[HN Gopher] A mysterious company's Covid-19 papers in top medica...
___________________________________________________________________
A mysterious company's Covid-19 papers in top medical journals may
be unraveling
Author : onemoresoop
Score : 256 points
Date : 2020-06-03 13:16 UTC (9 hours ago)
(HTM) web link (www.sciencemag.org)
(TXT) w3m dump (www.sciencemag.org)
| ed25519FUUU wrote:
| > _Antimalarial drugs touted by the White House as possible
| COVID-19 treatments looked to be not just ineffective, but
| downright deadly._
|
| Immediately when the long knives came out against HCQ I was
| cynical. A drug on the market for 60 years (and over the counter
| in many countries) is "extremely dangerous"?
|
| Or, more likely because it's out of patent there's a lot of
| _money_ interested in exploring other things as a treatment.
| tw000001 wrote:
| >more likely because it's out of patent there's a lot of money
| interested in exploring other things as a treatment
|
| HCQ was not even remotely controversial until Trump tweeted
| about it.
|
| Our institutions have lost their collective minds with their
| spiteful, childish hatred for a politician. Academia and news
| media have completely lost sight of objectivity.
| programmarchy wrote:
| People started hoarding HCQ in early February when the first
| Chinese studies were coming out. Didier Raoult's (crazy
| looking French doctor) reports in mid-March sparked the first
| controversies. I remember worrying at that point there'd be
| some big-pharma-backed media operation to discredit a cheap,
| patent-expired drug since there are trillions of dollars at
| stake. Trump tweet was in late March.
| PiggySpeed wrote:
| > A drug on the market for 60 years (and over the counter in
| many countries) is "extremely dangerous"?
|
| Yes it can, if used in a different context. You can't
| generalize stuff in medicine. There are hundreds of factors in
| play: co-morbidities, genetics, interacting drugs, timelines,
| dosages, dose delivery forms, routes of entry, previous
| surgical procedures, demographics...
| boomboomsubban wrote:
| >A drug on the market for 60 years (and over the counter in
| many countries) is "extremely dangerous
|
| Tylenol has been on the market for a 60 years, often over the
| counter, but off label recommendations involving a high dose
| could be deadly. Drugs should always be considered "extremely
| dangerous."
| emmelaich wrote:
| Anything in high dose can be dangerous. So that's not
| helpful.
|
| Anything. For instance, water.
| gnusty_gnurc wrote:
| So much of the lockdown and gov't response around the world has
| been political. It fundamentally rests on virtue, not science.
| It's clearer with every passing day. There were legitimate
| concerns in the beginning, but by now it's bizarre to see when
| people decide to ignore lockdown with the right political
| justifications.
| gator-io wrote:
| Fantastic analysis of the Lancet study's flaws:
| https://www.youtube.com/watch?v=IUD_wvkNhnk
| gamegod wrote:
| This is a garbage analysis that ends up with a plug for
| vitamins and t-shirts. You don't write off a journal for making
| mistakes. Retraction is part of the scientific process.
|
| What this YouTuber failed to mention is that there were already
| a couple of other studies before this one that reached the same
| conclusion - that there was no evidence of it working for
| COVID-19, or that it potentially made things worse in the most
| sick patients. The retraction of a single paper doesn't
| invalidate the body of evidence (albeit small) provided by
| other papers prior to it.
| gamegod wrote:
| As a reference, here's an observation study published in NEJM
| on May 7th, that wrote:
|
| https://www.nejm.org/doi/full/10.1056/NEJMoa2012410?query=fe.
| ..
|
| > "In this analysis involving a large sample of consecutive
| patients who had been hospitalized with Covid-19, the risk of
| intubation or death was not significantly higher or lower
| among patients who received hydroxychloroquine than among
| those who did not..."
|
| Note that this study did not use any of the data from Mehra
| et. al. You see all the other studies that found similar
| results by reading the references.
| gator-io wrote:
| I'm not arguing other studies - they seem fine, except none
| of them studied the early use of HCQ with Zinc.
|
| I'm saying specifically that the Lancet should not have
| published the Surgisphere study due to its flaws.
| gator-io wrote:
| Don't get hung up on the how the channel survives. The
| channel, whose host has a Phd in pathology, has been focused
| on Covid issues for months, after being demonitized by
| YouTube.
| ufo wrote:
| If a channel advertises snake oil supplements and products
| then that should be a valid reason to criticize them.
| gator-io wrote:
| And just to be clear, the supplements are recommendations
| based on research, not advertisements. No commissions.
|
| Go back a few episodes and you'll see the rationale for
| them.
| gator-io wrote:
| And from his experienced analysis, the study is clearly,
| obviously junk, and the Lancet should be held to account
| for publishing it.
| [deleted]
| devit wrote:
| So they suspect that Surgisphere has manufactured or falsified
| the data?
| gator-io wrote:
| Yup. More than suspicious.
| tuna-piano wrote:
| Ugh. I'm so disappointed in this whole situation. Feels like
| Theranos.
|
| I want to cover my eyes and ears for the media and political shit
| show that's going to come from this. It's true that a certain
| politician shouldn't be trumpeting unproven treatments, but the
| media seemed to celebrate when that politician was "proven"
| wrong. Did we forget that we should all be rooting for treatments
| to work?
|
| I hoped during this pandemic science would move fast and
| sacrifice some accuracy for speed. But I didn't expect (a
| seemingly) complete fabrication could go so far with so many
| eyes. Now I worry the overreaction toward accuracy-over-speed
| will cause significant slowdowns in published data.
|
| We shouldn't over-punish honest mistakes when we value speed over
| accuracy... but this just feels awful. Would think prison is
| likely to come.
|
| A good read:
| http://freerangestats.info/blog/2020/05/30/implausible-healt...
| lbeltrame wrote:
| > We shouldn't over-punish honest mistakes when we value speed
| over accuracy...
|
| But we should still make sure these behaviors are not rewarded.
| Science was right when they called against "Pandemic Research
| Exceptionalism". I think at this point in time, where available
| knowledge has increased a little, we can afford to be stricter
| than before.
| jmull wrote:
| > but the media ...
|
| I don't think you can blame the media here.
|
| They reported on extremely important and relevant scientific
| research that was credible by any kind of reasonable
| journalistic standard. How could they have done otherwise?
|
| Contrasting the research claims against the claims of "a
| certain politician" would be a natural and necessary part of
| that.
|
| Some commentators went too far -- some always do, often the
| same ones -- but the failing here wasn't generally the media.
|
| > Did we forget that we should all be rooting for treatments to
| work?
|
| I don't think that's being forgotten that outside the lunatic
| fringe. Notice that this story is getting wide coverage, just
| like the coverage of the original finding.
| ImaCake wrote:
| Reading the abstract to the Lancet article [0] would probably
| convince any decently trained science reporter that all is
| good. They tick all the boxes for what you are supposed to do
| when you do a case-control study. It reads as very
| professional and well done. I certainly thought that it
| passed the bullshit test on first read. The problem is with
| the data itself, and it isn't obvious it is fabricated
| because it is such a ridiculous over the top lie that you
| wouldn't think someone would try to make such a lie.
|
| 0. https://www.thelancet.com/journals/lancet/article/PIIS0140
| -6...
| ImaCake wrote:
| The freerangestats article is the clearest and easiest to read
| discussion of this topic I have found so far. Glad to see it in
| the top comment :)
| HideousKojima wrote:
| >We shouldn't over-punish honest mistakes when we value speed
| over accuracy
|
| Looking at some of the specifics, these don't look like
| "honest" mistakes, and I'm doubting any integrity on the part
| of the peer reviewers and the Lancet too with how blatantly
| false some of their data are. It doesn't even pass the smell
| test:
|
| https://mobile.twitter.com/JamesTodaroMD/status/126610886125...
| ImaCake wrote:
| The blog post linked by the parent post very clearly argues
| the data is fake. So I think you are misinterpreting what the
| parent post is saying. But I totally agree with your
| sentiment that this is truly terrible and everyone involved
| should be more than a bit ashamed.
| FireBeyond wrote:
| > I want to cover my eyes and ears for the media and political
| shit show that's going to come from this. It's true that a
| certain politician shouldn't be trumpeting unproven treatments,
| but the media seemed to celebrate when that politician was
| "proven" wrong. Did we forget that we should all be rooting for
| treatments to work?
|
| We're hoping for _a_ treatment to work. Trump's motivations
| were largely self-interest, financial investments and other.
|
| We didn't celebrate because Trump was wrong. There was
| skepticism about the treatment, but he (not a physician) was up
| there pimping it. Even he didn't necessarily believe it was the
| cure. For all he said that, he said "Hey, take it anyway, why
| not? Can't hurt!" (when indeed it can). Finally came conclusive
| evidence that "You are wrong. Be quiet." Though Trump being
| Trump, that didn't overly work.
|
| It's no different to "Pharma Bro" Martin Shkreli, who once
| lodged an appeal / protest against a drug being approved...
|
| Not because it was dangerous. Or less effective. Or more
| expensive.
|
| No, in fact it was safer than treatments out there. And more
| effective. And cheaper.
|
| And all those reasons meant he opposed it. Because it wasn't
| _his_ drug. People who say "Big Pharma is holding the cure to
| cancer", etc., all those conspiracy theories? Shkreli literally
| opposed a better drug because it would cost him and his company
| profits.
| gfodor wrote:
| Even I hadn't let my cynicism about our national discourse sink
| so low as to think medical treatments would be politicized.
