At the very bottom, it says "original data will be published on web-based public database in 6 months after the research" which is a bit disappointing.
What would be the motivation for that 6 month delay? Cynically it only seems like a way to grab headlines without any possibility of informed criticism, but I really want to believe that there are other possible motivations!
Maybe it would take a lot more work to get the data into a publishable format and they don't think that's their highest priority right now? Being charitable here.
Can anyone mention a reasonable explanation for the 6-month delay? All I can think is that they want to prevent irresponsible purchases thus only including it in treatment guidelines for now.
This paper's completely misleading. Coronavirus also has shown benefit in animal models -- for example, "Antiviral Activity of Chloroquine against Human Coronavirus OC43 Infection in Newborn Mice"
"Survival rates declined in a dose-dependent manner, with 88% survival when treated with 5 mg/kg chloroquine and 13% survival when treated with 1 mg/kg chloroquine. Our results show that chloroquine can be highly effective against HCoV-OC43 infection in newborn mice and may be considered as a future drug against HCoVs."
Thank you for this reasonable view. Those last few days, I have seen a great many people here piling on chloroquine and aggressively promoting it to others. Those people were sometimes alledged scientists. This is worrying. Some countries have it in their emergency guidelines, yes. But is it beyond reasonable doubt that quinine derivatives are useful in humans? No. Absolutely not.
People are incredibly prompt to jump in on unproven suggestions during a crisis, while at the same time shitting on standard evidence-based medical care all year long. Go figure...
A small-sized chinese study with unreleased data? Color me skeptical.
That sort of data while it doesn't prove hydroxychloroquine did it, it does give some hope. If it was the other way that they - that they'd treated everyone with that and had a bad death rate then that would pretty much prove it didn't work.
I'm all for it if it works. But the diversity of practices and opinions among specialists shows that any current advice is just that: expert opinion. Here, we're doing kaletra. 100 kms from here, they're doing hydroxychloroquine.I understand the desperation, but I don't think it's for healthy citizens to pile up egoistically on ressources that might be more useful elsewhere.
From experience, expert opinion situations are not too encouraging. But let's hope we're lucky this time.
Now if you'll excuse me, I'll be off intubating highly contagious cases without appropriate protection equipment if you're looking for me in the coming days. Personally, I'm hoping that the disease preferentially targets politicians and health ministers #-(
The trial numbers are referenced in the sciencedirect paper but I really wish they would share the outcomes of the trials. WHO should be on this one would think!
But their data also shows TCM is better than placebo. Is chloroquine more effective than TCM?
Keep in mind that antivirals only work well if you start taking the during the first two days, TCM is reasonably safe and over the counter, whereas if you're in the US then good luck even getting tested in the first 10 days let alone prescribed something.
> • The outcomes of some current clinical trials of chloroquine in China have been announced, without access to the data.
Shameless tangent, China has just booted its most competent respiratory disease epidemiologist from heading epidemic control committee for not backing Xi Jinping's "herbal remedies"
The RFA source in the taiwan news mentioned the replacement took place in Feburary, and you can see that Zhong Nanshan remains in a leadership role up to yesterday [1].
A similar source [2] to the RFA one mentioned that Zhong was replaced on a post called "新冠病毒专家组组长" (leader of the COVID expert group); he's more commonly known as "国家卫健委高级别专家组组长" (leader of the senior expert group in national health commission; see [1]). Judging from the titles it's likely normal personnel changes.
Not to downplay the issue here: there have been reports of doctors being forced to include herbal medicines in the treatment from higher up, despite having little evidence supporting their efficacy. Just a random fact check.
