Highlights from that paper (all of which look quite reasonable to me, as a non-expert):
• In vitro data suggest that chloroquine inhibits SARS Cov-2 replication.
• In past research, chloroquine has shown in vitro activity against many different viruses, but no benefit in animal models.
• Chloroquine has been proposed several times for the treatment of acute viral diseases in humans without success.
• The outcomes of some current clinical trials of chloroquine in China have been announced, without access to the data.
• Peer review of the results and an independent assessment of the potential benefit for patients are essential.
This seems to be the link to the details of clinical trials in China that are made available
http://www.chictr.org.cn/searchproj.aspx?title=氯喹&officialna...
At the very bottom, it says "original data will be published on web-based public database in 6 months after the research" which is a bit disappointing.
"Survival rates declined in a dose-dependent manner, with 88% survival when treated with 5 mg/kg chloroquine and 13% survival when treated with 1 mg/kg chloroquine. Our results show that chloroquine can be highly effective against HCoV-OC43 infection in newborn mice and may be considered as a future drug against HCoVs."
People are incredibly prompt to jump in on unproven suggestions during a crisis, while at the same time shitting on standard evidence-based medical care all year long. Go figure...
A small-sized chinese study with unreleased data? Color me skeptical.
It seems to me beyond reasonable doubt that quinine derivatives are useful in humans. A miracle cure maybe not but almost certainly useful.
1. http://m.koreabiomed.com/news/articleView.html?idxno=7428
>The outcomes of some current clinical trials of chloroquine in China have been announced, without access to the data
Which are...?
Keep in mind that antivirals only work well if you start taking the during the first two days, TCM is reasonably safe and over the counter, whereas if you're in the US then good luck even getting tested in the first 10 days let alone prescribed something.
C.f.: https://www.sciencedirect.com/science/article/pii/S104366182...
Shameless tangent, China has just booted its most competent respiratory disease epidemiologist from heading epidemic control committee for not backing Xi Jinping's "herbal remedies"
Not to downplay the issue here: there have been reports of doctors being forced to include herbal medicines in the treatment from higher up, despite having little evidence supporting their efficacy. Just a random fact check.
Sources (all in Chinese; note epochtimes doesn't have a particularly good reputation):
[1]: https://www.fmprc.gov.cn/web/fyrbt_673021/t1755063.shtml
It’s up to you to choose which news source to believe, knowing that the former can print anything (including wild speculation) and the later will only print government approved information (including blatant obvious propaganda).
> TCM has never missed a single fight against epidemics throughout Chinese history. TCM classics have provided sufficient evidence of how TCM cured epidemic diseases such as smallpox over the past several thousand years.
I don't have any reason to trust an article from a Taiwanese publication over one from the PRC but the above quote leaves me highly sceptical about the rest of the article.
It's not fair to responsible people who are capable of researching safety and dosages to have to pay for the ignorance of others. Especially when this drug is OTC in most of the world. You don't need a medical degree to safely administer most drugs - and you should have the right to take that risk, even if that means ignorant people getting hurt or dying.
As can inflating the price (high taxes) for non-doctors who are purchasing preemptively. If you are sick, go to a doctor and get it at the normal price. If you are a prepper, pay extra, buy less.
At this point, I would label it as dangerous as aspirin.
Nanny states breed incompetence.
And I know I won't die because it's already safe enough to fight malaria. But maybe you don't know that. That's fine. I do. Let me arbitrage my knowledge.
Basically the goal is to allow zinc to get into a cell, it needs a helper to get inside the cell (a Zinc Ionophore). Apparently based on the 2nd video, Hydroxychloroquine is even more effective than Chloroquine. It's really important to note however that these are lab based findings, not from studies on patients.
Essential oils have been evaluated for their inhibitory activity against SARS-CoV and HSV-1 replication in vitro by visually scoring of the virus-induced cytopathogenic effect post-infection. Laurus nobilis oil exerted an interesting activity against SARS-CoV with an IC(50) value of 120 microg/ml and a selectivity index (SI) of 4.16. This oil was characterized by the presence of beta-ocimene, 1,8-cineole, alpha-pinene, and beta-pinene as the main constituents.
https://onlinelibrary.wiley.com/doi/epdf/10.1002/cbdv.200890...
Edit: https://www.macleans.ca/news/canada/a-made-in-canada-solutio...
