[Newbiesaukee]

I have been on the Forum for many years and it has been an important part of my life. In particular, I learn things from experts by training/ experience that I knew nothing about....boating, engines, agriculture, government...even politics.

The subject I want to discuss is important and I know about it. I won’t discuss politics except one statement at the end and, even that, is not really political. I have never worked for the pharmaceutical companies.

Modern medicine is not a science...it is an art, dealing with people is a skill. The advances in medicine have been spectacular over the past 150 years. Some of today’s treatments would have been unthinkable to me when I was a medical student.

The reason for this success is that medicine has been built on the scientific method. And as far as the medications we use, the basis of this success is the double blind study. And some of the medication disasters have been largely because the studies have been poorly done or not done at all.

All of you know the basics. You believe a drug will cure headaches. You take a hundred volunteers, you divide them into 2 equal groups and give the medication to one group and a similar appearing pill without the med to the other group and you see if it “works.” Does the real pill group get better than the placebo group? The technique is much more complicated than this but this is the basic idea. And the placebo effect is REAL. Even in terminal cancer studies, as many as 10 % of patients who get placebo get better compared to untreated patients. In acne studies the placebo rate can reach 40%.

Anyway, to the point. A lot of medical advancements have been by accident...insulin, penicillin,etc. When patients have devasatiing infections they usually die of and they are cured with penicillin you don’t need a placebo.

Let’s get real. There is a lot of vital information about Covid 19 we do not know. We know that the vast majority of those who get it recover. It seems to be that older people are more likely to die than younger but still most recover. This is important; if everyone died, then a new drug that worked might not require the same testing.

Chloroquine and hydroxychloroquine have been around a long time. They are relatively safe. I have used hydroxychloroquine in lupus patients always concerned about the serious visual side effects. The observations of their possible effectiveness is interesting and MUST be pursued. But we do need a control group because of the high natural cure rate of the disease. As the drug and (unfortunately) lots of patients are available a good trial can be done relatively quickly. So,why shouldn’t people just take it, like the President suggests.

1. We still need to know if it really works. If it doesn’t we will have lost precious time and huge resources just “trying it.”

2. Although it is relatively safe, we do not know if it is safe in Covid 19 patients. Sometimes drugs work in some diseases but make others worse.

3. Again, in this largely self curable disease, we don’t want millions of people taking it who do not need it.

4. The idea of taking it to prevent the disease has, at present, even less evidence that it works.

A quick word on vaccines...we do know how to make them but they also need to be tested to see if they work (few do 100%). And new vaccines may have very unexpected consequences and serious side effects.

Finally, the politics. The President has every right to overrule his advisors in any field, military, legal, etc. It is ok to,use his “gut.” If u don’t like it, don’t elect him.

BUT, he knows very little about science and medicine. He has very good medical advisors whom the people trust. To me, it is just wrong, scientifically and ethically to keep promoting unproven treatments. And if it works, and probably 90% of patients will not need it, then encouraging the public to get their docs to write a prescription may make it harder for the ones who need it.

I don’t care if he wears a face mask. And if I were president with the ability to test everyone around me all,the time I probably wouldn’t wear one either. But touting unproven therapy IS a different issue.

Finally, just for the record I had read about the positive study a few days before the President described the “game changer.”
I have not written a prescription for myself or family.