A Hydroxychloroquine A Day

at

US President Trump announced yesterday that he is taking the drug hydroxychloroquine as protection against the novel coronavirus

Ignoring his own FDA
Something moved Donald to say
He’s taking a pill
That could possibly kill
So there may be good news on the way

John Moynes

Getty

Update:

This afternoon.

A letter just released but dated yesterday from Dr Sean Conley, physician to US President Donald Trump, defending the use of hydroxychloroquine.

 

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64 thoughts on “A Hydroxychloroquine A Day

    1. Celticon

      Got any evidence to back up your claim that it has been used “successfully” to treat COVID-19 in those countries? Would be very interested to read it.

        1. millie in quarantine

          Yes that’s why you never post anything valid* to back up your claims.

          *valid=from a webpage that doesn’t promote conspiracy theories and disinformation, thanks

        1. f_lawless

          “Not great really” – is the wrong conclusion. Clinical studies so far have been limited and inconclusive – some suggest evidence of positive outcomes, others don’t. That’s why, as the Guardian article says, there’s “multiple large-scale, double-blinded randomized controlled trials currently underway” which are ” the gold standard for demonstrating a drug’s effectiveness “.

          Q&A with the leader of one such trial: https://health.ucsd.edu/news/releases/Pages/2020-05-15-nih-begins-clinical-trial-of-hydroxychloroquine-azithromycin-to-treat-covid-19.aspx

          1. Otis Blue

            Eh, it’s the right conclusion to a commenters claims – now deleted – that it had been used successfully to treat Covid-19.

            As is clear, the science is inconclusive.

  1. V

    he’s changed his tie
    Red to Black

    Qs? What’s that code for?

    Roulette Colours – not a good sign

        1. V'ness

          Not really Millificent

          Its pretty clear now that Sourdough starter was the next stage to control and monitor the internet
          In fairness they were spot on about the toilet paper massacre

          Operation Hashtag Organic StatisfyHer is stage 3
          Apparently

          Meanwhile recent dispatches from the People’s Republic Rebel held front in Passage East indicate that Tanora is getting great results and out preforming Remdesivir at rate that’s being compared to Waterford Hurling.

        2. millie in quarantine

          Please send on all further dispatches as a matter of urgency. I need to add another layer of tinfoil to my bunker.

          As an aside, I am absolutely dreadful at sourdough. My last loaf was an insult to bread. Banana bread I could throw together in my sleep at this point. It’s more of a cake though.

          1. V'ness

            Heads up on the Sourdough

            Mary Berry herself tips some dried yeast into her starter mix (flour and tepid water)

            and lets it off to its own devices for a week or so until tis stinking and rancid

            And banana bread is a bitta’ve cod, grand if you’ve a load of spotty bananas you’ve forgotten about, but if you have, then tip a bag of dark chocolate chips in to the batter.

            I personally find it hard to commit to sourdough
            like I did my soda last night, 10 mins work ffs,
            and there’s a hum from the bottom after its’ 30 minutes @200º a choir could take their key from

          2. Janet, I ate my avatar

            I made Naan bread, actually I made biscuits, well they tasted ok in the curry anyway

          3. V now a very Public Juridic Person of Pontifical Right.

            ahem,
            this’ll likely be interrupted differently – and Bertie’ll probably destroy himself

            too wet for flat breads, like naans or focacchias is a good thing

            did you add flour to try and tidy them up?
            maybe you just left them in too long – even 90 seconds over can be the difference

            rather than overthink it, just have your (I know sorry Broadsheet) Ghee glaze ready the second they come out or off the skillet

          4. Janet, I ate my avatar

            yeah I had the ghee ready, and chopped mint, I reckon I added yogurt in wrong order, I’ll blame the damp so

  2. SOQ

    What is the problem here? Trump along with his doctor obviously believes it is an effective prophylaxis. If you disagree- then just don’t take it?

    The Indian Council of Medical Research, under the Ministry of Health and Family Welfare, has recommended chemoprophylaxis with hydroxychloroquine (400 mg twice on day 1, then 400 mg once a week thereafter) for asymptomatic health-care workers treating patients with suspected or confirmed COVID-19, and for asymptomatic household contacts of confirmed cases.

