Bayer donates 3M chloroquine phosphate tablets for potential Covid-19 treatment
reuters.com
reuters.com
[Edit] To be clear, I am not a doctor and this is not medical advise. Please research this topic yourself. There are many studies on nih.gov on zinc ioniphores. Here is a video discussing both compounds by a doctor. [3] They are also not giving medical advise.
[1] - https://examine.com/supplements/quercetin/
> In conclusion, our study strongly suggests co administration of antioxidant flavonoid like quercetin along with CQ for antimalarial therapy. This is particularly important when CQ is administered as long-term prophylactic treatment for malaria as chronic exposure has shown to be resulting in higher dose level of drug in the body.
You needn't use your real name, of course, but for HN to be a community, users need some identity for others to relate to. Otherwise we may as well have no usernames and no community, and that would be a different kind of forum. https://hn.algolia.com/?sort=byDate&dateRange=all&type=comme...
The preponderance of the evidence suggests that it's a well-understood drug that has been around for decades, used by 10s of millions for not only malaria but also arthritis. In fact it is safe enough that it is available over the counter in some countries. [1]
Please read what you're posting, at least.
The current HCQ protocol for COVID-19 is a 600mg dose daily (within about the safe limits for a grown adult, however can be a bit high) for 10 days.
This isn’t a recommendation of any sorts however the side effects are likely to be mild and reversible for this type of usage.
Many substances that have been ingested by humans are well understood, but if it comes to drinking a thimble of cyanide, well ... after you.
https://www.mediterranee-infection.com/wp-content/uploads/20...
It's also important to understand the medication interactions, which can be quite serious.
If enough respected virologists (like Didier Raoult) and doctors in China/South Korea see some positive signals, it makes sense to prepare for the event that it does indeed help. Keep in mind, this is already being used as a treatment in the US today. They likely have even better data than we do. Or if they don't, they still feel like it's worth taking a calculated risk on.
Derek lowe reviews the evidence here and has far more of a positive take on it than i'd expected. (as in , "not obvious nonsense!")
check my post history if you like, i’m skeptical too.
People are nitpicking. Yes, "we need further studies", that's at the end of literally every research paper ever, but the longer you delay the more people die.
It's no different than signing up for an experimental cancer drug. There are no alternatives that are known to work. You take the best shot with the possibility that looks promising right now. The alternative is dying without trying.
It's kind of a weirdly US-centric position, both from science fetishism and the fact that we're the the country with the fewest deaths so far. Oh golly gee I guess we better wait 18 months for a double-blind clinical trial and FDA approval and a Nature article. Other countries have the bodies piling up and they are pushing ahead, because a chance is better than no chance. Just like with cancer.
* https://www.chinalawtranslate.com/en/standards-of-care-for-s...
* Or https://www.reddit.com/r/Coronavirus/comments/fd15kg/preprin...
South Korea and Japan used the very same plan in their ICU's.
Maybe it's the crackdown of Western media on China, but right now italian doctors trust chinese experience more than western experts. Western experts still preach lockdown, whilst Italian officials in the meantime also found out that the asian recommendation of mass testing everybody is better. Without drastic lockdowns. Test everybody, wear masks, be responsible.
> else you waste money and lives. If your wonder drug is so great you'd notice immediately in the data and would cut the trial short.
The problem is that it was chinese and south korean data only. Trials are not cut short, western buerocracy still rule the hospitals. Many doctors do get their younger patients on those trials. But in the overloaded case, such as Italy and Spain it's too late. You need to apply virostatica early on for 10 days, not when it's too late. But those people are advised to stay at home and wait for the fever to go down. Without effective treatment plan, as outlined by the chinese.
No, it's that you couldn't guarantee that every patient could be tested every day in order to measure whether the drug is effective. That is what people are complaining about, and it won't be fixed until testing capacity is reliably there.
Bigger trials would only make that worse.
Medical advice should be given by doctors and what works for someone else may not work for you (be ineffective), cause side effects of all degrees of severity. Note that the original title includes the word 'potential'.
Also, reuters, cnn, msnbc, etc. covered it.
Making the info available here in HN is not tantamount to telling people to self-experiment. that is laughable.
They're miraculous. This is a well-studied, mass-produced drug which has been around for 70 years and appears to be highly effective at treating this virus.
