For the HN audience it would be like people taking an almost tribal approach to go-lang vs rust, debating it on national television, without any of them knowing what a loop is.
Tell me if I'm wrong, but low quality papers get published all the time, in all domains. But nobody cares about Rust vs Go in the current crisis.
Then the media take results at face value because they're constantly looking for breaking news, they give a platform to people with strong opinions rather than nuanced ones (good scientists probably don't have time for that anyway). It seems only logical that the general population has a misguided and emotional interest in the topic, especially when it has disrupted the life of so many.
Yes, low quality papers indicating that existing drug X may be effective in disease Y get published all the time, probably several a day. Fortunately most of these are left to pad academic's CVs and don't really influence the pharmaceutical industry.
And some of them are correct.
When we told her that's not a good idea she felt compelled to defend HCQ against the mainstream media slander, as if that were the problem here.
The real epidemic is the deficit of critical thinking among those who primarily look for media content to fit what they want to hear, and then close themselves off to any other input, evidence, or scrutiny.
The actual story of HCQ is pretty boring. It was a plausible treatment with a mixed bag of weak evidence for and against efficacy. It is not particularly dangerous.
Trump oversold and lied about the benefits. The MSM lied about the data against and the risks.
In such an environment, it's not surprising people take sides and dig in.
Many of us also regularly read scientific papers, pick up new tools or frankly whole new academic fields, just as parts of our daily lives.
All of this, on the one hand, gives us expertise in coming up with our own, often better informed views about the world, on the other probably makes us overconfident about our information synthesis abilities in fields other than the wider CS.
sed '/we/I/' etc.
Culture wars effecting your viral drug treatments? It's gone too far. Become a culture war conscientious objector.
> For the HN audience it would be like people taking an almost tribal approach to go-lang vs rust, debating it on national television, without any of them knowing what a loop is.
In the business world, this happens far too often. Usually a non-technical manager reads hyperbolic internet chatter about how Rust is the only way to write secure code or that Node.js will boost productivity by allowing your front-end devs to write back-end code, then they assume their understanding is superior to that of the actual programmers.
Once the non-technical people start having strong opinions on technical decisions that disagree with the experts, it’s not a good sign for the company. Likewise, once the president started advocating for medications that weren’t supported by evidence, it was obvious that this administration had no idea what they were doing with their response.
That's a great analogy, a perfect to pickup my mood for a Friday :D
Then months later as COVID got really bad there was multiple bad science on both sides of the argument just muddied the water in an extreme event the entire population has a never experienced before in their lives. Causing mass desperation and flailing about.
I previously published a timeline on HN earlier that showed the UK also blocked exports of the drug at least a full month before the Trump brigades and bad papers came out. And other examples of authoritative institutions giving off signals and rumours which could easily be taken advantage of by people desperate to save family members lives. It was also listed as safe in small doses as by WHO so people were willing to take the risk before the full science was out.
I also remember the general consensus became that it was only useful as a prophylactic not a treatment after the fact when the infection was serious, so it was even harder to pinpoint good evidence when the doctors were giving it out to thousands and only a tiny amount got serious infections. Then the uselessness is even easier to hide with an easy exit argument.
It seems strange to me to target this one individual among a large group. Maybe he was the first to give it academic credibility with an actual paper?
Thia still puzzles me, presumably he understands things like placebo effect and double-blind studies intuitively, and yet studies show no improvement.
On a similar note, the WHO recommendation against the use of Remdesivir is widely criticised by doctors in Poland, as based on a poorly-thought-through study. The claim is that Remdesivir helps patients only at certain stages of the disease, whereas the WHO study doesn't differentiate between such stages.
On the one hand, there's people who use the drug day-in-day-out, on the other a huge organisation which I'd think can do good-quality science. I remain confused.
But that was that, a suspicion, not to take it as the holy grail of the disease
It’s almost like everyone didn’t expect a basic human reality among a subset of the population to be a reality.
Fear has always been one of our strongest base motivations.
I’m generally cynical about all politicians and the lowest common denominator which is a hell of a lot of people. But I also don’t think the support for it during the early days was limited to just mom and pops boomers or whatever.
There’s plenty of blame to go around but I also think there was plenty of signals early on where the seriousness of the guilt is less than a lot of smug Twitter idealists are willing to admit.