    Is India wrong too? Who knows. But, they do produce 70% of the world’s hydroxychloroquine and are ramping up production big time. Orders flooding in from all over- even Britain has bought an extra £2 million worth of it.

      1. alickdouglas

        The problem here is that the FDA has provided clear and specific guidance on the off-label use of Hydroxychloroquine vs COVID. They authorised its investigation for clinical trials and in hospitalized patients where clinical trial participation is not feasible at the treating physician’s discretion. Interim data analysed more recently suggests that that the drug might be both ineffective against the virus and therefore have a negative risk/benefit for this use. Typically FDA regs are there to reel in manufacturers and prevent them from selling unwise applications of their drugs. Refer for example to GSK’s gigantic fine for off-label use of Paxil. As Hydroxy… is a generic, Trump and his physician appear unlikely to benefit in any material way from ‘promoting’ the drug. It therefore isn’t in the FDA’s interest to bring a case, but that shouldn’t distract that what Trump (and/or his prescribing Physician) is doing is reckless. The FDA is far from a perfect organisation, but through their efforts to provide evidence-based guidance on the use of drugs they are a cornerstone of ensuring safe medication in the US. For better or worse, many agencies piggy-back on top of FDA’s work, especially as regards guidelines and quality, so a strong FDA keeps our medication safe too. True, they need extensive reform, in particular to distance them from vested interests, but you don’t see Trump harping on about that, quite the opposite.

        1. SOQ

          Fair point but the FDA by their very nature are bureaucratic and slow and in situations like this where time is crucial, clinicians do have the power to make their own judgement calls.

          In this case the question is if it is of use as chemoprophylaxis. and there is no mention of such from the FDA- at least that I can find. The politicisation is not helping of course but on the other hand I suspect we would have never even heard of hydroxychloroquine if it wasn’t for Trump.

          As for vested interests, it is a case of ‘follow the money’- who will lose or gain if hydroxychloroquine does turn out to be effective as a prophylaxis against CoVid-19?

          1. alickdouglas

            Correct, clinicians do have that right and typically handle it well. However in this case the FDA have actually issued guidance that it should *only* be used in the hospital (or on a clinical trial), with this recommendation coming directly from studies in humans with COVID. That reco was issued in part because of the reported fatalities of people using it prophylactically at home. So yes, they don’t say ‘don’t take it prophylactically’ but it is implied by their wording.

            Who will gain? Tightening the screw of drug regulation throughout the early 2000s has managed to shake some–but by no means all–of the charlatans out of pharma development, and forced the bigger players to pay much more attention to patients. Trump and his cronies have been trying to row back on all types of regulation and scrutiny, financial, environmental and pharmaceutical. Evidence based evaluation is at the heart of a reliable regulator for any sector. By promoting quackery for COVID, they are encouraging people everywhere to distrust evidence, and to disregard the need for regulation.

            BTW, I do agree that the FDA need severe further reform, but in the opposite to the way that Trump wants to do it. They *should* be a force for good, and often, perhaps usually, are.

          2. SOQ

            Again same as my comment below- Trump is using it as a prophylaxis. not a cure. It is entirely possible that it can have mixed results as a treatment while also being an effective prophylaxis.

            That is exactly what has happened with HIV PrEP (Pre Exposure Prophylaxis) because Truvada only works for some people who are HIV+ yet is 99% successful at preventing infection in the first place.

          3. alickdouglas

            SOQ, in response to your PrEP comment, the difference is that Truvada has a very clear evidence base supporting its use as prophylaxis. I’m pretty sure that at least one of the Truvada trials was stopped because the impact was so obvious that the review board required the subjects on placebo/control to be moved over to therapy.

            That is clearly not the case for chloroquine and its similars vs. COVID. The most charitable interpretation of the data to date indicates that there might perhaps be some modulation of virus replication, but when it comes to analysis against clinical trial endpoints, the stuff doesn’t work.

            Trump’s statements are dangerous because he is suggesting that not only should we not wait for evidence, that we ignore the evidence that suggests that this stuff doesn’t work.

