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Comment by WilsonPaige | Hacker News Reader

Then we have a treatment (i.e., zinc gluconate + chloroquine): A zinc tablet (10-80 mg) dissolved slowly in the mouth, lavaging the throat and nose, while lying down will cease coronaviral replication on most of the surfaces of the upper respiratory system. Zinc sprays also work. This must be done within the first 3-4 days of infection with covid-19.

The covid-19 virus' usual course is to first infect the eye, nose and/or throat and then, after ~3 days, move down into the lungs.

If chloroquine (mg) stops the virus in the bloodstream then the combination of (dissolved zinc in mouth + chloroquine pill (up to 500 mg of chloroquine per day) should slow (if not stop completely) the virus, allowing time to clear the virus from the body without raising an excessive immune response ("cytokine storm"). But this treatment must be done within 3-4 days of contracting covid-19.

These medicines are cheaply available now.

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So, I'm no medical professional, just an avid reader of such news. But I believe that most of this post is incorrect.

I've seen no studies backing up the use of zinc for anything related to COVID-19. A search of pubmed for the terms 'covid zinc' or 'coronavirus zinc' show no papers referencing treatments. Same goes for medrxiv.

There are a lot of cold "treatments" involving the use of zinc in the way you suggest. I have even seen studies which support its use as a prophylactic to the common cold (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3273967/) though that one makes no reference to a common side effect, particularly the way you recommend its use, which is loss of sense of smell.

Further, I haven't read anywhere about the mechanism of infection you propose for this disease. It is said to attack the lungs, liver and small intestine due to its furin cleavage site (https://www.biorxiv.org/content/10.1101/2020.02.10.942185v1).

Finally, I am nearly certain you are spreading bad information about how this treatment works. Chloroquine is provided after active symptoms present. The first few days of infection are asymptomatic for most patients, certainly the first 4-7 days, if not longer. There is no medical call for treatment until a patient presents symptoms, and your advice risks leading people to attempt to hoard this medication.

We agree that chloroquine is indeed cheap.

Not vouching for the suggested treatment but chloroquine acts as a zinc ionophere enabling increased zinc binding/intake in cells, inhibiting RNA-dependent RNA polymerase, which would theoretically ultimately encumber the replication of the virus.

Right. The Zinc is already present intercellular, unless the patient is Zinc deficient.

> allowing time to clear the virus from the body without raising an excessive immune response ("cytokine storm")

Citation requested, that cytokine storms are a common pathology associated with Covid-19.

Because (a) I haven't seen that in the literature, & (b) it's at odds with the published age-banded mortality rates.

https://www.thelancet.com/journals/lancet/article/PIIS0140-6...

Not common but very serious.

For reasons beyond my understanding, the internet (or maybe just HN) has been in love with cytokines storms for a decade or so. Far more than warranted by the actual significance of the phenomenon relative to others.

It’s like quicksand in 19th century pop culture.

"We propose that the immunomodulatory effect of hydroxychloroquine also may be useful in controlling the cytokine storm that occurs late-phase in critically ill SARS-CoV-2 infected patients."

[0]https://academic.oup.com/cid/advance-article/doi/10.1093/cid...

where do I get chloroquine? is this something I can ask my general practitioner for?

This class of drug is a prophylactic for malaria. It, or one of its equivalents, is commonly given to you if you tell your doctor that you are traveling to a part of the world where malaria is currently endemic. It isn't the kind of drug where they worry much about abuse or misuse, as it is cheap and ubiquitous in the developing world.

A doctor can prescribe it. Best to take it under the supervision of a doctor.

It's commonly used for malaria. A related '-quine' is the active ingredient of Gin and Tonic.

The active ingredient of gin & tonic is definitely alcohol :)

Tonic was invented to make quinine palatable to British soldiers in India. About three minutes into the scheme, someone added gin.

So quinine is indeed arguably the original “active” ingredient, sugar was second (to mask the flavor), and alcohol “let’s just pretend this isn’t happening” was third.

Is this the same malaria drug that can cause depression and lead to suicidal thoughts?

GPs won't prescribe on the basis that you might get sick and require a particular medication. You can't walk into your GP's office and ask for antibiotics, for instance.

That's pretty much the exact set of circumstances that chloroquine is usually prescribed under.

My mistake, I didn't realise chloroquine was a malaria prophylactic (I've always been given other anti-malarials), I thought it was only a treatment for when you were actually diagnosed with malaria.

Under normal times, if you tell your doctor that you're planning on traveling, sometimes they'll ask if you want anti-malaria medication, and I believe chloroquine is one of the options they give you.

Yes my daughter got it on a trip to Tanzania last year.

Then you should go after the doctor for malpractice because malaria in East Africa is hydrochloroquine-resistant.

That’s the least bit of malpractice I’ve seen in the past year.

That is good news. But why 3-4 days? Because once it settles in the lungs it's out of reach for both treatments?

And do you mean 3-4 days from the appearance of symptoms or from the initial infection? From what I read, 3-4 days is not always long enough for someone to even know they have it.

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