It has never been approved, so it did not get to the point of having a brand name.
From what I read, it was previously tried against Ebola. While it was safe and somewhat effective for that, several other drugs were much more effective.
I read the New England Journal of Medicine observational study on remdesivir for COVID-19, and it didn’t sound to have overwhelming promise. The StatNews.com reporting seems more hopeful. Nothing certain yet.
Yeah, it is unfortunate that after the turnabout the CDC played with their guidance on mask that they did not follow up with an education campaign on how to properly wear, handle, and clean masks and other protective equipment. The [POST=22230904]already questionable efficacy of woven cloth face coverings[/POST] is further reduced by improper use, lack of hand washing/sanitizing hygiene, and reliance upon the mask for protection versus maintaining physical distance. If the guidance is that when starting to ease upon on restrictions is to wear masks in public, there needs to be both some kind of efficacy trials that can clearly quantify what works versus what doesn’t and give clear guidelines about how to wear and clean masks, how long they can be worn for, what kind of protection they may provide, et cetera. Otherwise, this mask-wearing is just kabuki, and a dangerous play at that if it causes people to be less cautious than they might otherwise be; although frankly, from what I’ve seen, many people aren’t taking this very seriously even in states where the leadership has been prompt to issue orders and forthright about the hazards, and it only takes a careless minority of people to provide an effective silent reservior for the epidemic to restart from.
Stranger
you’re 0 for 2. I can’t stand Trump’s updates and don’t watch them. I heard about it from the twisted panties crowd on this board. You act as if doctors are using the drug because Trump mentioned it. There’s no no reason for the histrionics over this. Trump isn’t a doctor and isn’t prescribing it.
And yet I’ve posted about other drugs. go figure. My position is the same for any drug. We are not in a position to wait on double blind-peer-reviewed-please-don’t-sue-the-drug-company testing. People are dropping like flies. Doctors around the world are trying different drugs to see what works and will react to what is reported in real-time.
This is quite wrong. It is true that “compassionate use” of off-label drugs to treat a critically ill patient is ethically acceptable in lieu of other alternatives, but hydroxychloroquine, if it works at all, needs to be applied as an early intervention to ameliorate inflammation before alveoli tissue starts to break down. And in order to know whether it has a real effect it is necessary to observe the effects on a test group versus a control group being given a placebo, particularly given the inability of physicians to predict the progression of the disease in any given patient. This is not something that can be determined “in real time” by a treating physician, and anecdotal reports are not a sound basis for public policy or medical treatment protocols.
And the problem, again, is that even if there are not harmful side effects from the drug itself, applying it in lieu of a more effective treatment and using up the available supply such that people with other conditions who need access to the drug to maintain their health are very real harms in and of themselves. This spastic, doing something even if it is wrong approach is the worst kind quack medicine that we do not need right now. What is needed is to separate effective treatments from those that are ineffective so that doctors can intervene in cases before the progress to a critical stage, and to do that rigorous studies with quantifiable results are necessary regardless of your opinion.
Stranger
Stranger speaks truth here (as do some others in this thread). Listen to him. I’d enumerate other wise ones in this thread, but I’m sick of COVID as it eats up most of my daily life, trying to organize our 24,000 inmate prison system into something that can deal with the pandemic.
I will recommend that Magiver’s input on COVID in this thread be taken with a very large shaker of salt. Do NOT take it with hydroxychloroquine unless you have lupus or malaria.
Funny, Donald Trump tweeted “People are dropping off like flies!” just this afternoon (apparently had to do with DrudgeReport.com traffic, except that is increasing.)
Double-blind testing is needed for the great majority of drugs because they only make incremental outcome improvements that are hard too reliably detect without the most stringent controls. If it is true that (for the right patients) you take a COVID-19 drug today, and, most of the time you are far better tomorrow, and death rates decline by more than half, double-blind will not be needed. Historical controls are fine for such extremely rare pharmaceutical home runs.
If that’s true then there may be hope for you yet. However, you don’t need to watch Trump’s daily circus act to hear him peddle bullshit. It’s all over the media, spreading very much like a virus. Even if you heard it here first, you got on board with Trump’s advice right quick, despite the fact that statements came out almost immediately from Fauci and others that there was plenty of reasons not to jump to conclusions.
There have been warning issued about some doctors hoarding the stuff. One was recently arrested and charged by the FBI for prescribing it as a prophylactic “cure” and charging his patience exorbitant amounts of money for it. This seems to have been fueled by Trump’s insistence that it’s an effective “cure”. Your insistence based on nothing but opinion is, in however small a way, is helping spread disinformation.
So 1 for 2.