          4. SOQ

            @alickdouglas

            Truvada was first used as a treatment but even then it was nowhere near as well tested as hydroxychloroquine. Besides, HCQ is prescription only so it is up to the GP to do a risk assessment on each individual patient.

            My core point is that along with Zinc it is being tested for two separate functions- prevention and cure- and they should never be mixed up.

            The statements made by Indian medical community is what you should be watching btw- not Trump.

            Oh an interesting footnote- the company making this drug is owned by the Indian state- there is no ‘for profit’ interests.

  3. Anvil

    The drug is being taken by a considerable number of frontline health workers.
    https://www.businesswire.com/news/home/20200417005586/en/Sermo-Reports-One-Quarter-Global-Physicians-Agree-Healthcare
    But of course if Orange Man Bad takes it the left-wing media have to condemn it.
    It is strange that a man who has come into close contact with Covid-19 sufferers including his valet has so far remained free of the virus.
    But Trump has a long-held phobia of germs – perhaps he just washes his hands a lot.

    1. millie in quarantine

      “There is little data about the efficacy of hydroxychloroquine, and the Centers for Disease Control and Prevention (CDC) has cited cardiotoxicity as a leading concern with the treatment, particularly in patients with underlying health issues and immunosuppression.”

      This article is from a month ago. In that time, new data has emerged. This is a rapidly developing situation. It’s a pity that more isn’t conclusively known about hydroxychloroquine as yet, because it was initially considered to be very promising.

    2. Toe Up

      He had sex with a pornstar without protection and willingly shakes hands in the middle of a pandemic. He’s not a germaphobe, he’s just extremely fortunate.

    3. V'ness

      Look it
      It would be very simple to say leave him off to consume what he likes
      He’s his own man, and clearly running his own Presidency

      But I’m surprised that National Security or who ever it is in the White House Situation Room, and his own personal protection unit in the FBI are letting the President of the United States put himself at risk

      So imo either its just all talk
      from him, which shouldn’t surprise anyone
      Or its true

      And I’m inclined to believe the latter since I don’t think he would be allowed off to self medicate and put the Country at risk by putting himself in such harms way
      I have no doubts some unit in the Pentagon/ White House Basement would have intervened

      1. SOQ

        Agreed and he didn’t just blurt that out by accident. If he now comes down with the virus then hydroxychloroquine as a treatment for CoVid-19 is a dead duck- so he is upping the stakes big-time.

      2. Anvil

        Hydroxychloroquine has been approved for medical use in the United States since 1955.
        It’s not some dodgy pill that a crazed scientist has just come up with.
        It is on the World Health Organization’s List of Essential Medicines and its side-effects are well known whether you take it for malaria or to prevent Covid-19.
        It has also saved a great many lives.
        It may not prove to be effective at all in Coronavirus but if the FDA has considered it safe to use for 65 years I don’t see how Trump taking it changes its danger one iota.
        Virtually every single drug sold over the counter or prescribed comes with a long list of side-effects which may or may not occur.
        Such ignorance on here today.

        1. millie in quarantine

          Such ignorance? You must know better than all the scientists working on those multiple studies into how hydroxychloroquine will react with a virus that we are still learning how to treat.

          I look forward to your paper and published findings on the subject.

          1. SOQ

            But the discussion today is if it is a successful prophylaxis against CoVid-19- not a treatment- and India seems to think so- otherwise they would not be throwing it out like sweets.

            Surely you would agree that if their front line workers are not getting infected then there is something to it?

          2. millie in quarantine

            And yet my response on this thread is to the link above, in relation to the use of hydroxychloroquine as a treatment. There are any number of studies looking at the use of it in relation to Covid-19, they all take time and usually more than one test group to establish any findings.

            I’m not discounting it, and if it works then brilliant obviously. But there is (naturally) a rush to find a cure, and there are problems with touting hydroxychloroquine or any other drug as a miracle cure (or preventative) before we have the full picture. We’ve seen in the past the dangers of that, with the thalidomide scandal, for example.

