What troubles me is that people politicized a potentially life-saving treatment. That's how dangerous our political climate has gotten. Orange man says HCQ good, but orange man bad therefore HCQ bad.
I could argue it was politicized the moment that politician claimed it was the be-all and end-all and his frenzied supporters declared it to work. All lack of success in science by the drug has already been dismissed as a political attack. Heck, the pandemic itself has been dismissed as a political attack too. The bodies are dismissed as a political attack.
And yet we still can't show the drug works.
I worry excess attention on this drug due to politic pressure is distracting from exploring life-saving treatments that aren't this drug.
There's an enormous pressure on science to deliver, and it has to actually prove it unlike the politicians.
There has been just one trial done properly to my knowledge, and that was published yesterday. And even that is just applied in a narrow case (post-exposure prophylaxis, modulo some important study limitations).
I believe it was done the best they could, given that UMN had to use very little money for it (~100K USD, as far as I understand). That's why IMO the limitations need to be fully read and understood.
But I think it was done in good faith (unlike the Lancet study): the PI tried to his best to avoid spilling the beans until it was published to avoid sensationalism, and at the same time, he signed the open letter against the Lancet paper (after he sent the paper for review, so he knew the results already).
Larger studies will likely be needed. It's clear that the effect size (if any exists) is quite small, like with remedisivir.
https://academic.oup.com/aje/advance-article/doi/10.1093/aje...
One of these "studies" is a 2-page Google Doc with no real data. Another is the discredited Raoult study, which is under investigation by the journal [1]. Another study cited is also by Raoult's team. The Brazil study (ref. 29) doesn't seem to have passed peer review (yet?) and has severe methodological flaws. Like the Raoult studies, the Brazil study was not randomized, but makes no attempt to control for confounding by indication or self-selection, such as with propensity score matching or similar methods commonly used in observational studies. The last study cited isn't a study, but an article from a local news station.
It should be taken early (either as preventative or early onset of symptoms) and with zinc. If so, then there is proof of success, see these five studies confirming its effectiveness in outpatients.
https://academic.oup.com/aje/advance-article/doi/10.1093/aje...
One of these "studies" is a 2-page Google Doc with no real data. Another is the discredited Raoult study, which is under investigation by the journal [1]. Another study cited is also by Raoult's team. The Brazil study (ref. 29) doesn't seem to have passed peer review (yet?) and has severe methodological flaws. Like the Raoult studies, the Brazil study was not randomized, but makes no attempt to control for confounding by indication or self-selection, such as with propensity score matching or similar methods commonly used in observational studies. The last study cited isn't a study, but an article from a local news station.
False. Not all. There's a reason why people were hopeful.
https://youtu.be/5i4BpTcBdrc?t=415
There are many more like this.
I understand the "doesn't work" at least when given late during the course of the disease (no idea when early, that's why we have RCTs to find out, otherwise it would be already done and deal), but causes harm? Aside the retracted study, even the deaths in the high dosage arm in the Brazil study, which prompted unmasking and lowered dosage, were defined "a statistically insignificant trend" (death is always serious, of course, but those words need to be taken into account).
Unless by "causes harm" you mean for availability for treatment of other diseases, of course.
A bit unrelated, but during the peak, my parents shared a video kn Facebook that I found quite surprising.
A doctor, with a legitimate medical degree and patients, made a meme level conspiracy video about how since a patent existed on a vaccine for a previous coronavirus, it would also treat COVID-19, but somehow tied the patent owner to Bill Gated and into a conspiracy by Gates to depopulate the world.
I nornally consider doctors pretty intelligent people, but jesus christ.
I don't think you fully caught the irony of what you just wrote.
There is no conspiracy here. The extraordinary claims regarding HCQ need extraordinary evidence, and that evidence is not available.
Your version of this summary is disingenuous and not in the spirit of Hacker News conversation, where we try to take the best possible interpretation of the conversation as it happens. There is no way to take the text "orange man bad" as anything but a petty dismissal of anyone who is not entirely supportive of a particular politician.
