
Bayer donates 3M chloroquine phosphate tablets for potential Covid-19 treatment - teddyvangogh
https://www.reuters.com/article/us-health-coronavirus-bayer/bayer-donates-three-million-malaria-tablets-to-us-for-potential-use-against-coronavirus-idUSKBN21637E
======
LinuxBender
An alternate zinc ionophore with less side effects is Quercetin [1] [2] which
some people here already take for other reasons, myself included. It is most
beneficial if being taken prior to infection to slow the RNA transcoding
process by getting more zinc into the cells, assuming one is not deficient in
zinc to begin with. I mention this because by the time someone is talking to a
doctor, the virus has likely already replicated in vast amounts. Chloroquine
currently requires a prescription, at least in the U.S. I am neither a doctor
or a scientist, as per my profile. Very few doctors study molecular biology as
a hobby or as part of their career.

[Edit] To be clear, I am not a doctor and this is not medical advise. Please
research this topic yourself. There are many studies on nih.gov on zinc
ioniphores. Here is a video discussing both compounds by a doctor. [3] They
are also not giving medical advise.

[1] -
[https://examine.com/supplements/quercetin/](https://examine.com/supplements/quercetin/)

[2] -
[https://www.ncbi.nlm.nih.gov/pubmed/25050823](https://www.ncbi.nlm.nih.gov/pubmed/25050823)

[3] -
[https://www.youtube.com/watch?v=vE4_LsftNKM](https://www.youtube.com/watch?v=vE4_LsftNKM)

~~~
HarryHirsch
Bioavailability of quercetin is low. That doesn't prevent the supplement
industry from profiting from it, unfortunately. The upside is, since it's
poorly absorbed from the gut, you probably won't die from it.

~~~
amanaplanacanal
There are formulations with higher bio-availability. Try Thorne Research
Quercenase.

------
wazoox
Warning: chloroquine has strong side-effects, and very high toxicity,
unfortunately pretty close to therapeutic doses, that may cause serious
arrhythmia, and even heart attacks. Don't ever try to self-medicate with
chloroquine.

~~~
pbreit
WARNING: the above is almost certainly wrong. Citation should be provided.

The preponderance of the evidence suggests that it's a well-understood drug
that has been around for decades, used by 10s of millions for not only malaria
but also arthritis. In fact it is safe enough that it is available over the
counter in some countries. [1]

1:
[https://en.wikipedia.org/wiki/Chloroquine](https://en.wikipedia.org/wiki/Chloroquine)

~~~
wazoox
From your own link,
[https://en.wikipedia.org/wiki/Chloroquine#Overdose](https://en.wikipedia.org/wiki/Chloroquine#Overdose)
: "Chloroquine is very dangerous in overdose."

Please read what you're posting, at least.

~~~
dogma1138
Hydroxychloroquine has lower toxicity and while it has side effects including
sight loss these tend to only occur with long use (years to decades) and are
mostly accumulative.

The current HCQ protocol for COVID-19 is a 600mg dose daily (within about the
safe limits for a grown adult, however can be a bit high) for 10 days.

This isn’t a recommendation of any sorts however the side effects are likely
to be mild and reversible for this type of usage.

------
fab1an
A word of warning to all who consider stocking up on and self-medicating with
Chloroquine: while this is a well-studied medicine, it can have severe side
effects, particularly in the eyes (including blindness). That said, let's hope
it has some effect as current anecdata suggests.

~~~
blhack
It's not anecdata. There was a small clinical study which was just completed,
and showed almost miraculous success with hydroxychloroquine.

[https://www.mediterranee-infection.com/wp-
content/uploads/20...](https://www.mediterranee-infection.com/wp-
content/uploads/2020/03/Hydroxychloroquine_final_DOI_IJAA.pdf)

~~~
prostheticvamp
Nope, not a miracle, top comment takes it apart.

------
capkutay
I wouldn't say 'take this with a grain of salt', but I also wouldn't brush it
off as fake either. Yes, the french study wasn't structured perfectly. But
such a trial isn't possible in the timeframe we're looking at.

If enough respected virologists (like Didier Raoult) and doctors in
China/South Korea see some positive signals, it makes sense to prepare for the
event that it does indeed help. Keep in mind, this is already being used as a
treatment in the US today. They likely have even better data than we do. Or if
they don't, they still feel like it's worth taking a calculated risk on.

------
hprotagonist
[https://news.ycombinator.com/item?id=22628302](https://news.ycombinator.com/item?id=22628302)

Derek lowe reviews the evidence here and has far more of a positive take on it
than i'd expected. (as in , "not obvious nonsense!")

