2020, 6:21pm UTC](https://boards.straightdope.com/t/hydroxychloroquine-study-does-not-meet-the-societys-expected-standard/851443/84 "2020-04-23T18:21:16Z")
> [@Magiver](#): > > There is a benefit to the person on death’s door step who survives. > > You have limited choices in this situation: > > - refuse any drug that hasn’t been through a double blind study that’s been reviewed. > - accept the option/risk of a drug or placebo and become a test subject. > - accept the option/risk of a drug and become a test subject. > > both of the last options offer the risk of a new drug but only one of them guarantees you will get the drug. Except the person on death’s door step is more likely to survive by doing nothing than taking hydroxycholoroquine. Are you not paying attention? ---
**Author:** ![Sage\_Rat](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/sage_rat/32/399_2.png) [@Sage\_Rat](https://boards.straightdope.com/u/Sage_Rat)\ **Post date:** [April 23, 2020, 6:38pm UTC](https://boards.straightdope.com/t/hydroxychloroquine-study-does-not-meet-the-societys-expected-standard/851443/85 "2020-04-23T18:38:09Z")
> [@Fotheringay-Phipps](#): > > people are talking past each other. I agree with everything that Magiver has written, except the concept that anything he has written applies to Hydroxychloroquine. If someone says “We have options on the table that might save people! It’s insane not to when the alternative is that they just die!” Then they are correct and there’s no particular argument against what they said. If that person then continues on and say, “Thus, we should pour melted lead into their eyeballs and tear out their tongue! Forget all other things we could do!” Well…then, no. Whether the basic sentiment is reasonable or not, that’s just stupid. Doing something? Yes, good, where we have options that make sense. Doing something stupid and harmful, though, that’s just stupid and harmful. ---
**Author:** ![Magiver](https://avatars.discourse-cdn.com/v4/letter/m/4491bb/32.png) [@Magiver](https://boards.straightdope.com/u/Magiver)\ **Post date:** [April 23, 2020, 7:29pm UTC](https://boards.straightdope.com/t/hydroxychloroquine-study-does-not-meet-the-societys-expected-standard/851443/86 "2020-04-23T19:29:31Z")
> [@scr4](#): > > Give the unproven medication to half your patients, perhaps? It won’t be a blind study but you might still get additional data points. I think giving it to all your patients would be unethical, since an unproven drug can be harmful. This “doing _something_ is better than doing nothing” mentality is a fallacy. Yes, but the question revolves around doctors using what is available at the time it is available. It is not based on internet posts or Presidential tweets. I think we’re talking past each other. Since I don’t have a horse in any pill race I’m going to go with what doctors think will work and will continue to adjust until it works. We don’t have anything that will directly stop the virus at this time so it’s a function of drugs that will interrupt the negative affects the virus has on the body. ---
**Author:** ![Telemark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/telemark/32/372_2.png) [@Telemark](https://boards.straightdope.com/u/Telemark)\ **Post date:** [April 23, 2020, 8:29pm UTC](https://boards.straightdope.com/t/hydroxychloroquine-study-does-not-meet-the-societys-expected-standard/851443/87 "2020-04-23T20:29:55Z")
> [@Magiver](#): > > Yes, but the question revolves around doctors using what is available at the time it is available. It is not based on internet posts or Presidential tweets. There are literally 1000’s of potential drugs to try. Throwing a random collection of them at people who are dying is unlikely to produce any useful information. You may save a few people, you may kill a few people, but without some logic and control you’ll never know which. ---
