U.S. Stockpiled 63M Now-Useless Doses of Hydroxychloroquine
medicinenet.com
medicinenet.com
Edit: https://www.usatoday.com/story/news/2020/05/23/hydroxychloro...
But: in March, it was one of very few leads on a treatment. Building some degree of a strategic stockpile and ensuring that manufacturing was increased made sense, even if it was a long shot. It's unfortunate that this had a negative effect upon people, but if there had been efficacy having that stockpile would have been extremely beneficial.
?? We had computational and in vitro studies showing significant efficacy against SARS-CoV-2 at attainable serum concentrations, and had seen efficacy of HCQ against other viruses in humans. Obviously in vitro data is not the same as efficacy in people, but positive, high quality in vitro data is incompatible with "no plausible mechanism of action."
Early human research was tainted by being not randomized and tainted by clinician opinions of efficacy, which kept us from knowing for sure for quite some time that what worked in the petri dish didn't work in humans.
> No better evidence ever came along.
Yup, which is why we have largely abandoned the idea...
Even if it does no good, there was reason to think it may. It's not proper to criticize a decision based on information that was not available when it was made, and that's all that's happening now.
Try cross-country sailplane flying. Try investing in the stock market. Go on a long sailing trip with no one to make decisions for you. Do some competitive multiplayer gaming. Try to be your very best at an activity that requires making the best possible decision based on uncertain information, adapting as that information changes and owning your mistakes.
Things look completely different when the outcome is known, when you see it on video afterwards. You need to have been in such a situation yourself to know, to have seen with your own eyes the same situation with and without the benefit of hindsight. It's startling. Just having an IQ of 120 isn't enough to appreciate this.
I would love to get the answer to whether hydroxychloroquine reduces the severity of Covid19 when given during the earliest stages of the disease. It's sad that we may now never get a good enough controlled trial that settles the question. It's a disgrace when the science is politicized to such a degree.
It's not politicised outside of the US. It was known to be junk science before Trump picked up on it. There is still some proper science to be done in clearly disproving all the junk claims, and don't worry, it will be done. But proper science takes time.
The Lancet is a medical journal edited by a British guy who posts strongly left wing and anti-Trump stuff to Twitter all the time. The Lancet published a paper claiming HCQ was dangerous that fell apart immediately, and should never have been accepted at all (e.g. it claimed to be based on the medical records of hundreds of hospitals and something like 90% of all US COVID cases, which is implausible).
Why did such a terrible paper get published? Probably because it appeared to strike a blow against Trump's credibility which the Lancet's editor so desperately wanted. In the end it blew up in his face, though.
Yes, and people are saying "Trump is an idiot, and he's promoting something that doesn't work". I haven't seen people argue that "Trump is an idiot, therefore HCQ cannot work" (nor the opposite).
> Probably because it appeared to strike a blow against Trump's credibility which the Lancet's editor so desperately wanted.
That sounds like it might be a good point, I'm not familiar enough with the details, and especially not with the editor's motivations.
I think you are probably thinking of the first Raoult study but there was a lot of history before then including plausible mechanisms and even somewhat positive double blind trials done in Wuhan in February. It's still used in places like Thailand where they have sane policy and basically no more local transmission.
To me 63M doses of a cheap drug sounds like a really small bet. We should be willing to make lots of them, on the slightest hope, knowing that most will be wasted. Get 50 experts and fund anything which gets 2 votes.
"A lot of people are saying..."
It seems rather crazy to me, but perhaps more importantly, it is a strategy that - implemented literally - would result in the US leadership being very easily led by others "anywhere in the world" in matters of drug research, a situation which would be very amenable to manipulation for profit.
That's obviously wrong. We want the US leadership to be very easily led by Fox News personalities and whatever is popping on Twitter.
But a $100M or whatever check to ramp up production, or to buy wholesale stock from elsewhere, that would have been worth writing on day 1. Even on extremely flimsy evidence, given the huge daily costs of this thing. Run the careful trials at the same time as building a huge factory which you probably won't need.
The issue im presenting is they are buying them to be prepared to treat Americans IF it worked. But because they bought so many so quickly, it put Americans in a position where they weren't able to have medicine they needed. The government has a responsibility to balance current needs with possible immeidate future needs, it doesnt seem like they did.
