When interpreting the observational literature (including my own work) I find it helpful to think like a threat actor: how can this association be broken?
Note that this is an article making huge claims about Alzheimer's but is published in Molecular Psychiatry. Given that signal, I'm just going to look at the abstract and not read the full text.
Here, the study population is patients with rheumatoid arthritis. This tells you up front that we don't have a typical population, but a highly selected one.
The use of HCQ is observational, not randomly assigned.
So, how could HCQ look protective even if it had no effect on Alzheimer's biology?
1. Maybe more rheumatoid arthritis patients should be on HCQ. It's a disease-modifying drug, after all. So it may be the case that people with better care, or more wealth, are more likely to be on HCQ. And that could be associated with other lifestyle factors that are never fully accounted for in an observational analysis.
2. Or it could be the case that people with dementia are less likely to have their HCQ prescriptions renewed, so the arrow of causation could even be reversed.
Additionally, one could imagine that HCQ might actually protect against Alzheimer's disease in people with rheumatoid arthritis—but not in a general population. That would be very big news, but would require further study.
And sure, it could be the case that HCQ reduces Alzheimer's risk in everyone. But you'd need a lot more evidence to buy that.
I think the study is somewhat more robust than you're letting on, since it compares HCQ against an alternative rheumatoid arthritis drug - Methotrexate. It's possible that the choice of prescribed drug itself is correlated with some other confounding factor, but it's certainly less likely to be so compared to HCQ vs nothing.
Also, the study itself is clear about the amount of evidence needed to validate whether HCQ actually reduces Alzheimer's risk: "This hypothesis merits testing through adequately powered clinical trials in at-risk individuals during preclinical stages of disease progression."
Methotrexate is standard of care, considered “strongly recommended” over hydroxychloroquine (source: https://onlinelibrary.wiley.com/doi/epdf/10.1002/acr.24596 ) for rheumatoid arthritis. If I read the paper right, hydroxychloroquine may be favored in “low disease” states.
So I would certainly expect some sort of difference in patient population. It would suggest those initiated on hydroxychloroquine would normally have less severe rheumatoid arthritis (or have some other difference that their doctor would choose to not use methotrexate by default), although I don’t know if that’s the case in reality.
Not having prescribed either since I was a PCP years ago, I would just say that I agree with this line of inquiry.
If both drugs were equally good and were pretty much used at random, then they could be good instruments. But if there is confounding by indication, then it’s harder to get value out of an analysis that compares them.
It doesn’t mean the conclusions are wrong (and nor does my comment above), it just tempers my interpretation.
You could try and reduce the possible effect by controlling for disease severity. If it reduced the effect a large amount it'd strengthen the case that the effect is actually due to RA disease severity. Actually I'd be a bit surprised if the authors didn't do that for an observational study.
Agreed. I didn't see it described in their methods, although it seemed that the main focus of this paper (based on length dedicated to the material) was the biological/model data rather than the EHR data.
This summary right here is what I would like to accompany any medical study that pop up online. Thanks for helping us stay skeptical (doesn’t mean that I’m not hopeful and that the claims is true)
Yes, I think the hypothesis is conceptually interesting. But rather than thinking about how it could be true, I try to think about how the data could be misleading. I do this to try to avoid making broader claims in my own work than I should.
I post this comment quite frequently on HN, but yet again this is not a randomized controlled trial, but rather an observational study. On top of that, they state several insignificant statistics using the point estimate (e.g. "Hydroxychloroquine initiators had an 8% lower rate of Alzheimer's disease and related dementias compared to methotrexate initiators (95% confidence interval 17% to 0%)" (paraphrased).
Hydroxychloroquine is used to treat Lupus by interfering with the communication between cells (not exactly clear in the research tbh). Lupus, Rheumatoid arthritis, and other uses for Hydroxychloroquine appear to be autoimmune responses where the body attacks connective tissue.
If Hydroxychloroquine reduces inflammation and reduces immune responses damaging connective tissue I could see it generally useful for incidents where the body damages itself (such as Alzheimer or dementia)
The main concern here (and most observational studies) is confounding by indication. Specifically, the same reason some people got hydroxychloroquine as opposed methotrexate is the same reason you see differences in the outcome. In this case there’s plausible confounding that needs to be addressed before any conclusion like the title could be drawn.
