Thanks for sharing! I’m not a doctor, so I found this a tough read. This document is clearly a proposal (attempting to convince the reader) instead of a summary, but it still contains a lot of useful information. Nevertheless, there were some parts I found especially confusing.
On page 2 they mention there are currently 22 studies, of which one has completed, on the effect of hydroxychloroquine (HCQ) treatment on COVID-19 patients. Further down in the piece (in particular in the section “What about the studies that show no benefit from HCQ?” on page 11) they dismiss some studies showing little or no effect. Is there a place to find more discussion on which studies are being discounted, and for what reason? They link one study only, citing that “only 400mg daily for 5 days was used”, although the suggested treatment in this document is “HCQ: 6.5-15mg/kg PO in divided loading dose followed by 400-800mg/day in divided doses for 4-9 days” (which encompasses 400mg daily for 5 days).
The recommended treatment is a combination treatment with four different components—an initial oral hydroxychloroquine administration and a daily treatment of hydroxychloroquine and two other medicines (zinc and Azithromycin). Furthermore the document states that this treatment is expected to work a lot better in early stages of the disease (this part is also unclear to me—again on page 11 they state that “[some studies] waited to initiate treatment until the disease was too far progressed to be effective” as grounds for dismissal). Does this mean this treatment is expected to have next to no effect in late stages? I’m worried about Bonferfoni-esque situations here; are 21 incomplete and 1 complete study strong enough to motivate this complicated treatment, especially if we allow ourselves to discount some papers with conflicting conclusions as well as restrict the time period over which the treatment is supposed to be effective?
This document summarises a lot of the evidence.
Thanks for sharing! I’m not a doctor, so I found this a tough read. This document is clearly a proposal (attempting to convince the reader) instead of a summary, but it still contains a lot of useful information. Nevertheless, there were some parts I found especially confusing.
On page 2 they mention there are currently 22 studies, of which one has completed, on the effect of hydroxychloroquine (HCQ) treatment on COVID-19 patients. Further down in the piece (in particular in the section “What about the studies that show no benefit from HCQ?” on page 11) they dismiss some studies showing little or no effect. Is there a place to find more discussion on which studies are being discounted, and for what reason? They link one study only, citing that “only 400mg daily for 5 days was used”, although the suggested treatment in this document is “HCQ: 6.5-15mg/kg PO in divided loading dose followed by 400-800mg/day in divided doses for 4-9 days” (which encompasses 400mg daily for 5 days).
The recommended treatment is a combination treatment with four different components—an initial oral hydroxychloroquine administration and a daily treatment of hydroxychloroquine and two other medicines (zinc and Azithromycin). Furthermore the document states that this treatment is expected to work a lot better in early stages of the disease (this part is also unclear to me—again on page 11 they state that “[some studies] waited to initiate treatment until the disease was too far progressed to be effective” as grounds for dismissal). Does this mean this treatment is expected to have next to no effect in late stages? I’m worried about Bonferfoni-esque situations here; are 21 incomplete and 1 complete study strong enough to motivate this complicated treatment, especially if we allow ourselves to discount some papers with conflicting conclusions as well as restrict the time period over which the treatment is supposed to be effective?