| Ultimately, it was a new low point. Once it started it was
| clear where this was going. Many may have died from it if the
| worse case scenario turns out to be true: this treatment does
| in fact work, and was stalled or prevented due to politics.
|
| Similarly, the complete disregard by the medical community of
| playing their role in reminding others organizing protests to
| take steps to prevent participants from spreading the virus has
| been equally disturbing. I've heard literally nothing from the
| medical community about tips, methods, or instructions for
| ensuring protestors do not cause a new outbreak. There does not
| seem to be any innovation happening in helping people organize
| and protest while keeping social distancing in mind. I don't
| know what that would look like, but it's a moral failure that
| the problem hasn't been worked whatsoever. I haven't even heard
| stories of people just handing out masks. Things are quite
| dire.
| crystalmeph wrote:
| >I've heard literally nothing from the medical community
| about tips, methods, or instructions for ensuring protestors
| do not cause a new outbreak.
|
| I think this is a typical example of the medical community's
| method of communicating with the public - until they've
| studied something to death, they're too afraid to say
| anything, and if pressed, will just tell you to keep doing
| what you're doing, even if emerging evidence to the contrary
| and widespread anecdotal counter-examples are starting to
| surface.
|
| Think about the whole mask fiasco at the beginning of this
| mess. The CDC actually told Americans that wearing masks
| might make them more likely to get the virus, despite masks
| being an effective preventive measure against all other known
| respiratory viruses to my knowledge, plus the widespread
| usage of masks by literally billions of people in Asia is a
| pretty good indicator that it can be done safely.
|
| During "normal" times, this general approach may be 100%
| right, you need to be very sure you understand even low-
| incidence side effects before you tell 8 billion people what
| is good for them and what isn't. But that's simply the wrong
| approach in the face of a fast-moving pandemic - you need to
| be able to do basic risk/reward analysis quickly and
| recommend the path that is most likely to work, even if
| you're not 100% sure, and you're operating on some educated
| guesses in the absence of hard data.
|
| Basically, they need to operate more like engineers and less
| like doctors, at least for a little while =)
| cm2187 wrote:
| Agree. On science taking its time, one thing that baffles me is
| that in the US and the UK, HCQ trials are only starting, as we
| reach the tail of this pandemic. Would someone know what is the
| rationale for waiting so long?
| noelsusman wrote:
| They're not only starting now, they've been going since early
| February. This one just finished:
| https://www.nejm.org/doi/full/10.1056/NEJMoa2016638. It found
| no preventive effect. Other trials are looking at treatment
| effectiveness.
| garmaine wrote:
| Sigh. They were not giving zinc supplements.
|
| It's really frustrating that the theorized mechanism of HCQ
| effectiveness as a prophylactic is its ability to transport
| zinc across cell walls (zinc interrupts the viral RNA
| replication), yet these trials don't include zinc
| supplements.
| lbeltrame wrote:
| > Sigh. They were not giving zinc supplements.
|
| Check the supplementary data. There were confounding
| factors, but a group of patients took zinc, and there is
| no difference between the two groups.
|
| Bear in mind that this study has no say on the use as a
| treatment.
| stephc_int13 wrote:
| The Lancet is a property of Elsevier.
|
| There is, to say it mildly, a bit of controversy about them in
| the academic world.
|
| https://en.wikipedia.org/wiki/Elsevier#Academic_practices
| Gatsky wrote:
| I gave up reading The Lancet some time ago. They have a poor
| record frankly with this kind of thing, Andrew Wakefield et al
| chief among them. They should have been cancelled over that one.
|
| Anyway, the larger point is that these established journals have
| failed us. Their added value, already low, has dropped below zero
| in this pandemic. They are slow, opaque, rent seeking parasitic
| entities seemingly run by individuals who don't grasp basic
| statistics. The combination of preprint servers + twitter has
| proven far more effective in looking after humanity's best
| interests.
| PiggySpeed wrote:
| No, you don't understand this.
|
| The Lancet is one of the most impactful journals in medicine,
| and has played an important role in shaping how medicine is
| practiced. It is rigorous in its process, but it's not
| foolproof. So yes, there are some bad studies that come
| through, but that is why healthcare professionals are TRAINED
| to interpret studies--we separate all the bullshit from the
| legitimately useful stuff.
|
| You should see some of the crap that comes through in some of
| the lower-impact journals.
|
| > The combination of preprint servers + twitter has proven far
| more effective in looking after humanity's best interests.
|
| This view is incredibly false and dangerous for so many
| reasons.
| macinjosh wrote:
| > So yes, there are some bad studies that come through, but
| that is why healthcare professionals are TRAINED to interpret
| studies
|
| So healthcare professionals are trained to separate the wheat
| from the chaff, but peer reviewers are not?
| loulouxiv wrote:
| Well if healthcare professionals are trained to interpret
| study, and separate the wrong from the useful stuff I guess
| it won't be so hard for The Lancet to hire some of them to
| review papers... I tend to believe Didier Raoult when he says
| in his last interview that anybody who works in medecine
| could easily tell this paper smelled really fishy, and I am
| sure it would be less costly for The Lancet than the
| reputation loss they are going to suffer.
| devin wrote:
| You act as if highly-trained professionals don't ever
| disagree.
| creaghpatr wrote:
| That they have that level of impact would appear to be
| problematic, given this news, rather than the other way
| around.
| bobcostas55 wrote:
| You are confusing impact with quality. They are not the same
| thing.
| Gatsky wrote:
| I am a healthcare professional, and I've published in one of
| the Lancet Journals. I understand perfectly fine.
|
| Here's the thing - The Lancet is not impactful. Researchers
| choose to publish their impactful research in The Lancet.
| Other researchers donate their time to peer review this
| research. It is the researchers that have shaped how medicine
| is practiced, not The Lancet. It is the researchers and the
| peer reviewers that are rigorous. The Lancet itself is none
| of these things, it is a business run by people who don't do
| research. Without the people who actually do the work, or the
| patients that volunteer for the research, it is nothing. The
| Lancet, like all top tier journals, has long forgotten this
| distinction.
|
| The problem isn't healthcare professionals lacking training.
| Take the Wakefield study. Did any doctor decide to stop
| offering vaccines because of that study? No. But it had a
| large impact on a the anti-vax narrative. These top journals
| have influence far beyond the professional sphere. This is
| why your suggestion we should give them a free pass is
| dangerous.
|
| I think it is clearly true that rapid publication and out in
| the open discussion and peer review is very healthy. I don't
| see how you could argue otherwise? Why wouldn't I want to be
| able to read the opinion of someone I respect intellectually
| eg Andrew Gelman, on a study they have decided to comment on?
| How is that 'dangerous' if I am a healthcare professional who
| should be able to critically review a published paper as you
| suggest? Why do I need to rely on the reviewers the journal
| has chosen? The Journals want to keep things as they are to
| maintain their importance and their bottom line. We suffer as
| a result.
| DiogenesKynikos wrote:
| How can you criticize The Lancet for a small number of
| faked studies that have gotten through, but then praise
| pre-print servers, which are rife with complete nonsense?
|
| Pre-print servers are great for getting results out
| quickly, but the level of quality control is extremely low.
| Journals are slower, but have a higher level of quality
| control.
|
| There is a trade-off between speed and quality control, and
| both pre-print servers and journals sit at useful points in
| that trade-off.
|
| Given the pressure to get information that might help fight
| CoVID-19 out quickly, journals have probably shifted
| towards the "quick/low-quality" end of the spectrum in the
| past few months. They'll move back when things calm down.
| Gatsky wrote:
| Specifically I am praising pre-print servers in the
| current crisis, not in general. I don't propose they can
| replace journals wholesale in the near future.
|
| The harm done by bad research in the Lancet is colossal
| because the results are widely read and disseminated,
| that is obvious isn't it? Pre-print servers are still
| quite obscure. Anyway, arxiv has been running for a long
| time with much success in certain fields, and hasn't been
| overwhelmed with nonsense, so your characterisation of
| pre-print servers is poorly calibrated and hyperbolic.
|
| Also the Lancet charges money for its products, and can
| therefore expect to be held to greater account.
| DiogenesKynikos wrote:
| So the pre-print servers are better because not a lot of
| people read pre-prints?
|
| > arxiv has been running for a long time with much
| success in certain fields, and hasn't been overwhelmed
| with nonsense, your characterisation of pre-print servers
| is poorly calibrated and hyperbolic
|
| I just said that the level of quality control on pre-
| print servers is extremely low - which it is. They check
| for very little beyond blatant plagiarism and obvious
| junk (determined within minutes).
|
| I didn't say that pre-print servers are useless. They're
| very useful, but it's undeniable that prestigious
| journals apply an additional filter, which is much more
| exacting.
|
| If you were to pick a random study from a pre-print
| server, and a random study from the Lancet, which do you
| think is more likely to be reliable? Which do you think
| has undergone more thorough peer-review?
| Gatsky wrote:
| You don't seem to be reading my comments. I agree with
| you that pre-print servers are not useless, and that
| prestigious journals are also not useless. Pre-print
| servers obviously have a lot of questionable content,
| this is immediately obvious. As I said, they are not a
| replacement for peer-reviewed journals (except maybe in
| the early stages of a pandemic, which was my long
| departed original point). It is also true that good
| research gets published in prestigious journals. Lots of
| good research also doesn't get published in prestigious
| journals because the editor of the Lancet decides it
| isn't interesting enough, or they chose clueless or
| callous reviewers who kill the paper in peer-review, or
| they just accepted a paper with the opposite result last
| week or for many other arbitrary reasons unrelated to the
| quality of the research or utility to humanity.