Generally hydroxychloroquine is used in mild rheumatoid, whereas methotrexate is used in moderate-severe disease.
Inflammation in rheumatoid (and other inflammatory diseases) contribute to atherosclerosis and plaque buildup. Rheumatoid increases the risk of coronary disease by 1.5-2x.
That difference alone could account for the difference in dementia, particularly vascular dementia.
If this is true they already have several big patient groups taking it on a daily basis for the rest of their life so should be possible to look at if the prevalence of Alzheimers is lower in those groups.
That makes me instantly sceptical that the arthritis and/or associated conditions might have played a role. I'm sure they've controlled for that as much as possible, but it's easy to miss some confounding factor since the cause and mechanism of AD is poorly understood. That makes it harder to tease out what confounders to look for.
It seems like researchers would be able to gather data from the natural experiment due to some places in the world where this drug is routinely used against malaria.
I can see an awful lot of potential confounding factors there, though. Life expectancy in most countries in Africa, for instance, isn't even long enough for non-early onset AD to develop. You'd expect less AD just because half or more of the population is going to die from other stuff at 65 or earlier.
Yeah, it's interesting that they mention it as a "neuroprotective therapy" rather than any kind of treatment. That suggests that it doesn't do anything to reverse damage, but can only slow (perhaps halt?) the progression of the disease.
The largest effect size I know of, predicting incidence of real dementia in real people (46,000 people over 70), is that a recent Tdap booster predicts a 40% reduction. Nobody knows how or why, or isn't saying. Apparently treatment for herpes has a large effect size, too.
Looks like we're running through the same playbook we saw with COVID, and the obesity comorbidities.
Being obese in your 30s-50s increases your chance of developing dementia or Parkinson's later in life by somewhere between 500 and 800 percent.
Losing the weight is such an OBVIOUS intervention for things like diabetes and CVD risk, but it affects risk factors for nearly every other chronic disease on the list, including something like half of all cancers.
And yet, we're researching the type of micro-optimizations indicated in this article.
Don't be fat from 30 to 60. That's it. That's the solution. And yet, all I see is:
Medically: Masking the symptoms with medication, with not even a cursory nod to improving lifestyle factors.
Societally: Wild adoration of Lizzo and "Health At Any Size" ridiculousness.
That's great news. Alzheimer's and dementia are so such terrifyingly difficult conditions to try and help someone with. Glad we're finding atleast some possibilities to help. Does anyone know of anything others like this?
I don't think you re-patent an off-label use, you re-patent a minor modification. See for example ketamine to eskatamine; or citalopram to escitalopram.
Once you have the new med you use the courts to prevent the off-label use. See eg lucentis or avastin for Wet AMD.
It's... complicated but I assume the GP meant new drug product exclusivity [1] which is a process by which a pharmaceutical manufacturer can get a short window of exclusivity for a new approved use without rights over the original patent. That exclusivity is largely for generic manufacturers [2] though and it's separate from the patent patent term restoration [3] the FDA grants to patent holders to help with the time it takes to get to market.
"Re-patent" would mean something different like Shire patenting Vyvanse by adding an amino acid cap to amphetamines, changing it enough that it becomes a new drug with a new patent. That would require clinical trials and all the expense that goes with them.
I think the OP just made a fly-by comment using very imprecise language. Most people assume drug exclusivity works through patents without giving generics with expired patents (like HCQ) much thought.
They wouldn't need to modify it for exclusivity via Abbreviated New Drug Application - I just don't see the FDA accepting any evidence short of a phase III clinical trial that HCQ helps with Alzheimers to fulfill the new use requirements. At best they'd be able to run a proper clinical trial for some cocktail of generic drugs and use ANDAs to prevent competitors from using those generics in their own cocktail for a few years.
HN is divided on topics where society at large is divided. It would be strange if it weren't.
It's also a highly international forum and divisive topics play very differently in different places. Readers often mistake a comment for something weird and radical coming from a person nearby, when in fact it's an unremarkable comment coming from a person far away. It's unfortunate that this leads to so many brutal online arguments. In person, people instinctively modulate their communication with respect to such variables; online they don't, because the information isn't available and we can't make it available.
HCQ is a much misunderstood substance as a result of the political furor around it.