Yes chloroquine has been shown effective in vitro (https://www.nature.com/articles/s41422-020-0282-0). Yes hydroxichloroquine has been shown effective in vitro very recently as well (https://academic.oup.com/cid/advance-article/doi/10.1093/cid...).
Yes both compounds are already actively being used and approved for use by Asian and EU countries against Covid19:
Here are the Netherlands treatment guidelines (in Dutch): https://lci.rivm.nl/covid-19/bijlage/medicamenteuze-behandel...
Here are the Italy treatment guidelines (in Italian): http://www.simit.org/medias/1555-covid19-linee-guida-trattam...
How they found out about it: https://www.jqknews.com/news/388543-The_novel_coronavirus_pn...
Approval and recommendation of the chinese: https://pubmed.ncbi.nlm.nih.gov/32075365-expert-consensus-on... https://pubmed.ncbi.nlm.nih.gov/32074550-breakthrough-chloro...
I don't think there is much doubt left about it's efficiency at this stage. Hydroxichloroquine is much safer than chloroquine and it's just a 5 day course at pretty low dosage (2x400mg on day1 as a charge dose, then 2x200mg for 4 days).
More importantly, the drug is readily available, mass producded and doesn't cost 300$+/box like lopinavir/ritonavir. This drug isn't also 100% experimental and probably in the 3 digits rangs like remdesivir.
The only real issue is that with a lot of doctors using it, the temporary shortage of the drug could be troublesome for many Lupus patients around the world who depend on Plaquenil for their management.
sorry if there is a smarter way to save comments
These trials and the validation can take about a year.
Here is the official list of currently being developed covid19 vaccines (all in pre-clinical stage)
https://www.who.int/blueprint/priority-diseases/key-action/n...
Also this would have a terrible effect and indeed cause supply shortages as another commenter pointed out.
There is some info here from a doctor https://www.reddit.com/r/medicine/comments/fbfj0r/covid19_pr...
There is some evidence that hydroxychloroquine may be better as a prophylactic. Here's medcram talking about it from in vitro results https://youtu.be/vE4_LsftNKM?t=192
Re real patients I thought this interesting on lupus patients using hydroxychloroquine at a hospital in Wuhan:
>In the early stage of the study group, through the clinical analysis of 178 patients with new coronavirus received by the hospital from December 2019, it was found that none of them was systemic lupus erythematosus. After that, in the consultation of 80 patients with systemic lupus erythematosus treated by dermatology department of the hospital, it was found that they were not infected with new coronavirus pneumonia. https://www.jqknews.com/news/388543-The_novel_coronavirus_pn...
Which suggests it may work in real life. Lupus patient get a pretty high dose but looking at the in vitro stuff it looks like a low dose say 400mg/wk might work.
There may be a possibility here to save millions of lives - if this does go full pandemic with 60% global infection, taking say weekly hydroxychloroquine might reduce the effects to something mild flu rather than ICU death. It seems to me enough upside to make it worth doing a serious research effort which I don't think is being done.
I noticed when looking at the data, that while chloroquine facilitated a massive uptake a zinc, it was still true that increasing the extracellular zinc concentration (without chloroquine) still increased the cytosol's zinc concentration (by a lesser amount).
I promptly ordered zinc supplements. Obviously I'll see a doctor if I have symptoms, but I'll also hedge my bets.
Also a link to the study would be helpful.
however, I don't know about how it compares and if these are as potent as Chloroquine so it would be nice if an expert could opine on whether these natural compounds are as potent.
Thats the mechanism that works in test tubes, but not in humans so far. Pulling Zinc into cells is what determines this hypothetical effect, not to be confused with whatever has the strongest side effects.
Edit: just did a search and your insight led to this study on zinc and Coronavirus from 2010:
https://journals.plos.org/plospathogens/article?id=10.1371/j...