Sources (all in Chinese; note epochtimes doesn't have a particularly good reputation):
I am Chinese, when has zhong nanshan ever being removed from heading the epidemic control committee. Just a few days ago he was making statements and directives as a member of that committee. This news is so fake it just smells like another Taiwan news piece smearing the Chinese government. (I have seen a number Taiwan news article that are just straight out lies. They often spin whatever happens in China has negative on the government, and push the government is evil narrative. Mainland also has it's share of fake news and propaganda. Both side is just equally guilty in brewing hostility against each other's government) And the government's treatment plan has never stated only to use TCMs instead of regular medicine. We don't have any effective drugs against the virus yet. All the treatment treats the symptoms. Say if the patient can't breathe so we give him oxygen. TCMs has a whole theory about regulating body as a system, it's supposed to reduce stress and improve immunity. I personally used TCMs and I have gotten better after using them. But the TCMs could very well be placebo. But when there is no drugs to use, why not try TCMs? Maybe it's just comforting thing. The patient is scared and super stressed. You give him this thing that claims to help, they gets to calm down, they are not stressed anymore, they sleep better at night, they are more hopeful. This is scientifically proven to help recovery. Also TCMs is cheap and you can get massive qualities in a short time. Whereas for Western medicine we gotta pay the drug companies expansive prices.
Feels like North Korea's magic ability to resurrect military commanders after they're allegedly executed by artillery cannon, etc., lies running laps before the truth puts on its shoes.
Taiwan isn’t Mainland China. The first source is from Taiwan, the 2nd from China.
It’s up to you to choose which news source to believe, knowing that the former can print anything (including wild speculation) and the later will only print government approved information (including blatant obvious propaganda).
> TCM has never missed a single fight against epidemics throughout Chinese history. TCM classics have provided sufficient evidence of how TCM cured epidemic diseases such as smallpox over the past several thousand years.
I don't have any reason to trust an article from a Taiwanese publication over one from the PRC but the above quote leaves me highly sceptical about the rest of the article.
It's quite tortuously contorted. He said he was proposing to launch proper clinical trials for "herbal remedies," dodging a request to give his blessing.
So the real story is he proposed doing scientifically valid testing, which could easily disprove their efficacy - and that somehow turned into "the experiments give some hope for the treatment of the novel coronavirus" ... due to a bad English translation?
Not simply bad, but like a 180⁰ of the original meaning.
Well, there is rich context to this. Chinese mainland media has been for weeks escalating the "herbal remedies" craze, and Xi somehow managed to insert himself even there.
Now the media (propaganda ministry) can't back off, because Xi will look like an idiot if they are to back off and acknowledge how foolish it is.
For Zhong, a man with a known anti-quackery sentiment, not speaking in single voice with CPC's herbal remedy peddlers, was enough to be seen as somebody not standing in line.
Imagine if homeopathy became a point of something the government says we have to see as cultural/national pride. And is prescribed by doctors/hospitals because of that, and scientific analysis has to show the results that also reflect that...
Sorry - I am having trouble following this. You're saying Xi Jinping wanted yes-men in order to push the herbal remedies, and Zhong Nanshan wanted real science?
Basically the goal is to allow zinc to get into a cell, it needs a helper to get inside the cell (a Zinc Ionophore). Apparently based on the 2nd video, Hydroxychloroquine is even more effective than Chloroquine. It's really important to note however that these are lab based findings, not from studies on patients.
What about zinc lozenges dissolved in the mouth, followed by a can or two of tonic water infused with green tea or matcha and a few drops of bay leaf essential oil.
Essential oils have been evaluated for their inhibitory activity against SARS-CoV and HSV-1 replication in vitro by visually scoring of the virus-induced cytopathogenic effect post-infection. Laurus nobilis oil exerted an interesting activity against SARS-CoV with an IC(50) value of 120 microg/ml and a selectivity index (SI) of 4.16. This oil was characterized by the presence of beta-ocimene, 1,8-cineole, alpha-pinene, and beta-pinene as the main constituents.
I looked around and found naturally occurring zinc ionophores: https://pubs.acs.org/doi/abs/10.1021/jf5014633
Quercetin is present in Red Onions and Epigallocatechin-gallate in green tea. Don't know if they are as effective etc but there's got to be alternatives to Chloroquine....
I read some links implying that Quercetin was potentially useful against coronavirus, although they sounded a bit like PR/sales, and site that had links is down (bad sign?) so I can't find the links now.