~~~
HarryHirsch
No, he doesn't. Derek has a favourable opinion of favipiravir and in the
footnote he calls the French trial "messy". That's very polite, considering
the shape of the data.

~~~
paulmd
Boy, "messy" data when performing initial experimental administration of a
drug, during an outbreak with no officially approved treatment, with limited
testing capacity.which is piling up bodies faster than mortuaries can cremate
them. How shameful.

People are nitpicking. Yes, "we need further studies", that's at the end of
literally every research paper ever, but the longer you delay the more people
die.

It's no different than signing up for an experimental cancer drug. There are
no alternatives that are known to work. You take the best shot with the
possibility that looks promising right now. The alternative is dying without
trying.

It's kind of a weirdly US-centric position, both from science fetishism and
the fact that we're the the country with the fewest deaths so far. Oh golly
gee I guess we better wait 18 months for a double-blind clinical trial and FDA
approval and a Nature article. Other countries have the bodies piling up and
they are pushing ahead, because a chance is better than no chance. Just like
with cancer.

~~~
HarryHirsch
It's not that you didn't have a supply of patients for clinical trials. You
have to make sure that your proposed therapy works, else you waste money and
lives. If your wonder drug is so great you'd notice immediately in the data
and would cut the trial short. What is concerning that the Chinese didn't
notice a great effect, else they would have told the rest of the world.

~~~
rurban
On the contrary the Chinese told the world very early how their successful
treatment plan worked.

* [https://www.chinalawtranslate.com/en/standards-of-care-for-s...](https://www.chinalawtranslate.com/en/standards-of-care-for-serious-and-critical-novel-coronavirus-pneumonia-patients/)

* Or [https://www.reddit.com/r/Coronavirus/comments/fd15kg/preprin...](https://www.reddit.com/r/Coronavirus/comments/fd15kg/preprint_article_from_the_shanghai_medical/)

South Korea and Japan used the very same plan in their ICU's.

Maybe it's the crackdown of Western media on China, but right now italian
doctors trust chinese experience more than western experts. Western experts
still preach lockdown, whilst Italian officials in the meantime also found out
that the asian recommendation of mass testing everybody is better. Without
drastic lockdowns. Test everybody, wear masks, be responsible.

> else you waste money and lives. If your wonder drug is so great you'd notice
> immediately in the data and would cut the trial short.

The problem is that it was chinese and south korean data only. Trials are not
cut short, western buerocracy still rule the hospitals. Many doctors do get
their younger patients on those trials. But in the overloaded case, such as
Italy and Spain it's too late. You need to apply virostatica early on for 10
days, not when it's too late. But those people are advised to stay at home and
wait for the fever to go down. Without effective treatment plan, as outlined
by the chinese.

------
jacquesm
WARNING: To all those who are reading threads like these and intend to self
medicate: you should not do this unless you are medically qualified or have a
doctor prescribe you whatever medication might help. The risk of side effects
is substantial and there is a reason many countries keep quack laws on the
book to go after those who practice medicine without a license.

Medical advice should be given by doctors and what works for someone else may
not work for you (be ineffective), cause side effects of all degrees of
severity. Note that the original title includes the word 'potential'.

~~~
teddyvangogh
chloroquine is prescription only in the US.

~~~
jacquesm
I know. It might even work. But until there is really hard proof and the side
effects are well documented saying it's out there is tantamount to telling
people to self-experiment, prescriptions or not. Illegal drugs are a thing.

~~~
chimichangga
He didn't "say it's out there". Bayer did, who apparently think there's merit
to this enough to issue a press release of their own and donate 3M pills.
Bayer probably knows more about this than you.

Also, reuters, cnn, msnbc, etc. covered it.

Making the info available here in HN is not tantamount to telling people to
self-experiment. that is laughable.

------
blhack
To those who aren't aware of it, there was a recently completed (small)
clinical study of hydroxychloroquine (and in some cases HCQ plus z-pack) just
completed in France. The results are here: [https://www.mediterranee-
infection.com/wp-content/uploads/20...](https://www.mediterranee-
infection.com/wp-
content/uploads/2020/03/Hydroxychloroquine_final_DOI_IJAA.pdf)