Ps: i do agree that his tone and style looks unorthodox. But results is the only thing we should care about.
Where are you seeing that? Because what I see is a very non-rigorous, non-randomized study. Also, what about this part:
>A total of 26 patients received hydroxychloroquine and 16 were control patients. Six hydroxychloroquine-treated patients were lost in follow-up during the survey because of early cessation of treatment. Reasons are as follows: three patients were transferred to intensive care unit, including one transferred on day2 post-inclusion who was PCR-positive on day1, one transferred on day3 post-inclusion who was PCR-positive on days1-2 and one transferred on day4 post-inclusion who was PCRpositive on day1 and day3; one patient died on day3 post inclusion and was PCR-negative on day2; one patient decided to leave the hospital on day3 post-inclusion and was PCR-negative on days1-2; finally, one patient stopped the treatment on day3 post-inclusion because of nausea and was PCR-positive on days1-2-3.
Really easy to have "miraculous" results when 20+% of your treatment group were excluded and also happened to be the ones with the most severe symptoms.
I think we could have a whole website of things that were continued to be used without a shred of evidence of effectiveness.
The fact that experts agree that this drug should be used doesn't mean they agree that it is miraculous. And this certainly doesn't suggest they disagree with the parent MD/statistician.
Maybe my faith in the collective ability of the world medical professionals to evaluate their treatment techniques is misplaced, but I still have faith that these people are acting in accordance with their scientific training.
Maybe that's wrong, and I shouldn't be trusting these people. But if I'm not trusting doctors (and especially infectious disease experts who are writing papers about their findings), then who should I trust?
I think a lot of this distrust in institutions and doctors is going to get us into a lot of trouble. I wish people would start listening to these orgs.
Why? I'm modeling the doctors and health officials who are making these decisions as agents which are presumably continuously evaluating their decisions. So basically:
A lot of experts are taking this action -> assume the action has a desirable outcome -> believe what the experts are saying (in this case both their words and their actions seem to agree with each other, and point to the idea that chloroquine is an effective treatment of covid-19).
I am genuinely at a loss as to why this stance (my stance) is anything other than completely obvious.
I'm sorry if but I'm having a difficult time figuring out what I have said that you disagreed with.
You don't seem to be taking people's statements at face value, but rather projecting additional meaning onto them, almost as if you conceive of fewer possible positions than there actually are, and pigeonhole us.
Consider my prior two statements in this thread which start with "the fact" and "you were". Do you agree that these statements were correct, on their own terms, in their own context, and independent of additional complexities involving degree if efficacy or various arguments for or against use, testing, or hopefulness?
Also, do you see that the people who disagree with your framing are not 'picking nits' nor are they having 'struck nerves'? Can you see other reasons why they might respond as they did?
For those that don't get the reference: https://en.wikipedia.org/wiki/Contagion_(2011_film)
And that's exactly what it is.
This is not that.
"Lets all pray for God to cure us" comes to mind.
Edit: yeah, yeah... you downvote me, but I bet you secretly wiki'd forsythia to see if it's a real thing.
We all want a miracle, but we need to be cautious about it.
I am more curious right now as whether this drug can work as a preventative medication for high risk individual to lower the chance for getting infected, TBH. That will help the medical stuff greatly.
South Korea will max end up with a IFR of 0.2-0.5%, 2 to 5 times worse than the flu.
Doesn't mean it can't be beneficial this time for this particular virus; we should always keep trying. I'm just saying it's probably a bit early to be calling miracles based on one small study.
No, the actual reason is that Chinese doctors noted a statistical abberation in their coronavirus patients: none of the patients had lupus. They called around and confirmed it, none of the hospitals had any patients with lupus. And the standard chinese treatment for lupus is... chloroquine.
https://www.jqknews.com/news/388543-The_novel_coronavirus_pn...
Chloroquine has proceeded from statistical anomaly, to successful case studies, to successful non-random trials, and now is in random trials. I'm not a doctor but I think there's a pretty good chance it'll be effective.
Yes, it is not officially approved yet, but it is being deployed in China, Korea, and other countries off-label. Right now there are no other options. I'd take chloroquine over nothing. Overall it is not pleasant but there are few dangerous side effects in the short term (retinopathy is a possible side effect if duration of treatment is on the order of months to years). It is an over-the-counter medication in a lot of the world, it is behind the counter in a lot of other places (including the UK).
