I'm undecided on whether HCQ is effective or not, but attempting to discredit it with shitty science is a large part of why people don't "believe science".
It’s not just about doses or timing. It doesn’t work.
This being shitty science has no bearing on whether HCQ works on not, but does relate to why people distrust the medical research establishment.
The people who created and executed these studies wanted to save lives. They created a method they thought would be most likely to work, and time and time again they didn’t. Different dosages, different timing, different places. No benefit.
The fact that people aren’t running more studies is not because there is a global conspiracy. It’s because the drug doesn’t do anything and researchers don’t want to waste their time and their patients lives satisfying critics who don’t care about the science.
Does HCQ work if you have some magic combination of zinc? Maybe. Is that more likely than another treatment given that HCQ has been heavily studied and shown no benefit and zinc had been heavily studied for a lot of things and shown no magical properties? Probably not. So researchers spend their time on things more likely to work.
> You came up with those parameters conveniently after the study was published.
> The fact that people aren’t running more studies is not because there is a global conspiracy.
> satisfying critics who don’t care about the science
> magic combination...magical properties
It seems like you've suddenly made a sharp u-turn from a good-faith discussion into crazy town. I thought we were hashing out differences, and now you're suddenly accusing me of making up excuses, believing in a global conspiracy, being anti-science, and thinking zinc is somehow a miracle drug. I think I should end the conversation here.
A lot of this HCQ stuff feels like God of the Gaps Theory at this point; as potential use cases are conclusively eliminated, so is the field of where it is "thought to work". Thought by whom, precisely?
March 30: https://www.clinicaltrials.gov/ct2/show/NCT04326725?cond=COV...
March 30: https://clinicaltrials.gov/ct2/show/NCT04326725?term=zinc&co...
April 6: https://clinicaltrials.gov/ct2/show/NCT04334512?term=zinc&co...
May 8: https://www.medrxiv.org/content/10.1101/2020.05.02.20080036v...
May 1: https://clinicaltrials.gov/ct2/show/NCT04370782?term=zinc&co...
https://www.nejm.org/na101/home/literatum/publisher/mms/jour...
https://www.nejm.org/na101/home/literatum/publisher/mms/jour...
This term alone makes me highly skeptical. Honest researchers shouldn't be "pro" or "anti" anything. Coronavirus doesn't have an opinion on HCQ. It is a virus that either responds biologically to HCQ in vivo or it doesn't. Pro or anti are political terms that change the conversation from scientific to propaganda based.
If the research indicates that HCQ has a powerful prophylactic effect against Coronavirus in a double blind study, then let the data speak for itself.
However saying that you're "pro-HCQ" or "anti-HCQ" immediately discredits you in my eyes because viral pandemics don't have emotions and therefore can't care whether you are pro or anti anything.
Honestly I don't really get this at all. Not even a little bit. Why? Anyone who actually has a motive (like a company trying to make money) should be kept far away from the regulators that oversee the study, and the whole point of double blind trials is to keep self interested bias away from the result of a study where lives are literally at stake.
Isn't the point of a clinical intervention to save lives? Either the intervention saves lives or it doesn't. The researchers should be selected from people who can maintain a neutral viewpoint. If that is impossible their neutrality should still be maximized and biases should be eliminated as much as humanly possible.
Simply accepting that bias as a matter of course is imo the worst way to approach it.
> Honestly I don't really get this at all. Not even a little bit.
It's ok for scientists to think something's true before they have all the evidence lined up - especially in a predominantly empirical field like medicine. That's how new ideas happen.
Have you ever encountered someone who is motivated by altruism? Someone who is motivated by getting the truth out there?
Doctors and scientists need to be objective. Advocating a treatment before the data is there, or cherry picking results is not science.
Certainly a scientist can say "I very much hope that HCQ is an effective cure for Coronavirus" but that is very, very different from being "Pro-HCQ".
When I hear "Pro-HCQ" that implies to me a very strong suggestion of treatment, i.e. - "You should take HCQ as a treatment for Coronavirus infection", which is extremely different from, "I hope that the research shows that HCQ will be an effective treatment for Coronavirus, and I am doing a study with the goal of showing that this is the case".
Does that make sense?
I think that middle option is actually how a scientist would interpret the phrase. I can see why a layman would read it otherwise, though.
> Isn't the point of a clinical intervention to save lives?
Why do you think saving lives can't be the motive? If you do a study, and conclude based on that study that a treatment works, you're supposed to remain "neutral"?
Let me put it this way, I wouldn't want to receive treatment from a healthcare provider who is "neutral" about the surgery they are about to give me, I want them to have a positive informed opinion based on experience, studies, etc.
A scientific researcher is trying to answer an unanswered question dispassionately. I don’t see how taking a bias in testing a scientific hypothesis can possibly determine the truth of a scientific fact.
Are researchers who say that applying leeches won’t cure cancer bad for cancer patients? Why shouldn’t they be hopeful that leeches cure terminal cancer, rather than being downers? The answer is that cancer is the enemy, not people who oppose medical treatments that don’t work.
It's not political, we're trying to find something that works.
I found the tone in this last paragraph to be a little off-putting in its finality and unwillingness to consider further studies:
> I’m not in a mood to be subtle. Hydroxychloroquine treatment for coronavirus does not work. It is not beneficial, and in fact appears to be actively harmful. As far as I’m concerned, administering it to infected patients now constitutes medical malpractice. I have no interest in goalpost-moving efforts to say that they didn’t administer zinc or azithromycin, or they picked the wrong patients or the wrong loading dose or whatever. No. This is special pleading, and it is not backed up by any hard data. None of the countries or regions where HCQ was enthusiastically adopted, with or without the addition of zinc, azithromycin or what have you have seen discernable benefits. It. Does. Not. Work. Give it up.
Depending on the other paragraphs in the article it could go both ways.
It's the article this entire discussion thread is about.
Politicians completely ruined this particular word combination for me.
My reflexive interpretation is that things were exactly the opposite of clear and the speaker is likely to be lying.
Doctors are very clear that HCQ is too dangerous to give to people unless those people are very ill.
You not understanding this balance between risk vs reward doesn't make the science shitty.
HCQ has been used for 60 years for malaria, lupus and autoimmune diseases.
Please, stick to what you know and leave medicine to specialists.
Wikipedia doesn't make you a doctor.
I will be stealing this line.
Honestly I could use “Wikipedia doesn’t make you a lawyer” even more frequently.
There are also quite a lot of other HCQ studies, many with azithromycin and some also given very early before significant symptoms appeared (see one example here: https://www.nejm.org/doi/full/10.1056/NEJMoa2016638). They also didn't find any benefit to HCQ.
The insistence on these very specific criteria is just blatantly moving the goalposts. There simply isn't enough indications that HCQ works, and plenty of evidence that it doesn't to justify even more large studies than it already got. This is arguably a huge misallocation of resources based on very flimsy initial evidence.