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Thread: Hydroxychloroquine and Chloroquine for Thousands in New York

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    Re: Hydroxychloroquine and Chloroquine for Thousands in New York

    Quote Originally Posted by bubbabgone View Post
    Why didn't you tell him that it's been known that an arrhythmia is a possible side effect of the drug treatment and so it requires a doctor's prescription but that the short duration of treatment with the drug for the virus mitigates the risk?
    He doesn't know that kind of thing so why did you let him ramble without informing him afterwards?
    Who doesn't know it? Dr. Fauci has mentioned the QTc prolongation as well (not before Threegoofs and I mentioned it here). If Trump were listening...

    By the way, I made a typo up there, too late to edit. I meant that the "number needed to treat" maybe larger, not smaller, than the number needed to harm. That is, risks may outweigh benefits.

    No, the short duration of the treatment doesn't help. If you push your QTc above 500, you can get a bad, bad, often fatal arrhytmia called Torsade de Pointes ANYTIME. People die of this.

    So, there is a *known* risk of the combination, a major detrimental interaction, and according to Threegoof's study, its incidence in these COVID-19 cases was 11%. A QTc of more than 500 is pretty critical. The treatment might be justified if despite the risk of sudden cardiac death, it is actually lifesaving regarding the viral infection itself.

    Well, mind you, there's no such evidence so far. ONE study showed a benefit in test results, not in clinical outcome, which was actually WORSE in the group treated with the drug. Another study failed to replicate even this small test results benefit. Both studies showed NO IMPROVEMENT whatsoever. Do you know what the name of the second study was?

    "No Evidence of Rapid Antiviral Clearance or Clinical Benefit with the Combination of Hydroxychloroquine and Azithromycin in Patients with Severe COVID-19 Infection"

    See post #128.

    What part of NO EVIDENCE OF CLINICAL BENEFIT you don't understand???

    If it is proven with a larger study that this thing actually doesn't help, would you be willing to take it, for no gain, under a risk of 11% of cardiac arrest???

    So if you need to threat 8 or 9 people to get one to be harmed (11% is between 1 in 8 and 1 in 9), but you need to treat 100 people to get one to be helped (given that only about 1% of people with COVID-19 die (*IF* it helps; so far the meager evidence that we have, is that it doesn't), that doesn't sound like such a great miracle cure, does it?

    That's the problem with you guys. It's not that I'm arrogant. It's just that I actually know what I'm talking about, out of decades of professional experience in this field. Dr. Fauci knows it too. Threegoofs knows it too. There are a couple of other posters here who are obviously professionals too, and they've ALL said the same. It's interesting that all professionals with scientific experience are saying, hold your horses, while all NON-DOCTORS are saying "this is great, let's all jump into it!!! Game changer!!!" With not an ounce of REAL evidence whatsoever. Great!

    Look, I'm NOT arrogant. Recently I published a long thread asking for advice on the purchase of a firearm. I don't know much about firearms. Several posters here who seem to be quite the experts in firearms, helped me. I was grateful to them and thanked them profusely for their advice, especially the one received from a retired cop, who by virtue of his profession, knows a lot about firearms. I followed his advice and that of others, and got myself one.

    So, people should get advice from those who actually know what they talking about. I wouldn't try to get firearm advice from Dr. Fauci.

    Here, an analogy. God forbid, you get a brain tumor. But in face of this very bad piece of news, there's a good piece too: it's operable. You can be saved although it's delicate and you can also die on the operation table. So, you go to a practice called Neurosurgery of _______ (name of your city), LLC, which has been recommended to you by your primary care doctor.

    So you go there, and present to the check-in clerk, a nice attractive receptionist.

    Here, just tell me. Who would you want the receptionist to hook you up with? The neurosurgeon, or the phlebotomist? Would you rather get advice on your delicate, potentially life-saving, but also potentially fatal brain surgery, from the phlebotomist, or from the neurosurgeon? You tell me.

    Because what you guys are doing regarding the combination of hydroxychloroquine + azithromycin to treat the infection caused by the SARS-CoV-2, frankly, is that you're asking the phlebotomist.

    I have nothing against phlebotomists. It's a noble profession and an important part of the health care team. But if I need a brain surgery, I'll want the neurosurgeon to tell me what needs to be done.

    Get it now?
    Last edited by GreatNews2night; 04-06-20 at 07:05 PM.

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    Re: Hydroxychloroquine and Chloroquine for Thousands in New York

    Quote Originally Posted by trouble13 View Post
    What i find interesting and perhaps promising is that they started this mass trial aprox 10 days ago and a week later NY is reporting higher reovery rates and less fatalities.

