E.g. June 23, 2020 "NIH: Trial Investigating Hydroxychloroquine for COVID-19 Stopped"
17 June 2020 "“Solidarity” clinical trial"
"hydroxychloroquine does not result in the reduction of mortality of hospitalised COVID-19 patients, when compared with standard of care."
And before, Jun. 9, 2020: "Three big studies dim hopes that hydroxychloroquine can treat or prevent COVID-19":
Thus, HCQ without Zinc is like using a bucket but forgetting the water to stop the fire. Just throwing buckets at the fire isn’t gonna work much when there’s no water in the bucket.
Have a look at this  studies that shows around a 9% less mortality when treated with Zinc and a even more when treated EARLY with HCQ PLUS Zinc. (Please take a look at the numbers in the last table, it’s very clear that HCQ + Zinc reduces mortality)
"This was an observational retrospective analysis
that could be impacted by confounding variables"; "We also do not have data on the time at which the patients included
in the study initiated therapy with hydroxychloroquine, azithromycin, and zinc." "The cohorts were identified based on medications
ordered rather than confirmed administration, which may bias findings towards favoring
equipoise between the two groups." "In light of these limitations, this study should not be
used to guide clinical practice."
230 studies looking at Hydroxychloroquine 
Only 10 studies looking into HCQ and Zinc 
This was then picked up by a crowd of "right wing deplorables" up to and including the orange man in the white house.
The scientific establishment can not allow this bunch of clowns to turn out right, thus further inquiry is being suppressed.
Call it a conspiracy theory, but that's exactly how human egos have played a role in the history of science.
"AAPS files with the court a chart showing how countries that encourage HCQ use, such as South Korea, India, Turkey, Russia, and Israel, have been far more successful in combatting COVID-19 than countries that have banned or discouraged early HCQ use, as the FDA has."
However: that chart is totally misleading, it's a typical "non sequitur". "Case fatality rate" is just a ratio "death" through "cases". Where those with weaker symptoms are recognized as "cases" the rate is lower. How they are recognized is not the same across different countries.
Note, you seem to be posting studies that did not pair HCQ with zinc, _and_ are not using it prophylactically. Is my understanding correct?
For example: https://www.sciencemag.org/news/2020/06/three-big-studies-di... links to https://www.recoverytrial.net/files/hcq-recovery-statement-0... which does not mention zinc, and it's patients admitted to the hospital (not prophylactic). Digging further, to the source given in that pdf, not a mention of zinc: https://www.recoverytrial.net/@@search?SearchableText=zinc which is the whole point of using HCQ in the first place.
I'm just posting studies that were the basis for what FDA decided June 15, 2020 (1):
"FDA has revoked the emergency use authorization (EUA) to use hydroxychloroquine and chloroquine to treat COVID-19 in certain hospitalized patients when a clinical trial is unavailable or participation is not feasible. We made this determination based on recent results from a large, randomized clinical trial in hospitalized patients that found these medicines showed no benefit for decreasing the likelihood of death or speeding recovery."
And I don't have more information than that.
"The Association of American Physicians and Surgeons (AAPS) is a conservative non-profit association founded in 1943. The group was reported to have about 5,000 members in 2014. The association has promoted a range of scientifically discredited hypotheses, including the belief that HIV does not cause AIDS, that being gay reduces life expectancy, that there is a link between abortion and breast cancer, and that there is a causal relationship between vaccines and autism. It is opposed to the Affordable Care Act and other forms of universal health insurance."
I get incredibly annoyed when people act like (a) these strokes / organ damage are happening in significant quantities and (b) that it’s unique to SARS-2
...at least that's what the clinical updated from the NYC doctors group is reporting on TWIV podcast each week.
Is it? From all lab confirmed cases in USA until end of May, almost every 200th in age group 20-29 was admitted to ICU. Almost every 100th in age group 30-39. (1)
Admitted to ICU means "probably considered intubation (or received it immediately)" Which is very, very unpleasant thing:
Is that "extremely rare" to you?
(In the USA there are 7.2% inhabitants aged 20-29, 6.7% aged 30-39. Even if the number of "unconfirmed but infected" is 10 times higher, that still gives around 24000 people in the USA aged 20-39 needing ICU, or 8 times more than died on 9/11. And those are just provably "non-elderly". All those 40 and older would need even much more ICU beds. I hope it's obvious that if there are not enough ICU beds much more people would die.)
