Coronavirus

[Causalien]

COVID-10 and Chloroquine

Did a pubmed search:
chloroquine covid-19 - PubMed - NCBI

10 results (that's not good - there should be much more if this worked)
From bottom to top (newest to oldest)

10 - This is an abstract (unpublished paper or poster) - it shows in vitro inhibition of infection into Vero E6 cell lines by therapeutic doses of Remdesivir and high doses of Chloroquine. Because this is an abstract, the authors have not made any comments on their data or conclusions. The data set is from a single set of experiments. This, however, is a very reputable journal.

9 - This is an editorial, not a research article. The authors report the in vitro data, and recommend follow up by randomized control trials. No treatment recommendation is made.

8 - Another editorial referencing back to the original Chinese clinical "trial" of 100 patients to which @bhzmark referred. No data presented.

7 - Additional editorial referencing back to original Chinese trial. No data presented.

6 - Unrelated article describing how to disseminate information from clinical trials. No data presented.

5 - Yet another editorial referencing back to original Chinese trial. No data presented.

4 - Review article - this is the best summary found to date of the history of chloroquine, the pros and cons, and the Chinese data, specifically this paragraph is a great primer:
"The in vitro antiviral activity of chloroquine has been identified since the late 1960's (Inglot, 1969; Miller and Lenard, 1981; Shimizu et al., 1972) and the growth of many different viruses can be inhibited in cell culture by both chloroquine and hydroxychloroquine, including the SARS coronavirus (Keyaerts et al., 2004). Some evidence for activity in mice has been found for a variety of viruses, including human coronavirus OC43 (Keyaerts et al., 2009), enterovirus EV-A71 (Tan et al., 2018), Zika virus (Li et al., 2017) and influenza A H5N1 (Yan et al., 2013). However, chloroquine did not prevent influenza infection in a randomized, double-blind, placebo-controlled clinical trial (Paton et al., 2011), and had no effect on dengue-infecteds patient in a randomized controlled trial in Vietnam (Tricou et al., 2010). Chloroquine was also active ex vivo but not in vivo in the case of ebolavirus in mice (Dowall et al., 2015; Falzarano et al., 2015), Nipah (Pallister et al., 2009) and influenza virus (Vigerust and McCullers, 2007) in ferrets."

The authors of #4 further go on to make the following statement:
"This would represent the first successful use of chloroquine in humans for the treatment of an acute viral disease, and is undoubtedly excellent news, since this drug is cheap and widely available. However, it should be considered carefully before drawing definitive conclusions, since no data has been provided yet to support this announcement."

BASICALLY - THE CHINESE SAY THEY HAVE DONE A TRIAL OF 100 PEOPLE, AND SEE SOME EFFECT, BUT HAVE NOT SHARED THEIR DATA. In the scientific community, not sharing your data so that others can reproduce your results is one of the biggest red flags there is. These authors call out the Chinese researchers on this:
"In conclusion, the option of using chloroquine in the treatment of SARS-CoV-2 should be examined with attention in light of the recent promising announcements, but also of the potential detrimental effect of the drug observed in previous attempts to treat acute viral diseases. We urge Chinese scientists to report the interim trial results currently running in China as soon as they are available. This should be preferentially done in a peer-reviewed publication with detailed information to allow the international scientific community to analyse the results, to confirm in prospective trials the efficacy of the proposed treatment and to guide future clinical practice."

3 - Yet another editorial referencing back to original Chinese trial.

2 - An in vitro study showing antiviral properties (we know this, nothing new is present here).

1 - These are the Chinese researchers making their recommendation for the use of Chloroquine, but they do not publish their actual data.


Does anyone have the ACTUAL original data from the Chinese researchers? Because everything I can find appears to go back to that one study of 100 patients, and then everyone is re-hashing the report and putting their own spin on it.


SHOW ME THE DATA!!!!

China has gone dark. They've ramped up their Internet army recently.

Try and look for the Hydroxychloroqin trials done in South Korea cause that's what they used.

 

[SMAlset]

You know it's serious when Ireland closes its pubs.
Government orders all pubs to close and advises against house parties

....

Especially before St. Paddy's Day Gotta be unpopular from patrons to bars alike.

At the opposite end I was quite shocked to see the Vive Latino concert held in Mexico with crowds like that that turned out. Don't know what Mexico's infection rate is but I can't believe after a few weeks it won't skyrocket.

Mexico holds big music festival despite coronavirus concerns

 

[renim]

I've always found BMI to be a misleading stat.

I'm 6' 0" and about 185 pounds that puts me just above 25 BMI. But I can spend an hour on an elliptical like it's nothing and I can bench press my body weight

Totally agree, the bmi of the NZ all blacks rugby team must be sky high.

BMI is a pragmatic approximation, but yes, the fittest people often have high BMI. And TOFI is a real problem also.

 

[AlanSubie4Life]

If you think EM does this for money you've misunderstood him all along. It's always been about trying to create the most positive sustainable impact in the least amount of time. Of course this is going to slow things down and he doesn't want that, but he'll find a way to keep progress going as quickly as humanly possible during such a time when most people are running around trying to secure tp.

