The FDA's Office of new drugs is split into divisions (dermatology, oncology etc) and the different divisions have different approval criteria as you mention. From my Onco friends' PoV, cancer patients are pretty much assumed to be dying anyway so the standard of risk is quite different from, say, Derm, whose patients don't really die of anything except cancers.
Note: I have presented to the FDA and have written clinical trial requests (e.g. IND) which have been approved, but I have never done a submission to OOD. However my friends who do really talk about the approval path in a different way than I used to.
Don't self-medicate with chloroquine. It's very hepatotoxic.
"Hydroxychloroquine has not been associated with significant serum enzyme elevations during therapy of rheumatologic diseases. Furthermore, clinically apparent liver injury from hydroxychloroquine is rare. " https://www.ncbi.nlm.nih.gov/books/NBK548738/
"Despite use for more than 50 years, chloroquine has rarely been linked to serum aminotransferase elevations or to clinically apparent acute liver injury."https://www.ncbi.nlm.nih.gov/books/NBK548224/
I prescribe Plaquenil extensively in patients with autoimmune conditions.The safety profile of this drug is excellent. It is also still used for malaria prophylaxis in healthy individuals .it is not a new drug. I don’t see the reason of labeling it as dangerous. The question is : does it work for Covid19 prevention and treatment? The answer is “the current limited evidence suggests that it does”. What i can tell you that I am aware of a number of doctors in the US who are currently infected or waiting for results who are taking the drug. And I cannot blame them.
The French study of HCQ had several limitations. Including that it was very small and some patients who got HCQ and progressed to go to the ICU were excluded from the study. Thus making the drug look better than it is
HCQ is not likely to be a miracle cure. It may be useful in combo with other drugs
It's easy to make not great data look like great data to untrained eyes. And it's tempting to cut scientific corners to bring forward a drug for covid-19. But if the drug doesn't work, we should be honest about that and look for better drugs
Should at risk people take HCQ as a precaution until something better comes along? Definitely. but we need to be careful in talking about its potential
Weren't the first studies done in combination with azithromycin (which is bizzare, as that's an antibiotic)?
The mechanism is also quite simple: administer them both together and the antimalarials kill the virus, the antibiotics kill the pneumonia.
I assume they chose that as a broad spectrum prophylaxis for and opportunistic concurrent infection but perhaps they chose it specifically for this reason.
Like fine, we can have this discussion about chloroquine. It's behind-the-counter in the UK, so on par with sudafed in terms of access control, and OTC in a lot of countries that actually have to deal with malaria directly. But the same argument gets applied to stuff like oral contraceptives, which are straight-up OTC in a lot of countries too, and can simply be discontinued if you notice symptoms.
At the same time, we allow drugs with insanely narrow theraputic ranges like tylenol/acetaminophen/paracetamol (seriously, almost as bad as the chloroquine people are freaking out about, a normal dose is 1-4g and a lethal dose can be as low as 5g) to be sold OTC here with no questions whatsoever. We allow combination products despite obvious risks for multiple dosing, we allow combination products to "dissuade addicts" from abusing opiods (like any addict has ever been dissuaded by a risk bodily harm). And doctors don't make a peep about that, because they're not accustomed to getting their cut on that one.
That's also why the AMA resists nurse practitioners so hard. The truth is, a lot of those drugs really should be "behind the counter", a pharmacist should simply have to give you a quick rundown of possible symptoms and what to do if you notice them (discontinue and see a doctor or go to a hospital depending on urgency, same as you would do with a doctor-prescribed drug), but doctors won't allow that because they wouldn't get their cut, so we just call them "nurse practitioners" instead.
US doctors really like playing gatekeeper, to a much greater extent than other countries (where coincidentally, money doesn't come into the picture as much).
The idea being that if you want to take a trip to somewhere tropical, you don't have to tie up a GP with a standard, low-risk medication, but it's not quite so low-risk that you just put it on the shelf. Behind-the-counter, if you will.
https://en.wikipedia.org/wiki/Over-the-counter_drug#United_K...
