What took so long? It's clear you've never been involved in clinical trials. This is blisteringly fast. These things usually take many months of planning and review.

Guess when we knew we would have to get serious.

Fast since it has been taken seriously you mean.

Main researchers and leaders were still laughing at us for worrying on Monday evening.

I'm sorry that you seem to work for a crappy hospital. I'm at Mayo, and we've been serious about it for weeks now.

I'm at one of the top european hospitals. And I'm working ICU.

It's the same all across the western part of the continent.

Chloroquine has a host of potential, damaging side-effects. It's reasonable to hold it to a higher standard when the risks of taking it are also higher.

And do the others not?

The fact that this particular treatment has a booster club is odder still. People are acting like they have a personal stake in which treatment wins.

I mean...it seems likely that some of the boosters who have been astroturfing it do actually have a stake.

Look at this thread: everyone has their “one weird trick” (substance) which they believe is the silver bullet. Including garlic.

I doubt that these people have financial stake in any of these products. Sometimes, the substance might be relevant to some opinion they hold dear. The guy recommending garlic might consider all modern medicine a conspiracy of the pharmaceutical industry. A significant number of people on HN and reddit have also been really into cytokines for the last few years, the reason for which eludes me (maybe it’s the one bit of biology they heard of at some point and they are still enamored by their smartitude and want everyone to take notice).

Quinine and similar might have just been popular for the funny Gin&Tonic tie-in. Then, the US president read about, called it “the biggest discovery in medicine” or similar on Twitter, and now the alt-right has a stake in its success.

Now people are dying from taking that stuff:

http://bannerhealth.mediaroom.com/trending-now-at-banner?ite...

It is the one treatment that is cheap, already manufactured in large scale, and not in control of any single entity. Of course people are rooting for it.

"already manufactured in large scale"

People who need it for medical conditions are finding it impossible to find. Not sure how large the production is.

Any treatment that is found to actually be effective in real studies is pretty clearly going to be nationalized, recreated by countries around the globe, and mass produced overnight.

> Not sure how large the production is.

It's large, or can be easily scaled up. Novartis is pledging 130M tablets, Teva 16M, Mylan is planning on ramping production up to 50M.

0: https://www.fiercepharma.com/pharma/new-commitments-mylan-an...

I think the patents on chloroquine are long expired so won’t yield large profits for the pharmaceutical industry. Given the regulatory capture of the FDA in the US, my cynical side would not be surprised if lobbyists find a way to twist things toward the favor of more profitable drugs.

There are always vested interests and people with a financial stake, though I was talking about something much lower-level.

A number of zero-medical-experience personalities have become mini-celebrities with their boosting of it. For those who saw the movie "Contagion", their behavior is shockingly similar to the Jude Law character and its boosting of Forsythia. Some of these people are active on HN, and it's amazing how often absolute trash science is heralded like it's some suppressed truth.

A few days back Trump was retweeting one such huckster. A guy who has repeatedly tried to recreate his own Wikipedia page (to be deleted again for non-notability). Who has a pretty standard hustler-and-exploiter bio. Now he's claiming that he's at the forefront of "working with companies" to get this magical treatment to the streets. It is deplorable.

The WHO usually isn't in the business of sponsoring trials. The development of a single master protocol takes time, especially for one as large as this, and pulling one together within just a few weeks is already quite incredible, given the many, many partners that have to be involved, and how carefully you have to design it to balance a bunch of different factors.

> Still seems chloroquine is required to meet a higher bar than the others which continues to be odd.

Does the article say anything about different bars for the different treatments? I must have missed that. What are you referring to?

It seems quite a few countries in Europe are moving towards hydroxichloroquine/chloroquine and away from lopinavir-ritonavir for the recommended treatment of severe cases.

Top comment alludes to the stage of the disease as being important. So when we talk severity, is it severity by stage? Or overall severity? How will these drugs help when the disease has already attacked the lungs causing the large immuno response?

One common answer to all questions about covid: we don't know. All we have is extremely preliminary evidence, and we're acting on it in hope of luck and also just to provide people with something to cling to.

Isn't lopinavir-ritonavir already verified it doesn't help?

Chloroquine has shown promising results but the number of cases was small and the study was flawed. Lopinavir-ritonavir has shown disappointing results but the number of cases was small and the study was flawed. If you show faith in one you've got to show faith in the other for the sake of methodological consistency.

Read the article. Despite poor results from China, WHO feels larger testing against a wider variety of patients is warranted.

Mostly by "global interest". Reading between the lines, I wonder if they're being pressured.