**Author:** ![scr4](https://avatars.discourse-cdn.com/v4/letter/s/59ef9b/32.png) [@scr4](https://boards.straightdope.com/u/scr4)\ **Post date:** [April 23, 2020, 8:35pm UTC](https://boards.straightdope.com/t/hydroxychloroquine-study-does-not-meet-the-societys-expected-standard/851443/88 "2020-04-23T20:35:13Z")
> [@Magiver](#): > > I think we’re talking past each other. Since I don’t have a horse in any pill race I’m going to go with what doctors think will work and will continue to adjust until it works. But the doctors don’t know what will work. Not without a controlled trial. I think that’s the part you are refusing to understand. > [@](#): > > We don’t have anything that will directly stop the virus at this time so it’s a function of drugs that will interrupt the negative affects the virus has on the body. …without having a negative effect of its own. That’s the important part. ---
**Author:** ![Magiver](https://avatars.discourse-cdn.com/v4/letter/m/4491bb/32.png) [@Magiver](https://boards.straightdope.com/u/Magiver)\ **Post date:** [April 23, 2020, 9:12pm UTC](https://boards.straightdope.com/t/hydroxychloroquine-study-does-not-meet-the-societys-expected-standard/851443/89 "2020-04-23T21:12:26Z")
> [@Telemark](#): > > There are literally 1000’s of potential drugs to try. Throwing a random collection of them at people who are dying is unlikely to produce any useful information. You may save a few people, you may kill a few people, but without some logic and control you’ll never know which. You aren’t really suggesting doctors randomly chose a drug to try in this situation? ---
**Author:** ![beowulff](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/beowulff/32/542_2.png) [@beowulff](https://boards.straightdope.com/u/beowulff)\ **Post date:** [April 23, 2020, 9:20pm UTC](https://boards.straightdope.com/t/hydroxychloroquine-study-does-not-meet-the-societys-expected-standard/851443/90 "2020-04-23T21:20:41Z")
> [@Magiver](#): > > You aren’t really suggesting doctors randomly chose a drug to try in this situation? Well, that seems to be what you are saying… ---
**Author:** ![echoreply](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/echoreply/32/3641_2.png) [@echoreply](https://boards.straightdope.com/u/echoreply)\ **Post date:** [April 23, 2020, 9:37pm UTC](https://boards.straightdope.com/t/hydroxychloroquine-study-does-not-meet-the-societys-expected-standard/851443/91 "2020-04-23T21:37:55Z")
> [@Mike\_Mabes](#): > > Could you recommend a book? I’ve always wondered. Did anything that doctors did work? To derail this thread a bit, the [Sawbones book](https://www.simonandschuster.com/books/The-Sawbones-Book/Justin-McElroy/9781681883816), and the [original podcast](https://maximumfun.org/podcasts/sawbones/), take a more entertainment level look at this topic (it is factual and well researched, but is not hard core history). On each episode they discuss a disease or medical practice, it’s historical treatment, and how that compares to the treatment today. If you want to listen, I suggest going back to the beginning, because the last few episodes would be on-topic for this thread. I remember that there were some ancient practices or treatments that did work. For example, Sphagnum moss might have some slight anti-microbial properties, so the practice of putting it on wounds may have been more useful than wrapping wounds in another random plant. On the whole though, until the last 100-150 years, people often recovered in spite of what doctors did, not because of what doctors did. To bring it back around to this thread, application of the scientific method to medicine and the developments that came out of that, like germ theory and vaccines, has brought about the profound change to where doctors usually can help. Throwing away all of the things we’ve learned about how to do evidence based medicine is not the way to make progress. Some things that cause delays such as funding, review, and analysis can be sped up. “Here is some money, everybody will drop everything else and work on _this_ problem.” If it takes 2-3 weeks to find out if patients respond to a treatment, then there really isn’t anything that can be done to speed up the study. ---