They're miraculous. This is a well-studied, mass-produced drug which has been
around for 70 years and appears to be _highly_ effective at treating this
virus.

~~~
cycrutchfield
>They're miraculous.

Where are you seeing that? Because what I see is a very non-rigorous, non-
randomized study. Also, what about this part:

>A total of 26 patients received hydroxychloroquine and 16 were control
patients. Six hydroxychloroquine-treated patients were lost in follow-up
during the survey because of early cessation of treatment. Reasons are as
follows: three patients were transferred to intensive care unit, including one
transferred on day2 post-inclusion who was PCR-positive on day1, one
transferred on day3 post-inclusion who was PCR-positive on days1-2 and one
transferred on day4 post-inclusion who was PCRpositive on day1 and day3; one
patient died on day3 post inclusion and was PCR-negative on day2; one patient
decided to leave the hospital on day3 post-inclusion and was PCR-negative on
days1-2; finally, one patient stopped the treatment on day3 post-inclusion
because of nausea and was PCR-positive on days1-2-3.

Really easy to have "miraculous" results when 20+% of your treatment group
were excluded and also happened to be the ones with the most severe symptoms.

~~~
prostheticvamp
Medical doctor and statistician weighing in just to say: I agree fully with
what you wrote. No miracles observed.

~~~
blhack
I don't mean and disrespect to you as a physician, but there appear to be many
experts who disagree with you to the point of acting out their disagreement at
scale. Chloroquine has become a standard part of treatment for this disease in
several countries, and its continued use seems to imply its efficacy.

~~~
jshevek
> _there appear to be many experts who disagree with you to the point of
> acting out their disagreement at scale. Chloroquine has become a standard
> part of treatment for this disease in several countries, and its continued
> use seems to imply its efficacy._

The fact that experts agree that this drug should be used doesn't mean they
agree that it is miraculous. And this certainly doesn't suggest they disagree
with the parent MD/statistician.

~~~
blhack
It seems like such a strange nit to pick here over my use of the term
miraculous. I don’t know what else you would call the results of the study I
linked (supported by the reaction of many national health orgs). Yeah, maybe
this isn’t the cure to this disease, and of course we need more testing, but
the result as reported are incredibly hopeful. It seems to have hit a nerve
with some people that I used the term “miraculous”, but I will continue to
defend that term. We are looking at a virus that has disrupted the global
order. Here is a study claiming incredible efficacy. That isn’t a miracle in
the divine sense, but if definitely reports as being extremely helpful during
a dire need.

~~~
jshevek
You were wrong when you presented alleged evidence/argument that experts must
necessarily disagree with the MD/statistician, above.

~~~
blhack
If doctors are using this, and not seeing an effect, why do they continue
using it? Doctors are humans, and prone to irrationality of course, but
they're also scientists.

Maybe my faith in the collective ability of the world medical professionals to
evaluate their treatment techniques is misplaced, but I still have faith that
these people are acting in accordance with their scientific training.

Maybe that's wrong, and I shouldn't be trusting these people. But if I'm not
trusting doctors (and especially infectious disease experts who are writing
papers about their findings), then who should I trust?

I think a lot of this distrust in institutions and doctors is going to get us
into a lot of trouble. I wish people would start listening to these orgs.

~~~
jshevek
Your post does not address my point. That's okay, if you simply wanted to say
the things you said. There are things you've said that I agree with, and
things which I strongly disagree with. In a conversation, I like to be careful
about going down too many side tangents if certain fundamentals are not
already mutually understood.

~~~
blhack
It seems like you disagree with my implication that use of something (in this
case, chloroquine to treat covid-19, the use of which seems to be increasing
daily) implies its efficacy.

Why? I'm modeling the doctors and health officials who are making these
decisions as agents which are presumably continuously evaluating their
decisions. So basically:

A lot of experts are taking this action -> assume the action has a desirable
outcome -> believe what the experts are saying (in this case both their words
and their actions seem to agree with each other, _and_ point to the idea that
chloroquine is an effective treatment of covid-19).

I am genuinely at a loss as to why this stance (my stance) is anything other
than completely obvious.

~~~
jshevek
No. Here, as in several places, you make unwarranted assumptions about other's
thought processes. Remember that "efficacy" is a matter of degree. I try not
to spend too much time and effort on strawmen.

~~~
blhack
I'm trying to understand you here. Is the assumption that doctors are taking
actions based on previous experience with those sorts of actions unwarranted
in your opinion? Or a strawman?

I'm sorry if but I'm having a difficult time figuring out what I have said
that you disagreed with.

~~~
jshevek
You seem sincere, and unlike prior comments to be approaching this in good
faith. Maybe you even welcome criticism as a means of improving your thought
process. I don't mean to be cryptic, and certainly don't mean to be rude, I
just try to conserve energy and not get caught up in non-constructive
arguments.

You don't seem to be taking people's statements at face value, but rather
projecting additional meaning onto them, almost as if you conceive of fewer
possible positions than there actually are, and pigeonhole us.

