Hydroxychloroquine

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Hello friends. Let’s talk about Hydroxychloroquine and COVID-19. I will abbreviate it as HCL in the rest of this post. I’ll start by saying that I wish that HCL was an effective treatment for COVID-19 (heck I wish anything was). However, based on the best evidence available now, I do not believe it is. Disclaimer: I am not a medical professional or doctor.

Unfortunately, the drug has become politicized ever since President Donald Trump said that it might help. At the time, that was not an incorrect thing to say, though it is debatable whether he should have said it or not. Some health professionals thought it might help too. And now here we are. Some of my friends and family believe that information about HCL is being suppressed to hurt Donald Trump. I do not believe this is the case.

Instead, I would suggest that what we have seen is the scientific method in play. The basic steps of the scientific method are as follows:

  1. Hypothesis
  2. Experiment
  3. Analysis
  4. Refine hypothesis and repeat

In this case, the hypothesis is that HCL can be used to effectively treat COVID-19. The experiments began as soon as doctors started treating COVID-19 patients using HCL. Early retrospective data looked promising and justified additional research.

In the world of medicine, Randomized double blind placebo control studies are the gold standard. In these studies, neither the participants nor the administrators know who is getting the drug or who is getting the placebo. Feel free to read the paper to learn more, but the main takeaway here is that not all studies are created equal and randomized double blind placebo studies (RDBPC) are the best. The downside of RDBPC studies is that they take a long time and are expensive.

At this time, all completed RDBPC studies do not show that HCL is helpful for treating or preventing COVID-19. It is worth noting, however, that one of the major studies was redacted by the authors because the data was not released. I will list some of them here (including the redacted study):

Additionally, the Henry Ford Health System is conducting a RDBPC study that has yet to conclude. This is notable because earlier this month, they released a study that showed that HCL helped cut the death rate for COVID-19 patients. In other words, they are hopeful that HCL helps COVID-19 patients and that their study will succeed.

There are other outliers whose views differ from the consensus. The latest article and study that HCL proponents have been linking to is written by Dr .Harvey Risch and can be found here. Risch is a professor of epidemiology at Yale.

Apparently, this made people angry because his dean made a statement that can be found here. The key quote is as follows:

If persons disagree with Dr. Risch’s review of the literature, it would be advisable to disseminate the alternative scientific interpretations, perhaps through letters or other publications with alternative viewpoints to the American Journal of Epidemiology, Newsweek, or other outlets.

I obviously do not have the credentials that Risch does, but I do find it concerning that not a single one of the studies he references in support of HCL are RDBPC. In any case, if you want see what an expert with a dissenting view has to say, this is your guy. If you read his paper, I do recommend that you read what other scientists have to say about it.

Finally, we have the group called “America’s Frontline Doctors” that were censored from social media. To be honest, this group is best left ignored. The majority of them have not treated COVID-19 patients and their whitepaper is simply a regurgitation of Risch’s paper except with strong political spin to it.

There is a chance that HCL is can help COVID-19 patients in someway. There is still plenty of research being done to figure that out. But, at this time, the best evidence we have doesn’t support it being helpful.