It was never a lead. The first study pushing it was immediately recognized as broken. No better evidence ever came along. No plausible mechanism of action was proposed.
?? 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.