
More on chloroquine/azithromycin and on Dr. Raoult - hprotagonist
https://blogs.sciencemag.org/pipeline/archives/2020/03/29/more-on-cloroquine-azithromycin-and-on-dr-raoult
======
jojo2000
In those troubled times, a lot of people are just critisizing instead of doing
something useful. There is a bibliography studying the effects of chloroquine
and derivates to fight viruses. As scientists, the base of our work is to read
papers and search for bibliography. Targeting people with ad hominem attacks
is plain lame. Do some science FFS, and act swiftly in times of war.

[https://www.sciencedirect.com/science/article/pii/S092485792...](https://www.sciencedirect.com/science/article/pii/S0924857920300996)

[https://aac.asm.org/content/53/8/3416](https://aac.asm.org/content/53/8/3416)

[https://www.sciencedirect.com/science/article/pii/S0006291X0...](https://www.sciencedirect.com/science/article/pii/S0006291X0401839X)

[https://link.springer.com/article/10.1186/1743-422X-2-69](https://link.springer.com/article/10.1186/1743-422X-2-69)

[https://www.sciencedirect.com/science/article/pii/S016635420...](https://www.sciencedirect.com/science/article/pii/S0166354207004597)

[https://www.sciencedirect.com/science/article/pii/S147330990...](https://www.sciencedirect.com/science/article/pii/S1473309903008065)

[https://www.sciencedirect.com/science/article/pii/S016635421...](https://www.sciencedirect.com/science/article/pii/S0166354213001150)

[https://www.thelancet.com/journals/laninf/article/PIIS1473-3...](https://www.thelancet.com/journals/laninf/article/PIIS1473-3099\(06\)70361-9/fulltext)

[https://link.springer.com/article/10.1007/s00535-009-0132-9](https://link.springer.com/article/10.1007/s00535-009-0132-9)

[https://link.springer.com/article/10.1186/1743-422X-3-39](https://link.springer.com/article/10.1186/1743-422X-3-39)

~~~
hprotagonist
That Didier Raoult appears to have a history of image manipulation is not an
_ad hominem_ , and is apparently true. His 2006 offense was sufficiently bad
as to be banned from publication for a time in a leading journal in his field.
That is also not an _ad hominem_.

You also completely fail to engage with the first 2/3 of the text, which has
any number of impersonal methodological critiques which are not addressed
through a literature search.

~~~
jojo2000
You point the exact problem here.

As a scientist the first test is intuition. The second test is having people
getting better with treatment. The third test is conducting a full, deep study
with the utmost scientific rigor.

So now there is a dilemna. People die in front of you. You try something. It
seems to work. It uses a widely-used set of molecules (Hydroxychloroquine +
azythromycine (+Zinc in some protocols). Will you try it, or will you make a
double-blind study with half the people at risk of dying ?

History of aviation. People just couldn't believe that it was possible.

[http://www.wright-
brothers.org/History_Wing/Aviations_Attic/...](http://www.wright-
brothers.org/History_Wing/Aviations_Attic/They_Wouldnt_Believe/They_Wouldnt_Believe_the_Wrights_Had_Flown.htm)

"Not wishing to be miserly with his information, Root sent an eye-witness
account of what the Wrights were doing to the Scientific American, with a
letter telling the editor he was free to use it. But the editor was not to be
taken in and made no effort to investigate what Root had dropped into his lap.
Though the Scientific American printed in 1905 many articles about flying,
nearly all were about devices that maybe ought to be tried."

I don't fail in anything, I just don't need to engage in endless debates about
methodology. Half of the studies in psychology fail to replicate. There are
problems everywhere in science, because geniuses are still rare and now
ostracized because they produce new researched and are judged by lords of the
old order. If you scratch hard, you can always find _something_.

Some people criticize, others just act. The people who create are always going
to be the targets of the people who spend their time criticizing.