In Africa when you suffer from Malaria they gradually give you Chloroquine, Amodiaquine or even Quinine. From my experience, Quinine is the strongest. I grew up taking those medicines. Man. They knock you out. Your ears are no longer working the first 3 days of taking Quinine. You lose the sense of smell. I guess they slow down the Corona 19 virus. My mom has already sent me Amodiaquine and Quinine here in Italy.
Chloroquine encourages cells to take in zinc, zinc inhibits RdRP, RdRP builds copies of viruses.
Thats the mechanism that works in test tubes, but not in humans so far. Pulling Zinc into cells is what determines this hypothetical effect, not to be confused with whatever has the strongest side effects.
There are many papers online giving confidence that 50-80 mg zinc (gluconate) reduces colds by a day or two and 1000-2000+ IU vitamin D3 reduces flu by a day or two. So while I disagree with your conclusion that Chloroquine won't work, I wish I could give you 100 points for making the connection between zinc and RdRP.
Edit: just did a search and your insight led to this study on zinc and Coronavirus from 2010:
Increasing the intracellular Zn2+ concentration with zinc-ionophores like pyrithione (PT) can efficiently impair the replication of a variety of RNA viruses, including poliovirus and influenza virus. For some viruses this effect has been attributed to interference with viral polyprotein processing. In this study we demonstrate that the combination of Zn2+ and PT at low concentrations (2 µM Zn2+ and 2 µM PT) inhibits the replication of SARS-coronavirus (SARS-CoV) and equine arteritis virus (EAV) in cell culture. The RNA synthesis of these two distantly related nidoviruses is catalyzed by an RNA-dependent RNA polymerase (RdRp), which is the core enzyme of their multiprotein replication and transcription complex (RTC). Using an activity assay for RTCs isolated from cells infected with SARS-CoV or EAV—thus eliminating the need for PT to transport Zn2+ across the plasma membrane—we show that Zn2+ efficiently inhibits the RNA-synthesizing activity of the RTCs of both viruses. Enzymatic studies using recombinant RdRps (SARS-CoV nsp12 and EAV nsp9) purified from E. coli subsequently revealed that Zn2+ directly inhibited the in vitro activity of both nidovirus polymerases. More specifically, Zn2+ was found to block the initiation step of EAV RNA synthesis, whereas in the case of the SARS-CoV RdRp elongation was inhibited and template binding reduced. By chelating Zn2+ with MgEDTA, the inhibitory effect of the divalent cation could be reversed, which provides a novel experimental tool for in vitro studies of the molecular details of nidovirus replication and transcription.
Just lol'd at the concept of a 'verification tweet'... Seriously folks - just because someone on Twitter sounds authoritative, doesn't mean they are spouting facts.
Chloroquine is a really interesting drug because it is derived from quinine which is one of those "early history medicine man/woman" kinda things (Quechas) that turned out to be effective for two things: antiviral properties and great taste.
* It was used for centuries to combat malaria until it recently (~10yrs) became ineffective (I took some in the 80's for a year while working in Central America and had amazing dreams).
* It is the basis many awesome aperitifs: Byrrh, Bonal, [tonic water,] and other herbaceous spirits
If it can be used as an antiviral for COVID-19, well, that would be a really cool example of an old/ancient medicine still doin' its thing.
Paper's main source seems to be a news briefing in Chinese.
Here's google translate: "We organized more than a dozen hospitals in Beijing, Guangdong and Hunan provinces to jointly evaluate the safety and effectiveness of chloroquine phosphate in the treatment of new coronary pneumonia. In the clinic, we are very sure to see the curative effect, whether it is from the rate of exacerbation, antipyretic phenomenon or the image improvement time of the lungs, the negative time and negative rate of viral nucleic acid, and the shortening of the disease course, and a series of indicators, systematically Based on comprehensive research, the medication group was better than the control group. For example, a patient in Beijing was admitted to the hospital on the 4th day of the onset of disease at the age of 54. One week after taking the medicine, the nucleic acid turned negative, and all the indicators improved, meeting the criteria for release and isolation."