People have interpreted a broad array of responses to Trump's advocacy to mean "orange man bad," from actual blind hatred to observations that full trials need to be put on to confirm effectiveness. I have no problem dismissing the former, but when calls for scientific rigor are met with "oh, you're just a Trump hater" we have a real problem -- in that the act of discovering a fact is now politically risky for anyone who suggests it.
Fortunately in this case the publication process is working; the paper came out, was questioned, those questions were investigated, and it was determined the data was insufficiently open to defend the study, so it was retracted.
Ask yourself what would have happened if a paper agreed with the president's assertions, but was based on faulty/unavailable data? Would anyone questioning the paper be met with "orange man bad" dismissals? What effect might that have on NIH/NSF-funded research, do you think?
However people across the world associate the prestige and respects of the POTUS office as conferring authority on his statements. They think he has access to sources of info they may not (His HCQ boosterism seems to have been based on tweets and watching Fox News cable hosts though, no inside info).
Analysis of his tweets have shown they often match the programming of his favorite Fox News TV shows exactly. (A time stamped remark based on something he sees on fox, then an equal delay and a new Tweet based on programming a similar amount later in the show).
This dynamic tension between the advice of experts and Fox News that Trump receives played out very visible in the HCQ saga where Dr. Fauci in the live press conferences kept trying to walk back Trump’s remarks in the same conferences. https://www.statnews.com/2020/03/20/trump-coronavirus-drug-j...
> WASHINGTON — President Trump on Friday admitted that his enthusiasm for an antimalarial drug unproven as a coronavirus treatment was based largely on gut instinct, after an open disagreement with the nation’s top infectious disease expert at a White House press briefing.
> When reporters asked Tony Fauci, the director of the National Institute of Allergy and Infectious Diseases, whether the drug hydroxychloroquine was effective at preventing coronavirus, he said simply: “The answer is no.”
> But when Trump came back to the microphone, he told reporters that “we ought to give it a try.”
> “I think we disagree a little bit,” Trump added. “I feel good about it. That’s all it is, just a feeling, you know, smart guy. I feel good about it.”
Published a peer reviewed study, in March. But political opponents and people in favor of chaos, chose to bankroll a fake study and publish it in the so-called prestigious Lancet journal to make Trump look bad. Democrat governors like Michigan's threatened doctors for daring to prescribe the drug: https://news.yahoo.com/michigan-governor-threatens-doctors-p...
This is a drug that's been around for 60+ years. And the propaganda machine somehow turned it into a bad thing. I don't know who's behind the propaganda, maybe it's other pharm companies that want to profit, maybe it's political enemies...but I don't care, this is unacceptable and immoral.
Raoult’s study is problematic as you can see by reading it. He explicitly removed the person who was taking HCQ and got worse and died from the study. It also was not a RCT and generally speaking is basically not a very strong piece of data in favor of HCQ’s effectiveness.
Then Fox News hosts and other right wing people, who were opposed to non-pharmaceutical interventions to slow the spread of the coronavirus, began to tout HCQ as a “100%” cure for the virus which would mean that life could continue as normal.
The regulations in places like Michigan were because unqualified doctors were abusing their prescribing authority after they heard about the drug in the POTUS’ press conference. The spike in prescriptions correlates exactly to when POTUS made his statements , see https://www.nytimes.com/2020/04/25/us/coronavirus-trump-chlo... “ By that evening, first-time prescriptions of the drugs — chloroquine and hydroxychloroquine — poured into retail pharmacies at more than 46 times the rate of the average weekday, according to an analysis of prescription data by The New York Times. And the nearly 32,000 prescriptions came from across the spectrum — rheumatologists, cardiologists, dermatologists, psychiatrists and even podiatrists, the data shows.”
The regulations allowed the supply of the drug to continue for the people who have been taking it for ailments such as arthritis, where it’s been known to be effective for a long time and many patients depended on it only to have their drug supply locked up by abusive prescriptions.