I don't think he does it just for money - he clearly has other motivations, and he wants his company to succeed. But the crazy tweeting about the coronavirus is really not doing him any favors. And the email that was reported seems ridiculous. It really makes me wonder how he can be so smart but so tone deaf (and in fact, apparently ignorant of the facts, in this case). I mean, I guess we'll see who was right in the end, but I don't think those tweets and that email are going to age well.

It's just counterproductive, and it does not help his business or his reputation. He needs to be focused 100% on protecting his employees - if that means slowing down output, so be it. But I bet they can continue if they implement the right policies. Presumably they have experience from China that they are using. But these tweets...man...

I guess maybe you could argue that he is such a perpetual optimist, that that optimism is blinding him to the danger here.

 

[ReddyLeaf]

I don't think he does it just for money - he clearly has other motivations, and he wants his company to succeed. But the crazy tweeting about the coronavirus is really not doing him any favors. And the email that was reported seems ridiculous. It really makes me wonder how he can be so smart but so tone deaf (and in fact, apparently ignorant of the facts, in this case). I mean, I guess we'll see who was right in the end, but I don't think those tweets and that email are going to age well.

It's just counterproductive, and it does not help his business or his reputation. He needs to be focused 100% on protecting his employees - if that means slowing down output, so be it. But I bet they can continue if they implement the right policies. Presumably they have experience from China that they are using. But these tweets...man...

I guess maybe you could argue that he is such a perpetual optimist, that that optimism is blinding him to the danger here.

If anyone could get full respirator protection for his employees, it’s Elon. One call to China and they would bring dump truck loads to GF3.

 

[EinSV]

Adjusted for population, New York is 10 days behind Italy, with 729 confirmed cases per Gov. Cuomo.

I haven't compared testing in NY v. Italy so reality could be less or more.

Alexander Higgins - Coronavirus Updates on Twitter

 

[Andy O]

I'm considering picking up some tonic water. Tonic contains quinine, which is apocryphally somewhat effective for the same things as chloroquine. Just an excuse for some people to drink gin, of course.

 

[powertoold]

Especially before St. Paddy's Day Gotta be unpopular from patrons to bars alike.

At the opposite end I was quite shocked to see the Vive Latino concert held in Mexico with crowds like that that turned out. Don't know what Mexico's infection rate is but I can't believe after a few weeks it won't skyrocket.

Mexico holds big music festival despite coronavirus concerns

Seems like a lot of countries in similar latitude as Mexico are fairing pretty well...

 

[Johnny Ma]

So these are all very different demographics, different containment, tracing and sampling methods:

• Early Wuhan: only the most severe cases got to a hospital.
• South Korea: extreme transmission tracing methods: they are using cell phone GPS data and CCTV footage to individually track down those unknown individuals who interacted with known cases and isolate them, within hours. Big Brother-esque but very effective: daily infections are now down to around 1-2% rate. Also young demography with 42 years average age.
• Italy: likely only the worst got to hospitals, likely tens of thousands to hundreds of thousands infected. Older demography of 65 years average age, and air pollution and pre-existing pulmonary conditions exacerbated the ICU overload.
• Germany: better tracking of clusters and younger demography. Containment measures are slow though, so this will peak much higher I'm afraid.
• Diamond Princess: best case study so far due to isolation and 100% test coverage, and low 1% mortality of the ~50 years old demography. Supports overall 0.5% mortality rate I used.

Note that these sampling biases are relatively stable, I.e. these countries will produce seemingly self-consistent but contradictory numbers.

Yes, nearly 22% of Italy's population is above 65, as of 2018 stats. I keep reading that they have way too few ICU beds per capita. Germany and SK way higher number of beds and both similar strategies - test, test, test.

Analyzing the data I'm pretty sure early transmission rate is at least 20%/day, but can be 40% in favorable clusters.

(Btw., what kind of lab is yours, roughly, if you can share?)

@Doggydogworld: the 12.5% rate used in the 20k estimate by Trevor Bedford is IMO excessively cautious - which is understandable, as they are one of the highest estimates already and have a reputation as non-alarmist experts to protect. Raw data I looked at from various countries shows peaks of 50% daily infections, 20%-30% sustained daily rates. (I'm not an epidemiologist.)

R&D in a very large hospital system. Lab's expertise is mostly in data science. We are not tasked with dealing with this situation (yet!) but we are a numerate bunch. I'm intentionally not posting our numbers because we could be very wrong. One of our assumptions is that our local outbreak started in what is effectively the Biogen conference on steroids, amphetamines, pcp, and lots of other things, with many different persons spreading the infection.

Shanghai and China is employing extreme social distancing measures at workplaces as well, which dropped R0 well below 1.0.

I believe Shanghai's data that they haven't had a new infection in 7 days, despite much of the area back to work for the last 35 days.

Herd immunity is a pipe dream I'm afraid, the virus didn't have (nearly) enough time to spread globally I believe.

I don't know. UK has chosen a contrarian and potentially very dangerous route, which is to basically do nothing and reach herd immunity quickly. I'm closely monitoring their numbers.

China is very confusing to me. I know people there and it seems like they're having a better, yet delayed response, despite what the media say.