| rscho wrote:
| Journals have been hype/politically-driven since as long
| as one can remember. And peer-review quality is a joke.
|
| Preprints are not perfect, but I'd wager that anything
| free and truly open to review is better than what we have
| now.
| [deleted]
| cm2187 wrote:
| But I keep hearing that the definition of good science is
| "peer reviewed" science. So you are right that it is not
| the peer review that makes the science, but what about the
| science us laypeople can rely on? How else can we tell a
| serious claim from a fantasist one?
| frenchyatwork wrote:
| Peer reviewing is mostly orthogonal to journal
| publishing. Publishing in a journal generally requires a
| peer review, but there's no reason why you need a journal
| publication to get a peer review. Journals largely exist
| to manage prestige and career advancement in academia.
|
| As for what science lay people can rely on? I'm not sure
| there's a simple answer to that question.
| rscho wrote:
| Healthcare pro also. You are right. Academic publishing has
| become extremely toxic to both science and the healthcare
| system in general.
|
| A major issue with this is the political and hierarchical
| benefits of publishing. It encourages professionals to
| focus on that, to the point that clinical work is now
| looked down upon and producing loads of shitty papers will
| propell you to the forefront of the academic star system
| and make you rich. It's truly cancer for our healthcare
| system.
| [deleted]
| ColanR wrote:
| > You should see some of the crap that comes through in some
| of the lower-impact journals.
|
| Thank goodness that "healthcare professionals are TRAINED to
| interpret studies."
| jxy wrote:
| It is exactly such kinds of ignorants of basic statistics, the
| faulty generalizations of the effectiveness of established
| journals, have failed the humanity.
| cracker_jacks wrote:
| Is there a statistical demonstration of the effectiveness of
| established journals? It seems like you would have to do some
| form of counterfactual study to prove/disprove this. As far
| as I know, the argument of the effectiveness of journals only
| stems from the survivorship bias (e.g. all things considered
| research until recently has been published by journals).
| SiempreViernes wrote:
| No, you can look at the stuff people put up on the
| preprints to see what would happen if there's basically no
| screening at all.
| cracker_jacks wrote:
| The preprint model has actually been wildly successful
| for many communities (https://arxiv.org/,
| https://www.biorxiv.org/). I don't think anyone is
| arguing against peer review, but the idea of peer review
| and an established journal is being conflated. If
| anything, publishing established journals can create a
| level of implied authority that reduces much need
| scrutiny.
| sam36 wrote:
| > Andrew Wakefield
|
| Is that really all it took? Here's 1000 more that came to
| similar conclusions: https://vaccine-
| injury.info/pdf/vaccinepeerreview.pdf
|
| Have fun!
| BFatts wrote:
| Uh, secret meetings and confidential cover-ups? This reads
| more like a spy novel than a trustworthy document.
|
| Sorry.
| Gatsky wrote:
| Well there were people that thought books were the work of
| the devil when they first came out. It takes a 2 or 3
| generations to get the most important ideas completely
| accepted. The Flynn effect is helpful here.
| tobltobs wrote:
| > The combination of preprint servers + twitter
|
| Filtering noise with noise?
| jfk13 wrote:
| The great thing is that there's such a range of noise to
| choose from, you're sure to be able to find some you like.
| Angostura wrote:
| > They have a poor record frankly with this kind of thing,
| Andrew Wakefield et al chief among them.
|
| Would you care to name some others?
| cgh wrote:
| EAT-Lancet: https://www.thelancet.com/journals/lancet/article
| /PIIS0140-6...
| asmithmd1 wrote:
| Autism and vaccine study https://www.npr.org/sections/health-
| shots/2010/02/lancet_wak...
| chimprich wrote:
| That /is/ the Wakefield study.
| Gatsky wrote:
| Of the top 10 most highly cited papers that have been
| retracted, 3 of them are in the Lancet, more than any other
| journal [1].
|
| [1] https://retractionwatch.com/the-retraction-watch-
| leaderboard...
| dsjoerg wrote:
| That number can't be interpreted without context -- how
| many of the top 100 most highly cited papers are in the
| Lancet? If it's ~30 then your data point doesn't mean
| anything.
| triceratops wrote:
| Papers in Lancet are generally more highly cited than
| average, since it's the most prominent and respected
| medical journal. Is it any surprise that even the retracted
| papers in Lancet are highly cited? Surely that's a function
| of their visibility.
| ufo wrote:
| I'm not sure what kind of conclusion we can take from that
| dataset. It is only 10 papers and it doesn't take into
| account the average number of citations for the non-
| retracted articles in each journal.
| Gatsky wrote:
| I was asked to provide examples of the Lancet's poor
| track record, which I have done. I am not trying to prove
| it is better or worse than any other journal.
| _Microft wrote:
| How do you know that it is a _poor_ track record if you
| do not know how it is ranked against others?
| jtc331 wrote:
| Even if the Lancet had published all top 10 highly cited
| papers, wouldn't 3 of them being retracted be concerning
| to you?
| jrowley wrote:
| I imagine it'd be hard to bring preprint studies + twitter
| threads to head of your department and use that as the basis
| for institutional policy change? Although it could change
| individual physician's practice which I guess is where things
| start?
| lenkite wrote:
| ICMR in India does _not_ trust the Lancet study and have formally
| objected to it.
|
| https://www.thehindu.com/sci-tech/health/coronavirus-csir-ch...
|
| https://www.news18.com/news/india/icmr-says-hcq-reducing-ris...
|
| https://theprint.in/talk-point/lancet-hcq-study-row-did-who-...
| seesawtron wrote:
| This guy [0] did some good analysis of the "mysterious company".
|
| [0] https://news.ycombinator.com/item?id=23394357
| raphlinus wrote:
| James Todaro is not an honest scientist. I couldn't find any
| A-grade sources on him, but here's an interesting Wired piece:
| https://www.wired.com/story/an-old-malaria-drug-may-fight-co...
|
| If people don't know this story, Todaro and Rigano published
| what looked like an academic paper as a Google doc, with
| academic qualifications that verge on fraudulent, if not
| crossing the line. The original Google doc has been taken down
| for TOS violation, but it is still accessible on archive.org
| [1].
|
| To be clear, I decry the fact that HCQ has become a political
| soccer match (with apparently bad behavior on both sides),
| where what we really need is something that at least
| approximates an impartial, objective search for truth.
|
| The fact that people are getting their information from this
| guy (even though he's actually right about the Lancet study
| being flawed) is strong evidence that we're living in a
| dystopian information nightmare.
|
| [1]:
| https://web.archive.org/web/20200315004631/https://docs.goog...
| joncrane wrote:
| Linking directly to the article here:
| https://www.medicineuncensored.com/a-study-out-of-thin-air
|
| It reads like a Muddy Waters (famous stock shorter) screed.
| Good stuff. Fair to say the data is made up. The question is,
| who would be incentivized to do such a thing? Things that make
| you go hmmm....
| Threeve303 wrote:
| Perhaps this is the phenomenon behind fake news being applied to
| medical research?
| valarauko wrote:
| To the comments suggesting preprint servers as the solution, it's
| worth remembering that they are subject to much higher levels of
| noise, especially at high volume times like now.
|
| In early April, my co-authors and I were planning to submit a
| computational COVID manuscript (I was the first author). The
| journals were overrun with COVID submissions, and _required_
| preprint submission. This was a sticking point for my co-authors,
| who felt they had a much bigger paper on their hands given more
| time, and were opposed to a preprint submission. Personally, I
| was in favour of the preprint, since I felt we had hit the upper
| limit of what could be achieved with our collective resources.
| The other authors disagreed, and outvoted me to bring in a big
| name author who could steam roll his way into a reputable
| journal. The only way they could tempt a big name scientist would
| be to offer up the first author credit, so I bowed out.
|
| At the time, there were 4,500 preprints dealing with COVID, which
| just seems bonkers. Honestly, even most of the published work
| around COVID is of poor quality.
| SiempreViernes wrote:
| What, they forced you out of a paper you did most of the work
| on?
| valarauko wrote:
| Honestly, it's not that straight forward, which is why I
| didn't mind leaving the manuscript in the end. I did much of
| the work bringing it to a workable manuscript, but I didn't
| originate the project.
|
| I was approached by the corresponding author, who had
| originated and done most of the initial work. This was just a
| data dump, and he felt he didn't have the time or the ability
| to polish it into a manuscript. My contribution was to
| analyse the data, and write most of the manuscript. However,
| it became clear that the two other authors were pushing a
| narrative which I felt wasn't well supported by the data we
| had. We discussed two possible options: bring in an
| immunologist to determine if our results make sense, which I
| voted for, or stick to our guns. The second option would have
| also required submitting to a preprint, which they were
| against. The corresponding author felt the claims were
| justified, and decided that a more forceful (and prestigeous)
| first author was what was needed instead, and I agreed. Since
| my contribution wasn't all that much (about a week of my
| time?), and I wasn't convinced by the findings, I didn't mind
| losing the authorship. This sort of negotiating happens all
| the time in academia, so it's unsurprising.
| drocer88 wrote:
| A lot of people got hung up in the politics of this issue. A
| prominent politician endorsed using hydroxycholoroquine.
|
| Bill Maher recently made a good point: "Liberals are falling into
| lionizing someone because because they are the anti-Trump. Even
| before the virus America had a far too chronically sick
| population which is one reason we've lost so many now. We need to
| demand something better than how the entrenched medical
| establishment manages symptoms but cures and heals far too
| little".