> Pharmacy Medicines (P) are medicines which are legally neither a POM or GSL medication. These can be sold from a registered pharmacy but should not be available for self-selection (although directions to discuss a 'P' product may be allocated shelf space with associated GSL items). 'P' medications are reserved from the GSL list as they are either associated with a need for advice on use, or used in conditions which may require referral to a medical prescriber. Suitable trained counter assistants may sell a 'P' medication under the supervision of a pharmacist and will ask questions to determine if the customer needs to be referred for a discussion with a pharmacist.
You're not going to be able to get a registered professional to give you anything for off-label experimentation, especially not something with potentially serious side effects like chloroquine.
There’s a non-zero chance this virus gets into my home and a high-90’s chance the health care system will just turn us away if we got in trouble.
I'm fine if there's a serious reason for a physical examination, but a lot of stuff the doctor is effectively filling the role of a pharmacist: telling you side effects and if you have this set of serious side effects then to stop it and/or go to a hospital, here's your script, pay at the front desk. A lot of stuff is unnecessarily shoehorned into Rx-only, and despite a lot of talk about "reducing costs" there is no real drive to actually do so.
A great example is oral contraceptives. You may have to try a couple different blends before you find the right mix for your body. Some of them will be uncomfortable. Some may cause dangerous bleeding and you need to go to a hospital. There is not zero risk here, or with any drug. But the doctor has no way of telling which might be which for your particular body, they are there to tell you the risks, sign the paper and let you try it out. And that's why oral contraceptives specifically are being looked at as something that could be moved out of Rx only and to either OTC or pharmacist-prescribable - but the problem is there are really a lot of drugs that don't belong there.
A pharmacist can read the risks to you just as easily and not charge you $250 for a 15 minute office visit and another $250 for a one-month followup 15 minute office visit.
I have lots of 6-month maintenance visits that are literally 5 minutes. Everything going well? "Yup!" "OK, we'll call in your prescription, pay up front". They're just using their gatekeeping power to extract a check.
All this information is available online. You can look up the physician fee schedule straight from the CMS. https://www.cms.gov/apps/physician-fee-schedule/search/searc... . Here are the cardiology codes - https://myheart.net/cardiology-coding-center/coronary-interv...
To add an additional data point, doing a heart transplant is 89.50 wRVU * 36.0391 = $3225. I don't think doctors are living as well as you think. CPT code 33945.
Providers in fact make a point that they lose a significant amount of money at Medicare rates and have to limit the number of Medicare/Medicaid patients they see as a result.
I can confirm that a "45 minute" (5 minutes with nurse taking vitals, 25 minutes waiting in office exam room, 15 minutes with doctor) specialist "new" office visit was just billed to me for $246. They didn't charge me half the rate they charge a heart attack, they charge the heart attack patient 100x as much.
I don't think you understand how US billing works. Probably not from the US, or probably not subject to the system due to age (child or senior) or privilege (an engineer on a cadillac PPO plan perhaps).
Anyone who has ever experienced the US system knows that's absolutely normal.
For outpatient visits, this source says medicare pays 92% of what private insurance pays for established outpatient visits, and 80% overall https://money.cnn.com/2014/04/21/news/economy/medicare-docto... .
I am a US citizen who used to be a software engineer who now attends a US MD Medical school and I have student health insurance.
For the heart attack patient, it isn't the physician who is charging the huge amount. It's the hospital. The physician is only going to get a certain factor (somewhere between 1x - maybe 3x on the extreme end) of that $440 for the wRVUs.
> The researchers found the gap between the prices Medicare and private insurers pay hospitals increased from 2015 to 2017. Specifically, the researchers found private insurers in 2015 on average paid 236% of Medicare rates, and by 2017 that grew to 241% of Medicare rates.
https://www.advisory.com/daily-briefing/2019/05/13/hospital-...
