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The entire CV-19 episode is going to prove to be a master class in critical thinking skills. I think there's a great book in there somewhere. This is a story of common wisdom and normal channels continuing to get it wrong. (and then the eventual correction occurs)

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.




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