|
| I guess pushing "the narrative" was more important than the
| science.
| y-c-o-m-b wrote:
| I think you're simplifying it to fit your own narrative and
| paint the entire thing as a political issue when the science
| was at question all along.
|
| Dr. Anthony Fauci made the issue very clear from the beginning.
| It is irresponsible to push hydroxycholoroquine as a viable
| treatment based off of anecdotal information and without more
| legitimate studies. Trump is not a medical professional and has
| no business telling the public something can treat COVID-19,
| especially without support from the majority of the medical
| profession. Plain and simple.
| jtbayly wrote:
| This. People are so desperate to attack Trump that they're
| willing to accept any result that paints him as doing something
| stupid. And if they can blame him for people dying, all the
| better. In the meantime, ignoring the science and falling for
| the politics means that people may well die since the science
| may not be able to happen now.
| belltaco wrote:
| Why is a politician endorsing an unproven drug?
|
| Oh it's because he's "getting great calls about it" from Fox
| News personas who are not doctors themselves, and instead
| fell for bad studies from a questionable French doctor.
| pessimizer wrote:
| > Why is a politician endorsing an unproven drug?
|
| Why do we pretend like we've never met Trump when we talk
| about him? He's endorsing it because one of his friends
| mentioned it to him. That doesn't give everybody else an
| excuse to be as irresponsible as he is. The reason he's
| listened to is because he's the president of the US, the
| reason scientists are listened to is because of a
| perception of high standards and integrity. If scientific
| institutions play the Trump game, afterwards he'll still be
| President, but they'll have nothing.
| jtbayly wrote:
| Why are politicians making medical decisions to quarantine
| whole states, based on unproven medical data?
|
| Give me a break. The initial data in an emergency is all we
| have to go on, and it looked likely that the drug could be
| helpful. It's _still_ unknown. Same as Vitamin D, which all
| kinds of people are promoting. If Trump refused to promote
| it, you 'd have people here up in arms that he refused to
| let people know about it, blaming him for untold deaths if
| people had simply been informed.
|
| Meanwhile, initial data made it look like lockdowns would
| save lives, too. The jury is still out on that, too, but
| it's looking like it didn't do nearly as much as people
| thought it would.
| notaharvardmba wrote:
| Also insider trading
| javagram wrote:
| The insider trading argument was proven to be nonsense.
| He had a <$5000 interest in a mutual fund that
| fractionally owns the drug manufacturer . For multi-
| millionaire to care about this would be like dumpster
| diving for pennies.
|
| If anything the drug magically curing coronavirus would
| make the entire stock market, and his re-election
| chances, go up dramatically, so there is no need to look
| for an insider trading argument when plain old wishful
| thinking/stupidity explains it all.
| hajile wrote:
| This is the issue with front-page lies and 9th page
| retractions.
| javagram wrote:
| More like an issue with social media I think.
|
| What front page carried an accusation of "insider
| trading" over the HCQ?
|
| It appears to have been a story spread by twitter and
| facebook posts. https://www.politifact.com/factchecks/202
| 0/apr/09/facebook-p...
|
| Using the "Front page" of a newspaper or reliable news
| source is much more likely to get real news than social
| media...
| lenkite wrote:
| This fallacy that HCQ is unproven is utterly astounding. I
| am truly sorry, but Americans have just been completely
| brainwashed by their media. You have been owned by your
| medical overlords who do not want generic medicine to work.
| y-c-o-m-b wrote:
| Unproven _to treat COVID-19_. Leaving out that last part
| is the debate. If you 're not going to discuss the whole
| context, then you're being disingenuous and just trying
| to work people up into a political fight.
| lenkite wrote:
| Also statement from American Journal of Epidemiology,
| https://academic.oup.com/aje/advance-
| article/doi/10.1093/aje...
|
| Backing news article https://medicine.yale.edu/yigh/news-
| article/25085/
| lenkite wrote:
| It is not an all-out, miracle cure but it definitely
| helps. Not trying to work anyone into a political fight,
| but I do firmly believe the US medical industry is doing
| active propaganda to prevent use of HCQ for Covid-19.
|
| https://medicine.yale.edu/yigh/news-article/25085/
| ilikehurdles wrote:
| > It is not an all-out, miracle cure but it definitely
| helps
|
| Researchers have withdrawn[1] studies that claimed much
| weaker statements than this.
|
| [1]: https://www.medrxiv.org/content/10.1101/2020.05.05.2
| 0088757v...
| y-c-o-m-b wrote:
| That is a single person. Have those been peer reviewed
| and scrutinized by the wider medical community?
|
| If you open the study, you'll see there are open-labeled
| non-randomized trials he is referencing.
|
| It's been a handful of months since COVID-19 grasped the
| globe. Too early to take things as gospel. As we are
| finding out in this thread, these types of studies are
| open to bias and rife with mistakes or
| misinterpretations. If we are to take the desired lesson
| from this thread, it's that data surrounding these
| medical journals need to be highly scrutinized before we
| can take them in as evidence.
| lenkite wrote:
| No, that is ongoing. Here are a collection of studies.
| (Not complete). The comprehensive studies that will
| satisfy your criteria are being carried out by several
| national and international bodies (including WHO). One
| will need to wait till September end. Contrary to all US
| media propaganda, WHO did _NOT_ cancel all HCQ studies -
| only the solidarity trial in specific was cancelled.
|
| http://www.ijmr.org.in/preprintarticle.asp?id=285520
|
| https://swarajyamag.com/insta/icmr-study-reveals-four-or-
| mor...
|
| https://www.medrxiv.org/content/10.1101/2020.04.27.200733
| 79v... https://www.medrxiv.org/content/10.1101/2020.03.22
| .20040758v...
|
| The older HCQ study wrt SARS:
| https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1232869/
|
| Document of a collection of studies (a bit biased -
| please don't be irritated) https://docs.google.com/docume
| nt/d/1545C_dJWMIAgqeLEsfo2U8Kq...
| belltaco wrote:
| >No, that is ongoing. Here are a collection of studies.
| (Not complete). The comprehensive studies that will
| satisfy your criteria are being carried out by several
| national and international bodies (including WHO). One
| will need to wait till September end
|
| So in other words, unproven.
| belltaco wrote:
| >It is not an all-out, miracle cure but it definitely
| helps.
|
| The studies that the right wing news media and Trump were
| referring to back in March showed a one hundred percent
| cure rate.
| lenkite wrote:
| Do not care about left wing or ring wing media. I believe
| the US media were shouting the HCQ will kill you - a
| disgusting joke when nearly every frontline Covid-19
| healthcare worker in India is on HCQ for over two months
| now - following national recommendation by ICMR. I don't
| trust the US media at all - it's all based on special
| interests.
| javagram wrote:
| > I believe the US media were shouting the HCQ will kill
| you
|
| Mainstream media sources in the USA were mainly warning
| not to obtain HCQ without a prescription (as several
| people did in various countries and killed
| themselves/spouse with overdoses). And also that people
| shouldn't rashly expose themselves to the virus,
| believing the president and his political allies that
| they could be "100%" cured using HCQ. For instance,
| https://www.businessinsider.com/coronavirus-twitter-
| deletes-... "Twitter removed [. . .] In the tweet on
| Friday, Giuliani quoted conservative youth activist
| Charlie Kirk, who claimed that an unproven anti-malaria
| drug, hydroxychloroquine "in at least three international
| tests was found 100% effective in treating the
| coronavirus," according to screen shots of the message
| published by Mediate."
|
| HCQ continued to be used under emergency authorization in
| hospitals by doctors fighting the coronavirus, because
| it's possible it somehow helps although it hasn't been
| proven to work.
|
| However, the media attempted to fight the spread of
| misinformation which claimed a 100% effective treatment
| was available, which was leading to issuing unneeded
| prescriptions for HCQ and a shortage for patients who
| actually needed the drug for other conditions.
| https://www.nytimes.com/2020/04/25/us/coronavirus-trump-
| chlo... " And the nearly 32,000 prescriptions came from
| across the spectrum -- rheumatologists, cardiologists,
| dermatologists, psychiatrists and even podiatrists, the
| data shows."
| lenkite wrote:
| https://docs.google.com/document/d/1545C_dJWMIAgqeLEsfo2U
| 8Kq...
| alkonaut wrote:
| The narrative was never that the drug was good or bad. What
| people were upset about was that a politician stept in and
| started pushing for treatments. It makes no difference what so
| ever if a politician turns out to be _correct_ , it's an
| absolutely unthinkable thing to do regardless.
|
| Now, you could argue that people _wanted_ the politician to be
| right or wrong (depending on views) and that this muddled the
| reporting, and that 's probably right.
|
| But it doesn't change the fact that everyone should be upset
| when their politician starts doing experts' jobs (poorly).
| blhack wrote:
| >The narrative was never that the drug was good or bad.
|
| Multiple prominent journalists came out saying this like: "if
| you take HCQ, you will die."
|
| Thousands of headlines were written saying "Donald Trump
| pushing _dangerous_ drug " etc.
|
| The narrative from the left was that the drug was bad. The
| narrative from the right was that it is a miracle cure.
| NEITHER of them are correct yet.
| belltaco wrote:
| >Multiple prominent journalists came out saying this like:
| "if you take HCQ, you will die."
|
| Huh? Can you point to some of those claims?
| blhack wrote:
| Sure: https://www.businessinsider.com/fox-news-neil-
| cavuto-shocked...
