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Comment by shoyer | Hacker News Reader

For a slightly more balanced perspective, try this paper: https://www.sciencedirect.com/science/article/pii/S016635422...:

Highlights from that paper (all of which look quite reasonable to me, as a non-expert):

• In vitro data suggest that chloroquine inhibits SARS Cov-2 replication.

• In past research, chloroquine has shown in vitro activity against many different viruses, but no benefit in animal models.

• Chloroquine has been proposed several times for the treatment of acute viral diseases in humans without success.

• The outcomes of some current clinical trials of chloroquine in China have been announced, without access to the data.

• Peer review of the results and an independent assessment of the potential benefit for patients are essential.

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>The outcomes of some current clinical trials of chloroquine in China have been announced, without access to the data.

This seems to be the link to the details of clinical trials in China that are made available

http://www.chictr.org.cn/searchproj.aspx?title=氯喹&officialna...

I checked the most recent result from that search: http://www.chictr.org.cn/showproj.aspx?proj=50843

At the very bottom, it says "original data will be published on web-based public database in 6 months after the research" which is a bit disappointing.

What would be the motivation for that 6 month delay? Cynically it only seems like a way to grab headlines without any possibility of informed criticism, but I really want to believe that there are other possible motivations!

Maybe it would take a lot more work to get the data into a publishable format and they don't think that's their highest priority right now? Being charitable here.

Most likely because this is a general notice and when situations are boring their bureaucracy can take them 6 months.

Can anyone mention a reasonable explanation for the 6-month delay? All I can think is that they want to prevent irresponsible purchases thus only including it in treatment guidelines for now.

maybe they forgot to change that page on their powerpoint template? I know I've done it.

I think the 6 month delay relates to patient by patient data. They can release group statistics before.

This paper's completely misleading. Coronavirus also has shown benefit in animal models -- for example, "Antiviral Activity of Chloroquine against Human Coronavirus OC43 Infection in Newborn Mice"

"Survival rates declined in a dose-dependent manner, with 88% survival when treated with 5 mg/kg chloroquine and 13% survival when treated with 1 mg/kg chloroquine. Our results show that chloroquine can be highly effective against HCoV-OC43 infection in newborn mice and may be considered as a future drug against HCoVs."

https://aac.asm.org/content/53/8/3416

Thank you for this reasonable view. Those last few days, I have seen a great many people here piling on chloroquine and aggressively promoting it to others. Those people were sometimes alledged scientists. This is worrying. Some countries have it in their emergency guidelines, yes. But is it beyond reasonable doubt that quinine derivatives are useful in humans? No. Absolutely not.

People are incredibly prompt to jump in on unproven suggestions during a crisis, while at the same time shitting on standard evidence-based medical care all year long. Go figure...

A small-sized chinese study with unreleased data? Color me skeptical.

“Some countries” is of course South Korea, which has had one of the lowest mortality rates of covid19.

1. http://m.koreabiomed.com/news/articleView.html?idxno=7428

And of course, you provide evidence of a causal link to quinine derivatives. This is ridiculous.

If you really knew the scientific state of clinical research, you would be far more skeptical.

That sort of data while it doesn't prove hydroxychloroquine did it, it does give some hope. If it was the other way that they - that they'd treated everyone with that and had a bad death rate then that would pretty much prove it didn't work.

Another interesting bit of data along those lines is the Chinese added chloroquine to their their treatment guidelines on feb 19th and their death rate dropped about 3 or 4x shortly after https://neutron-assets.s3-ap-southeast-2.amazonaws.com/img/c...

I'm all for it if it works. But the diversity of practices and opinions among specialists shows that any current advice is just that: expert opinion. Here, we're doing kaletra. 100 kms from here, they're doing hydroxychloroquine.I understand the desperation, but I don't think it's for healthy citizens to pile up egoistically on ressources that might be more useful elsewhere.

From experience, expert opinion situations are not too encouraging. But let's hope we're lucky this time.

Now if you'll excuse me, I'll be off intubating highly contagious cases without appropriate protection equipment if you're looking for me in the coming days. Personally, I'm hoping that the disease preferentially targets politicians and health ministers #-(

I linked this above http://news.southcn.com/nfplus/gdjktt/content/2020-03/09/con...

It seems to me beyond reasonable doubt that quinine derivatives are useful in humans. A miracle cure maybe not but almost certainly useful.

How is it balanced when the counterpoints themselves are just speculations?

Thanks for this summary.

>The outcomes of some current clinical trials of chloroquine in China have been announced, without access to the data

Which are...?

The trial numbers are referenced in the sciencedirect paper but I really wish they would share the outcomes of the trials. WHO should be on this one would think!

but the Chinese have been trying it in vivo in real ICU patients and they discovered it's better than placebo

But their data also shows TCM is better than placebo. Is chloroquine more effective than TCM?

Keep in mind that antivirals only work well if you start taking the during the first two days, TCM is reasonably safe and over the counter, whereas if you're in the US then good luck even getting tested in the first 10 days let alone prescribed something.

C.f.: https://www.sciencedirect.com/science/article/pii/S104366182...

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