(the US just likes making sure doctors get paid even if a medication is quite safe. There are a lot of medications like oral contraceptives that are routinely done over-the-counter in most other places that we insist are so wildly dangerous you couldn't begin and discontinue them if you noticed side effects. And on the flip side, there's lots of drugs like tylenol that we know to be horribly unsafe and yet they remain OTC anyway, or even in "abuse resistant" combination products. Chloroquine is a pretty standard antimalarial and places that have malaria don't think it's a big enough deal that you need a doctor to get it.)
Given the lack of other options, given the known nature of the drug, if I was in a hospital dying of COVID would I want to give it a shot? Yes. Same principle as experimental cancer drugs. Some chance is better than no chance.
Anyone we can treat with pharmaceutical interventions instead of ventilators frees up those ventilators for more critical patients. Even if they still have to remain under some degree of medical supervision, it frees up ICU beds.
It shows promise and should be pursued—and it is. Let’s not oversell it though.
> there's lots of drugs like tylenol that we know to be horribly unsafe and yet they remain OTC anyway
Interestingly, one of the other therapeutic leads that doctors are following up on is whether Tylenol is safer than ibuprofen for Covid patients. It got reported that it was, but it’s not yet clear how true that is.
You need meticulous study design when you're looking for small effect sizes, with a large enough effect you can extract useful information even from flawed data.
I tried finding out how much chloroquine is prescribed world wide per year, but couldn't find it. It may give us a clue into how much is already being used.
I know that it isn't used except for pregnant women as a malaria treatement because the first line antimalarials aren't proven save in pregnancy, but also that the malaria protozoa has some resistence to Chloroquine in many countries (Ecuador, among others)
https://www.sciencedirect.com/topics/chemistry/chloroquine
From this, it doesn't look like there are any major hurdles in the necessary precursors. E.g. chloroaniline is very commonly used for making many drugs (incl. chlorhexidine), methyl acrylate is similarly in the six-figure-tonnes-per-year category, and that diamine also looks to have a nice synthesis route.
Fingers and toes crossed for this one.
https://www.fiercepharma.com/pharma/bayer-preps-u-s-donation...
But it would make sense for medical staff and other people in high risk occupations.
Autoimmune diseases, can be way, way worse, particularly arthropathies, since, if unchecked, they cause permanent damage. Also IME, as a rule disease modifying drugs have really nasty side effects. You take them anyway, because you have no better alternative :(
For example, it enhances influenza: https://www.ncbi.nlm.nih.gov/pubmed/25715935
I'm pondered if a mass use for covid would work. I think it's probably too unproven and covid to small a percentage of the population to make dosing everyone a good idea. What I would try if I were running things is bulk testing and giving people a chloroquine type med straight off if they were positive.
I do answer their survey that they all are very professional.
you can buy the cinchona bark on amazon, recipe is very good.
How much less than 83mg/litre is unclear. You would do yourself damage with the sugar should you try to drink enough for a dose. Also it is unclear how effective quinine is compared with hydroxychloroquine.
Finally, quinine can have serious side effects, take care.
I have minor symptoms, and have been self-isolating since Wednesday (18) because many people around me were coughing on Monday (16) & Tuesday (17). The government here in NZ has not issued any lockdown instructions.
Due to comments here on HN, I decided to buy 4x 1.5 litres of ordinary Schweppes tonic water. Panic buying had not yet struck (it has now, but mostly bread, pasta, and toilet roll). I shared one bottle around the office, and gave one to my homestay family.
I've been drinking about 3 glasses per day, a litre at most. It's a sub-clinical dose for sub-clinical symptoms. The bitterness causes immediate sputum production in my mouth. Despite feeling a sore throat yesterday, I haven't yet started coughing.
I'm advocating for it in direct messages to friends: not because it's some miracle cure for the virus, but because it eases the coughing symptoms and thus might slow the spread. The placebo effect is probably also very real: I feel like I'm doing something, and that calms me down.
Quinine is super bitter, it doesn't take much for flavor use, and the stuff on the shelf is nowhere near the strength that would have been given for brits in tropical posts during those days.