| alkonaut wrote:
| > Multiple prominent journalists came out saying this like:
| "if you take HCQ, you will die."
|
| Any good journalist said "might". A dangerous drug is one
| that might be bad.
|
| Even if the drug has zero positive effect for Covid and
| only the _known_ side effects of HCQ, it 's a bad drug.
|
| A non-expert pushing it as a cure or even a _potential_
| cure is dangerous because it risks hoarding, shortages.
|
| Basically: no one really cares whether the drug works or
| not. I don't care whether journalists did a bad job, or
| whether there was a terrible fraudulent article from some
| scientists or a company.
|
| I very much _do_ care whether politicians are doing their
| job and not acting like experts, however.
| blhack wrote:
| I didn't say a good journalist, I said a prominent one.
| My measure of "good" journalists would be people who only
| commented on the science behind this stuff, and didn't
| offer their usually useless take.
| leereeves wrote:
| Democrats were also writing various versions of _New study
| shows Trump is racking up a second body count with his claims
| about hydroxychloroquine_ [1] based on this study.
|
| 1: https://www.dailykos.com/stories/2020/5/22/1946903/-Donald
| -T...
| lenkite wrote:
| What happens when a _national medical board_ of the world 's
| most densely populated nation adopts HCQ formally as a
| preventive and treatment measure for Covid 19 ?
|
| According to American media, there should be hundreds of
| thousands of people dying of HCQ by now...
|
| https://www.newindianexpress.com/nation/2020/may/29/icmr-
| wri...
|
| https://timesofindia.indiatimes.com/india/hcq-and-ppe-
| used-t...
| belltaco wrote:
| As he said, it's a matter of pushing unproven medicines, it
| doesn't matter if it turns out to be good.
|
| What you're saying is like someone claiming betting all
| your life savings at the casino was a good move because
| they happened to win.
|
| The French studies showing a 100% cure rate pushed by the
| rightwing to viewers and Trump were really bad quality.
| SomeoneFromCA wrote:
| Well Zemmelweis has also been pushing unproven medical
| procedures. He turned out to be right. Without him we
| would have already been dead.
| lazyjones wrote:
| >But it doesn't change the fact that everyone should be upset
| when their politician starts doing experts' jobs
|
| The experts were mostly using the drug already as an
| experimental treatment for Covid-19 all over the world at
| that point. As was their job, while Trump's was to give
| people hope.
| [deleted]
| fareesh wrote:
| The lengths to which the American media will go to score points
| against President Trump should worry any reasonable person. Sadly
| the filter bubbles of the Internet bury so many of the
| retractions and fact checks that favour Trump, so many of the
| aforementioned reasonable folks almost never see the whole story.
|
| The most egregious lie peddled by the media is the "Very Fine
| People" statement, which, is claimed to be a reference to white
| supremacists, when in fact in he clarifies in the very speech,
| "and I am not talking about the white supremacists, they should
| be condemned totally". Armed with those facts, the reader/viewer
| is free to draw their own conclusions with regard to the
| President's inner thoughts and hidden meanings, but the whole,
| unfiltered picture is almost never presented. An omission like
| this is what potentially amplifies racial tensions across the
| country.
|
| We are now seeing this type of narrative again with the
| Hydroxychloroquine charade. A number of scientists and academics
| in Brazil penned a great open letter on this topic (the media and
| HCQ) a few weeks ago, which I thought was a great read:
|
| https://conexaopolitica.com.br/ultimas/brazilian-scientists-...
| enumjorge wrote:
| Here's the transcript of the press conference if anyone wants
| the "unfiltered picture" [0]. You had white supremacist flying
| neo-nazi flags shamelessly out in public, which while sadly
| normalized a bit by now, was a huge deal back then. One of them
| runs his car through counter protesters, killing one. Any other
| president would have condemned their actions immediately.
| Instead Trump takes two days to say anything, and then spends
| most of the press conference defending why he took so long.
|
| The criticism about fine people "on both sides" was that he was
| equating the alt-right protesters with the alt-left. That's
| insane. The alt-right was literally flying nazi flags, and one
| of them drove his car through a crowd. He only says that he's
| not walking about the white supremacist after being asked about
| it multiple times. Read the transcript. He's trying to draw a
| false equivalence between the two groups.
|
| The way you portrayed his response is very dishonest.
|
| [0] https://www.politifact.com/article/2019/apr/26/context-
| trump....
| DSMan195276 wrote:
| > The most egregious lie peddled by the media is the "Very Fine
| People" statement, which, is claimed to be a reference to white
| supremacists, when in fact in he clarifies in the very speech,
| "and I am not talking about the white supremacists, they should
| be condemned totally"
|
| This is silly. For one, news outlets _did_ report his statement
| in full - perhaps not in the headline, but they did give his
| full statement in the articles. However, you 're leaving out
| that he made a statement a few hours after the attack the
| condemned bigoty and violence "on many sides". He only ever
| issued a clarification days later due to the outcry against him
| not condemning the literal neo-nazis and white supremacists.
|
| Second, you're _also_ leaving out the fact that he goes on to
| clarify that the "good people" he's talking about were the
| ones there the _night before_ , at the explicitly white-
| nationalist torch rally[1] on August 11th, where they chanted
| nazi and white-nationalist slogans. The idea that anybody there
| constitutes "good people" or that not all of them were white-
| supremacists is absolutely ridiculous.
|
| [1]
| https://en.wikipedia.org/wiki/Unite_the_Right_rally#August_1...
| fareesh wrote:
| Getting far away from the original point here but I'll
| address it.
|
| The statement was reported in full - technically correct but
| my claim references the summarisation of his remarks that is
| made frequently, even to this date, which omit important
| context.
|
| You are correct that the remarks made immediately after the
| event referenced violence on many sides, this is an entirely
| different topic, however. Like I said, this too is
| technically correct, and readers and viewers are free to form
| their own opinions about the fact that he chose to frame it
| this way in his initial remarks. This is not, however the
| "very fine people" statement, which is a reference to non
| violent people who were having a debate over removal of the
| statue in question, many of whom were not white supremacists.
|
| As for "night before", this too is very clearly qualified:
|
| "No, no. There were people in that rally -- and I looked the
| night before -- if you look, there were people protesting
| very quietly the taking down of the statue of Robert E. Lee.
| I'm sure in that group there were some bad ones. The
| following day it looked like they had some rough, bad people
| -- neo-Nazis, white nationalists, whatever you want to call
| them."
|
| Now you might ask yourself which group of quiet protesters he
| has been shown by his staff, but it's quite clear that he is
| of the impression that they are not white supremacists.
|
| Again, this is not a defense of the statement or a defense of
| the man's eloquence, which he obviously lacks to an
| incredible degree. The allegation that he called neo nazis
| fine people is bad for your country. If people in your
| country believe their President actually said that, isn't
| that terrible for your society? The American media should not
| be above criticism for playing these kinds of tricks.
| DSMan195276 wrote:
| > which is a reference to non violent people who were
| having a debate over removal of the statue in question,
| many of whom were not white supremacists.
|
| Where are these people, exactly? The 'Unite the Right'
| rally was a white supremacist and neo-nazi rally. They
| chanted racist things, has nazi flags, was organized by two
| neo-nazis, and had scheduled neo-nazi and white supremacist
| speakers. I don't really know how more direct you can get
| on what kind of rally it was. The idea that tacking a
| "except for the white supremacists" on the end and that
| makes the statement somehow different is ridiculous, that
| covers literally everyone that was there.
|
| And you're complaining about _headlines_ , obviously they
| don't have the entire context, if it was a paragraph long
| it wouldn't be a headline. The context they did omit
| (Which, as I noted, really doesn't make things any better),
| is still in the articles.
|
| > Now you might ask yourself which group of quiet
| protesters he has been shown by his staff, but it's quite
| clear that he is of the impression that they are not white
| supremacists.
|
| There _was no_ "group of quiet protesters", that's the
| problem. That night there were neo-nazis and white-
| supremacists, that's it. The whole point of the criticism
| is that he's pretending like that side wasn't as bad as it
| actually was, or that there was somehow good people in it -
| if he has the impression that these people weren't white
| supremacists or neo-nazis, that a pretty big deal.
|
| And the idea that "his staff" showed him something
| misleading is simply untrue, as Trump himself said he
| waited three days to hold his speech because he wanted to
| get "all the facts". If it was really that hard for him to
| find videos of the event that's trivial to find online
| (it's even _in_ the wikipedia article I linked), perhaps he
| shouldn 't be in his current position :P But I think it is
| fair for the media (or anybody else) to assume he did see
| them.
|
| > The allegation that he called neo nazis fine people is
| bad for your country. If people in your country believe
| their President actually said that, isn't that terrible for
| your society? The American media should not be above
| criticism for playing these kinds of tricks.
|
| Except that, he did say that, about a white supremacist
| rally. The media even asked for a clarification and he
| doubled down and talked about the "people from the night
| before" which were even more explicitly white supremacist.
|
| If you want to claim the media somehow mislead everybody on
| what he said then show me one of those "good people" he's
| talking about - who are apparently fine people despite
| going to an explicitly neo-nazi and white supremacist
| rally.
| fareesh wrote:
| > If you want to claim the media somehow mislead
| everybody on what he said then show me one of those "good
| people" he's talking about - who are apparently fine
| people despite going to an explicitly neo-nazi and white
| supremacist rally.