It is not a miracle drug and it is not useless for all medical purposes. It is a relatively mild anti-malarial drug with some anti-inflammatory properties. It is prescribed for autoimmune disorders in addition to malaria. Its anti-inflammatory/immune regulation effects are probably not that strong but its safety profile is well understood.
I don't think that's accurate. It's mechanism is well known and to my knowledge the only ones saying that it was a cure were those trying to prevent it's use by misrepresenting it and those promoting it by saying THEY said it was a cure. It doesn't work by itself, and all of the research since before covid says as much. I know of no doctors who said by itself it was a cure for anything, only the press made that claim.
It's an ion transport channel facilitator. It's never been alleged to work by itself to my knowledge. It allows the immune system to work better especially when used in conjunction with other agents (z-pack and ivermectin for example). It's effectiveness and molecular mechanism was well documented from the beginning. I learned about it in March 2020 and was able to read up on it and it's use in treating covid before social media started banning anything that referenced it. But it, like ivermectin (an equally well documented DNA replication inhibitor) were demonized and mocked despite the vast body of research on it and it's use.
Australia had great research (though small sample size, it was thorough) on it's use and effectiveness at the beginning of the pandemic and it was shut down despite it being clearly explained the strict conditions under which it was effective (treatment within the first 8 days of showing symptoms, used with z-pack, etc). They even had research quantifying how it's effectiveness dropped without the z-pack components or as those treated didn't start treatment until 8 or more days. Not a controlled study but even Idris Elba was treated with it and raved about it's effectiveness in conjunction with the z-pack. It was all over the news before Trump mentioned it and then BAM! Censorship and propaganda campaign against it.
It's not that he "supported" it, he touted it as a COVID-19 cure (an utterly baseless claim) when mask-wearing and distancing were the only available true preventers of transmission at the time. He politicized it, not the "other side".
It's not at all weird that new research about Alzheimers hit the HN front page; Alzheimers is a recurring fascination for the site. Unfortunately, so are political debates, which, unlike neurodegenerative illnesses, are generally off-topic for the site.
Do you know how many papers about Alzheimer's are published on a daily basis? It would be a perpetual topic on the front page of HN if every pilot study were shared and upvoted like this one.
Yes, there was political furor over it. The original people who were supporting the possibility that this drug MIGHT be useful against covid were legitimate doctors and researchers.
Some politicians got overly excited about that, some politicians got overly upset about that. All of the legitimate discussion happening around it got lost in the crossfire of annoying politicians.
This seems a bit revisionist. Nobody got upset at people getting excited, everyone was excited about its potential initially. The annoyance came specifically about certain politicians endorsing its use, without any disclaimers, without evidential support, and even after the evidence showed it didn't work.
None of the legitimacy ascribed to HCQ compares to the legitimacy of the vaccine. The only reason HCQ rose to prominence was because of COVID denialism, not because of actual scientific or therapeutic concerns as a reasonable alternative to the vaccine.
False. We didn’t have a vaccine available until early 2021. People were scrambling to find a therapeutic way to treat Covid and there was anecdotal evidence that hcq and ivermectin might work. They wanted large scale trials but they were unscientifically denied which made people very suspicious about the reasons why.
Yes, they turned out to be ineffective but the reaction against them was mindblowingly biased and filled with propaganda.
1. Some legitimate research suggests that it might be useful against COVID.
2. Quacks announce that it definitely is the miracle drug against COVID that “THEY” don’t want you to know about.
3. Legitimate doctors counter the quacks and explain that its utility against COVID is not proven.
4. Trumpist Populists back the quacks because if the establishment is against it it must be good. It must be something “THEY” don’t want you to know about.
5. Democrats and other anti-Trumpists react hard in the other direction and conclude that it must be quack nonsense. There is no chance it could be legitimate because quacks and populists said it was legitimate.
6. Legitimate researchers from (1) are utterly forgotten because now it’s politicized and rational discourse is impossible. In the end all we have is evidence-free screaming and conspiracy theories.
Same exact sequence of events happened with Ivermectin, the debate over whether vaccine mandates were needed, debates over the utility of the vaccines themselves, the question of whether having had COVID is equivalent to having been vaccinated (or better?), and many other topics.
People need to learn that statements without evidence are like the “null” value. They mean precisely nothing, especially if they are from people without expertise.