**Author:** ![Magiver](https://avatars.discourse-cdn.com/v4/letter/m/4491bb/32.png) [@Magiver](https://boards.straightdope.com/u/Magiver)\ **Post date:** [April 23, 2020, 9:39pm UTC](https://boards.straightdope.com/t/hydroxychloroquine-study-does-not-meet-the-societys-expected-standard/851443/92 "2020-04-23T21:39:23Z")
> [@Chisquirrel](#): > > Except the person on death’s door step is more likely to survive by doing nothing than taking hydroxycholoroquine. Are you not paying attention? Yes, I’m paying attention. The study from Brazil involved a combination of Hydroxychloroquine at 5 times the normal dosage combined with another drug that is known to cause heart issues. That’s like taking 5 times the normal dosage of Tylenol and hoping the side effects don’t exist. From what few anecdotal examples I’ve seen the people that have used the drug and improved/survived were given normal dose levels early on. And again, I’m not promoting the drug but it’s been around for a looooong time and it’s side affects are known at the dosages normally prescribed. ---
**Author:** ![RioRico](https://avatars.discourse-cdn.com/v4/letter/r/f04885/32.png) [@RioRico](https://boards.straightdope.com/u/RioRico)\ **Post date:** [April 23, 2020, 9:59pm UTC](https://boards.straightdope.com/t/hydroxychloroquine-study-does-not-meet-the-societys-expected-standard/851443/93 "2020-04-23T21:59:00Z")
> [@Telemark](#): > > There are literally 1000’s of potential drugs to try. Throwing a random collection of them at people who are dying is unlikely to produce any useful information. You may save a few people, you may kill a few people, but without some logic and control you’ll never know which. > [@Magiver](#): > > You aren’t really suggesting doctors randomly chose a drug to try in this situation? Reread **Telemark** ’s post and you’ll see that’s exactly what he’s NOT suggesting. _“Throwing a random collection of them at people who are dying is unlikely to produce any useful information.”_ Still, it could be worse. “If you have a bad cold, take a shot of malaria.” -R. Zimmerman “If you have bad COVID, take a shot of icewater.” -S. Hannity ---
**Author:** ![scr4](https://avatars.discourse-cdn.com/v4/letter/s/59ef9b/32.png) [@scr4](https://boards.straightdope.com/u/scr4)\ **Post date:** [April 23, 2020, 10:03pm UTC](https://boards.straightdope.com/t/hydroxychloroquine-study-does-not-meet-the-societys-expected-standard/851443/94 "2020-04-23T22:03:42Z")
> [@Magiver](#): > > Yes, I’m paying attention. The study from Brazil involved a combination of Hydroxychloroquine at 5 times the normal dosage combined with another drug that is known to cause heart issues. No, there is a [newer study](https://apnews.com/a5077c7227b8eb8b0dc23423c0bbe2b2). Evidently you _haven’t_ been paying attention. > [@](#): > > And again, I’m not promoting the drug but it’s been around for a looooong time and it’s side affects are known at the dosages normally prescribed. The side **e** ffects depend on the patient’s condition. Side effects on COVID-19 patients are not known. ---
**Author:** ![Fotheringay-Phipps](https://avatars.discourse-cdn.com/v4/letter/f/d9b06d/32.png) [@Fotheringay-Phipps](https://boards.straightdope.com/u/Fotheringay-Phipps)\ **Post date:** [April 23, 2020, 10:30pm UTC](https://boards.straightdope.com/t/hydroxychloroquine-study-does-not-meet-the-societys-expected-standard/851443/95 "2020-04-23T22:30:50Z")
> [@Magiver](#): > > You aren’t really suggesting doctors randomly chose a drug to try in this situation? I suspect a lot of doctors prescribe the drug because their patients are clamoring for it. Their patients have been influenced by the pop-knowledge created by (mostly right-wing) media. I know some people who took it, and it was mostly by their own initiative (i.e. they asked the doctor to prescribe it to them rather than the doctor recommending it on their own). ---
**Author:** ![QuickSilver](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/quicksilver/32/7832_2.png) [@QuickSilver](https://boards.straightdope.com/u/QuickSilver)\ **Post date:** [April 24, 2020, 12:30am UTC](https://boards.straightdope.com/t/hydroxychloroquine-study-does-not-meet-the-societys-expected-standard/851443/96 "2020-04-24T00:30:13Z")
> [@Magiver](#): > > Yes, I’m paying attention. The study from Brazil involved a combination of Hydroxychloroquine at 5 times the normal dosage combined with another drug that is known to cause heart issues. > > That’s like taking 5 times the normal dosage of Tylenol and hoping the side effects don’t exist. > > From what few anecdotal examples I’ve seen the people that have used the drug and improved/survived were given normal dose levels early on. > > And again, I’m not promoting the drug but it’s been around for a looooong time and it’s side affects are known at the dosages normally prescribed. You know what else has been around for a long time? Ultraviolet light and disinfectant. ---