In a thread about Hydroxychloroquine, you’re advocating for it’s use to treat COVID-19. I don’t know what you’re saying about other meds in other threads. But you’re likely as wrong about your reasoning there as you are here. Not the least of which, the reason why medical researchers do double blind peer reviewed studies.
And that’s 2 for 2.
Yes it is true. And that’s why there are a number of drugs currently being tried. So you’re wrong and admit it.
You’re coming into this with the assumption that hydroxychloroquine or other drugs are effective treatments for Covid-19, and all this science is just red-tape getting in the way of using them. That is wrong. At this moment, there is not any known effective treatment. If there was, doctors would be using it as much as possible. We need to wait for the results of well run studies, such as this one, to draw those conclusions.
Flip it around. Assume that hydroxychloroquine is not an effective treatment. Would it still be right for doctors to give it to people with severe cases of Covid-19? What if it is only effective when given before symptoms appear?
Yes, there were reasons to think that hydroxychloroquine and some other drugs might be effective. The way to proceed isn’t to just give them to people and hope for the best, but to do studies and find evidence. These things often don’t work out. What if somebody only has a 20% chance of surviving, but hydroxychloroquine drops that to a 10% chance? At least hanging a jade egg over their bed will only hurt them if the string breaks.
It’s very convenient of you to truncate my post to remove the entire discussion about the potential for harm in using hydroxychloroquine if it is not an effective treatment, but regardless it is unclear what you believe me to be “wrong” about. Please expand.
Stranger
I get it now. It is your argument that at some point there will be a drug or drug cocktail that will be found to be an effective treatment for COVID-19, therefore you will be proven to be right, as you’ve been claiming all along.
Is that the point you’re trying to make?
So much like a game of bingo, or a casino slot machine, the right combo is bound to come up as long as we gamble long enough with enough lives.
A number of drugs are being tried. How do you know that they’re doing more good than harm? Are they helping or killing people?
People under fire in the trenches often make really bad choices.
I haven’t seen this anecdote posted: Alabama doctor regrets taking HCQ/Z-Pack. Michael Saag, an infectious disease specialist at the U of Alabama–Birmingham, came down with COVID-19 so he prescribed himself hydroxychloroquine and azithromycin combo. He got better, but he has no idea if it was because of or in spite of the drugs, and even he had no idea that he was supposed to be monitored for heart arrhythmias.
Have you tried any?
People need to learn about the concept of statistical power. The bigger the effect size, the smaller the study needed to validate it and the clearer the signal. The smaller the effect size, the more muddy and ambiguous the results are. We’re far along enough in this disease progression to be reasonably sure there isn’t any “game changer” therapy. If there were, we would have seen clearly and more unambiguous signs of it across multiple studies across the globe. Here’s a report by a doctor who spent seven weeks working in a Wuhan ICU
He talks about the much more mundane technical challenges like making sure the hospital doesn’t run out of oxygen and setting up systems to follow protocols and all the other boring, unsexy work that comprises creating a consistent standard of care.
In my line of work, there’s the concept of “silver bullets” and “lead bullets”. “Silver bullets” are inevitably the concepts that outsiders tend to get the most excited about because they’re the sexy things that ride in and save the day like in the movies. We’re gonna throw some ML-Big-Data-Blockchain-Viral-Loop at the problem and it will magically get fixed!
Silver bullets deserve to get investigated but it’s rare they end up being the game changers they promise to be. Instead, usually what marks the difference between success and failure is just a long hard slog of lead bullets: Are we implementing and following checklists? Is code review being done? Are our designs consistent with the design guidelines? Are our CSR ratings where they need to be?
In the case of this virus, given that we’re already failing at so many lead bullets (lack of PPE, lack of tests, lack of centralized quarantine, etc.) investing resources in shoring those up are almost certainly going to have a higher ROI than banking your hopes on some magical drug.
There’s still a chance that some drug or some combo cocktail of drugs is going to improve outcomes by 1%, 5%, maybe even 10%. And multiply that by some number of millions of cases and it’s significant enough to be investigated. But for it to increase outcomes by 30%, 50%? The depressing truth is we’re probably out of sexy options right now and the only options we have left are the deeply unsexy but necessary ones.
Looks bad for the Hydroxy crowd:
medRxiv: “Outcomes of hydroxychloroquine usage in United States veterans hospitalized with Covid-19”
Stranger
If you’re a doctor and the last 20 patients went down because nothing worked then what do you suggest? Where is the double blind study coming from and if you’re one of the people dying do you want to be the one taking a placebo for a future study?
Based on the evidence in the study Stranger linked to, I’d rather get the placebo, as the patients that received hydroxychloroquine died at a greater rate than the ones that didn’t.
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.