Meaning “precisely nothing” means that they are neither a positive indicator nor a contrarian indicator. They are meaningless noise that should be completely ignored.
This should be higher, that's exactly how it went.
The FDA even said: "both hydroxychloroquine and chloroquine phosphate “have shown activity in laboratory studies against coronaviruses,”", but they stressed it was not proven yet. i.e. your step 1 was based on current evidence.
Then everything went insane exactly as you describe.
Meanwhile: exactly zero people campaigned that HCQ was an evil substance that should be taken off the market. Opponents of COVID snake oil weren't Lupus deniers.
This entire thread is completely off topic; it's the kind of thing we get ourselves mired in when we don't have the expertise to engage with the actual story, which is whether or not HCQ is protective against Alzheimers.
Are you saying he's a legitimate doctor and researcher?
Because https://en.wikipedia.org/wiki/Didier_Raoult#Controversies has him being censured for falsifying diagrams, being credibly accused of "ethical, procedural, and methodological problems" in his HCQ trial, and conducting illegal clinical trials on people who could not legally consent.
I mean, sure, he might be credible but his track record suggests otherwise.
Who has been well-known in France for his hot takes in media about how sun rays don't cause skin cancer or how alcohol is more beneficial than harmful. He was also involved in an long list of academic malpractices (including faking data in research papers, but that's mostly related to the fact that he has put his name way too many papers from people in his lab to review them all).
He's basically a former good scientist with excellent political skills which helped him climb to the top and has been slowly been corrupted by his own hubris.
The fact is that the original claims about HCQ weren't coming from politicians, they were coming from doctors. You might not like the doctors, those doctors might have heterodox ideas, but that is okay.
My issue was the "might". HCQ wasn't being sold as a 'maybe'. Maybe, that's what that Dr's science said... but we'd be fooling ourselves if we said that HCQ in the public discourse was being sold as a 'maybe'. It was being sold as an alternative to a vaccine. The discourse was 'why are we not exploring HCQ and instead telling everyone to take vaccines. Don't take vaccines, take HCQ' when, at the time, there was no science supporting that hcq would be effective treatment for covid (when someone didn't already have worms...) let alone it was comparable to the vaccines in any way. The poster is trying to downplay this distinction, and it's completely dishonest.
Look at the guys career history, awards won, research published etc. Yeah, he was wrong about HCQ, but the idea that he is just some fake doctor, or not legitimate in some way is as disinformative as the idea that some mysterious "they" is hiding HCQ from everybody.
The use of ivermectin and hcq were started because doctors were trying to develop a protocol to help with treating Covid in 2020 and there was anecdotal evidence that it worked.
Spray and pray drug therapies work. That's how the best drugs have been invented. The fact that Doctors would rather just let a patient die then try a few known drugs was very sad. It was known in April that ventilators didn't really work. Tons of doctors on youtube blowing the whistle.
It definitely doesn't say nothing. It says that I don't believe the poster can be serious. I don't. It's not my burden to disprove unreasonable assertions.
At least one of the snake oil salesman was a politician, which caused there to be as much of a political furor about HCQ as Ivermectin, the vaccines, the masks, the lockdowns, etc.
"for something for which there was no initially no evidence" - that's not true. There was evidence that it had antiviral properties against covid-19 in vitro. This is extremely weak evidence (most compounds which are effective in vitro are ineffective when administered to an actual human in safe doses, as HCQ proved to be), but it isn't "no evidence".
There was quite a lot of political furor, including treating it as much more dangerous than it really is to prevent people from using it off label as COVID prophylaxis.
> for something for which there was no initially no evidence
That's not true:
"The FDA has, however, issued an emergency use authorization for the drug.
In press releases, the FDA has stressed that “there are no currently approved treatments for COVID-19.” However, the agency says both hydroxychloroquine and chloroquine phosphate “have shown activity in laboratory studies against coronaviruses,”"
This is back in 2020, so yes, there was some evidence. Later studies showed it didn't work - but that wasn't known in 2020.
If you are willing to dilute a few large, high quality studies with a multitude of small or low quality ones, then I'm fairly sure you could conclusively prove anything regardless of reality.