 

[Johnny Ma]

Could it be that doctors are figuring out effective therapies? And that use of therapies is inconsistent across countries?

As more data comes in, my best guess is demographics and number of ICU beds per capita explains the differences.

We had good data from the start on the CFR by age. Only SK and Germany have responded properly, as far as I can understand. UK is taking a very big gamble, but might be right. I can't imagine having the confidence to make the decision they did, though.

All countries should be ashamed for not leveraging information technology to inform those most at risk (the elderly and people with specific health problems) to self isolate. Instead, many have chosen to induce panic. My local grocery stores are packed. Lines of people standing in close contact with strangers for far longer than they normally would.

The working class in the US is about to be decimated. Rate cuts won't help. This is catastrophic failure at all levels of government.

 

[linux-works]

why are people refusing to understand?

13 Of The Most Unbelievably Selfish People In The Entire World

its frightening that so many think its a JOKE.

they're not just darwining themselves, they're doing it to all of us.

 

[Cosmacelf]

UK is taking a very big gamble, but might be right. I can't imagine having the confidence to make the decision they did, though.

What exactly is the UK doing that's different from everyone else?

 

[dfwatt]

I'm considering picking up some tonic water. Tonic contains quinine, which is apocryphally somewhat effective for the same things as chloroquine. Just an excuse for some people to drink gin, of course.

Unfortunately you would need to drink somewhere in the vicinity of 10 L to get enough quinine for it to be meaningful if assuming again if quinine inhibits illness progression in covid-19.

 

[KSilver2000]

I might have to stay off of the net this week. Every time I look at my NextDoor, I cant help but get frustrated. Not good for my health and should be spending time more with kids.

I cannot tell you how many people are still out there shouting overreaction using the usual, stupid graphics and statements of how this situation pales in comparison to the seasonal flu or other matters like the seasonal flu and homelessness (as if they cared about that to begin with).

You really can’t fix stupid.

 

[Johnny Ma]

What exactly is the UK doing that's different from everyone else?

Trying to reach herd immunity by letting the virus burn through the population as fast as possible. No shutdowns of anything.

They're afraid they'll shut down, seemingly get a handle on things, then have multiple reinfections that cause further shutdowns, which will destroy the economy and ultimately do more harm than the virus can itself - poor people are much more likely to die. It's a utilitarian approach.

I think they're doing targeting isolation by age group, now.

I offer no opinion on this strategy.

I welcome correction on this, but I think it's accurate as of a few days ago for the herd immunity goal and as of the time of this post for targeted isolation by age.

 

[bhzmark]

Does anyone have the ACTUAL original data from the Chinese researchers?

If it was COVID-17 or COVID-18 we would have published data. The Chinese registry says data will be published after 6 mos.

Meanwhile this is the best we got.

 

[bkp_duke]

If it was COVID-17 or COVID-18 we would have published data. The Chinese registry says data will be published after 6 mos.

Meanwhile this is the best we got.

View attachment 522239

But that's . . . nothing. Seriously, there is zero data there.

Edit - "Bioscience Trends" - that's not a very rigorous peer-reviewed journal.

Nature, Science. Those would be top-shelf journals.

 

[gerebgraus]

I don't think he does it just for money - he clearly has other motivations, and he wants his company to succeed. But the crazy tweeting about the coronavirus is really not doing him any favors. And the email that was reported seems ridiculous. It really makes me wonder how he can be so smart but so tone deaf (and in fact, apparently ignorant of the facts, in this case). I mean, I guess we'll see who was right in the end, but I don't think those tweets and that email are going to age well.

It's just counterproductive, and it does not help his business or his reputation. He needs to be focused 100% on protecting his employees - if that means slowing down output, so be it. But I bet they can continue if they implement the right policies. Presumably they have experience from China that they are using. But these tweets...man...

I guess maybe you could argue that he is such a perpetual optimist, that that optimism is blinding him to the danger here.

It was tone deaf perhaps, but he was completely right, and corona virus policies optimize the health of the healthcare industry against the health of the nation. (And that is usual. Typical health guidance benefits the healthcare industry greatly against the benefit of people. (e.g. eat low fat high carb food, take statins whether it would benefit you or not, etc. etc. and then etc.) It is well understood who is at risk, and those should be (self) quarantined. The rest of the population would reach heard immunity much faster, which in turn would reduce the time needed for the quarantine. Number of people committing suicide etc. because of the economic disruption will be much higher than the extra slightly faster death of late stage geezers.

 

[bkp_duke]

This is the article you are referring to:
https://www.jstage.jst.go.jp/article/bst/14/1/14_2020.01047/_pdf/-char/en

Literally, there is no data presented there. It's a page long (1.5 with references).

EDIT - reference 5 is to the "actual data". But I've been trying to go there for hours, and I don't get anything to actually show up (granted, I'm poking around and don't read Chinese).

 

[Johnny Ma]

EDIT - reference 5 is to the "actual data". But I've been trying to go there for hours, and I don't get anything to actually show up (granted, I'm poking around and don't read Chinese).

??

The English in the link to reference 5 is a translation of the Chinese characters you see.