    Sent from my SM-G965U using Tapatalk
    The peak and inflection point in New York was supposed to happen this week, using epidemiological models, before this attempt to treat with these drugs was even done. And I doubt that whatever trials are happening, are influencing the bulk of the population which is hundreds of times bigger than the population receiving trials. Not to forget, the deaths are always delayed. From infection to death the average is 4 to 5 weeks. So, no, most likely what you are seeing has nothing to do with these trials.

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    Re: Hydroxychloroquine and Chloroquine for Thousands in New York

    Quote Originally Posted by jmotivator View Post
    Well, it kind of has no choice. A 10,000+ person drug trial is pretty definitive.
    Not always. Hopefully but not always, because some trials may show positive results, while others may not show results, and the evidence may still be inconclusive. Medicine is full of "for this proposed treatment, two trials showed efficacy while two others didn't, so we still don't know and more research is needed." We read these lines over and over, in aggregators that present a digest of the information to busy doctors, such as UpToDate.

    Again, people reading me here often think I don't want this to work for some sort of partisan reason (although I'm not even a member of any party). Far from this. I very much will love to see it work. I want this to save many American lives if it works. It's just that I don't know yet if it works or doesn't. I do know that the combination is potentially harmful, as it is a notorious one for causing QTc prolongation in the heart.

    So, what I'm trying to do with my posting, is two things: 1) discourage lay people from jumping into this using bogus and unethical online prescription mills, or some doctor in the family, or some gullible front line doctor that can be influenced into writing a script, with little understanding of science, because if that's how people proceed, people will get hurt. 2) hope that politicians and TV pundits will stop dispensing medical advice when they are not qualified to do so.

    THESE are my goals. Not the scoring of political points. You can believe me or not; I can't do anything to convince you if you don't, except to say that when the SARS-CoV-19 first penetrated our defenses and some partisan people started blaming Trump, and despite my profound dislike of Trump, I did say, "it's not really his fault; a virus with these characteristics would escape containment sooner or later, and no governments in the world have actually been able to fully stop it, even the ones that jumped right at it with draconian measures."

    I posted several times actually defending Trump, which *is* atypical of me. But I did turn against him when "Dr." Donald J. Trump started dispensing medical advice to the population, on drugs he has absolutely no clue about and is utterly unqualified to utter an opinion on.
    Last edited by GreatNews2night; 04-06-20 at 07:04 PM.

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    Re: Hydroxychloroquine and Chloroquine for Thousands in New York

    Quote Originally Posted by bluesmoke View Post
    What are you saying? Are you saying that Trump is right, that chloroquine is safe to take, that chloroquine is a savior drug? Do you think what YOU SAY is actually being done in New York and is a good thing? What are you saying, if anything at all?
    Even if Trump's "guess" turns out to be right, Trump is STILL WRONG to act like he's a medical doctor or a scientist.
    So if Cuomo wants to take a gamble, so be it. But if Cuomo starts acting like Trump does, he too is wrong, because he is not an MD or a scientist either.

    The point is, when a doctor or other science professional expresses an opinion about a drug or a procedure, it is generally recognized as legitimate.
    When a politician does it, it is not, and the politician should not receive credit for an illegitimate hunch or a guess.

    That's the point, and that's always been the point.
    If it's not the point, then every single one of us here on DP deserves a medical degree.
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    I'm willing to let you die and keep all my liberties, tho. We are not a team.

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    Re: Hydroxychloroquine and Chloroquine for Thousands in New York

    I'll tell you what, and this is not arrogance, it's just a fact:

    If someone wants to dispense medical advice, there is well-established path which is the only legitimate one. Get to a good pre-med college. Study hard, really hard for 4 years. Take the MCAT and get a high score. Make sure you have a pretty darn good GPA, too. Get some other interesting assets in your resume. Apply for the 154 MD programs and/or the 54 DO programs we have in our fine medical schools. Match to one of them. Make sure either your family is rich or you're prepared to get into a very humongous student loan debt. Study very hard for 4 years. Sit for the USMLE Step 1 and the USMLE step 2 which are pretty difficult. Get good scores. Apply to residency training. Match to one of America's teaching hospitals. Get a training license from the state medical board and keep studying and working hard for another 3 to 7 years depending on your specialty. Take the USMLE step 3. Graduate from training and obtain a full license (demonstrate moral standards and solid credentials), then take your specialty's board exam. Hopefully get a job and start paying back your student loan, and make sure to keep up with the Maintenance of Certification requirements from your specialty board, which involve CME (Continuous Medical Education).