Consider my prior two statements in this thread which start with "the fact"
and "you were". Do you agree that these statements were correct, on their own
terms, in their own context, and independent of additional complexities
involving degree if efficacy or various arguments for or against use, testing,
or hopefulness?

Also, do you see that the people who disagree with your framing are not
'picking nits' nor are they having 'struck nerves'? Can you see other reasons
why they might respond as they did?

------
viggity
Does anyone know how quickly the production of Chloroquine Phosphate and
Hydroxychloroquine can be ramped up (say, to the tune of 500M people * 7g per
"course" = 3.5 million kilograms?

I tried finding out how much chloroquine is prescribed world wide per year,
but couldn't find it. It may give us a clue into how much is already being
used.

I know that it isn't used except for pregnant women as a malaria treatement
because the first line antimalarials aren't proven save in pregnancy, but also
that the malaria protozoa has some resistence to Chloroquine in many countries
(Ecuador, among others)

~~~
semi-extrinsic
Not a medicinal chemist, but here is an overview of the synthesis routes we
know of:

[https://www.sciencedirect.com/topics/chemistry/chloroquine](https://www.sciencedirect.com/topics/chemistry/chloroquine)

From this, it doesn't look like there are any major hurdles in the necessary
precursors. E.g. chloroaniline is very commonly used for making many drugs
(incl. chlorhexidine), methyl acrylate is similarly in the six-figure-tonnes-
per-year category, and that diamine also looks to have a nice synthesis route.

Fingers and toes crossed for this one.

------
morninglight
Starting back in the 60's, hundreds of thousands of Americans serving in the
military and peace corps in areas with malaria were given daily chloroquine
for extented periods of time. Think Vietnam. How long does it take to evaluate
safety?

~~~
lithiumfrost
It’s prescribed here in Canada, but at least in Alberta, the prescription goes
along with annual in-depth retina screening to catch retinal toxicity before
there’s permanent vision loss. It’s ok, but there’s a reason it’s not
available over the counter.

------
roenxi
I wonder if there is a point where literally everyone just gets a dose of
chloroquine. My understanding is it stops the virus replicating and so is
almost a preventative rather than a treatment.

~~~
pbreit
It may not work as a prophylactic (preventative measure) and in fact, as an
immunosuppressant, may actually make things worse.

For example, it enhances influenza:
[https://www.ncbi.nlm.nih.gov/pubmed/25715935](https://www.ncbi.nlm.nih.gov/pubmed/25715935)

~~~
zwily
Someone else in this thread said that chloroquine experiments started because
Chinese doctors noticed that none of the covid-19 patients had lupus (and
basically everyone there with lupus takes chloroquine). If that's true, maybe
it could be prophylactic. /IANAD

------
pknerd
Pakistan with other few Asian countries already using it for Corona Virus
patients. Even 300K tablets sent to China for curing the disease.

------
Xunxi
What will the effect of drinking quinine tonic be as a preventative measure?

~~~
robocat
Wikipedia: In the United States, the US Food and Drug Administration (FDA)
limits the quinine content in tonic water to 83 ppm[3] (83 mg per liter if
calculated by mass), while the daily therapeutic dose of quinine is in the
range of 500–1000 mg,[4] and 10 mg/kg every eight hours for effective malaria
prevention (2100 mg daily for a 70 kg adult).

How much less than 83mg/litre is unclear. You would do yourself damage with
the sugar should you try to drink enough for a dose. Also it is unclear how
effective quinine is compared with hydroxychloroquine.

Finally, quinine can have serious side effects, take care.

~~~
peterburkimsher
This is anecdata, so beware. For a full story, email me.

I have minor symptoms, and have been self-isolating since Wednesday (18)
because many people around me were coughing on Monday (16) & Tuesday (17). The
government here in NZ has not issued any lockdown instructions.

Due to comments here on HN, I decided to buy 4x 1.5 litres of ordinary
Schweppes tonic water. Panic buying had not yet struck (it has now, but mostly
bread, pasta, and toilet roll). I shared one bottle around the office, and
gave one to my homestay family.

I've been drinking about 3 glasses per day, a litre at most. It's a sub-
clinical dose for sub-clinical symptoms. The bitterness causes immediate
sputum production in my mouth. Despite feeling a sore throat yesterday, I
haven't yet started coughing.

I'm advocating for it in direct messages to friends: not because it's some
miracle cure for the virus, but because it eases the coughing symptoms and
thus might slow the spread. The placebo effect is probably also very real: I
feel like I'm doing something, and that calms me down.

