On the science and ethics of Ebola treatments | Hacker News Reader

On the science and ethics of Ebola treatments

scientiasalon.wordpress.com

35 pointsquantisan7 comments

This is a full-throated and compelling defense of double-blinded, randomized, controlled trials even - and especially - in resource-constrained situations with a terrible disease like Ebola.

It is far more interesting and historical than the title suggests, and if you have not yet done so I encourage you to read the article.

incidentally the way Zmapp is made (it's made in tobacco plants) it's unsurprising there is a shortage. Interestingly, there is in the last year commercialized technology (humanized yeast) that would make manufacture much much simpler.

The second issue, of course, is patents, which are undoubtedly getting in the way here.

"But if there were ever a disease for which this is not a big deal, it is Ebola. It seems extraordinarily unlikely that the drug could make matters any worse for an Ebola patient than they are already."

It can increase the mortality from 50%-60% to 100%. It can protract death, make it more painful, instill false hope.

It can increase the mortality from 50%-60% to 100%. It can protract death, make it more painful.

That is true for any drug. What are the odds of that, though? one in 100? one in 50,000? one in a million?

That's the point: these are experimental treatments. We don't know. And experimental human treatments have gone bad for no reason at all -> http://en.wikipedia.org/wiki/TGN1412

It IS extraordinarily unlikely that a drug, tested in animals, will cause a worse result than one of the worst diseases we've ever seen. Concern about "false hope" is bizarre to me - it's not like this is a long-term disease like cancer, where false hope can damage a graceful death and grieving process. It's going to be over for these patients, usually brutally, in days.

A drug might make things worse, it could allow a patient to live a bit longer after their friends have rescued them from the isolation ward and enable them to infect more people.

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