Toxicity is relative. I came across one mention that said it's 40% less cytotoxic. Overall, both drugs are supposed to be relatively safe at careful dosing levels, but both have significant risk if the dosing is just a little bit too high, and a therapeutic index for covid-19 has yet to be determined. Near as I can tell from a quick lit review, there's risk of blindness and also renal failure if renal systems are already weakened. Liver toxicity can also (but rarely) be a problem-- however, the cocktail proposed using antibiotics makes that more problematic, as antibiotics can also adversely impact liver function. Considering both liver risks are small at careful dosing, that may not be an issue if the risk is additive, but if it's potentiating then there's a real problem and we really need to understand if there are more at-risk people for those issues that will die from the cocktail than will die from covid-19 complications.
This is why the larger scale trials are necessary, and doctors should be extremely cautious in using any of these drugs unless the covid-19 trajectory looks to be trending towards death anyway. Outside of studies, they should probably not be prescribed for low or medium severity cases.
*Foot note: I'm not a doctor or medical professional. I'm well informed on these matters, but a little knowledge is dangerous. Take the above in that context.
Here in Brazil, for whatever reason, the president has been talking up chloroquine, while Trumps talking point is hydroxychloroquine.
I don't know how people who have no medical training or experience who are actively trying to undermine their advisors with such experience determine which of these medicines they're going to place their bets on, but given the lack of good results in either, it seems like either bet is as bad as the other.
COVID-19 kills anywhere between 0.7-4% of the people it infects. (Some countries like Italy saw a much higher mortality rate, nearing 15% in Italy, I believe, but that was due to the breakdown of the overwhelmed health services).
How would one even tell if any of the chloroquinine derivatives have been effective without a systematic study when 96 out of 100 people (at worst) would have recovered anyways? That's another thing that makes the 20 person French study which kicked off all this so much more ridiculous.
There was a 44% chance that they would have all recovered without any intervention. But it was probably higher for this group since they did have intervention, and they clearly had a high level of medical assistance.
> COVID-19 kills anywhere between 0.7-4% of the people it infects. (Some countries like Italy saw a much higher mortality rate, nearing 15% in Italy, I believe, but that was due to the breakdown of the overwhelmed health services).
That is mixing up IFR and CFR. We don't have any good way of knowing IFR yet, and it may be quite a while before we can get a good estimate. The denominator in CFR is confirmed cases, so Italy's inflated CFR could be (and probably is) entirely related to the lack of sufficient testing.
Italy has a very high IFR of 1%, the same rate as their every year flu epidemic. Or better very two years. The flu comes every two years.
Italy has traditionally the highest flu death rates in the world. This year, with COVID-19, it is still lower than in a bad flu year.
When you read 15% this might be the CFR, the case fatality rate. But only about a tenth is getting tested. So it means nothing.
You can only look the death numbers, and after it settled down at the excess death rate. From there you get the real IFR. So far we are at an IFR of 0.3 - 0.6. A little bit higher than the flu, but in absolute numbes lower than a bad flu year.
IIRC, Italy had a health care professional study that put their IFR at something around .35% or so. Similar for Germany, and the CDC just did a study of HCP's here and came up with 0.26% IFR (but the sample was 75% women).
Please check your calculations more carefully before posting a number. the 21% mortality rate represents a percentage of all closed cases in the worldmeters data, not the sum total of all cases both active and closed either through fatality or recovery. The CFR from worldmeters based on total cases counted so far and total deaths counted so far sits at about 6% (and bear in mind that the total count of cases on the site is far, far off from the probable real number of cases.
21% of people who have been confirmed to have the virus and don't anymore are dead. If the semantic argument hinges on the use of the CFR term, we don't need that term (though everything I've seen indicates CFR measures resolved cases, not total). People are using your small number to justify their belief that the virus is no worse than the flu. That does not reflect reality, and that belief is harmful.
Nobody here is arguing that it's no worse than the flu, least of all me. We still don't know the IFR of this virus and i'd be delighted if it was only half an order of magnitude worse than that of the flu but i'm certainly not claiming it is, and my "small number" of 6% is still huge, and in no way whatsoever an attempt to compare this to the flu. How could I with a massive 6% mortality rate? that would be than two orders of magnitude worse than the flu. No, what im very clearly and simply stating is the factual inaccuracy of claiming that the 21% from the worldmeters site is the CFR of Covid-19. As is made very obvious right on the site itself, this is not the case. Its CFR as a result of total cases to-date and total deaths to-date is sitting at around 6%.