Again, I just provided you an example of me getting billed $250 for 15 minutes of physician time during an office literally this month. Right now. Just paid it today. Will seeing the bill solve this discussion for you?
> For the heart attack patient, it isn't the physician who is charging the huge amount. It's the hospital. The physician is only going to get a certain factor (somewhere between 1x - maybe 3x on the extreme end) of that $440 for the wRVUs.
That's not what we were discussing, you're changing the topic from an office visit to a heart attack. A doctor's office visit is mostly doctor time, there's no surgical ampitheatre necessary for an office visit. No recovery time in a hospital bed. Completely different situation.
$1000 an hour net billing rate for a specialist office visit sounds about right. That's what I just got billed.
And yes, student insurance is unusually generous and usually subsidized by the university in terms of provider reimbursement as well as direct rates. You are not paying the full freight there.
Furthermore, you are far, far off the reservation suggesting the normal billing for a heart attack is $3200. You are underneath the Dunning-Kruger curve here, you don't even know what you don't know and you think you are informed for it.
> Heart attack hospitalizations cost a median $53,384 and strokes cost $31,218, according to the study. The resulting catastrophic costs make it difficult for uninsured patients to keep up with basic living expenses such as transportation and housing, according to researchers.
https://newsarchive.heart.org/uninsured-patients-faced-devas...
Feel free to tell the American Heart Association that they're wrong by a factor of 15. Let me know when they update the article. You're wrong, it's no longer worth continuing the debate with you.
Again, like I said, I mean this in the gentlest possible way: if you think an average heart attack billing (not just for the doctor, the whole thing) is $3200, you're too privileged to have been exposed to the realities of the American system. You are more incorrect than you have the worldview to even grasp. Even the doctors' association themselves think you are wrong.
I'm not trying to change the topic from office visit to heart attack. I provided the RVU calculation for the outpatient visits. That is how much the physicians are getting paid. You said that physicians are making a couple hundred bucks of each outpatient visit, which I don't believe is accurate, and I provided the calculation of why I don't think that is accurate. The total cost of the visit can be $250, but the physician is not getting anywhere near that.
I don't think it's accurate to say that they will be able clear $1000/hr. There is additional time needed to document each patient (often equal to the amount of time seeing the patient). I think seeing 3 visits in that time is plausible, but the physician is not getting that whole $250 (which is the point I'm trying to make). The clinic revenue may be $750 for that hour, but that needs to cover all of the overhead, and the physician will get whatever is left.
Make sure you are looking for sources that compare how much the private insurance pays physicians compared to medicare in particular vs how much they pay hospitals compared to medicare. The numbers will be different.
The $53,384 is what the hospital charges for the heart attack. The physician only gets the wRVUs for the services they provide in the hospital (if they're employed), so the 12.56 wRVU for the cardiac revascularization + the admission history and physical (2.61 wRVU CPT 99222) however many days of progress notes (2.00 wRV 1x each day - CPT 99233) in the hospital and the discharge summary (1.28 wRVU - CPT 99238) they write for the patient. So if a patient got revascularized and were in the hospital for 4 days before being discharged that's 12.56 + 2.61 (admission day) + 2 * 2.00 (2 inpatient days) + 1.28 (discharge day) = 20.45 wRVUs for the admission = $737 for the physician for that hospitalization.
I'm trying to make the distinction here between how much the hospital gets paid vs. the physician who provided the care. It's not accurate to say the physician is making $53,384 for the heart attack hospitalization, that is what the hospital is charging. The physician may make ~$1000 for an admission like that. If the physician is self-employed or in a group, they will charge for the facility RVUs and malpractice RVUs as well, because they need to cover the overhead of having a clinic to see the patient after the hospitalization.
If your bill breaks down the overhead for the clinic separate from the physician charge, then I'll agree that the physician made the $250 straight cash, but I don't think that is in any way the average amount any kind of doctor will make off an outpatient visit. Look at what you're suggesting, that a physician makes $1000/hr * 2080 workable hours in a year (not likely a physician only works 40hrs a week..) = $2+ million a year.