1) It can be calculated from https://www.cdc.gov/mmwr/volumes/69/wr/mm6924e2.htm For 20-29 182469 confirmed, 864 ICU, for 30-39 214849 confirmed, 1879 ICU. (Additionally, males were admitted to ICU almost twice as much as females)
Once again, dexamethasone has to be given to 8 intubated people to save one, and that's considered the drug with the most visible effect in fighting Covid-19 up to now -- i.e. the most successful drug up to now! You can imagine how little effect other drugs produced in the verified trials.
In that context, talking about ICU and intubated is exactly on topic, hand-waving "strokes" isn't.
Moreover, the comment actually said "strokes / organ damage" not "strokes." Nevertheless, the main effect of dexamethasone is on the intubated patients.
- Strokes (and organ damage) are the result of cytokine storms
- Strokes (and organ damage) in COVID-19 are "extremely rare"
That may be true or untrue, but you are not responding to those claims, you are responding to something else. I'm not even sure what that is, because nobody actually wrote it down.
And I claim that the number of patients that could be saved using dexamethasone even in the age groups 20-39, if they get infected, is nothing "extremely rare" among "non-elderly": only before end of May, surely more than 100 US patients aged 20-39 could have been saved. If "non-elderly" means "still working" the number is even much higher.
The comment is about what causes strokes: Is it the virus itself, or the cytokine storm? If it is the virus itself, that would be rather unique. The comment argues that it is the cytokine storm.
This is relevant because there is a hypothesis that COVID-19 is uniquely dangerous because the virus itself directly attacks organs and causes strokes.
Furthermore, if Dexamethasone helps with the cytokine storms and the cytokine storms cause strokes/organ damage, it only follows that it also helps with the strokes/organ damage.
Therefore, nothing in the comment suggests that Dexamethasone wouldn't help patients, regardless of age. To the contrary. You appear to be fighting windmills.
"cytokine release syndrome is highly likely to be causing the (extremely rare) instances of stroke in non-elderly"; "I get incredibly annoyed when people act like (a) these strokes / organ damage are happening in significant quantities"
in his comment replying to dexamethasone effects and I have shown that the "quantities" of those who are helped by dexamethasone are significant. I started by quoting his "extremely rare" and replying "Is it?" (as is "is that really extremely rare" because he is as he writes "incredibly annoyed" in his comment to dexamethasone effects) and showed the numbers.
And you haven't shown anything else.
Note that it was never about "strokes" alone, which was your original claim, but about dexamethasone. For him was "extremely rare": "stroke in non-elderly COVID-19 patients, organ damage, etc." Note the "etc." too. Only you and nobody else here reduced that to "strokes" alone in your first response. Let me state it again, I don't see your comments contributing anything here.
He said "strokes are extremely rare", you showed numbers on ICU admissions. Those are obviously two very different things.
> Note that it was never about "strokes" alone, which was your original claim, but about dexamethasone.
The words "extremely rare" only appear in conjunction with strokes. The word "organ damage" also appears later, as "not significant quantities", which is still different. Dexamethasone does not appear in the comment at all.
I don't know where to go from here. This seems to be the hill you want to die on. May you rest in peace.
"The [steroid] drugs suppress the immune system, which could provide some relief for patients whose lungs are ravaged by an overactive immune response that sometimes manifests in severe cases of COVID-19. But such patients may still need a fully functioning immune system to fend off the virus itself."
"no effect on mild infections"
Basically if taken too early it does the wrong action, but it helps some of those already on oxygen. And it's cheap.
They are planning on testing an inhalant version but who knows where that will land in terms of effectiveness. It might make things worse so that is much further out unless things are really lucky, which we haven’t had a lot of with coronavirus.
Interestingly, their insurance company has been trying to push them into performing his infusions at home for a couple years, as it is more cost effective. My sister has to fight them on it every couple of months to continue having them performed at the hospital.
Before the first infusion, she was advised by hospital staff that the insurance company might refuse coverage for infusions onsite if the procedure was ever performed in-home.
Here's the FAQ page for one of the biggest USA home IV companies. It's a good starting point if you're curious.
Basically you tell the FDA how to store and handle and the FDA says “ok, give me the data that proves the drug is stable under those conditions”.
Beyond that the FDA doesn’t really care who administers it.
I myself have fear of needles, so I'm biased in this sense. I would not use this drug, except with a Oxazepam. Which I prefer not to, as these too are addictive.
An infusion is something that takes a longer time as the drug is taken slowly into the bloodstream (might be something that takes a couple of hours).
This doesn't seem wise; the side effects of remdesivir seem worse than the typical course of a cold/flu.
ICER, which is a drug price watchdog, suggested using a value added analysis that the max price remdesivir could justify was 4500. ICER is not pharma's friend, and they dont usually end up suggesting a max price twice what the pharma company charges.