Abstract
Increasing the intracellular Zn2+ concentration with zinc-ionophores like pyrithione (PT) can efficiently impair the replication of a variety of RNA viruses, including poliovirus and influenza virus. For some viruses this effect has been attributed to interference with viral polyprotein processing. In this study we demonstrate that the combination of Zn2+ and PT at low concentrations (2 µM Zn2+ and 2 µM PT) inhibits the replication of SARS-coronavirus (SARS-CoV) and equine arteritis virus (EAV) in cell culture. The RNA synthesis of these two distantly related nidoviruses is catalyzed by an RNA-dependent RNA polymerase (RdRp), which is the core enzyme of their multiprotein replication and transcription complex (RTC). Using an activity assay for RTCs isolated from cells infected with SARS-CoV or EAV—thus eliminating the need for PT to transport Zn2+ across the plasma membrane—we show that Zn2+ efficiently inhibits the RNA-synthesizing activity of the RTCs of both viruses. Enzymatic studies using recombinant RdRps (SARS-CoV nsp12 and EAV nsp9) purified from E. coli subsequently revealed that Zn2+ directly inhibited the in vitro activity of both nidovirus polymerases. More specifically, Zn2+ was found to block the initiation step of EAV RNA synthesis, whereas in the case of the SARS-CoV RdRp elongation was inhibited and template binding reduced. By chelating Zn2+ with MgEDTA, the inhibitory effect of the divalent cation could be reversed, which provides a novel experimental tool for in vitro studies of the molecular details of nidovirus replication and transcription.
Mentioned:
Kaletra, an anti-HIV medication that includes the drugs lopinavir and ritonavir.
Hydroxychloroquine, sold under the brand name Plaquenil.
[1] https://www.upi.com/Top_News/World-News/2020/03/12/South-Kor...
https://twitter.com/katyw2004/status/1236848300143280128
verification tweet: https://twitter.com/mshah85/status/1237231277251514368
G&Ts almost certainly won't have any effect on your susceptibility to infection nor your prognosis once infected. But they might help with (or make worse?) the anxiety associated with the panic.
* It was used for centuries to combat malaria until it recently (~10yrs) became ineffective (I took some in the 80's for a year while working in Central America and had amazing dreams).
* It is the basis many awesome aperitifs: Byrrh, Bonal, [tonic water,] and other herbaceous spirits
If it can be used as an antiviral for COVID-19, well, that would be a really cool example of an old/ancient medicine still doin' its thing.
As an aside, the number of preppers and conspiracy theorists out on HN under stories like this is awful.
Remember, the world has vast infrastructures (CDC, WHO, NHS and equivalents) for working out the right course of action in these situations. They are staffed by professionals who understand how medicine and medical trials work, and how and when to deploy public health measures. I'm not saying their word is law, but hanging out on internet forums and then panic buying random stuff which isn't obviously efficacious off the back of a misunderstanding of the science is not personally or socially productive. At worst, it harms people in genuine need and stymies the ability of society to respond.
1) It's not random stuff; there is associated research and a theory of operation how it counteracts the virus
2) Lacking obviousness? By the time the research is settled, you may be very sick already.
3) There is no misunderstanding, there is a risk analysis based on the currently available knowledge. Risk of chloroquine poisoning X probability of effectiveness X risk of acute viral infection.
4) Crowd-sourcing information has shown to be very effective in other times of crisis, a viral outbreak is no different.
The internet is not a place for the information police. We share our ideas here.
Here's google translate: "We organized more than a dozen hospitals in Beijing, Guangdong and Hunan provinces to jointly evaluate the safety and effectiveness of chloroquine phosphate in the treatment of new coronary pneumonia. In the clinic, we are very sure to see the curative effect, whether it is from the rate of exacerbation, antipyretic phenomenon or the image improvement time of the lungs, the negative time and negative rate of viral nucleic acid, and the shortening of the disease course, and a series of indicators, systematically Based on comprehensive research, the medication group was better than the control group. For example, a patient in Beijing was admitted to the hospital on the 4th day of the onset of disease at the age of 54. One week after taking the medicine, the nucleic acid turned negative, and all the indicators improved, meeting the criteria for release and isolation."
"Audio transcript of the news briefing held by the State Council of China on February 17, 2020. The National Health Commission of the People's Republic of China. http://www.nhc.gov.cn/xcs/yqfkdt/202002/f12a62d10c2a48c6895c... (accessed February 18, 2020). (in Chinese)"
Third reference in https://www.jstage.jst.go.jp/article/bst/advpub/0/advpub_202...
Report "Expert: Chloroquine Phosphate has a negative time of 4.4 days, faster than other drugs" (google translate) http://news.southcn.com/nfplus/gdjktt/content/2020-03/09/con...
I posted it on reddit (271 comments) https://www.reddit.com/r/COVID19/comments/ffztou/expert_chlo...
Some enterprising Nigerian has apparently been trying to illegally sell it in the UK at least.