Right, you could. For example you could "prove" that masks work by citing a single hairdresser that didn't spread covid while wearing a mask and so dilute decades of evidence against masks. Goes both ways, see?
It's one thing to debate the effectiveness of something and quite an other to declare that the only/main reason for a certain stance is moral deficiency.
There have been large scale controlled studies on masking (via recommending mask usage, sending masks, etc. to a randomly selected group of villages / districts). They showed that masking has a moderate effect on COVID spread.
At the beginning of the Covid-19 pandemic but after the announcement that was made to "prevent a paucity of masks for health care workers", there were several studies that came out showing how masks were ineffective! The methodology of course was to get someone with COVID, put a mask on them and them have them cough into a petri dish. Then check the dis to see if COVID was present, it was so obviously masks were bad. The science had spoken.
These studies were posed all over the place including HN as proof that you didn't need masks.
Then a little while later, someone changed their mind or something and all of a sudden we all needed masks, even homemade cloth ones would do. Or even a bandana on your face.
The point is that if there is a political will, science will be made up to support or debunk it. Which is bad for science and society in general.
I have no idea about HCQ or it's usefulness but I have a feeling that if it had a different political backing then we might be talking about HCQ deniers instead of HCQ conspiracy supporters because we had the same thing with masks.
I am aware that cloth masks are now no longer recommended and the limitations of them. I was aware of their limitations from the beginning, not in specifics but from a general understanding point of view.
I am not upset at the lack of "perfect guidance". I am angry that we were lied to by top people who should have known better and I am saddened that we have a large cadre of scientists who are willing to spin and twist data to fit political winds in order to push a narrative.
My overall point is that initially, when there was political will to limit general public use of masks, the messaging was that masks were ineffective. We had studies and science to back that up.
Once the political message changed, all those studies and science were thrown out and new studies and science were brought in to back it up.
The parent and context of this is to show how studies and science is not pure and has been bent to political will to back the prevailing attitude of the time.
Down thread a commenter is talking about how "It showed that masks worked. Unscientific people with an agenda then sliced and diced it", that shows a lack of understanding of the situation where everyone(including/especially scientists) is playing games and it hurts us all.
So when the political attitude says that HCQ is bad and not helpful for COVID and then we have a mountain of evidence and studies that show that, it is hard for someone who is trying to pay attention to really understand if it is harmful or not because of how political everything is.
Please note that I have no opinion on HCQ myself. I have not taken it not nor do I plan on seeking it out if I get COVID as I think we already have other therapeutics that will work.
Can you link me to the original studies that you are referring to about how masks were ineffective?
I acknowledge there was confusing messaging to this effect very early on in the pandemic but I feel like it was corrected pretty quickly. People in my community were donating spare n95 masks to health care workers in March 2020.
The HCQ guys are condemned because it's been proven over and over again not to work and they ignore reality, give people bad advice which costs lives.
Also I'm pretty sure no doctors or the government recommend that people be overweight. You can both be a healthy weight and take prevention measures that actually work (vaccines, paxlovid for those >50). It's not one or the other.
It showed that masks worked. Unscientific people with an agenda then sliced and diced it into smaller subgroups (such as purple masks) where there was insufficient statistical power to consistently show whether masks worked for all the subgroups.
>We additionally show that HCQ exerts dose-dependent effects on late long-term potentiation (LTP) and rescues impaired hippocampal synaptic plasticity prior to significant accumulation of amyloid plaques and neurodegeneration in APP/PS1 mice.
iirc (I am not qualified!!) Alzheimers relates to plaques in our brain, and this sounds to me like it fixes a precursor to the plaque accumulation (the loss of plasticity?)
The plaques are a side effect of something we don't understand yet. Treating the plaque or slowing it is not a solution, we need to find and fix the cause.
A lot of modern health woes are turning out to be caused by inflammation, and HCQ is a relatively safe, cheap immunosuppressant. It makes sense that it would help out. As far as conspiracy theories go, it's been profitable for various parties to suppress knowledge of it over the years, as they can't patent it then sell it for extreme markup. I myself take a $10k/month immunosuppressant to treat a condition that HCQ is also effective for.
> it's been profitable for various parties to suppress knowledge of it over the years, as they can't patent it then sell it for extreme markup
Just like NAC, which the FDA tried to outlaw from being sold as supplement when it‘s a completely harmless, proven-beyond-doubt miracle drug for anything between significantly reducing bipolar disorder symptoms, preventing symptomatic flu and reducing covid mortality.