Amazing drug otherwise. My autoimmune symptoms have greatly reduced on it. Wish I could take the full dose.
For those not understanding the jargon (like myself).
I hear beer and wine are hepatotoxic too.
That's why I take milk thistle (silymarin).
I assume the Koreans are all taking silymarin with their chloroquine, which is why they aren't dying en masse from liver failure, right?
Also, for those considering to use the Cinchona bark itself as a prophylactic measure, as a natural / herbal / ayurvedic remedy, note that it also has potentially risky side-effects like slowing the heart, constipation and impact on the nervous system. In large quantity cinchona is UNSAFE and can be deadly. Symptoms of overdose include ringing of the ears, headache, nausea, diarrhea, and vision disturbances. Cinchona can also cause bleeding and allergic reactions, including hives and fever. It also interacts with a lot of other medicines like anti-coagulants, heart medicines, antacids etc. Be sure to check your medication list first.
2. it's already available for compassionate use.
The FDA is allowing chloroquine and remdesivir to be used for 'compassionate use' to treat the coronavirus.
https://www.businessinsider.com/chloroquine-remdesivir-compa...
I have to watch does as it has a strong stimulant effect at times.
It is Life changing for me, but i was having a lot of severe anxiety attacks from it.
Dr doubled the doSe. Yea a week long freak out occluded before I figure out what was going on.
Still worth it. Just have to be careful
"Novartis, Mylan and Teva to supply tens of millions of chloroquine tablets to fight COVID-19"
https://www.fiercepharma.com/pharma/new-commitments-mylan-an...
https://en.wikipedia.org/wiki/Glucose-6-phosphate_dehydrogen...
also doctors:
https://twitter.com/ml_barnett/status/1241172371404357633
It isn't totally clear to me what you are implying, but there isn't anything wrong with them stocking up on hydroxychloroquine if it is likely to be effective against COVID-19. It would be a shame if they thought it worked but government regulation prevents them from prescribing it to ordinary patients.
It doesn't. It's FDA-approved, it's just off-label for this use.
> It isn't totally clear to me what you are implying, but there isn't anything wrong with them stocking up on hydroxychloroquine if it is likely to be effective against COVID-19
lmao are you implying that doctors are self-prescribing or using straw man prescriptions because they just love their jobs that much?
bud, if that's a good policy we can get the chain of command at the hospital to do it, not Dr Nick writing a fake prescription for his dog and taking it on the sly.
Oh yeah but that's not an FDA approved use and there's "no clinical evidence that it works".
What I'm saying is there's a huge disconnect between what doctors are saying, and what they're doing. There is pretty strong evidence it works. There is a half century of evidence it's safe. That's why they're willing to give it to their family members.
Doctors just don't want to cause a rush on the supply. But they themselves want to hoard it for their family.
BTW the whole reason Trump mentioned this is because he's on it. Someone told him these pills would help keep him from getting infected, and he blurted it out because he has no filter and just says whatever crosses his mind.
Maybe the part where he burned spies that took us decades to get into the Kremlin in a moment of unthinking blurting. Or the part where he livetweeted a classified photo from a briefing (on his unsecure phone that he's not "allowed" to have, if he cared) that revealed classified satellite orbits and capabilites and had to be (arduously) scrubbed from the internet. Or the part where some people talked to him about the problems of mass shootings and he proposed "taking all the guns and worrying about the due process later". Or maybe the other 4 years too.
It's really not a radical thesis at this point. Guy has no filters whatsoever. Name your position, guy has blurted out a dozen unthinking things over the years. He just says whatever wanders across his mind. Whatever seems good at the moment.
Some of them can be retracted later. A lot can't. The damage is done. You can't put those drugs back on the shelves.
By the way, he didn't just say it was hopeful, he suggested it was approved. Which is where Dr Fauci had to step in.
