“In my view, hydroxychloroquine should not be used in a hospital setting,” says Martin Landre, a physician and researcher at the University of Oxford’s Newfield Department of Population Health and one of the heads of recovery. “Outside the hospital setting it would be appropriate to use in the context of a randomized controlled trial, but not otherwise.”
Speaking of which: The Minnesota study did not see people in hospital, so by definition were not ill. And this led to some methodology problems. The lack of easy and fast Kovid-19 testing in the US meant that not everyone in the study population had a diagnosis made through PCR testing, or taking a sample through a nasal swab and for the genetic material of the virus It had to be analyzed. For these participants, the team of researchers confirmed that they had Kovid-like symptoms, and that they had contact with someone who had an infection Was Confirmed with a test. This is a slightly dicier set-up, but still valid.
The Minnesota team originally intended to use death or hospitalization numbers to see if the drug helped people in the study. Although, both in the US outnumber the sky, the actual mortality and hospitalization rates are significantly lower or much lower in group size in a study of only 500 people. So without looking at the data, the team switched to another metric: symptom reduction. (Participants reported their own symptoms on a day-to-day 10-point visual scale; the most common ones were cough, fatigue, and headaches.) Here, hydroxychloroquine also made no difference. Two weeks after starting, 24 percent of the 201 people taking the drug still had 30 percent of the 194 people taking placebo. Again: no significant difference.
Those results were actually going to be part of an earlier team paper showing that hydroxychloroquine did not work as a preventive in the same way, protecting people from getting sick after exposure to the disease. That “post-exposure prophylaxis” paper was accepted New England Journal For medical Came out early and in early June. But as time went by and the drug faded a bit from news and presidential briefings, it became difficult to find a home for the paper on how the drug proceeded as a treatment. “The negative fact that hydroxychloroquine did not work was not as nousworth, I think. They were not interested in a null study,” says David Boulware, the infectious disease doctor who runs the team. “The study There were eight or nine days to design. Seven weeks to study. Actually it was two and a half months to get published… in a normal time frame which is faster. In a Kovid time frame, it Glacially slow. “
Lacking confirmation, PCR-based testing also slightly bombarded the study. “True believers are going to criticize it. Not everyone used to do PCR tests, because this is the United States and people did not have access to PCR tests, ”says Bowleware. “This is not a complete study, but I think it is correct.”
By “true believers”, Boulware refers to those who remain assured of the value of the drug. For months, they have parsed each hydroxychloroquine study for factors that they think could affect its effectiveness that the researchers did wrong – one dose too high, one dose too low, too soon, too late. Considered as important without zinc, given by. . Proponents of drug use have considered them all important to its success. In some cases, they are correct – dosage matters. A major study of the drug in Brazil stopped early due to severe heart problems in people taking it, a known side effect. But this study was also using exceptionally high doses, well beyond levels as preventive or treatment. The Recovery and Minnesota teams used a more specific protocol.