Fun fact: The FDA also just banned NMN as a supplement so that it can be patented, marketed, and sold as a longevity drug exclusively by Metro Biotech.
Wonderful people over there at the FDA, looking out for the public's best interest.
No. Interestingly, the root cause of all these positive correlations might be the same. One thing that Hydroxychloroquine is undeniably good at is that it's a very effective dewormer. Anything that is either caused or made worse by worms, or by the immune system going haywire because of worms, will be improved by Hydroxychloroquine.
So, it helped against covid (in key populations) because one of the key interventions against covid will kill you if you also have worms. So in places like Bangladesh and Pakistan where intestinal worm infections are common, covid outcomes improve because the worms got killed. If this[0] is correct (and it is a very new result, so might as well not be), the positive correlation might well be that your immune system stays calmer if you have no worms.
> So, it helped against covid (in key populations) because one of the key interventions against covid will kill you if you also have worms.
What intervention?
I thought I read somewhere that it's easy to overdose on hydroxychloroquine? If so I'd be worried about a forgetful senior accidentally taking a double or triple dose.
THis is true of most medications and as a result there are a lot of solutions that have been developed to help people ensure they get their drug regime right. Firstly, a lot of people in altzheimer’s care will have full or part-time carers to help[1].
Secondly there are things like “pill organizers”/dossette boxes[2] where the pharmacy will actually dispense the drugs into a container which is designed to make it simple to ensure people take their correct daily dosage of drugs.
[1] Here in the UK the national health provides some community care and there are also voluntary organisations. Obviously individuals can also pay privately to have enhanced levels of support.
I'm not a doctor but it doesn't look highly risky. The usual adult dose for malaria is 2000 mg over the course of two days. Long term usage may be a different matter.
I suspect that concerns about safety were because people were using it off brand without medical supervision these last couple of years, which is less safe.
Different medications have different ratios between their effective doses and their harmful doses. The smaller the ratio, the more sensitive the results to an overdose.
Relishing in other people's actions that were driven out of fear during a crisis when our institutions (media and state) failed to keep public trust for millions. Empathy, even for those who make foolish decisions is difficult but necessary, you should try to understand rather than judge.
Keeping just to the utilitarian perspective, cooperative strategies in humans overwhelmingly have better outcomes in both individual well-being and output (innovation, manufacturing, zero-sun games). Cooperation is extremely hard to achieve and sustain without some empathy for your peers. Similarly, judgement runs counter to group cohesion, except in the divergent strategy of establishing an Us/Them dynamic, sustainable in the short term but leading to homogeneity, worse outcomes.
Tossing the utilitarian perspective, being transactional and self-serving in your daily life tends to get you invited to less parties.
People who pride themselves on lacking empathy are kind of trapped because no one can explain in a way that doesn’t require some empathy to understand.
This is a philosophical question that man has sought to answer since the Stone Age. Much smarter people than us have dedicated their lives to the study of ethics and come up with wildly differing ideas, I don’t think you’re going to find an objective answer here.
I don't really have an objective answer for you. I do find personal value in empathy, I get less mad when I can understand why someone did something I disagree with. It doesn't change what they did nor does it excuse it.
>What is the mutually agreed desired result of acting in those ways
Whether you blame Fox news, CNN, Trump, the deep state, the CDC, doesn't matter when addressing the failures of the state and the media. They lost trust with the public. This is measurable in polls and has created a divide in the American people. The result is that individuals and fringe institutions gained ground with millions of Americans; misinforming them and creating controversies that should not have happened.
If the mainstream media and the state didn't lose trust then why would people turn to less credible sources? Because everyone is dumb/crazy? If that is the conclusion people are coming to it seems rather harsh and elitist in my opinion.
It is the media as a whole. It isn't accurate to insist that it's only Fox News promoting misinformation about election fraud or HCQ, in the face of MSNBC promoting misinformation about the mortality of COVID, or promoting misinformation about hydroxychloroquine, or CNN promoting misinformation about BLM riots, or both of them promoting misinformation about Russian active measures, etc., or vice versa. It is emphatically all media. To say otherwise is just engaging in partisan flamewar.