"Audio transcript of the news briefing held by the State
Council of China on February 17, 2020. The National
Health Commission of the People's Republic of China.
http://www.nhc.gov.cn/xcs/yqfkdt/202002/f12a62d10c2a48c6895c... (accessed February 18, 2020).
(in Chinese)"
I don't think there is much doubt left about it's efficiency at this stage. Hydroxichloroquine is much safer than chloroquine and it's just a 5 day course at pretty low dosage (2x400mg on day1 as a charge dose, then 2x200mg for 4 days).
More importantly, the drug is readily available, mass producded and doesn't cost 300$+/box like lopinavir/ritonavir. This drug isn't also 100% experimental and probably in the 3 digits rangs like remdesivir.
The only real issue is that with a lot of doctors using it, the temporary shortage of the drug could be troublesome for many Lupus patients around the world who depend on Plaquenil for their management.
I remembered your comment today because we had a doctor call our pharmacy to order +1000 hydroxichloroquine tablets for everybody in his assisted living facility, requiring 12 tablets per patient for prophylactic use. Our Pharmacist in charge referred him to literature and informed him they would need an Rx for each patient even if we had that kind of supply, but overall this was not an appropriate practice without a full list of all medications that patients are currently taking. Anyway I thought you'd find this interesting.
If you don't mind, would you mind sharing the source for the hydroxychloroquine dosages you mentioned? I clicked your links (understand Italian) and as far as my computer gave me, none of them worked, which was strange but maybe a problem with my browser.
I just posted a story about a vaccine being found. Would be great to know from the experts in this area if the approach they describe in the article makes sense
I'm fairly certain finding the vaccine is really quite easy to develop and has been done by multiple companies small and large already. The main issue is to do the clinical trials and get it approved and mass produced in a timely fashion.
These trials and the validation can take about a year.
Here is the official list of currently being developed covid19 vaccines (all in pre-clinical stage)
In the article I referenced, the company says they use a novel plant based method which allows mass production, and expect phase three clinical trials to be completed by November.
The company, Medicago, is not on the list you provided. It also seems to be a Pentagon funded biotech company so trying to understand how credible this news may be (I'm sure there are many unscrupulous companies trying to claim a miracle cure at this point!)
It makes sense that vaccines need more careful assessment before rollout than treatment pharmaceuticals. When the medical infrastructure has reached triage grade saturation, even coin toss treatment candidates could become rational if they can run in parallel to conventional treatment. Exposing the still healthy to a vaccine is an entirely different risk calculation.
A reasonably opportunity to throw money at the problem would be to fund speculative production ramp-up for likely candidates ahead of approval, this should not be left to the invisible hand alone.
There are many variants of the flu. Most of them are well-enough understood to vaccinate against, and most of those have an already-tested-and-approved vaccine. The yearly flu vaccine is a combination of those vaccines for the strains the public health experts think are going to be an issue that season.
Sometimes they get it right. Sometimes they don't, and we have a bad flu season (see also: this year).
That paper is old and a bit vague. A more recent report is from a trial with 120 patients at Sun Shanxian Memorial Hospital. 110 got better with chloroquine, the hospital's coronavirus tests showed negative on average 4.4 days after starting treatment.
This seems pretty inconclusive to me; as noted by other posters, we have no data from some of the trials in China and peer review of the potential patient benefits hasn't materialised yet. Not trying to be a downer, but..
As an aside, the number of preppers and conspiracy theorists out on HN under stories like this is awful.
Remember, the world has vast infrastructures (CDC, WHO, NHS and equivalents) for working out the right course of action in these situations. They are staffed by professionals who understand how medicine and medical trials work, and how and when to deploy public health measures. I'm not saying their word is law, but hanging out on internet forums and then panic buying random stuff which isn't obviously efficacious off the back of a misunderstanding of the science is not personally or socially productive. At worst, it harms people in genuine need and stymies the ability of society to respond.
> random stuff which isn't obviously efficacious off the back of a misunderstanding of the science
1) It's not random stuff; there is associated research and a theory of operation how it counteracts the virus
2) Lacking obviousness? By the time the research is settled, you may be very sick already.