Or was there enough retail panic-buying to generate shortages? If everybody with a prescription tried to buy 3 months worth, because they are scared of shortages, then I bet there would be shortages. (Isn't that exactly what happened with toilet paper?)
Hopefully not too many people did without needed medicine.
Probably there will be some suffering relating to stockpiling of steroids (dexamethasone, methylprednisolone), that we're now learning -do- work in the severely ill, too.
https://nypost.com/2020/06/06/who-reverses-position-on-face-...
Different authorities can't even agree:
https://abcnews.go.com/Health/cdc-offer-conflicting-advice-m...
The mask situation is absurd, one more failure on top of so many others for the global health establishment.
The masks were alway recommended to slow transmission.
That video you linked to doesn't in any way disagree with anything I've said, nor rebut the point. In fact it supports it. It's just a video of Anthony Fauci talking about why he changed his position on masks: without admitting to it directly, he 'explains' that he wanted to ensure medical workers had access to them. But he is on record as having recommended against masks in the past. Here's Snopes saying so:
https://www.snopes.com/fact-check/fauci-masks-no-longer-need...
In the March 2020 clip, Fauci said: “Right now in the United States people SHOULD NOT BE walking around with masks … You should think of healthcare providers who are needing them and the people who are ill.” (my caps)
https://thehill.com/changing-america/well-being/prevention-c...
He also acknowledged that masks were initially NOT RECOMMENDED to the general public so that first responders wouldn’t feel the strain of a shortage of PPE. (my caps)
Now many countries have introduced face mask requirements (which is dumb, but clearly a change of position).
Not only has mask advice changed but it's changed for dumb reasons: there's no scientific evidence masks work to stop SARS-CoV-2 transmission, especially not the cloth masks being actually deployed. This article investigates what's really known about this tactic:
https://off-guardian.org/2020/06/06/coronavirus-fact-check-6...
From May 3rd:
"Gilead CEO says remdesivir will be available to patients this week: ‘We’ve donated the entire supply’"
"Gilead expects to produce more than 140,000 rounds of its 10-day treatment regimen by the end of May and anticipates it can make 1 million rounds by the end of this year."
https://www.cnbc.com/2020/05/03/gilead-ceo-says-remdesivir-a...
https://www.reuters.com/article/us-roche-hldg-novartis-searc...
The company behind its production is donating its stockpile to the US Government: https://www.forbes.com/sites/alexandrasternlicht/2020/05/03/...
there have been efficacy all along against lupus/etc. Yet ephemeral unproven chance of efficacy against coronavirus was chosen over well known benefit for the already suffering people. That looks extremely illogical and kind of cruel to me. Not surprising though given that it isn't logic nor compassion that drives the government actions these days.
Not that even this was intended, but it's unsurprising that efforts to stockpile and allocate supplies don't work perfectly.
I've got Kaiser and the pharmacy is unable (or unwilling) to tell me, given a drug, dosage, quantity, and my Kaiser ID how much it will cost unless I actually try to have the prescription filled there.
For some drugs, Kaiser is the way to go. Lipitor, e.g., is free.
For some, taking the prescription elsewhere and using a GoodRx coupon instead of insurance is better. E.g., irbesartan is $46 for 90 days mail order via Kaiser (mail order is cheaper than in-person), but only $22-31 at several other well known pharmacies with a GoodRx coupon.
I've heard that if you get a printed prescription from your Kaiser doctor, instead of having the doctor send the prescription electronically to a pharmacy, you can take the printed prescription and your Kaiser card to the Kaiser pharmacy and then they will tell you what it would cost without you having to actually have it filled to find that out, but I've not had a chance to try this to see if it is true.
And there are mechanisms for getting meds back into the pharma distribution system. Some small wholesalers specialize in stock from failed pharmacies, and even from fire sales.
A group of physicians is suing the FDA for limiting access to drug: https://www.channelnewsasia.com/news/world/doctors-fda-acces...
The organization's general counsel is Andrew Schlafly, the son of Phyllis Schlafly, who is pretty well-summed-up by these quotes: https://www.cnn.com/2016/09/06/politics/phyllis-schlafly-quo...