They measured virus, not outcomes, they measured virus in the throat, not the lungs, the starting point was not the start of the disease but some later (more arbitrary) point in time, the two groups were not randomly assigned and the study wasn’t really blind.
It could be that they just happened to compare two groups where the treatment group was further along in the illness – especially since they try to sell that as a disadvantage for them, but that could honestly be an advantage for them. We know that virus in the throat decreases as the illness progresses. (Virus in the lungs is much more relevant and also dangerous here, better would probably be outcomes.)
Not really evidence, sorry.
But it is most definitely evidence.
I don’t think it’s intentionally bad but it’s still bad. In the end it’s easier to make things worse … and chloroquine could, we don’t know. So I wouldn’t touch it.
1st February: https://www.lejdd.fr/Societe/le-professeur-didier-raoult-ce-...
"This coronavirus isn't so bad"
26th February: http://m.lamarseillaise.fr/analyses-de-la-redaction/decrypta...
"The coronavirus isn't more dangerous than seasonal flu."
That's why it's difficult to understand how an expert could casually claim that this was nothing more than seasonal flu.
If he had the evidence explained to him and then just assumed it would be different in France that would be unscientific, but we'd all need to read French to ague about that.
It's difficult to understand why a country would go on lockdown and build emergency hospitals for something nor worse than seasonal flu...
I would have been 12 or 13 years of age and this would have been in mid 70s.
As part of that same preparation I also had 2 jabs (I think for Yellow Fever and Cholera) and if I remember correctly I had to take one malaria tablet a day, for a period of two weeks prior to the start of the trip.
I honestly don't remember any side effects from taking those malaria tablets, but I do remember the 2 days of numbing pain in my arm, which I assumed was caused by the two jabs.
Are you are talking about the study that was trendy yesterday? The control group is not randomized, and most of it was in others hospitals. They are not counting the 6 patients that they lost in the treatment group (1 just leave, 1 had too much nausea, 3 where transfer to ICU, 1 die). It is more strange that they didn't lost any patient in the control group.
For certain individuals who just happen to have a bad reaction, COVID could well be just as fatal as cancer. In terms of how fast it can kill people, in certain cases, it can be worse than a lot of cancers.
Where are you getting this number? It is significantly higher than any I have seen.
https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e2.htm - TABLE. Hospitalization, intensive care unit (ICU) admission, and case–fatality percentages for reported COVID–19 cases, by age group —United States, February 12–March 16, 2020
https://www.worldometers.info/coronavirus/coronavirus-age-se... - Age of Coronavirus Deaths
It's been around for 70 years, taken by millions over very long periods of time with relatively minimal negative side effects.
Compared to antibiotics with a 8 hour half life.
Lets stay home instead.
For a couple of weeks, fine. However on the other end of this spectrum is "Millions starve".
At some point we need to ask is that fair to the youth? (note: I'm an old fart)
To acquire immunity while there are still hospital beds available in some places, in the unlikely event that you need one. That won't be the case a month from now.
If instead, we all stay home and quarantine, the second we start reducing the quarantine the virus flares back up again. If instead, we start acquiring immunity in low-risk populations, at a rate that the hospitals can sustain, we'll have a degree of herd immunity and a portion of the population that can no longer spread it.
I'm certainly not an epidemiologist though; anyone smarter than me that can way in on that thinking?
A fair portion of low-risk people will require intervention. Given that a lot more people are low than high risk, you're still overwhelming the health system, and all those low-risk people are still going to interact with others while they are asymptomatic but transmissible.
Time means more ICUs, more ventilators. It means industrial capacity can shift from making consumer goods to medical supplies like masks. It means medical personnel get training and experience with the disease instead of shooting in the dark. It means labs and research teams can give more informed treatment advice.
It means small businesses and industries can try to reallocate resources and jobs and maybe save part of the economy. It means more time to educate the population to avoid high risk activities, wear masks, wash hands and so forth.