With regard to HCQ, the evidence supporting its use was from small scale studies and not reproducible (hence why Fox News's take was misinformation); however, there was evidence that it improved survivability, especially in some less-developed countries, so saying "no evidence" or even "bogus" like MSNBC did was also misinformation.
(Personal theory: Comorbodity of COVID and other conditions HCQ is effective against was a confounding factor in less-developed countries; and the remaining delta is due to HCQ's immunosuppressant qualities calming the cytokine storm.)
A comment chain here will not reconcile the bubble realities. I disagree strongly with your comment, as you seem to with mine. It’s not going to go anywhere from here.
I think it's more than fair to blame the media, which has had centuries to build up their reputation and credibility. They were incapable of preserving public trust during a national crisis. They have all the advantages over individuals or fringe organizations. We aren't talking about a few thousand people that got indoctrinated into a cult, we are talking about millions of people, some highly educated, who turned away from the mainstream media altogether.
I agree with you. There were several agencies putting out responsible messaging and trying to keep public trust. Ultimately it was a failure. Millions of people didn't trust the gov and turned to alternatives like this. I'm not sure why you're being downvoted. Key figureheads undermined public trust.
The government's information was obviously was filled with inconsistencies that were obvious to anyone with the slightest prior mistrust of them.
Ivermectin has a long history of safe and beneficial usage in the developing world, billions of doses. Yet it was actively discouraged as "horse medicine" here. Anyone with experience or relatives in the developing world would immediately question the veracity of such a discouragement.
What a lazy response. At least you got the no evidence part right.
For about a year governments around the world were willing to do _anything_ to get past Covid ASAP. To ignore that and chalk this up to a lazy conspiracy theory has less than zero merit.
Yeah, but I thought a lot of /inconsistencies/ were overblown with 1 side of the political spectrum jumping on any change in messaging to promote distrust. I wouldn't expect 20-30 people giving press conferences over 2-3 years to say the same things. I do remember precautions changing, like not using masks (supposedly to reserve them for hospital staff), and then it changed. I think a lot of the problem was we want to be treated like level-headed adults. We want to know the intent behind the messaging. Without being transparent, so many conspiracies filled the void.. :(
>> On 5 June, researchers in the United Kingdom announced the results from the largest trial yet, Recovery, in a press release. In a group of 1542 hospitalized patients treated with hydroxychloroquine, 25.7% had died after 28 days, compared with 23.5% in a group of 3132 patients who had only received standard care. "These data convincingly rule out any meaningful mortality benefit," wrote the investigators, who ended the study early and promised to publish the full results as soon as possible.
Late treatment and high dosages may be harmful” and it goes on "while early treatment consistently shows positive results. "
The treatment study they did in my country had a result of 30% less dead.
But then came the obviously fake hcq study that was published in the lancet (lancetgate) that stopped all research into hcq, just think how many lives could have been saved otherwise.
No, not all research was stopped. Plenty more was done. We know HCQ is not effective for COVID and your 'source' uses a lot of crank studies, non-peer reviewed bullshit and more. Especially suspicious given that the site in question doesn't even have a proper human behind it so I can't see their biases and why they're pushing this so hard. Who is bankrolling then?
Note that this is an article making huge claims about Alzheimer's but is published in Molecular Psychiatry. Given that signal, I'm just going to look at the abstract and not read the full text.
Here, the study population is patients with rheumatoid arthritis. This tells you up front that we don't have a typical population, but a highly selected one.
The use of HCQ is observational, not randomly assigned.
So, how could HCQ look protective even if it had no effect on Alzheimer's biology?
1. Maybe more rheumatoid arthritis patients should be on HCQ. It's a disease-modifying drug, after all. So it may be the case that people with better care, or more wealth, are more likely to be on HCQ. And that could be associated with other lifestyle factors that are never fully accounted for in an observational analysis.
2. Or it could be the case that people with dementia are less likely to have their HCQ prescriptions renewed, so the arrow of causation could even be reversed.
Additionally, one could imagine that HCQ might actually protect against Alzheimer's disease in people with rheumatoid arthritis—but not in a general population. That would be very big news, but would require further study.
And sure, it could be the case that HCQ reduces Alzheimer's risk in everyone. But you'd need a lot more evidence to buy that.