As the pandemic deepens, physicians face an agonizing decision — to medicate or not to medicate?

Here’s the dilemma: Over the past few weeks, some small studies suggested a decades-old malaria drug called hydroxychloroquine may have the potential to combat the novel coronavirus known as Covid-19. And as the results trickled out, the tablet has become more valuable than gold.

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    • Did you follow this story back to its source? The NY Post cites the NY Times, which cites an extract on a website of unreviewed papers, WHICH has a link to the full paper. Especially with this study, it is important to put the finding into context. Take a look at this line:

      “62 patients who met the trial criteria were randomly assigned [into] two groups, all received the standard treatment (oxygen therapy, antiviral agents, antibacterial agents, and immunoglobulin, with or without corticosteroids)”

      Note that the authors are not claiming that Hydroxychloroquine (HCQ) cured anyone by itself. They are observing improvement WHEN ADDED to their existing therapy, which you will note is quite robust in itself.

      Elsewhere, I have read that their antivirals consisted of Kaletra and Ribavirin. Not sure which antibiotics were used, or which immunoglobulins or how many received prednisone or other corticosteroid. But note that it’s an entire package of therapeutics: antivirals (including antiretrovirals), antibiotics, antibodies, and steroids, not just a single regimen of HCQ.

  • It is stated by the French doctor who conducted the two tests with apparently startlingly successful results says clearly the drug:
    1 needs urgent other cofirmatory similar non-blind tests – which should be well underway NOW!!!!
    2 The drug stops the virus replicating SO the drug should be given EARLY before patients suffer the consequences of a massive virtual infection.3
    # In the circumstances of this rapid pandemic there is no moral or functional justification for blind trials, since to not offer the drug to a control group would guarantee their illness, and in some cases, their death. The medical profession sounds as though it is engaging in poer politics.

    • A double-blind trial versus a placebo would be truly unethical. HOWEVER, if you wanted to test it against another equally promising therapy, and IF you could structure it as a double-blind trial, that would be both ethical, and informative. As long as all patients are receiving equally promising therapies, it’d be good to try to see which one was actually best.

  • “Full blown clinical trials” would be nice.

    In the meantime, more than 1000 people died yesterday with no hint of a real treatment plan in place. Ventilators only let the disease run its course and hope the patient survives.

    Tell those families there was no need to attempt this treatment.

    Sheesh.

    • Why are you assuming that they haven’t received this treatment? New York has had the bulk of the cases, and deaths, and yet the governor ordered the medication to be made available primarily for hospital use, and drug companies have shipped in additional doses.

      Once someone is on a ventilator, it may be too late to give them oral medicine, but I’m sure it’s being used before that. It’s clear that whatever benefit this treatment has, a lot of patients are still dying.

      Regarding ventilators, once all the ones in this state are in use, everyone else who presents as critical and can’t get a ventilator, has zero chance of survival. Whether the recovery rate for critical patients on a ventilator is 60%, 50%, or 20%, without one, it’s 0%.

      A handful of patients might be able to get external mechanical oxygenation (“heart/lung machine”). And while there are probably even fewer hyperbaric chambers in New York, I wonder if hyperbaric oxygen might save anyone.

  • The FDA can be great, but they can also be ludicrous. One example of the latter aspect is how they suddenly and without notice banned one of the most effective antacid medications because it could exhibit raised levels of NDMA at high temps (one lab simply recommend keeping the medication refrigerated, but apparently the FDA would rather ban it altogether), yet in the same study they admitted that you could utilize said medication for 70 years and experience no problems with it (the cancer study was in animals, and completely unproven in humans). Meanwhile, we know that acid reflux can lead to esophageal cancer, and the alternate PPIs have their entirely own set of known issues, including potential cancer concerns, but the FDA is touting them as acceptable alternatives.

    Also, meanwhile, scores of patients who were told to stock up on their prescriptions due to the pandemic are now suddenly being told to throw that very medication out and seek different prescriptions (forget their ability to deal with added stress at the moment, nor the possible need for lab work following certain changes).

    Sometimes, the FDA really doesn’t make any sense whatsoever, and they seem to make patients’ lives a living hell at times.

    It’s a given that every single medication has potential side-effects, and we will never be 100% risk-free in taking any of it; we simply weigh the risk vs. reward of doing so and make our decisions accordingly.

  • Someone asked if this is getting used on critical patients. To my knowledge, it’s here in NYC and getting used for covid-19 patients. Oral tablets might be a little hard to administer to intubated patients, so I have my doubts about that. But, all you have to do is look at our death rate and wonder if it’s having any effect at all. And now we hear that only 20% of intubated patients are surviving this disease. If you don’t think doctors would welcome ANYTHING that works, at any stage of this disease, you’re wildly mistaken.

    • It’s currently only being used on a small fraction of the many thousands of patients in NY.

  • Your article and thoughts are just plain dumb. Blood on your hands. You and Cuomo both.

  • When will the West learn its lesson, whatever studies, data that comes from China, it’s always a lie. Communist Chinese government can never be trusted at all. They are all evil! They appear to want to help solve this covid19, but deep inside they only want to save their own, though they could sacrifice thousands of their citizens, it does not matter, as long as the West esp. America suffers. They have no humility at all! Unbelievable despite the evidence that coronavirus came from China, it could distort it and say, it came from the U.S. i mean that is pure evidence. What else proof do we need to keep on including Chinese input on this covid19. They are laughing at us definitely!

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