[fanofourforebears]

Countries that don’t have free media (e.g. China) or have strong CDC(0 (e.g. Taiwan) have done very well in managing the virus.

What countries have a free media for comparison with those that do not in your opinion?

Why would you try to claim that there is too little freedom of the press or too much power in Public Health in the US and that those are the reasons for the American failure?

Well... why would you claim the opposite?

The much simpler explanations (Occam’s Razor) are that Americans did not test, isolate, mask, and social distance sufficiently.  You could more easily argue from that that the US had too much freedom of expression and too little public health if your objective were to limit death.

According to who?  What is the "science" supporting what you have just stated?

---

To underscore BC's point, the reason why therapies of all kinds can seem great in observational studies and then turn out not to be effective in a randomized, blinded, controlled clinical trial is that observational studies generate all sorts of spurious correlations that seem promising, but observational studies cannot establish causality. So those early observational studies of HCQ looked great but the positive findings turned out to be spurious (i.e., wrong). In general, observational studies can be useful in generating hypotheses that can be studied in randomized controlled trials, but they are not evidence of effectiveness. A point lost on the HCQ promoters, including our departing leader. And as a consequence, many people were exposed to the potential harms of the drug in exchange for no benefit, and supplies grew short for those who needed the drug to treat certain autoimmune diseases for which it has been proven effective.

Disagree.  And I am not a this or that treatment promoter or defender.  Consider whatever study you think was compelling to stop the use of HCQ or whatever study that made Remdesivir the standard of care and think... how come?  Was there really a control group, was the placebo really a placebo and just how much or little HCQ was used, knowing that too much of many drugs can be fatal.  Studies just are not that well done today and many involving the "new" virus lack the foundations needed to even begin a study, namely Why were the basics skipped?

---

Didier Raoult had a reasonable scientific hypothesis and found some promising initial data.  Here is his initial paper:

https://pubmed.ncbi.nlm.nih.gov/32205204/

The scientific literature is littered with promising therapies that don't work.  The generic PTS (probability of technical success) for a drug entering clinic making it all the way to approval is about 15%.  A substantial majority of drugs don't make it, despite drug companies hiring very smart people and investing a lot of time and effort to try to focus on the ones with a strong scientific hypothesis and promising initial data.

Alas, the gold standard for whether a drug works or not is a randomized, blinded, placebo controlled clinical study where patients come into the study and have the same chance to get the active drug as the placebo, and nobody knows what the patient got until the very end.  This way, you can ensure that the patients who got the active drug weren't treated differently from those who didn't, and you can compare a relevant endpoint (like mortality) between those patients who got the active drug to those who got placebo.

And, it turns out that when hydroxychloroquine was looked at under those circumstances, time and again patients who got hydroxychloroquine did no better than those who got placebo.  That's not an attempt to suppress the truth; it's just the way science works.  Hydroxychloroquine doesn't work as Raoult thought it would and many of us hoped it would.  It's not an indictment of Raoult; there's no shame in advancing a hypothesis that doesn't pan out, and it is not evidence that the press is under undue influence from mysterious forces that harbor an unexplained antipathy towards hydroxychloroquine (but not, apparently, to dexamethasone).  In fact, to the extent there is a complaint out there it is that hydroxychloroquine has been given too much coverage, and dexamethasone, which has been shown to reduce mortality in hospitalized patients with COVID-19, hasn't been given enough.

BC

I think if you look a little more critically at the "disqualifying" studies you will see some problems in substantially all of them.  Show me the dose and show me what was used as the "placebo".  In other news, at least the good guys won the big game today!!

[fanofourforebears]

Countries that don’t have free media (e.g. China) or have strong CDC(0 (e.g. Taiwan) have done very well in managing the virus.

What countries have a free media for comparison with those that do not in your opinion?

Why would you try to claim that there is too little freedom of the press or too much power in Public Health in the US and that those are the reasons for the American failure?

Well... why would you claim the opposite?

The much simpler explanations (Occam’s Razor) are that Americans did not test, isolate, mask, and social distance sufficiently.  You could more easily argue from that that the US had too much freedom of expression and too little public health if your objective were to limit death.

According to who?  What is the "science" supporting what you have just stated?

---

To underscore BC's point, the reason why therapies of all kinds can seem great in observational studies and then turn out not to be effective in a randomized, blinded, controlled clinical trial is that observational studies generate all sorts of spurious correlations that seem promising, but observational studies cannot establish causality. So those early observational studies of HCQ looked great but the positive findings turned out to be spurious (i.e., wrong). In general, observational studies can be useful in generating hypotheses that can be studied in randomized controlled trials, but they are not evidence of effectiveness. A point lost on the HCQ promoters, including our departing leader. And as a consequence, many people were exposed to the potential harms of the drug in exchange for no benefit, and supplies grew short for those who needed the drug to treat certain autoimmune diseases for which it has been proven effective.

Disagree.  And I am not a this or that treatment promoter or defender.  Consider whatever study you think was compelling to stop the use of HCQ or whatever study that made Remdesivir the standard of care and think... how come?  Was there really a control group, was the placebo really a placebo and just how much or little HCQ was used, knowing that too much of many drugs can be fatal.  Studies just are not that well done today and many involving the "new" virus lack the foundations needed to even begin a study, namely Why were the basics skipped?

---

Didier Raoult had a reasonable scientific hypothesis and found some promising initial data.  Here is his initial paper:

https://pubmed.ncbi.nlm.nih.gov/32205204/

The scientific literature is littered with promising therapies that don't work.  The generic PTS (probability of technical success) for a drug entering clinic making it all the way to approval is about 15%.  A substantial majority of drugs don't make it, despite drug companies hiring very smart people and investing a lot of time and effort to try to focus on the ones with a strong scientific hypothesis and promising initial data.

Alas, the gold standard for whether a drug works or not is a randomized, blinded, placebo controlled clinical study where patients come into the study and have the same chance to get the active drug as the placebo, and nobody knows what the patient got until the very end.  This way, you can ensure that the patients who got the active drug weren't treated differently from those who didn't, and you can compare a relevant endpoint (like mortality) between those patients who got the active drug to those who got placebo.

And, it turns out that when hydroxychloroquine was looked at under those circumstances, time and again patients who got hydroxychloroquine did no better than those who got placebo.  That's not an attempt to suppress the truth; it's just the way science works.  Hydroxychloroquine doesn't work as Raoult thought it would and many of us hoped it would.  It's not an indictment of Raoult; there's no shame in advancing a hypothesis that doesn't pan out, and it is not evidence that the press is under undue influence from mysterious forces that harbor an unexplained antipathy towards hydroxychloroquine (but not, apparently, to dexamethasone).  In fact, to the extent there is a complaint out there it is that hydroxychloroquine has been given too much coverage, and dexamethasone, which has been shown to reduce mortality in hospitalized patients with COVID-19, hasn't been given enough.

BC

I think if you look a little more critically at the "disqualifying" studies you will see some problems in substantially all of them.  Show me the dose and show me what was used as the "placebo".  In other news, at least the good guys won the big game today!!