In every way it’s better if we delay the pandemic now that we know about it than if we just let it peak exponentially and kill the maximum number of people.
1) Such an individual would be contracting an unknown virus in an environment where hospital staff are the least prepared and practiced at dealing with it.
2) Such an individual is still exposing themselves to high risk of mistiming the outbreak and hitting it at the peak.
3) They might accidentally catch a different disease thinking it is COVID. Then if they got COVID they'd have 2 diseases; which is probably going to be quite bad.
If we all avoid getting COVID-19 for, say, another 2 months it is likely we'll have an available and effective drug for treating it. There are something like 5 different candidates I've heard of, so even if the odds of any individual one working out are <30% there is still a good chance there will be effective treatment by mid year. The contain, delay and avoid strategy really is a better bet.
I don't believe this is likely at all. At best we will have something that kinda sorta works in some patients. If this was likely we'd have a drug for the common flu long time ago. To remind you, the flu takes about 50K lives in the US every year.
It is a little white lie that is important to tell the public to help build compliance, the lower you can push it the fewer people will die, but hospitals simply are going to be overloaded regardless. The choice we can make is one between "very overwhelmed" and "overwhelmed to the point of non-functionality".
"shelter for 12-18 months" is a little bit of an exaggeration but not much. Simulations suggest that after an initial harsh quarantine period (up to several months) to get transmission under control, we will need to shelter for about 2/3rds of the time (2 months on, 1 month off) for 12-18 months, and other measures for 100% of the time. The vaccine will be what finally terminates the situation. https://www.imperial.ac.uk/media/imperial-college/medicine/s...
Even then that may be optimistic (especially if the population is not fully compliant). Italy is not just working from home and social distancing, they are straight up quarantining everyone, and they still have overloaded hospitals and bodies piling up faster than they can cremate them. Presumably the quarantine will slow things down on the order of weeks to months, but right now things are brutal.
https://mobile.twitter.com/foxmulder22791/status/12404540564...
The Chinese strategy of requiring everyone to get a phone app, to track them via GPS, doing widespread testing and then quarantining the people who have been in contact appears to be a much more effective strategy than blind quarantine or social distancing. No app, no uber, no groceries, no public transit, etc. The US citizenry absolutely will not stand for the mark of the beast though.
The Korean thing about masks and gloves probably helps too. Too bad the hospitals are down to about 11 days of masks let alone for the citizenry.
I'm not trying to be a downer but if chloroquine works that's a really fucking big deal, because that would give us a fairly straightforward alternative to treat cases or even prophylactically treat vulnerable populations. Unless you have a tool in your toolbox we are mostly just moving the deck chairs here and choosing between "really bad" and "oh shit".
I'd happily be tracked 24/7, and I'm sure so would many many others, if it meant reducing the spread and getting back to some sense of normalcy a bit quicker.
https://www.nytimes.com/2020/03/01/business/china-coronaviru...
The other thing is that other countries like Iran and Israel are just pulling the data directly from Google Location Services or from telcom location data. I assume the US will probably follow at some point, since that data can be accessed without a warrant since it's third-party-controlled data.
UK government: "at least a year." https://news.sky.com/story/coronavirus-social-distancing-nee...
Modelling: "2 months on 1 month off until a vaccine is developed". https://www.imperial.ac.uk/media/imperial-college/medicine/s...
/shrug
It's unprecedented and I tend to agree with you that at some point the economic carnage is going to force alternatives, but right now that's the plan. Not the plan they're telling you publicly, but the real one they're planning for and reacting to.
At the end of the day if that's the plan you'll go along with it because the men with guns will make you.
As I've commented elsewhere, an approach using contact-tracing via app and GPS data, backed by widespread testing (millions per week) and small-scale isolation of affected, along the lines of China or South Korea, seems to be more effective.
https://twitter.com/CarolYujiaYin/status/1239583581325778944 (deffo not propaganda /s)
https://www.nytimes.com/2020/03/01/business/china-coronaviru...