3) There is no misunderstanding, there is a risk analysis based on the currently available knowledge. Risk of chloroquine poisoning X probability of effectiveness X risk of acute viral infection.
4) Crowd-sourcing information has shown to be very effective in other times of crisis, a viral outbreak is no different.
The internet is not a place for the information police. We share our ideas here.
It's an analogue of quinine, which tonic water nowadays may contain varying (quite small) amounts of, depending on brand etc.
G&Ts almost certainly won't have any effect on your susceptibility to infection nor your prognosis once infected. But they might help with (or make worse?) the anxiety associated with the panic.
Tonic water can contain up to 83mg/L actual quinine. Three 2L bottles of tonic water could get you 500mg, a therapeutic dose of quinine. Unfortunately, I have not found any place that manufacturers note how much quinine is in their tonic water.
I propose a new cocktail consisting of one part gin, three parts tonic, 200 mg hydroxychloroquine plus ice and a slice. Call it a Corona Cocktail maybe. Job done.
Yeah, I remember reading something similar years ago. But I suspect with the proliferation of "craft tonic water" there may be some "flavours" that don't contain quinine at all.
I read somewhere that gin & tonic was invented because they needed the gin to cover up the taste of the quinine, since the tonic needed to have a _lot_ of quinine to be effective.
As someone who has taken uncoated chloroquine tablets mumble years ago, the taste is one of the most foul bitter over-riding tastes one will ever encounter. No amount of sugar mixed in with it took the edge off the taste. The only thing that did it was when they coated the tablets, preventing the chloroquine from touching the tongue.
A surprising amount of medicines have this incredibly foul taste. I was forced to take oseltamivir during the H1N1 epidemic, and I had to share a pill once (two of my siblings needed a half dose). It tasted so incredibly bitter and just mouth-wrenching
The worst taste experience I ever had was when I accidentally bit down on an ibuprofen gel cap before swallowing it with a small mouthful of room temperature coffee (it was all I had at my office desk). Wow... it instantly numbed the back of my mouth and throat and tasted like volatile chemical waste. I washed it all down as fast as I could with more coffee but that taste and tingly sensation stuck around for 20 minutes.
Chloroquine, a drug mostly used against malaria, was shown in the 2000s to have some effect on SARS-CoV; in cell-culture studies it both reduces the virus’s ability to get into cells and its ability to reproduce once inside them, possibly by altering the acidity of the Golgi apparatus http://archive.vn/yfAWD
One more reason to love gin and tonic! I had a feeling this old-time, classic drink crafted by the British to make malaria prophylaxis quinine more palatable and fun in colonial times, in India I believe, was a winner. From the bark of "cinchona" trees in Peru, quinine derivatives, are now showing some promise to treat SARS Cov-2. This is quite amazing.
Some GPs in some EU countries did decide do take it prophylactically due to lack of PPE. But most around me agree this is a risky and probably bad advice. The current publicly available guidelines do not recommend taking it before you develop symptoms and do not recommend taking it at all if you are asymptomatic and/or very young. And also certainly they do not recommend any self medication without doctor's approval as there can be serious adverse effects with chloroquine (less with hydroxichloroquine).
Also this would have a terrible effect and indeed cause supply shortages as another commenter pointed out.
There is some evidence that hydroxychloroquine may be better as a prophylactic. Here's medcram talking about it from in vitro results https://youtu.be/vE4_LsftNKM?t=192
Re real patients I thought this interesting on lupus patients using hydroxychloroquine at a hospital in Wuhan:
>In the early stage of the study group, through the clinical analysis of 178 patients with new coronavirus received by the hospital from December 2019, it was found that none of them was systemic lupus erythematosus. After that, in the consultation of 80 patients with systemic lupus erythematosus treated by dermatology department of the hospital, it was found that they were not infected with new coronavirus pneumonia. https://www.jqknews.com/news/388543-The_novel_coronavirus_pn...
Which suggests it may work in real life. Lupus patient get a pretty high dose but looking at the in vitro stuff it looks like a low dose say 400mg/wk might work.