This is not semantics, interpreting clearly stated numbers and definitions of basic terms badly to get a mortality rate that's almost four times larger than the case is simply wrong, and much more harmful than stating lower but more accurate numbers. I have no idea where you got your definition of CFR from or how you interpreted it like that, but CFR does not measure deaths as a percentage of resolved cases, it measures deaths as a percentage of all cases so far during a given period of time (in this case since the pandemic started). This is how it has been widely understood in discussions of CFR per country among all affected countries and you can find these figures on many different serious websites, with the percentages of fatalities clearly stated as CFR numbers that are based off all cases so far in any given country (Italy or Spain, for example). If this is mistaken, someone please do correct me and show me where it's claimed otherwise. If im wrong then, for example, nobody would be talking about Italy's CFR of 10%, they'd be discussing a different and considerably higher percentage derived only from resolved cases in that country vs its total deaths to-date.
I don't see anyone here arguing that. An IFR of 0.35, let's say, would be great news at the same time as it would be significantly worse than the flu. Using bad numbers to come up with a 21% CFR is not responsible, and is arguably fearmongering.
Bad numbers? Those are the numbers. How are you getting an IFR of 0.35? Where is the source for that? Does that source represent a projection or data coming from the results of tests being conducted?
My source for the CFR represents the totality of real information the world has presented us to date.
"A CFR can only be considered final when all the cases have been resolved (either died or recovered). The preliminary CFR, for example, during the course of an outbreak with a high daily increase and long resolution time would be substantially lower than the final CFR."
The epidemiologists are the ones projecting IFR at ~0.35. It's not responsible to use a crudely calculated CFR when you have ample evidence that the case rate is vastly underestimating the infection rate. It's also terrible to try and use 'recovered' numbers when a lot of localities do not track and report recovered cases.
From what I read [1], the Chinese "trail" (no data, only vague description) on chloroquine phosphate was mainly focused on mild - severe cases, not critical cases. These cases were not very likely going to die even without the drug. So fatality rate would not be a good metric to follow on. Metrics used in the "trail" also does not contains fatality rate, there were only something like "lung improvement rate in X days".
Another interesting point is China explicitly banned usage of macrolide antibiotics (which includes Azithromycin) together with chloroquine [2]. It was posted on Feb 26, 2020. I tried to use Wayback Machine to check whether they rewrote the history, but it seems like Wayback Machine only saved it recently. Another source (and with English translation) [3] indicate it is at least earlier than Mar 1 though. I did a Google search on key sentence "禁止同时使用喹诺酮类、大环内酯类抗生素及其他可能导致QT间期延长的药物" and found widespread reposting around March 1, so the date is likely genuine.
> Some countries like Italy saw a much higher mortality rate, nearing 15% in Italy, I believe, but that was due to the breakdown of the overwhelmed health services
That's one factor. France and Britain have such extreme mortality rates vs case counts because of their very poor testing rates (which has been openly admitted by both nations, this isn't my opinion). Germany's mortality rate is so relatively low in part because of their vast testing program caught a lot more cases.
Britain has probably had between 5x-10x the positive cases that they've reported up to this point. They were only able to test 12,750 people per day as of a week ago. That's a minimum of 1/10th the rate they needed to be at. If the US has had 600,000 positive cases, it really has had 3+ million cases, given the poor rate of testing.
But the major problem with the french study was that they determined the outcome by testing throat swabs with RT-PCR test. But throat swabs become negative in the second week for most patients, indepedendent on the progress of symptoms of CoVid-19. As has been show by top German virologists, including Prof. Drosten, see https://www.nature.com/articles/s41586-020-2196-x_reference.....
So they measured in the french study something that would always go down.
Experts that say that a solution in form of vaccine is 1 year out don't offer immediate help.
If some self-appointed expert claims to have a solution, a politician might take a bet on that solution and either later claim they were first to bet big on the solution or just move on to the next bet or blaming of someone else later.
> This is this the more toxic variant though right? It’s meant to be hydroychloroquine
Hydroxychloroquine has fewer side effects than chloroquine which has fewer side effects than quinine which has fewer side effects than the bark it's made from that contains a bunch of other compounds including quinidine.
All quinine class drugs produce heart arrhythmia as a side effect in some patients, more so with increasing doses, and all come with warnings that they should not be used or should be used with caution in patients with heart conditions. These contraindications of these widely used drugs have been known for decades.
He's not in any way medically or chemically trained either, and has a well established history of sometimes saying things that are not factually correct during briefings. Why would you rely on that as a source?
According to Trump's own words on the coronavirus, you can call it "a flu". During one of his daily press briefings, he listed off things you can call it, and that was on the list.
Influenza and coronaviruses are both categories of virus, but they are very different categories. They are not only not the same family, they are also not the same order, class, or phylum.
That's like if we were being attacked by horses, and Trump said, "You can call these horses many names... including octopus."
