Comment by ytNumbers | Hacker News Reader

Comment by ytNumbers | Hacker News Reader

I'm quite impressed with the work that went into these simulations. The folks who put this together did a great job. It would have been a great method to explain to the public how lock-downs save lives by not overwhelming our hospital ICU bed capacity, but for one critical omission. My idea for a way to improve these simulations would be to include what could be the most important public policy issue of them all: In many US states, the governor has forbidden (or greatly restricted) pharmacies from dispensing hydroxychloroquine. How many people could be kept out of the ICU (when the medicine is used in conjunction with azithromycin or zinc) if governors allowed pharmacies to dispense this medicine? I've yet to see a study where hydroxychloroquine, when used in conjunction with z-pak or zinc, was found to be ineffective against COVID-19. Of course, that's not proof of anything, but, with 25% unemployed in some of the biggest US cities, rigorous scientific studies may wind up taking more time than we can afford to wait. Therefore, it seems to me that the best way to find out what works to save lives (and keep people out of the ICU) is to look at what the front-line doctors are doing at one of the most prestigious hospitals in the world:

https://www.the-hospitalist.org/hospitalist/article/221558/c...

What about the study clearly showing no benefit, but a higher death rate in the group that DID use hydroxychloroquine?

See: https://www.cnn.com/2020/04/21/health/hydroxychloroquine-vet...

Seems to me the Remesedevir is the better option, and may be the first silver lining.

I've told my wife, if I can't make the choice do not let them put me on that chloroquine no matter what. Also no ventilation without sedation/paralytics (in case of shortage, I'd rather die than be vented and wide awake).

The U of Minnesota trial[1] (they aim at recruiting 3000 people, currently 700-ish) will tell if there is any prophylactic effect or not when using hydroxychloroquine. As with remedesivir, the effect size is probably not very large (so no miracles) and thus a lot of patients are needed to determine if the effect is true or only random.

[1] https://covidpep.umn.edu/

Do you mean the non-prescripted dispensing of hydroxychloroquine? I think it is quite reasonable to rely on prescriptions by a doctor. Swedish hospitals stopped giving hydroxychloroquine to patients a month ago as it has more negative side effects than benefits.

There have been a lot of studies funded for various drugs. Honestly at this point, it seems like they're just throwing every compound that's been approved as safe, and that might show some hope for interaction, at this thing in hope something works.

That's describing the development effort for every drug, ever.

I did read about how Swedish hospitals stopped using chloroquine for COVID-19 due to severe side effects. I've googled, but I'm unable to find anything definitive regarding whether or not Sweden has given up on hydroxychloroquine, which seems to have less severe side effects. In the US, hydroxychloroquine can only be obtained when prescribed by a doctor (depending on which US State you live in, your governor may or may not allow it to be dispensed outside of a hospital setting). Even though hydroxychloroquine has been around for over 70 years, there's risk associated with it. It's obvious to me that the front-line doctors at Yale are throwing everything they can think of at this virus to keep as many people out of the ICU as possible. They've obviously made a lot of progress in a very short time. It reminds me of the way some startups with minimal runway develop an MVP and then keep iterating in an attempt to get better results. It's a harsh environment, but that's what forces people to innovate quickly, and sometimes succeed. As they say in the movies: GO! FIGHT! WIN!

AFAIK Sweden says no to both.

The Swedish Medical Products Agency (Läkemedelsverket) said on April 2nd that chloroquine/hydroxychloroquine should be used for the Covid-19 indication within clinical studies only, otherwise only for the approved indications (arthritis, lupus and similar). This is because the available data does not offer robust conclusions on efficacy and safety. [1]

This is in line with EMA recommendations, which defer use within emergency programs to national authorities. [2] And in Sweden's case they say "no".

[1] https://www.lakemedelsverket.se/sv/nyheter/klorokin-och-hydr...

[2] https://www.ema.europa.eu/en/news/covid-19-chloroquine-hydro...

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