My only question was why this one guy to target among a sea of other signals. But I also think from a purely skeptics (publication) perspective it’s fair they target the ones who aren’t ‘supposed’ to be among the stupid group and should know better (which would then exclude random family doctors, early recommendations for exploration, and the perpetually dumb politicians) and this guy was super influential as a microbiologist. So it might make more sense in that context.
It isn't hard: the Lancet has published a completely made-up study written by an unknown team, before they retracted the paper. If I wanted to fuel conspiracy theories, I don't think I could come up with anything better.
Or the WHO themselves claiming that masks do not work for months then suddenly reversing their position in the middle of the pandemic. But "Trust Science" they said.
The advice about masks was on their website on March 2020 largely because they were worried about mass public buying of masks, leaving a shortage for frontline medical workers (https://www.reuters.com/article/us-health-coronavirus-who/ma...).
The guidance was updated as more evidence came in and production of masks scaled up. This should not be compared to outright quackery.
That did not change the fact that they lied and misled the public and killed people.
It is a bit misleading, sure, but no lies, they let secondary sources lie for them. So about misleading the public, I think we can say it is the case.
Now about "killing people". Did they kill or did they save people? Remember that people fought about toilet paper, even though there was no real shortage and it is just a comfort item (protip: you can wash your ass in the shower).
With masks, there was a real shortage, and it is an essential item for health care workers. We couldn't let nobodies stockpile hundreds of masks while people who are supposed to treat you get sick. That would really have killed people. And despite downplaying the importance of masks, is was still a mess.
I know a pharmacist who got tasked with supplying masks to health care workers who had masks "disappear" in transit, and health care didn't get their masks. Herself should have got N95 masks, but she didn't, instead only having surgical masks, and she had to keep them longer than recommended. She also had to deal with hysterical customers who "needed a mask" for no good reason. And it was as the importance of masks was downplayed. I don't want to imagine what would have happened if it wasn't.
Public Communications and Science are different things.
If masks are very scarce, and we need to ration, then we want to prioritize certain groups.
Once they are plentiful, the marginal benefit of masks becomes beneficial to the extent it doesn't interfere with front-line usage, in which case, we definitely want people o wear masks.
And so we use different words, mediums, forms of messaging to get people to change their behaviour, some of it more effective than others.
The medical community has to triage all the time, literally at your hospital right now, they are using their knowledge to ration the resources they have available at any given moment. If you complain of 'chest pain' then you go to the front of the line.
The Razor Award should be a thing now, because news about some kinds of science spreads quickly.
Then why didn't they say so instead of lying to the public? "masks work, but we need to allocate them to health workers because we don't have enough of them". Anyone can understand that.
? They quite clearly told us that they were prioritizing medical workers.
Read the WHO's guidelines yourself.
Here's the WHO guidance as of April  June , which is pretty early. You can see the guidance evolve during that time and it was still early.
Here is the CBC's public notice on March 25, a couple weeks before the epidemic hit hard in Canada 
"The advice on whether or not to wear masks to reduce the spread of COVID-19 has shifted since the start of the pandemic. Public health officials now say that wearing masks can prevent some potentially infectious respiratory droplets from spreading to others, but most still recommend that N95 masks, above, be reserved for health care settings."
Frankly, the only thing I remember about masks early on was 'get them to the front line workers' to the point where in my family we were going to donate our own N95s to the hospital, but they were already used.
Studies that use HCQ+ZINC+AZITROMYCIN EARLY (in the first 3-4 days after Covid symptoms appear) and in the proper dosage have consistently shown tremendous improvement in outcome.
But most studies apply those medicines AFTER HOSPITALIZATION (often 1-2 weeks after symptoms appear), which is far, far too late for them to be effective. Other studies gave massive overdoses of HCQ which can interfere with the heart rhythm. So the studies were "designed to fail" and did.
Raoult has nothing to apologize for; he was correct and has been vindicated by other properly-executed studies.
More generally, I spent way too much time comparing the pandemic responses of various European countries. For France, one thing that stood out to me was an outsize focus by media and politicians on research by French scientists.
By the time Macron visited Raoult, the spotlight was already on and shining bright. He was more or less forced to visit him for domestic political reasons: Raoult tapped straight into the anti-establishment anti-elite yellow-vest zietgeist , if Macron hadn't at least shown some gesture towards him they would have seized the trope of the "intellectual snob who is too aloof to talk to the people and their hero". The populist politicians from the south of france were already riding the Raoult train by then: Estrosi, Melenchon etc
So he went, he talked, he got his photo taken, and he left. Raoult got the attention he craves, Macron took some bullets out of the guns of his enemies, and nothing much happened. I agree that a more principled stand would have been nice, but that's politics :/
There have been multiple studies on this, and it has been a mixed bag. This one is positive:
There are others that are positive, and still others that are negative.