The US population is going to hate hate hate that one. But it's that or stay inside except for going to the grocery store for the next 12-18 months.
If we don't choose option A, and we don't choose option B, we implicitly choose option C: 20% of our seniors die in a single year. Choosing not to choose is still making a choice. I believe there's a song about that.
The all-cause mortality rate in Europe has been dropping in the past few weeks and is now well below normal levels. To me this looks like people have been overdoing the whole stay indoors and avoid any sort of risky behavior.
That sounds very much like a "worst-case", afaik German CureVac are right now in the stage of selecting the last 2 candidates for a vaccine, they expect first clinical trials around June/July, I'd be surprised if they are the only ones that far along.
That's not meant to say this will be over the instant we have a vaccine, but finding one is right now the big X factor that makes all estimates veer on the rather pessimistic side.
I'm already locked up (Italy). I'll go insane, seriously, if I need to stay shut in for 18 months.
It's also resetting our global warming clock. Something youth were keen about getting the world to do. If they can't handle staying at home for an extended time then global warming might not be that important after all.
Either shutting down all Chinese factories for a period of time reduced CO2. Or they made no difference and we can run those factories without fear.
Wouldn't a global recession/depression reduce production?
Increased funding for scientific output or more climate models isn't going to make a difference. People have to buy and use less. You can't have it both ways here either.
> Increased funding for scientific output or more climate models isn't going to make a difference. People have to buy and use less. You can't have it both ways here either.
The science I'm most interested in isn't climate models. It's better solar panels, or better wind turbines, or better batteries, or better fission reactors, or (useful) fusion reactors, or space based solar shades, or ways to remove CO2 from the atmosphere, and so on.
People buying and using enough less unfortunately does not seem to be a realistic solution to the problem. People buying less might be able to delay us hitting disastrous amounts of warming by a few years, but that only buys us time for the above kinds of research.
Close to half of COVID infections result not even in a cough. Going by the mostly elderly population on the Diamond Princess, mortality with proper treatment is going to be significantly lower than 1%. Flatten the curve? Sure, but we can't be locking down the entire country indefinitely.
The youth already begrudge the elderly, locking them down for months will make them wish they were dead. Remember how a year felt like an eternity when you were 16?
Also, most youth don't care about global warming either. They're just virtue signaling. It really isn't that important, if they understood what they would have to give up on to stop it, they would embrace it and look forward to spring break in North Dakota.
Possibly?
> Going by the mostly elderly population on the Diamond Princess, mortality with proper treatment is going to be significantly lower than 1%.
If we're all sick at once can we all get proper treatment?
We're all making assumptions and treating our ideas like they have to be true. We still don't actually know, we will only know in retrospective, and that's important to keep in mind. We can't know what's going to happen, and I think we need to be more cautious than optimistic. Where's the line between that an insanity? I don't know, but we can't act like we know the math, especially when we're getting equal and opposite information every day.
I am not saying everyone should get sick at once, a certain period of isolation is acceptable - for now.
In the long term, it is not reasonable to isolate everyone. Covid-19 will stay with us for years.
Stop spreading FUD
I'm all for staying home for now, but at some point we will have to come out, and we need something to help those that are already infected.
If CQ works as prophylaxis, we could potentially have a sort of interim herd immunity by having large portions of the population that could tolerate CQ taking it prophylactically while we wait for a vaccine. This is basically the current approach in regions with a lot of Malaria, and they've been waiting for a vaccine for a very long time.
The danger of course is SARS-CoV-2 developing resistance to Chloroquine as Malaria has. We need lots of people working as fast as possible on a vaccine.
Chloroquine's safety profile isn't great, but the safety profile of COVID is way worse. If you look at Chemotherapy for example, one would never take any of those drugs unless you had cancer.
COVID isn't quite as bad as cancer, but Chloroquine, especially for a short course, isn't anywhere near as bad as most chemo drugs. Many people take it for years as prophylaxis -- not even to treat an existing disease.