          3. Anvil

            The scientists are looking at how effective the drug is in preventing coronavirus not whether it produces side-effects.
            Those side-effects have been well-known as the drug has been in use for 65 years.
            Surely even you can see the difference ?
            Think of it like Viagra or Sildenafil to give it its proper name.It was originally developed to treat one illness but was later found to be good at another one.The side-effects can be the same on you whether you have trouble raising a stiffie or not if you take it.
            Interestingly,it is the 217th most commonly prescribed medication in the United States.
            Hydroxychloroquine is the 128th.

          4. alickdouglas

            In response to Anvil’s comment, when it comes to use for a certain indication, it’s not the overall list of symptoms that matter it’s the benefit-risk. There’s a sound logic to it: As an example, if you have severe malaria symptoms in a resource-short region, it’s fairly likely that you’ll be administered quinine, and it might very well save your life. Quinine remains highly effective against falciparum malaria. However if you are not severely unwell it’s highly unlikely you’ll get quinine, the side effects are pretty awful for many people. The safety profile of chroloqine and its associates is pretty good, but far from perfect, so its use comes with both an increased risk of mortality and illness. So far studies indicate that it is not particularly impactful against COVID, and hence by taking it the evidence suggests that you are increasing your overall risk of illness and death. On the other hand chloroquine’s impact on malaria is reasonably well understood, and hence it’s used for that when appropriate

          5. SOQ

            Hydroxychloroquine is much better tolerated than quinine- that is the reason it was created. Thousands if not millions of front line staff are already using Hydroxychloroquine and like the majority infected with CoVid-19 itself I expect- they feel perfectly fine.

          6. bisted

            …I have long been convinced of the health restoring powers of Indian quinine and have been administering this tonic for many years…

          7. alickdouglas

            SOQ–this is exactly the point; the chloroquines were invented to try to produce a product that was safer, but they are also (typically, for the most severe cases of malaria) less effective. This is where risk-benefit matters, and when risk benefit is favourable a physician will use quinine over chloroquine, despite the risk. The situation for COVID is different. The chloroquines appear, from recent well controlled testing in humans to be borderline or not at all effective in controlling the virus but they still carry health risks. Therefore it is unwise to use them because there is evidence to show that they seem to provide little benefit, but nevertheless carry risk. Aspirin is in a similar position when it comes to risk benefit. A decade or so ago, it was generally felt that everyone should be taking aspirin, it has now become clearer that actually, the benefit is probably less than we thought, and the risks for some people substantial. The degree of quackery regarding COVID is significant, and if we want to see impactful, safe drugs and vaccines in the future, we are going to have to set the bar much higher, and not fall for propaganda from Trump, manufacturers, Tony Fauci or anyone else.

  4. V'ness

    Kittens
    Grow up to be cats

    And before you know it you’re got a Jackie Tyrell and a Tommy Walsh pair of manky ugly toms causing mayhem with the neighbours

    And destroying the gaff

    Just saying
    Maybe be a bit more tactful with that edit lads

  5. newsjustin

    “Hell no, I won’t give my kids the MMR vaccine. And don’t even get me started on a non-existent COVID19 vaccine.”

    but

    “Take Hydroxychloroquine on the chance it’ll help, sure what’s the harm.”

    And

    “I won’t wear a mask. Masks are for cowards. God and some sunshine will keep COVID19 from my door. I’m not afraid.”

    vs

    “These are my guns and I’m keeping them. All it takes is one good guy like me with a gun to stop a crazy guy.”

  6. jamesjoist

    President Trump says he’s taking hydroxychloroquine , do you believe him ? Would that man tell a lie ?

  7. Janet, I ate my avatar

    little bit of lead in the left ear…my Granny’s cure for doses, very effective

    1. V'ness

      have you managed to find someone to sharpen their pencil
      in your ear Janie?

      is that the new thing now – c’mon

      its been a while for me

          1. bisted

            …heard that lead in the left ear as a remedy for a greyhound who hung to the outside in races…it was told one night by a good story-teller and everyone was intrigued…someone asked the inevitable question about how you got the lead into the ear…usually with a .22 rifle…

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