This doesn't shake my attitude toward science in the slightest, but it does leave me feeling very uninformed. But maybe, just maybe, that is the correct phase-state to be in given the data? Or have I been zone-flooded?
We spend so much time in science classes learning what past scientists have already proven correct, and people come to believe that that is how science is in general: correct.
But working researchers spend most of their time not knowing what is correct, and sometimes not even knowing how to measure correctness. They wallow in uncertainty; that’s what makes it research.
I mean, now you can understand why the WHO is always putting out statements along the lines of "no evidence yet for X", while random bloggers and HN commentators are already completely convinced of X (or completely convinced against it). Real knowledge takes time. Individual studies don't settle questions.
All drugs have side effects, for example https://www.webmd.com/drugs/2/drug-5482/hydroxychloroquine-o... So each drug is a (small) risk for the patient. The idea of testing the drugs in RCT before using in the patients in the wild is that you can be quite sure that the benefits are greater than the risks.
We are not shamans.
Do you have a link to that research?
> “The difficulty seems to be, not so much that we publish unduly in view of the extent and variety of present day interests, but rather that publication has been extended far beyond our present ability to make real use of the record. The summation of human experience is being expanded at a prodigious rate, and the means we use for threading through the consequent maze to the momentarily important item is the same as was used in the days of square-rigged ships.”
- Vannevar Bush, As We May Think (1945): https://www.theatlantic.com/magazine/archive/1945/07/as-we-m...
It really , really puts things in perspective and makes me wonder how we are doing much better relatively to most people in ww2 but yet we don't seem to have (or even wish for) a positive outlook on life and the future.
With HCQ, there are multiple layers of noise to disentangle. Best I've got, and I've been watching this for months, is that HCQ and antivirals, in general are somewhat useful before you get infected or extremely early in the infection. They don't cure anything and nobody expected them to. They're also not appropriate to give to people by the time they show up to the hospital. By then it's too late.
That's general advice that has nothing to do with CV-19. It might be relevant that some of these drugs have been around for over 100 years and while not mundane and harmless, they have well-known safety profiles. (Other drugs that might be included in this group would be Tamiflu, or Acyclovir)
So that's the general advice you might get a year ago if you went out with a doctor and had a couple of beers. As you know, however, the HCQ thing especially got severely political. Suddenly we were seeing studies where doctors gave large doses to ICU patients, and implemented a lot of other protocols that made no sense, probably ended up hurting people, but made for good headlines.
As an outsider, there seemed to be a sort of "competition" in some parts of the academic community to come up with various papers that could technically be called scientific, but existed much more as a publicity vehicle. I could easily count a couple of dozen studies, on various topics, that were not of a high quality. I imagine there are all sorts of reasons for that.
Now we're reaching the apex of this small deviation in the mainstream of scientific research. We've got tons of data of dubious provenance being distributed to various studies to say things we're already primed to hear. It was only because a lot of people took the time to call bullshit that this was caught. Congrats to the folks that did that work.
I have no opinion about any of these drugs, but that's my evaluation of the technical quality of the discussion in the area you bring up. I think the it will eventually will all work out, and it's going to make a hell of a story to tell. But we've got a ways to go yet for all of the systems involved to adapt as they need to. We've made great progress. In many ways, CV-19 was not the pandemic everybody was expecting, and it was quite difficult for many organizations to change gears as quickly as required.
It's best used with zinc and early. That's what five studies confirmed here:
One of these "studies" is a 2-page Google Doc with no real data. Another is the discredited Raoult study, which is under investigation by the journal . Another study cited is also by Raoult's team. The Brazil study (ref. 29) doesn't seem to have passed peer review (yet?) and has severe methodological flaws. Like the Raoult studies, the Brazil study was not randomized, but makes no attempt to control for confounding by indication or self-selection, such as with propensity score matching or similar methods commonly used in observational studies. The last study cited isn't a study, but an article from a local news station.