There may be a possibility here to save millions of lives - if this does go full pandemic with 60% global infection, taking say weekly hydroxychloroquine might reduce the effects to something mild flu rather than ICU death. It seems to me enough upside to make it worth doing a serious research effort which I don't think is being done.
My wife was tested yesterday - she has fever sympthoms. The first thing I did was down 500mg of Chloroquine. I am in an at-risk group. Then i took the kids to our country house. Fingers crossed for her today. 36 hrs after she came home from work with a fever i am still fever free.
This will be a moot point for the foreseeable future, since if this actually works, limited supplies will be redirected to people who are actually infected.
Chloroquine is relatively easy to make. I think if prophylactic usage is recommended thousands of tons of the stuff will be produced in very short order.
Yes, I was reading about this recently. Another study compared zinc uptake into the cytosol for various extracellular zinc levels, with and without chloroquine.
I noticed when looking at the data, that while chloroquine facilitated a massive uptake a zinc, it was still true that increasing the extracellular zinc concentration (without chloroquine) still increased the cytosol's zinc concentration (by a lesser amount).
I promptly ordered zinc supplements. Obviously I'll see a doctor if I have symptoms, but I'll also hedge my bets.
I was told by a lady behind me in line in the store yesterday (who had taken 10 packs) that she intends to take 1 per day but if she feels bad she’ll take 4 per day until she overcomes the covid.
There is enough stupidity around in normal times, and now is worse.
I couldn't quite believe that one would have to go so far as to take a drug like Chloroquine as a Zinc ionophore, so I looked around and found naturally occurring stuff like so: https://pubs.acs.org/doi/abs/10.1021/jf5014633
however, I don't know about how it compares and if these are as potent as Chloroquine so it would be nice if an expert could opine on whether these natural compounds are as potent.
Honestly this is a perfect example of a time when laws are excessively restrictive. I should have the right to purchase this drug and use it as a last resort in the case that I or my family are infected.
It's not fair to responsible people who are capable of researching safety and dosages to have to pay for the ignorance of others. Especially when this drug is OTC in most of the world. You don't need a medical degree to safely administer most drugs - and you should have the right to take that risk, even if that means ignorant people getting hurt or dying.
In emergencies it is pretty standard procedures to ration essential stuff in limited supplies. Food is regularly rationed during war times. It would not be ridiculous at all to limit the use of an OTC drug to hospitals during an emergency, if there is limited supply (don't know if that's the case with chloroquine).
I'm pretty sure that doctors dealing with a pandemic have read enough about the treatment options to know the guidelines. But hey, surely that can't know as much as a random guy on the internet.
Considering that news of coronavirus is so widespread that you're apparently aware of this, I would think that most doctors are probably aware of this too.
Medical personnel outside of China were still laughing this off as "just another flu" until mid February at the earliest. Unfortunately all I have is anecdote...but it took far too long for people to take this seriously, because doctors are humans too and aren't necessarily trawling internet forums for happenings.
Limiting the quantity that can be purchased to a particular address or credit card or similar restriction can help with this problem.
As can inflating the price (high taxes) for non-doctors who are purchasing preemptively. If you are sick, go to a doctor and get it at the normal price. If you are a prepper, pay extra, buy less.
There is a shortage either way; there hasn't been a change in the amount of the drug or the number of people who want it in either scenario. If anything, the price going up will increase production and the shortage will lessen as fast as the logistics chain can manage.
Basically instead of people choosing where it goes a government agency/hospital system chooses where it goes. After the CDC testing debacle, hopefully people understand that giving control to the government isn't a clear cut win. It is good if people have some control over their own destiny.
If I buy a test kit, mask, antiviral cocktail, ICU bed for myself, despite being unlikely to need it, and there's a shortage of these resources, I've lessened the sum effectiveness and response.
Personally? I assume the average person is an idiot, where nuanced topics that elicit emotional responses are concerned.
I'd choose experts doing their best to allocate effectively any day of the week.
The fact that experts are not perfect in no way bears on their nonetheless being better than the average person.
