Is there not an argument that given chloroquine's apparent efficacy, albeit statistically weakly or improperly demonstrated (so far), along with its long history of relative safety in anti-malarial prophylaxis (with known caveats), set against an exponential growth in dangerous pneumonia - it is therefore rational to want to at least offer it to all suspected cases and healthworkers in balance of the serious risks they face?
> Is there not an argument that given chloroquine's apparent efficacy, albeit statistically weakly or improperly demonstrated (so far), along with its long history of relative safety in anti-malarial prophylaxis (with known caveats), set against an exponential growth in dangerous pneumonia - it is therefore rational to want to at least offer it to all suspected cases and healthworkers in balance of the serious risks they face?
The term is "compassionate use". It's drug approval for patients where the drug is not fully tested.
It almost certainly wouldn't be approved for healthcare workers, but it might be approved for people who need ventilators.
The basic idea is that the situation is so dire - all of the normal medical options have been exhausted - that patients are legally allowed to essentially experiment on themselves.
The main dangers for the general public are the acute toxicity and drug interactions. Take chloroquine, which comes in 500mg tablets, it does not take many tablets to get to toxic or even lethal dose. The drugs can prolong QT intervals, so combination with other drugs with similar side effects like some antibiotics or antidepressants could be dangerous.
Note in the full text article they show simulation of how long it takes for the drugs to reach therapeutic concentration at the lung. Since we don't know exactly where the antiviral effect comes from, these are only guess works.
It's a misdirection of resources - of money, clinicians' time and study subjects. There's enough drug and patients to run a well-designed clinical study, once that is done we know if chloroquin is any good or if we need to keep looking. My guess is that we are better off looking at antivirals.
Not the GP, but "mild" probably actually means mild. Given that only (highly) symptomatic people are tested, we don't know how many people contracted the virus and only had mild cold symptoms. Developing pneumonia would already put you outside of that "mild" designation.
We have a pretty good idea in Italy how many cases are asymptomatic or very mild and it is enormous. Traveling right now but if you are interested I'll update tomorrow
> According to Crisanti, the director of the virology lab of U Padua, as little as 10% of #COVID2019 carriers show any symptoms at all. He sampled repeatedly the entire 3k+ population of Vo ', one of the initial clusters.
> 700 have been tested. Kári says that about half of those who tested positive have shown no symptoms, and the other half show symptoms have having a regular cold.
> "The vast majority of people infected with Covid-19, between 50 and 75%, are completely asymptomatic but represent a formidable source of contagion". The Professor of Clinical Immunology of the University of Florence Sergio Romagnani writes
In the discussion of the study over on Reddit, there were anecdotes of physicians prescribing hydroxychloroquine for themselves and their families, in enough numbers to make it difficult for patients previously prescribed it.
The FDA has investigated Plaquenil and there is a clear record of the side-effects and directed usage - I don't know why you think it'd be any sort of impediment.
The possible side effects include permanent blindness.
Giving this drug to people while you simply don't know if it does any good is only justifiable if you do it within a properly designed clinical trial. Which is the thing you should do. If you feel lots of people should get this drug - do a large trial. Will give us better data.
You only need to mitigate the peak of infections from this virus. And I don’t think anyone is suggesting it to be used as a preventive tool. It is to reduce the contagiousness of people tested positive (and hopefully also help them with the virus).
because it doesn't generate enough offense. most online arguments seems to be attempts at creating the maximum possible offense to create "engagement"
the fact you need to have 1 kilogram of chloroquine during years of treatment is an inconvenient complicated fact, while the emotional appeal of blindness scores more indignation.
