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Comment by bena | Hacker News Reader

Yes, it would be stupid. But is that what's happening here?

You have a ton of studies that says "no" and a few that say "maybe". But you want us to what? Keep studying until it finally says "yes"?

"Check this out, it shows promise"

"Ok." "Oh, it's not as effective as initially thought"

"Ok, but this study says it might be"

"Ok, but we just did a full study that says it's not"

"Ok, but this study"

And on and on. At what point do you say, "Ok, I guess we should move on".

It was never discarded out of hand.

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It was. Long before the bulk of the studies even processed, the media had flipped right over to "hcq is the devil and a hoax". This, from what I observed, was essentially independent of any actual scientific research or result.

The initial "hcq works" was also independent of any actual scientific research or result.

If someone says "Take this magical cure, maybe it could work... but I don't have any evidence of it yet", it's not so terrible to start from a position of skepticism. Could hcq work? Maybe, although with every randomized trial it seems less likely. But the people who initially pushed it did so from a position of wishful thinking, not actual science. This might have been a hoax of ignorance not evil, but in the end, I say it's still a hoax.

The issue here isn't that one side was correct, or one side was wrong. The issue here is that both sides talking points were barely even touched the actual results. You're right, "hcq works" was independent of the scientific work done then. However, "HCQ doesn't work" was the same. The reason we had those studies in the first place is because preliminary work showed some promise, and researchers decided to dig in to confirm this. What many people don't know is that the biomedical scientific process is fraught with false starts and failures to replicate. The results are subsequently slow.

At that time, the only responsible answer, and the answer that any biomedical scientist with integrity would give is: "Early results show X, though further follow up studies would be needed to replicate these results to confirm their validity"

But that's not what we got. What we got was a binary split between miracle cure and worse than homeopathy, depending on which side of the political divide you were on.

Both-sidism: in evidence-based medecine, a treatment is ineffective until it is proven effective.

Now that some monthes have passed, at least five peer-reviewed RCTs were conducted. In each of them hydroxychloroquine is ineffective.

> or one side was wrong

I argue that when someone declares, without evidence, that "X works", that is a hoax and should be criticized. Even if later evidence shows it works! Because it's easy to make a random guess, and it's hard to fight the collateral damage that wrong guess can cause.

There are a million things that might be the covid miracle cure (colloidal silver? high protein diet? grapeseed extract? etc, etc, etc). If I pick one of these on a hunch and start pushing it as a cure, I would rightly deserve to be called out.

There was a (very bad!) study done in France that showed some initial promise which is what kicked off the whole thing.

IvyMike says>The initial "hcq works" was also independent of any actual scientific research or result.<

No, there were Chinese, French and other reports and observational studies during the pandemic that supported use of HCQ:

>"Wuhan was the epicenter, and the Chinese physicians at the People’s Hospital of Wuhan University told their Western counterparts that they got the idea of using HCQ because none of the 178 patients they had admitted for COVID-19 had lupus—a surprise, since lupus is an immune disease, and some thought it might have made these patients especially vulnerable. They wondered why this might be, and whether HCQ, which these patients had been taking for this preexisting condition, might in some way be protecting them against COVID-19."<

taken from "Hydroxychloroquine: A Morality Tale":

https://www.tabletmag.com/sections/science/articles/hydroxyc...

That's a potential reason to investigate, not a conclusion.

That's one of the points made in the fine article. Recommended, thanks for linking it.

Have you considered that maybe your observations are nowhere near complete enough to make a determination?

It's not really the media though. It's respected doctors and their ep·i·de·mi·ol·o·gy.

Trump isn't pushing sound science.

He's hoping to buffalo people (like you) into thinking he's on to something. AND THE MEDIA IS SO AGAINST HIM. EVEN THO IT REALLY HELPS THE FAKE NEWS JUST WANTS TO HURT HIM. BECAUSE THEY LOVE HILLARY

In April, Dr Zelenco stated he had treated some 600 patients with HCQ+Zinc+Zpac with good results. And now more doctors are saying the same. Not a single trial has tested this treatment. This is why people won’t give up hope. From my reading it seems to be Zpac that creates the most heart risk and doxycycline is now sometimes used instead.

Zithromax is an antibiotic. Which is useless against a virus.

And why are doctors giving untested treatments to patients?

