| The obvious rebuttal is: no it isn’t. Experts have done a far more efficient job than non-experts at promoting wrong and dangerous disinformation, and attacking the credibility of those not deemed sufficiently elite. Distrust in medicine and evidence rise at the same rates as the hersteria from rulers yelling “Listen to me! Or else!” In an email, Jane Orient, who is not in the cool club, God bless her, summarized the situation well. There are, she said “two sides: 1. Let’s treat our patients as well as we can, share information, and learn as we go. 2. Let’s censor, threaten, and punish doctors on side (1), demand RCTs that meet our standard as the only kind of ‘scientific evidence,’ and deny treatment that doesn’t fit the NIH guidelines.” (I, as regular readers know, do not agree philosophically with the “R” part of clinical trials as any kind of guarantor except possibly to reduce the chance of cheating. That’s for another day.) Even doctors, most of whom are people, can become suspicious when the powers-that-be react first and foremost with censorship and bans. Let’s look at HCQ in the context of the new paper “Hydroxychloroquine as Postexposure Prophylaxis to Prevent Severe Acute Respiratory Syndrome Coronavirus 2 Infection” by Ruanne V. Barnabas and others in Annals of Internal Medicine. They begin by saying this: Hydroxychloroquine, a chloroquine analogue, has been used safely for over 6 decades as an antimalarial and to treat autoimmune conditions, with broad activity against intracellular organisms (13). With standard dosing, chloroquine inhibits SARS-CoV-2 replication in vitro (14, 15). Observational studies in health care settings supported the use of hydroxychloroquine to prevent SARS-CoV-2 (16, 17). Hydroxychloroquine and chloroquine are widely available globally; as such, they are ideal candidates for repurposed pharmaceutical interventions to prevent SARS-CoV-2 infection because they could be rapidly disseminated for new indications, including in resource-limited settings. So it couldn’t have been crazy or even dangerous to try HCQ, as many docs have. The idea in this new trial was to give HCQ or vitamin C as a placebo to those in households where a household member had been “exposed” to somebody to the coronadoom within four days. There is, obviously, some wiggle room in “exposed.” Plus, like all these trials, you have to trust people took the meds when they say they did. The outcome is clear enough: “Participants self-collected mid-turbinate swabs daily (days 1 to 14) for SARS-CoV-2 polymerase chain reaction (PCR) testing. The primary outcome was PCR-confirmed incident, SARS-CoV-2 infection among persons who were SARS-CoV-2 negative at enrollment.” -William Briggs The only industry that will survive? Regards,  George Gilder Editor, Gilder's Daily Prophecy |
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