[BostonCard]

I was responding to your assertion that since most people get better, what's the big deal. You're the one that took it off the topic of chloroquine. If this thing kills 1% of the people it infects (a realistic number) and it infects most of the populace (a realistic possibility for a highly virulent virus such as this), that's millions. It can be less if we practice distancing, wear masks, etc. Many projections take some of these measures into account. It's already killed 22 thousand Americans and we are just getting to know this thing.

It wasn't my assertion at all. Somebody posted this:
"Here's the thing, for the vast majority of people with this disease, they will get better with or without treatment."
Seems like the author was implying exactly what you're accusing me of. . . .

Two things can be true simultaneously.  The majority of people will get better, and, in fact, only a minority will even require a hospitalization... and to quote one of the presidential candidates, this is a big f-ing deal.

In context, what it means is that any uncontrolled study (of any drug) is very hard to interpret.  In the early days of modern medicine, penicillin did not undergo a randomized, placebo controlled study.  But that's because it was given to moribund patients with infections raging through their body, who almost certainly would have died.  When the drug cured them in a couple days (ah, the days before antibiotic resistance), it was obvious that penicillin was effective to treat life threatening infections.  You more or less know what the counterfactual would have been like, so rigorous testing with a placebo was not necessary.  To this day, we still have some drugs that are tested that way, though these are often for rare indications where very few people have the disease and the outcome is almost universally fatal (and well-characterized).

However, when you have an illness that "only" kills a 5% of those who are hospitalized, if you see that most patients you give the drug get better, it is hard to know what would have happened in the counterfactual.  Even if you treat enough patients to have expected one or two to have died, you don't know if you were "lucky", or if your study was biased in some way (for example, with entry criteria that excluded those most likely to die).  For studies like that, you need a placebo to compare it to.

Fortunately, the WHO is testing chloroquine/hydroxychloroquine, and comparing it not only to placebo, but also to remdisivir, Kaletra, and Kaletra plus interferon.

https://www.who.int/emergencies/diseases...treatments

BC

[BostonCard]

I was responding to your assertion that since most people get better, what's the big deal. You're the one that took it off the topic of chloroquine. If this thing kills 1% of the people it infects (a realistic number) and it infects most of the populace (a realistic possibility for a highly virulent virus such as this), that's millions. It can be less if we practice distancing, wear masks, etc. Many projections take some of these measures into account. It's already killed 22 thousand Americans and we are just getting to know this thing.

It wasn't my assertion at all. Somebody posted this:
"Here's the thing, for the vast majority of people with this disease, they will get better with or without treatment."
Seems like the author was implying exactly what you're accusing me of. . . .

Two things can be true simultaneously.  The majority of people will get better, and, in fact, only a minority will even require a hospitalization... and to quote one of the presidential candidates, this is a big f-ing deal.

In context, what it means is that any uncontrolled study (of any drug) is very hard to interpret.  In the early days of modern medicine, penicillin did not undergo a randomized, placebo controlled study.  But that's because it was given to moribund patients with infections raging through their body, who almost certainly would have died.  When the drug cured them in a couple days (ah, the days before antibiotic resistance), it was obvious that penicillin was effective to treat life threatening infections.  You more or less know what the counterfactual would have been like, so rigorous testing with a placebo was not necessary.  To this day, we still have some drugs that are tested that way, though these are often for rare indications where very few people have the disease and the outcome is almost universally fatal (and well-characterized).

However, when you have an illness that "only" kills a 5% of those who are hospitalized, if you see that most patients you give the drug get better, it is hard to know what would have happened in the counterfactual.  Even if you treat enough patients to have expected one or two to have died, you don't know if you were "lucky", or if your study was biased in some way (for example, with entry criteria that excluded those most likely to die).  For studies like that, you need a placebo to compare it to.

Fortunately, the WHO is testing chloroquine/hydroxychloroquine, and comparing it not only to placebo, but also to remdisivir, Kaletra, and Kaletra plus interferon.

https://www.who.int/emergencies/diseases...treatments

BC