> On average, the drug should help reduce hospital costs by $12,000 a patient, said [Chief Executive Daniel O’Day]. Gilead estimated the savings based on data showing that each day of hospitalization costs $3,000 and that patients taking remdesivir are discharged four days sooner than those receiving standard treatment, Mr. O’Day said.
> The company said it has entered into agreements with generic manufacturers to provide the drug at a “substantially lower cost” in developing countries.
That indeed is the sad state of affairs. Plus, a significant amount of these more obscure drugs may simply be the result of (intentional or unintentional) P-hacking.
Gilead is charging less than that for Remdesivir.
The price increase is concerning.
Yes! For many reasons.
And no wonder it's not being researched that much in capitalist countries. It will never be as profitable as these other drugs.
A quick search turns up over two dozen clinical trials with ivermectin, not all of them taking place in threshold countries. Israel, Spain, Mexico, Singapore are all highly developed countries.
Is it actually the chemical though? 'Blackmarket pet drug' is the perfect storm of poor accountability. Who the fuck knows what it actually is?
As soon as they announced it as a COVID treatment, I assumed it was another cash grab while people are confused, desperate, and scared.
I do think that there is a compelling argument for the the government trying to do more drug development and then licensing or open-sourcing the product.
Why do VCs get any return from startups? Isn't the reward that the startup exists at all?
Better yet, why does Gilead get to write a press release explaining the reason they're asking $3k per person for the drug is so they can "invest in scientific innovation that might help generations to come"? Isn't the reward the money they initially got from the government?
I am getting pretty sick and tired of public money getting used – and rightly so – to fund innovate medical research, and then any and all benefits or profits from the results of that resesarch being privatized.
If you are tired of giving away public money, negotiate terms.
I don't think this more of a policy problem than a legislation policy. The US government can simply stop giving away free money at any point it wants.
>it’s hand-waiving to pretend that the people on the receiving end of high drug prices should’ve negotiated better prices for themselves
I think you may have missed the point I was making in my last post. I am not saying that drug consumers should negotiate better prices (although this is how prices are controlled in every other first world country). What I was saying that the US government intentionally gives away money with no strings attached for R&D. The explicit purpose of this funding is to help companies make products and profit. If the outcome you want is different, we need to look at different terms or a different investment vehicles.
One simple option would be requiring recipients of federal research grants to publish in open journals and open source their patents. the down side, is that this may reduce the chances of them being developed at all.
In addition to the US government, there are similar challenges for non-profits and charities, which often give money to large drug developers, or sell internally developed drugs to the for profit sector. You might find this paper interesting  as well as the history of ivacaftor.
So whether the DoD or whatever government branch catalyzed progress doesn't matter much to me.
Case fatality rate for COVID-19 is estimated to be about 1.4% (still uncertain). That's 14000/1000000 chance of death, or 14000 micromorts.
Studies in the US have shown that people are ready to pay ~$50 per micromort. If we assume that remdesivir really is the ultimate coronavirus killer, it means that following statistics, people would pay $700k for it. Not that far off from your million.
In reality, safety standards in the US put the micromort at around $10, so that miracle cure would be about $140k.
Of course, it is just general statistics, a wealthy old man will pay much more than a poor kid (risk of death increase with age). It assumes remdesivir is a miracle cure, which isn't, we are not sure if it is effective at all.
In reality, it looks like treatment is going to be around $3000, which, if it improves my chances of survival by a few percent, is actually a sensible price.
But will you pay $3000 for each and every thing that improves your chance of survival by a few percent?
But $3000 for a percentage chance of a percentage chance is a lot tougher to argue for repeatedly.
Therefore, someone out there should be willing to pay me to take one of these (I'd settle for $2.5M):
 6 million riders, 5000 deaths per year
You could get the government to pay a lot of money to make motorcycles unnecessary, but they already are.
Also $50 sounds high to me. Most standards are closer to $5-10.
If I had a motorcycle, giving it up would be the payment. Hence, I could pass the value on to someone else who assisted me, in theory.
If I "paid myself" I guess that would mean I could choose something else risky to do with my "balance" of micromorts.
A world where motorcycles act like curses is an interesting concept for a short story, but not very relevant to a discussion of micromorts.
* Not everyone is going to put the same value on their own life.
* Some people will find major restrictions worse than a very small risk of death.
There's three perfectly good explanations.
Also if you use $5 per micromort, a pretty standard number, you get a motorcycle-riding cost of about eleven dollars a day. Plenty of people would pay that on purpose.
Also using perpetuity math is really wrong unless you plan to live hundreds of years.
Also if you ride a supersports like the one you linked, you certainly won't be getting that $40k in perpetuity... :P