Now it's time to act. Not pull over waiting for some authority to decide for
yourself. The list of publications is here to show that this available
treatment doesn't come from a magical hat.

~~~
hprotagonist
you’re good at grandstanding, but you have yet to meaningfully engage with the
numerous methodological critiques of Raoult’s work which, if unaddressed, make
his result unethical and inappropriate for use as approval to act. There have
been blinded trials of chloroquine; they have their issues too, but didn’t
show an effect.

the side effects of chloroquine are nontrivial, at least one person has died
in an attempt at self-medication by ingesting a substance that had a similar
looking word in it, and pre-existing patients who do need the drug are being
deprived of it as hucksters run rampant.

Keeping an even keel in a crisis and knowing when to make informed decisions
on limited data and when not to are skills we develop and must have the
strength to use as practicing scientists. Especially when it feels tempting
not to.

~~~
grayed-down
Give me a break...twice. The guy who ingested fish tank cleaner was a tried
and true moron. And when you have a crisis of this extent you do what you have
to do and relax the, ah, formalisms a little.

~~~
exmadscientist
"Relaxing the formalisms" is great!

"Tolerating scientific fraud" is not. This doctor has previously come very
close to scientific fraud. That means that for us to trust him again, his work
needs to be impeccable. It isn't.

This potential treatment is promising enough that it is worthy of study, and
in lieu of better solutions, administering to patients. These are drugs that
have a known safety record for human use. But if you stop and think this is
any form of "cure", you are deceiving yourself and endangering lives. It's
pretty clear that chloroquine/azithromycin probably doesn't make COVID-19 any
worse (in general). But it's not clear yet that it's actually a _good
treatment_ , and if we stop the search now, that is to our own detriment.

------
woliveirajr
> Now, it would be a more simple world if assholes were always wrong about
> things, and I am not yet prepared to say that Dr. Raoult is wrong about
> hydroxychloroquine and azithromycin. But neither does he seem to be the sort
> of person who is always a reliable source, either. I do not take pleasure in
> this. But I am less hopeful about this work than I was when I first read
> about it, and I can only wonder what direction those hopes will take in the
> weeks to come.

In weeks to come there'll be people living and people dying. I'm not sure in
which group I'll be. But all discussions about the Dr. Raoult personality
doesn't add up to the big question: does it work or not ?

~~~
hprotagonist
we don't know; the data that personality generated isn't helpful!

See here: [https://sciencebasedmedicine.org/hydroxychloroquine-and-
azit...](https://sciencebasedmedicine.org/hydroxychloroquine-and-azithromycin-
versus-covid-19/)

the results are so uninterpretable as to not help the SNR on the issue.

------
beagle3
With all the known cases (e.g. 100k in the US) and about 0.5-1% taking HCQ
continuously already for lupus and other diseases, if these people are
underrepresented, we have a big clue that it works, almost to the point of
proof (need to show that it's not the underlying condition that stops the
virus, a-la sickle cell anemia vs malaria). If they are equally represented,
it's discouraging, but not proof that it doesn't work (again because of
underlying being a confounder).

This information should readily be available to the CDC or whoever else is
tracking the cases. What am I missing? Why do you have to wait for double-
blind trials?

~~~
hprotagonist
hipaa, nonstandard data recording systems, time, confounds of preexisting
medical conditions, scattershot testing, and the overall saturation of the
healthcare system are going to make that signal more or less invisible.

~~~
beagle3
We are talking about the confirmed positive cases, these people are all
potential spreaders and are supposed to be closely monitored. This is a
standard CDC playbook (lots of people I’ll, find out what’s common to them).
The list you gave, if true, is total incompetence of e CDC to a level which
has never been demonstrated before - in fact, the CDC has generally done well
with their playbook even if it was a couple of weeks late (and we’re 10 weeks
since I heard from a friend who works with the CDC that they’re watching it)

------
Leary
More likely to work early on in the infection, I doubt any anti-viral would be
very effective once the patient experiences ARDS.