|
| I will do this - but again I will reiterate that it is
| one thing entirely to say that the President got his
| facts wrong, and another thing to say that he knowingly
| called White Supremacists very fine people. Those are
| completely different things.
|
| Good people like you and I can also be guilty of the
| first when we incorrectly reference the wrong people. In
| the second case you are talking about someone who
| knowingly references a group of white supremacists as
| good people. This is contradicted by his own words.
|
| Again, I really don't want to derail the original point,
| but since I used this as an example, I feel like I should
| back everything up with facts so that it's clear that I'm
| making these points from a position of having researched
| the topic thoroughly.
|
| As for the statue debate and the very fine people - I
| will first set the context of the statue debate because
| it is very common that people simplify it as "everyone
| against the removal was a White Supremacist", so let me
| tackle that line of thinking first.
|
| The context is that the vote in the city council to
| remove the statue of Robert E. Lee passed 3-2. The Mayor
| of Charlottesville Mike Signer and councilwoman Kathy
| Galvin were the people against this. The Mayor wrote
| about his reasoning here in this article
|
| https://www.washingtonpost.com/posteverything/wp/2017/05/
| 24/...
|
| The Mayor's op-ed discusses several reasons for his vote.
| Quoting from article:
|
| > One striking finding in the commission's official
| report: "Numerous Charlottesville African American
| residents who have lived through decades of suppression
| of their history oppose removal on the grounds that it
| would be yet another example of hiding their experience.
| For them, transforming the statues in place forces
| remembrance of the dominance of slavery and Jim Crow
| white supremacy." This echoed what I heard in town hall
| meetings at black churches and private conversations with
| dozens of members of my community. One noted leader of an
| African American mentorship organization, for instance,
| told me he believes the statues should remain as a
| "teachable moment" about our history.
|
| > Local civil rights legend Eugene Williams, who was
| recognized by the Virginia General Assembly in 2015 for
| his pioneering work in affordable housing, has spoken out
| against removal, saying he wants the city stopped "from
| trying to destroy history." So has Earvin Jordan, an
| African American Civil War historian at the University of
| Virginia, who says "Civilization should be constructive
| rather than destructive," noting, "Charlottesville has
| enough space to erect new statues."
|
| This is all to say that the backdrop of the statue
| removal was already a complex issue involving both white
| supremacists and very fine people who were against the
| removal. This was not an issue as simple as "the only
| people against the removal of the statue are White
| Supremacists".
|
| The day of the "Unite the Right" rally was actually one
| of many events concerning the statue in 2017. Previous
| events were held in May and July of 2017 as well, one of
| which was organized by White Supremacist Richard Spencer
| and another by the KKK.
|
| On the "night before" the Richard Spencer event in May
| (not the Unite the Right Rally), there was a candle-lit
| peaceful vigil to protest the arrival of Richard Spencer
| and his gang the next day. This crowd included the Mayor
| as well, thus being a composition of "very fine people on
| both sides" and "the night before". It's quite likely
| that Trump mixed up the Spencer event of May with the
| Kessler event of August. In my opinion (feel free to
| disagree), I'd argue that the media should have picked up
| on this and checked with him. The media didn't follow-up
| on this. I'm a random person in another country. If I
| know these facts, the media should have been able to
| piece this together too and call him out for having his
| facts mixed up. He has done this stupidly before by
| saying "did you see what happened in Sweden last night?".
| The media instead went with another story. A sinister
| one.
|
| The night before the Kessler event in August, there was
| also a peaceful protest attended by 500 members of clergy
| and others. It's unclear whether the Mayor was present,
| or whether the civil rights leader Eugene Williams were
| present, but the chances that there were zero people who
| were against the removal of the statue, are quite low.
|
| As for the day of the August Rally (Unite the Right), the
| New York Times interviewed a woman named Michelle Piercy,
| who was there with a militia group:
| https://www.nytimes.com/2017/08/16/us/politics/trump-
| republi....
|
| Michelle Piercy is part of a militia group called
| "American Warrior Revolution". These guys were present at
| the May event as well. There's Facebook videos on their
| page from the May event where they make their opinions of
| the statue removal known (against removal). They were
| present at these events because of previous run-ins
| between Antifa and the Alt-Right in other parts of the
| country. Their stated purpose is to be a "peacekeeping
| force" to ensure that everyone has free speech. On the
| day of the Unite the Right Rally, African American
| members of their group were present as well, including
| Michelle Piercy's partner. Along with them there were
| several other militia groups who were present for the
| same reasons. Eventually they were asked to leave by the
| police, and eventually sued by the city, and were asked
| to sign a document swearing they would never return to
| the city while armed again.
|
| This would satisfy many examples of "very fine people"
| who were against the removal of the Lee Statue, many of
| whom were present across multiple events at
| Charlottesville.
| tootie wrote:
| The Lancet is a British medical journal. Swing and a miss.
| whatthesmack wrote:
| This doesn't invalidate anything stated in the comment you
| were replying to.
| fareesh wrote:
| I wasn't referring to the Lancet. I was referring to the news
| stories I see when I read American news media. The criticisms
| of this study were not being reported at the time, while they
| were already known.
| tootie wrote:
| Nobody would really be talking about this treatment if
| Trump himself hadn't given a completely unjustified
| endorsement among the stream of misinformation he relayed
| in the early days of the pandemic. HCQ only ever had the
| thinnest scientific justification for study combined with
| huge political pressure. Further studies have shown very
| little in terms of effectiveness and the dangers were
| already known. The media has been giving Trump's nonsense
| far more credence than it ever deserves. Media reporting of
| the Lancet study and the fallout has been factual including
| the stopping of studies. The suspicious nature of the study
| is still nothing more than suspicious. There isn't proof
| that it's wrong. And the media most definitely have been
| reporting on the questions.
|
| https://www.nytimes.com/2020/05/29/health/coronavirus-
| hydrox...
|
| https://www.theguardian.com/science/2020/may/28/questions-
| ra...
|
| https://www.bloomberg.com/news/articles/2020-05-29/scientis
| t...
|
| It hasn't top headline news since there's no resolution yet
| to the questions and because something else has been eating
| up too many headlines in the last week.
|
| And, Trump has done himself no favors by constantly
| suggesting nonsense treatments like "strong flu vaccines"
| or injecting disinfectant. It's pretty conclusive at this
| point that he isn't very smart and his scientific opinions
| should be ignored and ridiculed.
| fareesh wrote:
| The police in my city, Mumbai are taking
| Hydroxychloroquine. When they researched two sets of
| groups - those who took the drug as per the prescribed
| dosage, and those who didn't. The group that wasn't
| taking the drug had a few deaths, but the other group did
| not.
|
| Anecdotal and small sample - but definite proof against
| the idea that "nobody would be talking about it". The
| drug is also used in Costa Rica and many other parts of
| the world.
|
| A Jewish doctor in New Jersey - Dr. Vladimir Zelenko
| wrote to the President about the drug, which is assumed
| to be the origin of his interest with it. Here is The
| Daily Beast lambasting him for calling this same lancet
| study "garbage"
|
| https://www.thedailybeast.com/vladimir-zelenko-
| controversial...
| beepboopbeep wrote:
| Donald Trump is a gibbering goblin of a human being. This is
| not the place to white Knight for him.
| whatshisface wrote:
| Even accepting the premise, surely if the Shire's media has
| painted Azog as a gibbering _green_ goblin, while in reality
| he 's only a gibbering goblin, you would want to hear about
| it.
| fareesh wrote:
| My point is proved, QED?
| sjwright wrote:
| If _beepboopbeep_ is the entirety of the US media, then
| yes. Otherwise no, it's just yet another comment by a
| single individual on the internet with no broader meaning,
| context or consequence.
| fareesh wrote:
| Sure, it was a sarcastic comment indicating that this an
| example of the narrative I was referring to.
| sjwright wrote:
| It cannot be an example of any narrative you refer to if
| beepboopbeep isn't a member of the media.
| sjwright wrote:
| Regardless, the media's actions are always irrelevant.
| There is enough unfiltered information published by and
| about the current POTUS that it's possible to form an
| opinion without the media's help. Their hyperventilating
| cannot be scored as points in POTUS' favour, only as
| points against the media.
| tw000001 wrote:
| Trump's behavior does not justify the media attempting to
| tell me what to think by misrepresenting nearly everything
| with deliberate spin. This isn't about white knighting, this
| is about holding the media accountable for it's total lack of
| objectivity. The media should not be choosing sides or
| telling people what to think.
|
| In fact Trump merely tweeted that HCQ was promising - what
| was _far more dangerous_ was the spin from the media and
| subsequent rush to show that HCQ was dangerous /ineffective.
| SketchySeaBeast wrote:
| But he didn't just tweet that it was promising and drop it.
| He said it many times, and then made the claim that he
| himself was taking it on live TV and then further doubled
| down on that claim. He spun it himself.
| drocer88 wrote:
| Um. No. The press took the bait .
| SketchySeaBeast wrote:
| But that doesn't match the "In fact Trump merely tweeted
| that HCQ was promising" of the person I was responding
| to.
|
| Is it media spinning a simple fact, or some sort of
| presidential war with the media that uses bait and ploys?
| tw000001 wrote:
| >https://mobile.twitter.com/realDonaldTrump/status/124136
| 7239...
|
| "...have a real chance of if being a game changer"
|
| There is absolutely nothing incorrect about this post.
| And what's worse, while the media (and left leaning
| doctors) were amplifying papers like the OP, they ignored
| the positive studies and set back the entire pandemic
| effort by turning public opinion against a promising
| drug.