But if the experts are imperfect and people are banned from helping themselves then there really is a problem.
I find it darkly ironic that in the US their centralised control of the medical system has royally screwed up the ability of people to access test kits and that is likely to become a rallying point for people who want more centralised control of the medical system.
If you do buy those things then you can share them with your neighbors. Someone is bound to want that stuff - a few more community sponsored ICU beds, masks, test kits and antiviral cocktails would be just what most countries need.
It wasn't a criteria; it was an observation that a system that allows people to help themselves in parallel to the experts is better.
The options aren't "experts hold all the power" or "paniced hoarders have all the power". At the moment, the US has set the dial to experts holding all the power and badly flubbed the response; the obvious solution is a mix of expert- and non-expert- control so that when the experts inevitably muck up it isn't the end of the game.
If people want to allocate a massive % of societies resources to masks, ICU beds and COVID-19 tests they should be able to. At present, they aren't allowed to and the government doesn't seem to be reacting very quickly.
This is classic economics; centralised control and price control where vendors are scared of being dinged for 'price gouging' have immediately resulted in massive shortages. If the government encouraged prices to rise until supplies were only just running out and gave the medical system enough money to buy what they needed in that environment then the situation would resolve much more quickly.
The people making face masks, ventilators, ICU beds and similar should be rolling in so much money from panic buyers that it makes sense to hold emergency reserves for the next crisis. That isn't what is happening, so instead we won't have resources for this crisis or the next one. So called 'panic buying' leads to a very healthy economic response after a month or two; which is where we happen to be vs COVID-19. If we'd had more panic buying earlier we'd be in a better spot now, and rapidly moving to a better spot in a month or two. If we allowed people to allocate resources to testing and hospitals despite the opinions of centralised agencies we'd also be a better spot. People like Bill Gates can fight malaria but they can't fight the CDC.
> government doesn't seem to be reacting very quickly
> If the government encouraged prices to rise until supplies were only just running out and gave the medical system enough money to buy what they needed in that environment then the situation would resolve much more quickly
> So called 'panic buying' leads to a very healthy economic response after a month or two
Your argument would be stronger if you dropped the opinionated hyperbole.
If the government transferred funds through the market, vs direct purchases, then we'd be at the mercy of whatever the masses decided they wanted to buy.
As of a few days ago, this would have meant that millions of dollars went to toilet paper manufacturers.
You seem to be of the opinion that a free market knows best in crisis situations. I feel otherwise. Doubt I'm going to be able to change your mind.
> Your argument would be stronger if you dropped the opinionated hyperbole.
Not actually true, hyperbole doesn't change the quality of the evidence or the strength of the argument.
> As of a few days ago, this would have meant that millions of dollars went to toilet paper manufacturers.
Nothing wrong with that. If people feel a desperate need to buy overpriced toilet paper then the toilet paper manufacturers and distributors should be encouraged to take advantage of that. If a roll cost $30 that would stop people buying trolleys of the stuff all at once. Instead, shops in Australia have held prices steady and run out of toilet paper; leaving me peeved I have to say. The situation is pretty much strictly worse than if the free market was encouraged in times of crisis.
> You seem to be of the opinion that a free market knows best in crisis situations.
No, not at all. But suppressing free market forces in a crisis is one of the worst possible responses because it delays the corrective action by suppliers. Prices should be shooting up and down, and governments should be giving hospitals emergency funding so they can buy what they need. That'll provide the best signals of what is needed in a crisis. I bet the free market understood the need for test kits a lot more than the CDC did in America; there would have been hospitals crying out to test people.
It isn't so much that I think the idea is good as much as there isn't really a way of stopping it and it will get the most resources allocated to the medical sector to set up more beds.
If you are relying on the hospital's goodwill and I'm willing to throw down $100k in bribes; I suspect I will mysteriously get myself an ICU bed. It would be better if that money went to the hospital where they can buy more beds than to corrupt administrators. Much like I can get toilet paper if I'm willing to pay $200 a roll; and it would be better if that was going to the manufacturer rather than drug dealers as is currently the case in Australia.