**Author:** ![PhillyGuy](https://avatars.discourse-cdn.com/v4/letter/p/ed655f/32.png) [@PhillyGuy](https://boards.straightdope.com/u/PhillyGuy)\ **Post date:** [April 24, 2020, 12:47am UTC](https://boards.straightdope.com/t/hydroxychloroquine-study-does-not-meet-the-societys-expected-standard/851443/97 "2020-04-24T00:47:26Z")
> [@Mike\_Mabes](#): > > Could you recommend a book? I’ve always wondered. Did anything that doctors did work? This book convinced me think that there was a reasonably effective nineteenth century treatment for psychosis, since largely abandoned: [The Art of Asylum-Keeping Thomas Story Kirkbride and the Origins of American Psychiatry](https://www.upenn.edu/pennpress/book/1918.html) One reason the kind-hearted Kirkbride system was abandoned is that the treatment was oversold as a cure, when often it just led to a very long remission. Then a new stress would arrive, the voices would return, and the patient would need another spell in the asylum. As for good pre-twentieth century treatments of viruses – of that I’m not aware. ---
**Author:** ![Chisquirrel](https://avatars.discourse-cdn.com/v4/letter/c/6bbea6/32.png) [@Chisquirrel](https://boards.straightdope.com/u/Chisquirrel)\ **Post date:** [April 24, 2020, 10:33am UTC](https://boards.straightdope.com/t/hydroxychloroquine-study-does-not-meet-the-societys-expected-standard/851443/98 "2020-04-24T10:33:20Z")
> [@Magiver](#): > > Yes, I’m paying attention. The study from Brazil involved a combination of Hydroxychloroquine at 5 times the normal dosage combined with another drug that is known to cause heart issues. So that’s a no, given the study cited is of US veterans. ---
**Author:** ![Exapno\_Mapcase](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/exapno_mapcase/32/1051_2.png) [@Exapno\_Mapcase](https://boards.straightdope.com/u/Exapno_Mapcase)\ **Post date:** [April 24, 2020, 4:17pm UTC](https://boards.straightdope.com/t/hydroxychloroquine-study-does-not-meet-the-societys-expected-standard/851443/99 "2020-04-24T16:17:22Z")
> [@RioRico](#): > > Reread **Telemark** ’s post and you’ll see that’s exactly what he’s NOT suggesting. _“Throwing a random collection of them at people who are dying is unlikely to produce any useful information.”_ Still, it could be worse. > > “If you have a bad cold, take a shot of malaria.” > -R. Zimmerman > > “If you have bad COVID, take a shot of icewater.” > -S. Hannity Your fake Hannity quote’s been trumped, in both senses of the word, by reality. [Trump suggests ‘injection’ of disinfectant to beat coronavirus and ‘clean’ the lungs](https://www.nbcnews.com/politics/donald-trump/trump-suggests-injection-disinfectant-beat-coronavirus-clean-lungs-n1191216) You can actually see the moment when Dr. Birks’s soul leaves her body at around 0:25 of the video. ---
**Author:** ![nearwildheaven](https://avatars.discourse-cdn.com/v4/letter/n/90db22/32.png) [@nearwildheaven](https://boards.straightdope.com/u/nearwildheaven)\ **Post date:** [April 26, 2020, 2:17am UTC](https://boards.straightdope.com/t/hydroxychloroquine-study-does-not-meet-the-societys-expected-standard/851443/100 "2020-04-26T02:17:36Z")
My dad just called me and told me that he “isn’t feeling well”, and wants some hydroxychloroquine. I certainly can’t get him any (unless he brought me a valid prescription and I was actively practicing) but I told him that he should go to a walk-in clinic tomorrow if he still isn’t feeling well, but they won’t give him any either because it’s not how all that works. [Previous page](https://boards.straightdope.com/t/hydroxychloroquine-study-does-not-meet-the-societys-expected-standard/851443.md?page=4) [Next page](https://boards.straightdope.com/t/hydroxychloroquine-study-does-not-meet-the-societys-expected-standard/851443.md?page=6)