    THAT'S how ou get qualified to dispense medical advice.

    Anything else, is called illegal exercise of medicine. Folks, do NOT get your medical advice from people who have NOT done the above. You'll get hurt.

    There is a reason why the process is so long and difficult: it's because Medicine deals with human life and death, and only very qualified people are allowed to do it, because this is darn serious.

    You want to dispense medical advice? Become a doctor. Simple (although becoming one is not simple).
    Last edited by GreatNews2night; 04-06-20 at 07:27 PM.

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    Re: Hydroxychloroquine and Chloroquine for Thousands in New York

    Quote Originally Posted by GreatNews2night View Post
    The peak and inflection point in New York was supposed to happen this week, using epidemiological models, before this attempt to treat with these drugs was even done. And I doubt that whatever trials are happening, are influencing the bulk of the population which is hundreds of times bigger than the population receiving trials. Not to forget, the deaths are always delayed. From infection to death the average is 4 to 5 weeks. So, no, most likely what you are seeing has nothing to do with these trials.
    You may be completely right, I don't know. I'm speaking strictly as a laymen with no medical expertise. It may be a coincidence that these thigs are occurring simultaneously.
    What I do know is that all the bickering going on in this thread isn't going to matter much in the end. As they expiriment more with these drugs the results will speak for themselves, whether positive or negative we will find out.

    FTR i have no issue with your position or Jacks. I think cautious optimism is the correct approach here.

    Sent from my SM-G965U using Tapatalk

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    Re: Hydroxychloroquine and Chloroquine for Thousands in New York

    Quote Originally Posted by trouble13 View Post
    You may be completely right, I don't know. I'm speaking strictly as a laymen with no medical expertise. It may be a coincidence that these thigs are occurring simultaneously.
    What I do know is that all the bickering going on in this thread isn't going to matter much in the end. As they expiriment more with these drugs the results will speak for themselves, whether positive or negative we will find out.

    FTR i have no issue with your position or Jacks. I think cautious optimism is the correct approach here.

    Sent from my SM-G965U using Tapatalk
    Well, my position *is* cautiously optimist. I said I hope these trials prove the efficacy of this combination of drugs. It's just that this is still unproven, is potentially dangerous, and I don't like medical advice being dispensed by people who aren't medical doctors. You may have noticed that I praised Dr. Fauci at all times. In my opinion Trump should shut up and let Dr. Fauci speak, when these press conferences get to the medical side of things.

    Even if Trump had made a point of issuing his opinion on this but had used these words, "cautiously optimistic", I wouldn't have had a problem with it. But the insistence with which he keeps touting this treatment as a miracle cure and a game changer while utterly unqualified in this field, with stuff like "I have a feeling" and "my guess is" and "I'm very smart, my hunch is" is what bothers me, and it is infuriating. Yesterday he didn't even allow Dr. Fauci to speak (because he knew the good doctor would counter the insanities that he was saying). He plain says, "people should use it, why not, they have nothing to lose."

    Yes, they do have something to lose. Their lives.

    If 11% - or 1 in 9 - of patients on this combination are showing QTc of 500, yes, they may die of this "treatment", while if any evidence that the 1% who would have died of this condition can be saved, 1 in 100, is still utterly unproven, then the number needed to harm is smaller than the number needed to treat. In other words, the risks may outweigh the benefits.

    You need to threat 9 people to already harm one... but you may need to treat 100 people to *maybe* save one.

    So, again, let's hold our horses.

    I'd endorse the "nothing to lose" if this combination of drugs were harmless. It is not, and Trump has no clue why. Do you think that Trump knows what a QTc prolongation is, and what risks it causes???
    Last edited by GreatNews2night; 04-06-20 at 08:12 PM.

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    Re: Hydroxychloroquine and Chloroquine for Thousands in New York

    Quote Originally Posted by GreatNews2night View Post
    Who doesn't know it? Dr. Fauci has mentioned the QTc prolongation as well (not before Threegoofs and I mentioned it here). If Trump were listening...

    By the way, I made a typo up there, too late to edit. I meant that the "number needed to treat" maybe larger, not smaller, than the number needed to harm. That is, risks may outweigh benefits.

    No, the short duration of the treatment doesn't help. If you push your QTc above 500, you can get a bad, bad, often fatal arrhytmia called Torsade de Pointes ANYTIME. People die of this.

    So, there is a *known* risk of the combination, a major detrimental interaction, and according to Threegoof's study, its incidence in these COVID-19 cases was 11%. A QTc of more than 500 is pretty critical. The treatment might be justified if despite the risk of sudden cardiac death, it is actually lifesaving regarding the viral infection itself.