>Zithromax is an antibiotic. Which is useless against a virus.

"Azithromycin Induces Anti-Viral Responses in Bronchial Epithelial Cells" has over 220 citations. (https://pubmed.ncbi.nlm.nih.gov/20150207/)

To be clear, I think this is a pretty bad "study".

But there are plenty of reasons why antibiotics are given to people with Covid-19 to deal with secondary infections.

> And why are doctors giving untested treatments to patients?

This seems a pretty bad-faith comment. In the early days of COVID-19 there was no "tested" treatment, so doctors use reasoning to try to find something. This is a completely normal thing to do.

Throwing stuff at the wall and seeing what sticks is a good way to get people killed.

Doctors are not researchers and they shouldn't be.

It's not a bad-faith comment.

This is all news to the medical profession. They have always and are trained to deal with novel situations by trying treatments based on inferring likely response based in symptoms.

Zelenco has been thoroughly disgraced for ethics violations. His work was so riddled with issues, that it was the subject of ridicule for weeks afterwards by legitimate scientists. It's not worthy of discussion in a good faith discussion on the efficacy of HCQ.

As far as I know this describes Dr Zelenco’s work. Google turns up zero hits for review of this paper. This paper demonstrates efficacy for his treatment. If you have any links discrediting this work I would like to see a link. It is observational. https://www.preprints.org/manuscript/202007.0025/v1

Dr. Zelenco was working with the FDA to get a trial of his protocol. The FDA director provided some help to get his trial started. The director got criticism for helping. Something about a small trial not being worth his time. I don’t know where this criticism/pressure came from. But this has politics written all over it.

Dr Zelenco made one mistake stating that he had FDA approval to run the trial. The truth is that he had his hospital approval. The district attorney was looking to prosecute him for this mistake. I believe it was a simple mistake. He is not versed in running trials. He was told his trial was approved. He failed to distinguish who made the approval. The DA getting involved is more politics. His trial never got run, probably because of DA pressure. I believe he is a good doctor and has not been discredited. Railroaded by politics more likely. You should be asking why no one wants to test HCQ+Zinc. Why is HCQ condemned without running this most obvious of necessary trials. Why is there no urgency to run a trial on HCQ+Zinc. Why is the media silent on the lack of Zinc in the trials. It might not work, but a trial is more than warranted.

He did one other thing I’m aware of which was to tell his community the current scientific projections of mortality of Covid19. Those projections have proven wrong, and his community blames the messenger.

This is a much better and thorough critique than I could write up:

https://respectfulinsolence.com/2020/04/03/zelenko-smith-aba...

hhw says>"Zelenco[sic] has been thoroughly disgraced for ethics violations. "<

What ethics violations? Please provide a cite that says "Zelenko has been thoroughly disgraced for ethics violations" or even charged with any ethics violations. You're slandering him.

https://www.nytimes.com/2020/05/01/us/coronavirus-doctor-zel...

> At what point do you say, "Ok, I guess we should move on".

This is a weird question. By "we" do you mean the media or politicians or scientists?

Politician should not ever be making claims that aren't backed up by strong studies. It's fine to say "I'm hopeful this will prove useful" etc, but to advocate for treatment using unproven medicines is irresponsible.

The media has a pretty difficult job here. Medical studies (particularly early ones) on treatments are rarely decisive (because doctors are trying anything to save someone's life, and that creates co-founding factors. Generally trying for balance ("this is a good study with promising results. Others show different results, and the differences are X and Y. Specialist Dr ABC says "XXXX") is about the best someone can do.

Scientists should keep studying it until we understand what is causing the different responses.

They've studied it enough to know that it doesn't have any appreciable effect.

To keep studying it would be to appease either the politicians or media.

In science, failure is actually an option.

> They've studied it enough to know that it doesn't have any appreciable effect.

Well results seem conflicted on this. This very study (the one linked here!, ie[1]) shows a significant result.

It's an observational study, but that is a normal part of the scientific process during medical research.

There are plenty of other studies showing no result. But this is hardly the only one showing positive results.

So I don't think the science is settled on this (and it would be astonishing if it was in the 4 months since this process started!). I think Trump's behaviour on this has been atrocious and has caused harm, but that doesn't mean anything regarding if it works or not.

[1] https://www.sciencedirect.com/science/article/pii/S092485792...

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