|
| It is a dereliction of social duty for the media to act
| in such a dangerously partisan manner. They owe society
| better for the power that they are allowed to wield.
| SketchySeaBeast wrote:
| That's dishonest to link a single tweet and act as though
| that's all the claims he's ever made about it. Here's a
| single press conference[1], which isn't nearly the extent
| of it, and doesn't include his claims he's taking it
| himself, but does include a "What do you have to lose?"
| argument.
|
| [1] https://www.statnews.com/2020/04/06/trump-
| hydroxychloroquine...
| beepboopbeep wrote:
| It's a petty game that both sides are engaging in, but
| one side is a singular person who is currently the
| "Leader of the free world". It's bizarre to me that
| people shrug off his behavior as if it's ok for him to be
| so petty and childish while wielding such immense power.
| mensetmanusman wrote:
| The best quote is at the end:
|
| "Here we are in the middle of a pandemic with hundreds of
| thousands of deaths, and the two most prestigious medical
| journals have failed us."
|
| There should be prison time if an investigation determines that
| this was done to increase certain drug sales.
| tootie wrote:
| There's absolutely no indication that would be true. This study
| in particular curtailed support for pharmaceutical treatment.
| tlb wrote:
| It reduced support for a particular cheap, off-patent
| medication that wasn't going to make anyone much money if it
| worked.
|
| Competing on-patent drugs, like Remdesivir, would make
| someone a great deal of money if they work better than HCQ.
| [deleted]
| eric_b wrote:
| I strongly believe there were people at the Lancet who _wanted_
| to believe the HCQ study, regardless of how well it was run.
|
| See, if you can skewer HCQ, that means you get to take a shot
| at a certain politician too.
|
| There were a number of researchers who criticized the study's
| structure and numbers from day 1. Over 100 researchers wrote an
| open letter about how skeptical they were.
|
| I understand journals make mistakes, but this was egregious and
| smells like agenda to me.
| newacct583 wrote:
| > See, if you can skewer HCQ, that means you get to take a
| shot at a certain politician too.
|
| For clarity, and I'm sure you agree: Trump's boosting of this
| drug as a "miracle" and "greatest breakthrough" was
| absolutely irresponsible _even if_ the drug actually works,
| for the simple reason that we didn 't know if it did (frankly
| we still don't), and that it is known to have significant
| risks (it still does, even usingly only baseline data and
| ignoring this study).
|
| This was a bad study. It's possible that the editors at the
| Lancet hate Trump. But... you're simply reading too much
| here. Bad science gets published all the time. In particular,
| bad science gets published in circumstances like we have now
| where there is desperate need for "fast science".
|
| Not everything has to be an "agenda" by global elites to
| damage your favorite politician.
|
| But even granting your framing: why are you so concerned
| about the Lancet boosting bad data as an "agenda" but not
| with Trump doing _exactly the same thing_ , with even less
| evidence? Why is it an "agenda" only when your enemies do it?
| pessimizer wrote:
| > Not everything has to be an "agenda" by global elites to
| damage your favorite politician.
|
| Not everyone who objects to frauds being used to bring down
| Trump likes Trump. Some people are very, very upset about
| how things like this hand him easy, unambiguous wins, and
| make it seem as if he can be trusted to the same degree as
| nominally legitimate sources of information. Also, whatever
| extent that those institutions compromised their own
| processes in the name of these attacks, for what other
| interests are their processes compromised?
|
| Should we just trust these institutions because they've
| been labeled "trustworthy" or instead turn our trust to
| institutions whose processes are more transparent,
| responsive, and formally isolated from outside interests?
|
| edit: It's important to note that this means that a
| majority of Americans will _never_ believe that this drug
| is not a legitimate treatment for the virus, no matter what
| further studies say. That 's an abject failure for the
| scientific establishment, and a victory for the anti-
| vaxxers of the world.
| newacct583 wrote:
| > a majority of Americans will never believe that this
| drug is not a legitimate treatment
|
| I don't think that's true at all, and I'll be the first
| to say it:
|
| I don't think there's any good evidence for HCQ at all, I
| think it's junk science, I don't believe a word about it
| that comes from this administration or anywhere in the
| right wing media. It's all pure spin to cover for some
| outrageously irresponsible rhetoric.
|
| But show me a real, controlled study with significant
| results, and I'll recommend this drug to everyone who
| needs it.
|
| But you have to show the data. And that means, yes,
| sometimes you discover you've published bad data and have
| to correct it. _THAT_ is what science is about, not
| proving the absence of political bias.
| bluGill wrote:
| Trump is not a scientist. He was presenting in terms of an
| exagerator. Irresponsible, but we already knew he was an
| exagerator so there was little harm. When scientists
| present something in terms of science we expect a greater
| standard.
|
| We should hold science to a higher standard. Politicians
| lie all the time, and exaggerate all the time.
| eric_b wrote:
| Where did I defend Trump's tweets? Where did I say it was
| OK for him to give false and misleading medical advice?
| Obviously he should NOT. HAVE. DONE. THOSE. THINGS. I think
| you're wearing your bias on your sleeve a bit too much. I
| get it, you hate him too. That's fine. But it's blinding
| you just like it did whoever let this garbage pass muster.
|
| Just because Trump does a thing that is despicable doesn't
| mean we give everyone else a pass too.
| newacct583 wrote:
| Where did I defend the Lancet? Where did I say it was OK
| for them to publish that paper? Obviously they should
| NOT. HAVE. DONE. THAT.
|
| I could go on, but I think you get the idea -- literally
| everything you wrote can be flipped right around, which
| is why you need to consider whether or not your own
| sleeve is maybe a little decorated.
|
| Seriously: I agree with you. I'm pointing out, however,
| that you're jumping in to claim "bias" by the "media" in
| a context where the "other side" very clearly already had
| blood on its hands over the same issue. And treating one
| side and not the other is helping no one.
| eric_b wrote:
| "Where did I defend the Lancet"
|
| Umm.... right here...
|
| "It's possible that the editors at the Lancet hate Trump.
| But... you're simply reading too much here. Bad science
| gets published all the time. In particular, bad science
| gets published in circumstances like we have now where
| there is desperate need for 'fast science'"
| pacala wrote:
| This is the reason why professionals don't engage in
| politics. In the short term it lends cover to the political
| actors of the day, and in the long term it destroys the
| credibility foundation of their own profession.
| CamperBob2 wrote:
| No, that's the reason why politicians don't -- or at least
| _shouldn 't_ -- pretend to be professionals.
| pacala wrote:
| These statements are not mutually exclusive.
| makomk wrote:
| Like maybe the Lancet's editor-in-chief? https://twitter.com/
| search?q=from%3Arichardhorton1%20trump&s...
|
| It's probably more obvious how much he's been using this
| pandemic as a political thing from this side of the Atlantic,
| since that's where his energy has mostly been focused.
| DiogenesKynikos wrote:
| In the linked tweets, the Lancet's editor-in-chief points
| out a lie in Trump's letter to the WHO that directly
| relates to the Lancet.
|
| How can you criticize the editor's behavior here? Would you
| rather he remain silent while the US president lies about
| the Lancet?
| macspoofing wrote:
| And what about the rest of the tweets?
| makomk wrote:
| There are probably a few tweets - like that one - which
| are justifiable as not being partisan or political. The
| rest of them... not so much, and this goes back pretty
| much to the day Trump was elected.
| mindslight wrote:
| You don't need to take a "shot" at a politician when that
| politician himself has done everything he can to create a
| public health catastrophe, including this politicization of
| HCQ. Pushing simplistic baseless claims undermines slower
| rational decision making. It's similar to "don't think of the
| elephant" - rather than giving every possibility a similar
| prior, it creates an undeserved focus on one particular
| approach which ends up hampering the decision making process
| with noisy overshoots in _both directions_ , swamping the
| legitimate signal.
| jakeogh wrote:
| Which professional published best case death estimate did
| we not beat? I am not aware of one.
|
| https://news.ycombinator.com/item?id=23028036
|
| Typical flu seasons:
| https://www.cdc.gov/nchs/data/health_policy/influenza-and-
| pn...
|
| Covid-19 death counts as of ~2 weeks ago:
| https://www.cdc.gov/nchs/nvss/vsrr/covid19/index.htm
| DiogenesKynikos wrote:
| The link you gave for "typical flu seasons" is difficult
| to read, because it's disaggregated by age. This CDC link
| gives the overall numbers by year:
| https://www.cdc.gov/flu/about/burden/past-seasons.html.
|
| In the US, three times as many people have already died
| of CoVID-19 as die from influenza in a normal year.
|
| The number of deaths from CoVID-19 continues to rise, and
| nobody knows what number it will eventually reach. With a
| 0.5% mortality rate and an R0 of 2.5, the expected death
| toll (before herd immunity is reached) would be ~1
| million people in the US, or the equivalent of 30 years
| of influenza deaths.
| jakeogh wrote:
| The sum totals are given in the first line for each
| season. 2015-2016 Flu: 7,961
| Pneumonia: 131,858 All: 1,769,940
| DiogenesKynikos wrote:
| Are those confirmed influenza deaths? They're several
| times lower than the CDC's estimates for total US
| influenza deaths, which are usually around 35,000/year.
| banads wrote:
| >You don't need to take a "shot" at a politician when that
| politician himself has done everything he can to create a
| public health catastrophe
|
| Are you sure about that? I was sure about that ("there's no
| way Trump can win") last election, and I was utterly wrong.