    Well, mind you, there's no such evidence so far. ONE study showed a benefit in test results, not in clinical outcome, which was actually WORSE in the group treated with the drug. Another study failed to replicate even this small test results benefit. Both studies showed NO IMPROVEMENT whatsoever. Do you know what the name of the second study was?

    "No Evidence of Rapid Antiviral Clearance or Clinical Benefit with the Combination of Hydroxychloroquine and Azithromycin in Patients with Severe COVID-19 Infection"

    See post #128.

    What part of NO EVIDENCE OF CLINICAL BENEFIT you don't understand???

    If it is proven with a larger study that this thing actually doesn't help, would you be willing to take it, for no gain, under a risk of 11% of cardiac arrest???

    So if you need to threat 8 or 9 people to get one to be harmed (11% is between 1 in 8 and 1 in 9), but you need to treat 100 people to get one to be helped (given that only about 1% of people with COVID-19 die (*IF* it helps; so far the meager evidence that we have, is that it doesn't), that doesn't sound like such a great miracle cure, does it?

    That's the problem with you guys. It's not that I'm arrogant. It's just that I actually know what I'm talking about, out of decades of professional experience in this field. Dr. Fauci knows it too. Threegoofs knows it too. There are a couple of other posters here who are obviously professionals too, and they've ALL said the same. It's interesting that all professionals with scientific experience are saying, hold your horses, while all NON-DOCTORS are saying "this is great, let's all jump into it!!! Game changer!!!" With not an ounce of REAL evidence whatsoever. Great!

    Look, I'm NOT arrogant. Recently I published a long thread asking for advice on the purchase of a firearm. I don't know much about firearms. Several posters here who seem to be quite the experts in firearms, helped me. I was grateful to them and thanked them profusely for their advice, especially the one received from a retired cop, who by virtue of his profession, knows a lot about firearms. I followed his advice and that of others, and got myself one.

    So, people should get advice from those who actually know what they talking about. I wouldn't try to get firearm advice from Dr. Fauci.

    Here, an analogy. God forbid, you get a brain tumor. But in face of this very bad piece of news, there's a good piece too: it's operable. You can be saved although it's delicate and you can also die on the operation table. So, you go to a practice called Neurosurgery of _______ (name of your city), LLC, which has been recommended to you by your primary care doctor.

    So you go there, and present to the check-in clerk, a nice attractive receptionist.

    Here, just tell me. Who would you want the receptionist to hook you up with? The neurosurgeon, or the phlebotomist? Would you rather get advice on your delicate, potentially life-saving, but also potentially fatal brain surgery, from the phlebotomist, or from the neurosurgeon? You tell me.

    Because what you guys are doing regarding the combination of hydroxychloroquine + azithromycin to treat the infection caused by the SARS-CoV-2, frankly, is that you're asking the phlebotomist.

    I have nothing against phlebotomists. It's a noble profession and an important part of the health care team. But if I need a brain surgery, I'll want the neurosurgeon to tell me what needs to be done.

    Get it now?
    See ... that's what I was talking about.

    You teased the word limit requirement with unnecessary words in a question anyone could answer with "I will follow my doctor's direction".
    Oh, and the short duration of the drug treatment for the virus absolutely ... positively ... is a mitigating factor. And you dismissed it.
    Which, btw, is also one of the things a person's doctor will know about their patients before prescribing the drugs.
    That's my polite way of telling you that your analogy was lamer than lame.

    I'm beginning to wonder if you should be taken seriously.

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    Re: Hydroxychloroquine and Chloroquine for Thousands in New York

    Quote Originally Posted by GreatNews2night View Post
    Well, my position *is* cautiously optimist. I said I hope these trials prove the efficacy of this combination of drugs. It's just that this is still unproven, is potentially dangerous, and I don't like medical advice being dispensed by people who aren't medical doctors. You may have noticed that I praised Dr. Fauci at all times. In my opinion Trump should shut up and let Dr. Fauci speak, when these press conferences get to the medical side of things.

    Even if Trump had made a point of issuing his opinion on this but had used these words, "cautiously optimistic", I wouldn't have had a problem with it. But the insistence with which he keeps touting this treatment as a miracle cure and a game changer while utterly unqualified in this field, with stuff like "I have a feeling" and "my guess is" and "I'm very smart, my hunch is" is what bothers me, and it is infuriating. Yesterday he didn't even allow Dr. Fauci to speak (because he knew the good doctor would counter the insanities that he was saying),


    Your position has been blanket denial. As near as I can tell, the biggest problem seems to be that Trump has promoted it.

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