Severe cases are not overwhelmed by the virus but by their own immune system response... in fact there is a lower viral load during the lethal phase of the disease.
Where HCQ might be useful is for prophylaxis or in early phase of the disease to quickly reduce viral load (therefore infectivity). In this setting, plenty studies are still ongoing and positive results are visible in multiple afaik.
I can't help but feel when historians look back on this that they will figure there were unnecessary deaths due to political biases.
Think PPE, potential treatments, Ventilators
Stockpiling something in the hopes that it might help is a waste of resources.
Also ventilators are very expensive and hcq is very cheap.
HCQ is able to transport zinc ions across cell boundaries, which is critical to getting zinc bioavailable within a cell. Zinc disrupts the viral RNA copying which is part of the replication process. So zinc + HCQ should slow down the progression of the disease by decreasing viral load.
Notably most studies did not pair HCQ with zinc, and most focused on near-terminal patients for which slowing down viral replication would be too little, too late.
It should be doctor and patient's choice whether to use it.
The Lancet was forced to retract an article critical of hydroxychloroquine, dubbed "LancetGate". [1] [2] [3]
[1] https://audioboom.com/posts/7605833-lancetgate-illustrates-s...
BARDA is awarding grants like $483 million to Moderna to start manufacturing even if the vaccine is never approved.
It may be totally appropriate for the government to make multi-billion dollar speculative investments in therapies that could help us more quickly restart the economy, the closing of which is costing trillions of dollars.
These investments, like all central planning approaches, will distort the free market and likely cause a misallocation of resources. For example more work on COVID therapies at the expense of cancer therapies which could ultimately lead to more deaths overall. But the cost of the shutdown dwarfs all of that, so basically anything that could expedite full reopening is worth the risk.
When disaster preparedness pays off everyone feels great. When disaster preparedness that doesn’t pay off is ridiculed as wasted investment, we get situations like we had with the National Stockpile, and what happened in CA with their disbanded disaster response field hospitals.
We need to accept the government wasting money in disaster preparedness if we want to ever actually be prepared. Otherwise it’s like complaining about the insurance premium because the house didn’t burn down.
Yup!
I hear people ask "Why weren't we ready for Covid?". Then in the next breath ask "Why are we stockpiling a drug that doesn't work for Covid?".
It doesn't work that way.
And at any rate, I know the gov’t has deals with pharma companies. They’ll often swap expired product so the stockpile stays current.
Why weren't we ready? Why did we waste money?
Both of those questions should be asked directly of the current administration, don't you think?
If the president was able to keep his mouth shut these HQ studies could have continued uninterrupted and the conversation around HQ wouldn't be such a political mess.
On the other hand, people who hate Trump like the editor of the Lancet actually did manage to interrupt studies. After publishing the now retracted "HCQ is dangerous" paper, lots of studies were suspended worldwide.
Yes it does. The president went on TV and blabbered about things he knows nothing about and turned HQ into a political issue.
His inability to shut up and listen to public health experts, his need to stroke his ego and insert himself into every situation, makes the president the fons et origo, the problem in the first place.
Remember when "the buck" stopped with the president? When the president was a respectable, thoughtful person? When the president wouldn't do something as foolish and irresponsible as telling Americans to try a drug he heard about on cable news?
He could have done one thing to improve America's response to Covid-19: shut up and listen to experts. But there's something innate in this president, his comically obvious case of narcissistic personality disorder, that doesn't let him do that.
I cant fucking stand this type of shit anymore. No critical thinking, just attach some initial opinion about something based on how its been politicized and never think about it again. It's either Trump is God is said ots good so it's good, or Trump is the devil and said it's bad so its bad. Then just dismiss any sort potential evidence to contrary as propaganda / conspiracy / etc.
Wish there was was away to get away from it.
Stop trying to make an issue out of nothing.
Meanwhile people who did actually need it because, you know, actual reasons, suddenly found that there was none available anywhere.
So large groups of people were buying up the supply, without any actual need for themselves. That's hoarding. It's even worse though, because they can't return those drugs, so yay!
It really feels like I've been playing Death Stranding for the past few months