Comment by giardini | Hacker News Reader

Comment by giardini | Hacker News Reader

The researchers gave whopping doses of chloroquine to both groups: (a) high dose chloroquine (600 mg chloroquine twice daily for 10 days or total dose 12g);

(b) low dose chloroquine (450 mg for 5 days, twice daily only on the first day, or total dose 2.7 g)

In addition, all patients received ceftriaxone and azithromycin.

So group (a) got 1200 mg chloroquine the first day and group (b) got 900 mg chloroquine the first day. No wonder they had irregular heart rates! Luckily a review board stopped group (a) treatment before they killed all the patients.

In contrast, the regimen for Covid-19 _successfully_ used by Dr. Zev Zelenko on ~700 patients is:

1. Hydroxychloroquine 200mg twice a day for 5 days,

2. Azithromycin 500 mg once a day for 5 days,

3. Zinc sulfate 220 mg once a day for 5 days.

https://www.freerepublic.com/focus/f-news/3829492/posts

The zinc sulfate is _important_ because it raises the blood level of zinc (Zn++ ion). Chloroquine is a zinc Zn++ "ionophore" which marshals Zn++ across the cell's outer wall into the cytoplasm where the Zn++ can halt viral replication.

"Chloroquine Is a Zinc Ionophore":

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4182877/

(PDF) https://journals.plos.org/plosone/article/file?id=10.1371/jo....

Some researchers seem to be missing the point that chloroquine and its analogs may play a different role here than in malaria, acting not directly against covid-19 but as a facilitator for Zn++, which then halts covid-19 replication.

Zelenko's use of an antibiotic(azithromycin = Z-Pak) is a prophylaxis against potential secondary bacterial infection; the antibiotic would not likely play a role against the viral infection directly.

Once again we see that randomized, double-blinded clinical trials can be more deadly and less informative than ad-hoc studies performed on the battlefield of medicine.

> Once again we see that randomized, double-blinded clinical trials can be more deadly and less informative than ad-hoc studies performed on the battlefield of medicine.

Can you elaborate?

I've always heard that it's unethetical to use unproven treatments and that the scientific method (rndm double-blind) was necessary to remove as much bias as possible.

Now such strict requirements obviously don't jam well with fighting on the front line of medicine.

I'm very interested to learn what "less deadly and more informative" ad hoc studies are in this context. (genuine, there is no irony in this comment, this is not my domain)

> In contrast, the regimen for Covid-19 _successfully_ used by Dr. Zev Zelenko on ~700 patients is:

For all we know, it was a successful placebo. Anecdotal evidence does not constitute scientific fact.

A single piece of anecdotal evidence does not constitute scientific fact.

~700 pieces of anecdotal evidence is a study.

If there's no randomly selected control group then the value of the results are fairly minimal.

The remaining population of COVID patients is a good control group. Or, if you prefer, randomly select sub-populations with similar demographic statistics.

Yeah sorry, I don’t think you understand how control groups work.

Yes, let's throw out valuable field evidence just because it doesn't fit some narrow definition of "valid experiment".

Compare 700 people who received a treatment to 700 demographically similar people who received the standard treatment in the same or similar hospital and you're going to get a useful result.

We can do your fancy RCT later when we aren't dying en masse from a novel and highly lethal virus.

I mean, people have tried doing studies like that for CQ/HCQ. They are riddled with questionable assumptions (that patient groups are similar or treatment regimens are equivalent) that make their conclusions completely unreliable.

In the end we will most likely find that all positive anecdotal evidence found was just confirmation bias. That's why RCTs are so important.

That's ridiculous

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1232869/

In vitro is not the same as in vivo

Reply on news.ycombinator.com