> Subsequent analysis of Raoult’s data found that his sample size was incredibly small, with only 6 patients given the hydroxychloroquine/azithromycin combination. The study was also found to be improperly controlled, and data was excluded for a number of patients whose condition worsened as they were either transferred to intensive care, or died. Subsequent studies have shown no clinical benefit for the use of hydroxychloroquine in patients with COVID-19.
> After Raoult’s study inspired a surge of interest in the use of hydroxychloroquine, [...]
His not very good research caused huge amounts of interest in hydroxychloroquine and distracted attention from other, far more beneficial, treatment.
Im not sure I want to live in a world where doctors and scientists cant publish their data.
Can we claim that we have some evidence based on a sample of 6 people?
I don't know if Chloroquine is effective on COVID 19, but I know that it's comically cheap and people took it for years against malaria without side effects.
So at worse it's a placebo.
On the other hand there's Remdesivir that's astronomically expensive, destroys kidneys and hasn't any effectiveness against COVID (even the OMS says so).
But it's still the recommended treatment in France since they forbid the chloroquine treatment.
Color me skeptical about their motivations but all the big proponents of Remdesivir have financial links with Gilead.
No, telling the masses that something works when it does not is much more than a placebo, it's very bad.
Didier Raoult before Covid research:
Didier Raoult after Covid research:
France has for many years been chastised for its failure to properly fund scientific research and Raoult is yet another example of this sad neglect. Note also that "The Skeptic" is a British organization, Raoult is French, and that this is yet one more shot fired in two seemingly endless barrages across the Channel in both directions.
Article re the Award:
There’s no “major” flaw in his studies as people keep repeating.
He was studying viral load in patients and excluded those who were in ICU because they did not have enough virus left.
Thus suggesting his cocktail as an early treatment.
There is indeed pseudoscientists and corrupt ones who published the famous now but ridiculous study in “the lancet” and who promote remdesivir.
ah, yes, it's all perfect. smh
Especially the "recovery" one, praised by everybody where the inclusion criteria was: "having flu like symptoms", without PCR. This is true science indeed.
1. Why is this a major flaw?
2. As stated by the title.
Remark: (Well conducted) RCTs introduce way too much variance.
As a statistician I care about a good trade-off between bias and variance.
OTOH, you don't need RCTs when you measure a physical property of a system.
3-6,8. Valid points. Especially as of publication date.
As of today, they updated the study with 3000+ patients.
7. This is not ethical.
9. Object of the study: measure viral load. After the cytokine storm, you don't care much about the virus.
10. We should ask DR directly about it, this is grave.
11-13. Irrelevant. They did PCRs to everyone, the important measure is the CT.
14. This is not good indeed.
15. PCR tests are reliable.
16. Why is it a flaw?
17-18. They published a lot of other papers on their work, and updated the early study.
Yes, this update was around July. They found an IFR of .7% with patient treated with HCQ. Lower than the 1.2% mortality rate in eastern France. But wait! In august, the IFR of eastern France was calculated again and was found to be around .7% (+-.3%) too?
SO since august, the narrative changed: HCQ soes not prevent people from dying at all, but prevent them to carry a viral load important enough to contaminate other people as much. With no real study, as doing so would be unethical. Convenient.
Honestly if you followed the story as much as i did (and i did buy HCQ early on, as my boss was a fan and sold me on Raoult with daily update), it became more and more ridiculous, with the organ point was the IFR recalculation in august, when i told myself i should be ashamed to have willingly believed something this early, coming from someone who, as Bergame started dying and Colmar was being infected, stated that the virus would not be coming to France, then, as my cousin bagged the 18th body in his hospital, posted a video called "Coronavirus: Game Over!", later edited and renamed.
Maybe I misinterpret what you’re saying, can you give me exactly the source for your numbers?
Your last paragraph feels like you have personal grief against him.
Please don't create accounts to do that with.
The website lists all kind of studies, you can get the data if you want and build your own website. :)
If you have no argument, just put "conspiracy theory" etiquette on your opponent. Huge win.