It'd be best if the hospital sold VIP bed insurance at some rate, and after you were a confirmed case with severe symptoms you then had priority access to a bed.
The alternative is drowning in your own body fluids after you're turned away by overwhelmed hospitals. Or watching it happen helplessly to your loved ones after they're turned away for being too old, as is happening in Italy. And in any case Chloroquine is a well studied, proven safe drug with minimal side effects and a high therapeutic ratio.
Therapeutic index of chloroquine isn't very high, and at the doses it's recommended for corona it's rather close to lethal doses, something like within an order of magnitude.
Malaria prophylaxis is dosed -once- a weeek. Half-life 60-70 hours.
Covid treatment is -twice daily-.
The therapeutic index of chloroquine in the treatment of covid-19 is relatively high. Some people take chloroquine or hydroxychloroquine at about half the acute dosage used for covid-19 (autoimmune disorders) for literal years.
Given the half life as you mentioned, once or twice a week with enough lead time would be a sufficient dosage against covid-19 too. It's just that if you want to reach the concentration of chloroquine that you would have to take it over a long time otherwise, you need very high doses. And since you're already infected and have a ton of the virus, you also need higher concentrations than for prophylaxis.
chloroquine is not frequently used for autoimmune.
At doses used for corona, it is within 50% of margin, or even lower if you are a slow metabolizer of an LD50 dose.
plaquenil on the other hand does have a higher therapeutic index.
The other major disadvantage is that these drugs can interact with protease inhibitors.
Kaletra, a protease inhibitor, is a combination of two drugs, one of which is a CYP3A4 inhibitor. It is used with some success on coronavirus patients.
Co-administering this with chloroquine 500mg/BID could easily result in chloroquine concentrations well above LD50.
The Chinese use 1g/day for treatment. A single dose of 3g can be fatal so not a massive margin. That said they've used it on hundreds of patients without adverse effects from the drug and probably a lot of lives saved from its effects on the virus.
And I know I won't die because it's already safe enough to fight malaria. But maybe you don't know that. That's fine. I do. Let me arbitrage my knowledge.
Clinical trials are already fast-tracked during epidemics; if you're really interested you may even be selected for one. But going out and randomly buying medicine because it seems like it might work (even though it might not, but you're cured without it, which means you're going to go out and tell everyone else to go buy it too) might not necessarily be the best way to deal with this.
> But maybe you don't know that.
I am aware of chloroquine's use in malaria treatment.
> But going out and randomly buying medicine because it seems like it might work (even though it might not, but you're cured without it, which means you're going to go out and tell everyone else to go buy it too) might not necessarily be the best way to deal with this.
Hey, that's okay, let me live or die on my own terms. It's my body. Stop trying to rule it.
I'm not making you take it. How about you don't make me not take it.
...but your body will take up a hospital bed and a team of healthcare professionals to deal with the side effects, thus taking them away from other patients.
All right, that's a fair complaint about the externalities. I will sign documentation excluding the need for cover in the shared medical system and commit $150k to disposal of my body should I die.
The amount is negotiable to release you from your responsibility to me.
Chloroquine phosphate, an old drug for treatment of malaria, is shown to have apparent efficacy and acceptable safety against COVID-19 associated pneumonia in multicenter clinical trials conducted in China. The drug is recommended to be included in the next version of the Guidelines for the Prevention, Diagnosis, and Treatment of Pneumonia Caused by COVID-19 issued by the National Health Commission of the People's Republic of China for treatment of COVID-19 infection in larger populations in the future.
Highlights from that paper (all of which look quite reasonable to me, as a non-expert):
• In vitro data suggest that chloroquine inhibits SARS Cov-2 replication.
• In past research, chloroquine has shown in vitro activity against many different viruses, but no benefit in animal models.
• Chloroquine has been proposed several times for the treatment of acute viral diseases in humans without success.
• The outcomes of some current clinical trials of chloroquine in China have been announced, without access to the data.
• Peer review of the results and an independent assessment of the potential benefit for patients are essential.