
People are dying of coronavirus because we’re too slow at clinical research - elsewhen
https://www.statnews.com/2020/04/22/people-are-dying-from-coronavirus-because-were-not-fast-enough-at-clinical-research/
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gus_massa
> _Obviously, for the patients who receive a placebo, this can be a sacrifice.
> And it can be a hard one to make._

If the new idea is bad, the sacrifice is in the experimental group and the
control group are the lucky ones that got the best treatment.

Note that in this cases where there is a "standard" procedure the control
group receives the "standard" procedure. They are not left alone to die.

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redis_mlc
The problem with your theoretical argument is that we already know there is no
standard treatment that works, and ventilators have a mortality rate of 66% to
90%.

So ... the control group is "left alone to die."

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gus_massa
The 90% is probably wrong[1]. Anyway, the current method is saving 10%-34% of
the patients. Nobody can guaranty that is perfect, but it's the best guess
after years of treating patients with similar symptoms.

[1] What is the original source of the 90%? Is it from this article:
[https://jamanetwork.com/journals/jama/fullarticle/2765184](https://jamanetwork.com/journals/jama/fullarticle/2765184)
From the article:

> _The study included all sequentially hospitalized patients between March 1,
> 2020, and April 4, 2020, inclusive of these dates._

> _As of April 4, 2020, for patients requiring mechanical ventilation (n =
> 1151, 20.2%), 38 (3.3%) were discharged alive, 282 (24.5%) died, and 831
> (72.2%) remained in hospital._

If you ignore the 831 patients that were still in the hospital, and consider
only the 38 that survived and the 282 that died, you get 282/(282+38)=88%. It
is a very short time. What are the odds for people that survive more than 4
days in the hospital?

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IAmEveryone
We kinda do now know that remdesivir and chloroquine are useless. The trials
are only continuing in a futile waste of research bandwidth to convince the
sort of people that considers a wall in the desert more useful than a post
office...

The rest is probably true, although maybe not as much now as in "normal"
times? An intern with a clipboard and a quarter should currently be able to
run a competent trial in NYC. I can't imagine approval being as difficult now
as it usually is. Maybe there just aren't that many promising candidates?
Maybe availability is a problem for more esoteric ideas?

From what I'm understanding, there is _a lot_ of experimentation of various
levels of rigour (non-mortis) going on for changes in treatment protocols,
such as timing, duration, and setting for ventilation, proning, fluid
management, etc.

For every debate the public engages in regarding on the pro and cons of
bleach-drinking, the medical profession is engaging in twenty debates on the
best management of potassium levels to protect liver functions in diabetic
patients etc

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tcbawo
There is as active discussion happening between doctors on the front lines
here and abroad. The world's healthcare practitioners are linked up through
social media in a way that is truly inspiring. The best new ideas are coming
from the bottom up.