| mindslight wrote:
| Anybody who was already paying attention doesn't need a
| study to condemn his actions, and the Trump cult doesn't
| give credence to scientific studies.
|
| As far as his chances of winning - I personally did see
| had a fair shot in 2016, because the issues he was
| talking about mattered to a lot of people that had been
| disempowered over the past 8 years. I personally believe
| in LGBT rights, but it was obvious that there was going
| to be a horrid backlash from the gloating of projecting a
| rainbow on the White House. But since being elected Trump
| has addressed very little of what he campaigned on - the
| swamp has been further packed, and he's basically golfing
| and shitposting instead of leading. At this point he's
| coasting on favorable propaganda from Faux news, and the
| middle of the country will have that illusion shattered
| as we blow past 200k deaths.
| beervirus wrote:
| > There should be prison time if an investigation determines
| that this was done to increase certain drug sales.
|
| What if it was "just" done to dunk on Trump after he touted the
| drug? The media sure did love the narrative that his favorite
| drug might be killing people.
| ucha wrote:
| For reference, this is the original study and HN comments:
| https://news.ycombinator.com/item?id=23273615
| fabian2k wrote:
| Hydroxychloroquine is a really frustrating topic as there's so
| much bad science involved. The early studies were terrible and
| didn't give any useful information. And now we have more studies
| in prestigious journals that appear to be at least problematic,
| if not based on outright faked data. And on top of that are the
| politics, endorsing and promoting it before any substantial data
| could be collected.
|
| We still have no idea whether hydroxychloroquine works or not for
| COVID19. And the hype is rather harmful and misleading as even if
| it did work, it is exceedingly unlikely to be a game changer but
| a small incremental improvement.
|
| This is also certainly a failure of peer review. Though that has
| always been rather weak for cases of outright fraud and
| scientific misconduct, it still relies on the researchers to be
| honest about the data they represent.
| dariusj18 wrote:
| This is one of the reasons politicians shouldn't wade into
| these decisions. They raise the stakes and create opposing
| incentives.
| dboreham wrote:
| >We still have no idea whether hydroxychloroquine works or not
| for COVID19
|
| Don't we know to a first approximation that it doesn't work?
| This because it has been widely tried and there wasn't an
| "Awakenings" experience where the patients obviously got
| better. So if it works at all, it only does so at the margin.
| So hard to tell that it's necessary to gather a large
| statistical sample to know one way or the other.
| ImaCake wrote:
| If the measure of effect is small, we probably won't know if
| it works until someone puts together a meta-analysis of all
| the randomised controlled trials. That could take months. And
| it seems like some of those trials have been paused because
| of the well known problems chloroquine has.
| fabian2k wrote:
| I personally think it is unlikely to work, and at best might
| have a marginal effect. That is mostly because most of these
| early results don't pan out, so that is a reasonably safe bet
| in any case. And as you said, a very strong effect would
| likely have been shown by now, with all the attention and the
| large number of people getting the drug.
|
| I was trying to keep objective when writing that, there
| simply wasn't any really well-designed trial yet. Though from
| what I read just an hour ago or so there is a new trial that
| is said to be randomized and well-designed that hasn't found
| an effect, but I haven't looked beyond the headlines there
| yet.
| SomeoneFromCA wrote:
| One of the potential reasons that ex-USSR has quite low
| death rate (even if we consider that numbers are forged,
| and actualy 5x (!) bigger than in reality is that all of
| these countries actively use antimalarial drugs.
| garmaine wrote:
| That's a straw man because it is not at all how it is
| theorized to work. HCQ + loads of zinc should cause the virus
| to replicate more slowly. It does nothing to the virus
| itself, so your body has to fight it just the same. However
| it should reduce the incidence of the most severe cases, by
| reducing viral load in patients. So the outcome would be
| fewer deaths (or alternatively, intubations), but not a
| magical cure.
| PiggySpeed wrote:
| People are losing their heads out there because they don't
| understand how to interpret studies.
|
| The most infuriating offenders are the media, who have been
| irresponsible with the presentation of clinical study results.
| They'll take the results of an observational study and herald
| it as some revolutionary insight, when in reality the doctors,
| nurses, and pharmacists interpreting these results are saying
| "hmm okay, well let's be cautious in our approach and wait for
| other studies to be done".
|
| Clinical practice should never change, and has never changed
| (to my knowledge) from the whims of a single OBSERVATIONAL
| study. But outside medical circles, people will see the results
| they want to see, and never look past the first 10 words of a
| headline.
| rdtsc wrote:
| > Chaccour says both NEJM and The Lancet should have scrutinized
| the provenance of Surgisphere's data more closely before
| publishing the studies. "Here we are in the middle of a pandemic
| with hundreds of thousands of deaths, and the two most
| prestigious medical journals have failed us," he says.
|
| Well maybe that's one positive thing here and people will be more
| skeptical about where this data is coming from
|
| > "We use a great deal of artificial intelligence and machine
| learning to automate this process as much as possible, which is
| the only way a task like this is even possible."
|
| He meant it as a defense and to paint themselves as highly
| knowledgeable professionals using advanced technology, but I read
| it as "we used machine learning to generate this data".
| mrfusion wrote:
| It feels like science is becoming more like religion every day.
| RcouF1uZ4gsC wrote:
| > Desai, through the spokesperson, also said of the company's
| work with patient data: "We use a great deal of artificial
| intelligence and machine learning to automate this process as
| much as possible, which is the only way a task like this is even
| possible."
|
| I wonder if we are heading for an AI winter soon. AI has been
| heavily hyped, but is having a lot of real world failures and is
| becoming associated with a bunch of fraud. At this time, I am
| less inclined and I believe a company if they invoke "AI" or
| "machine learning".
|
| Sure, businesses will still use machine learning for problems
| where it makes sense, but the hype of AI will die down and
| funding will dry up.
| tw000001 wrote:
| >. AI has been heavily hyped, but is having a lot of real world
| failures and is becoming associated with a bunch of fraud
|
| AI, specifically deep learning is _far more_ than self driving
| cars. The industry is in its infancy and we are building ML
| solutions for a multitude of industries. You don 't hear about
| any of it because none of it is sexy (or even accessable) to
| the layman - but rest assured, the industry is growing
| exponentially (like the research) and we are finding much more
| in the way of success than the high profile failures of self
| driving.
| SeanDav wrote:
| Interestingly, there is this article in the same publication:
| _" Core progress in AI has stalled in some fields"_
|
| https://science.sciencemag.org/content/368/6494/927
| ImaCake wrote:
| Some portion of AI companies are likely a bunch of lawyers and
| bullshit. Whenever someone talks about all the companies
| jumping on some software hype train, I think about this post
| written on HN some time back [0], and I imagine that at least
| half of the buisnesses on that hype train fit that description.
|
| 0. https://news.ycombinator.com/item?id=19169151
| ramraj07 wrote:
| You can't just "use AI" to solve record linkage and dataset
| cleanup; we deal with just data from the US and even then it's
| a messy problem; cannot imagine how much messier it can be for
| multinational datasets. There are many companies (including
| where I work now) which have a lot of data in this regard but
| you don't hear too much from them because doing any analyses
| with these large-scale messy datasets is a hard unsolved
| problem.
| battery423 wrote:
| I think AI/Machine learning fits much better at the big big
| companies like google.
|
| You only need one or 2-3 competiting Neuronal Networks for
| cancer detection and if you look how expensive it is to train
| that stuff, not many can actually do it anyway.
|
| But what tripples down are pre learned networks you can easily
| reuse for your small use cases which are specific and have
| plenty of data and only need to outperform the existing
| solution.
| tw000001 wrote:
| >You only need one or 2-3 competiting Neuronal Networks for
| cancer detection and if you look how expensive it is to train
| that stuff, not many can actually do it anyway.
|
| This is just wrong. You can train a cancer discriminator on a
| low end gpu on your desktop. The hard part is getting quality
| [often annotated] data - and thats why data brokers like
| Google are positioned to dominate.
| battery423 wrote:
| So why are those papers with good results are not running
| on 'low end gpus'?
|
| I don't mean running them, i mean training them.
| tw000001 wrote:
| Which papers? There are thousands of papers being
| published.
|
| There are a couple potential reasons. Powerful GPUs
| accelerate research and iteration. Some state of the art
| problems have hit the limits of current theory and make
| up the deficit by building massive nets - but even there
| we already have multiple automatic pruning/optimization
| algorithms to shrink those nets so that they work with
| smaller resources.
|
| Make no mistake, the field is advancing exponentially.
| The state of the art googlenet/inception that arguably
| kicked off the whole craze with image recognition are
| laughably obsolete now and easily outperformed by simpler
| nets.
|
| MNIST was the gold standard for recognition problems just
| a couple years ago, and now it's considered a solved toy
| problem.
| battery423 wrote:
| If i google for it specificly, the paper in nature
| states:
|
| "This study had some limitations. Mammograms were
| downsized to fit the available GPU (8 GB). As more GPU
| memory becomes available, future studies will be able to
| train models using larger image sizes, or retain the
| original image resolution without the need for
| downsizing. Retaining the full resolution of modern
| digital mammography images will provide finer details of
| the ROIs and likely improve performance."
| https://www.nature.com/articles/s41598-019-48995-4
|
| Here they use a Nvidia V100 https://www.researchgate.net/
| publication/336339974_Deep_Neur...
|
| Which yeah okay is more reasonable than i thought. But
| the advantage will still be at who ever has the hardware
| and thats just cheap for google.
|
| You wouldn't need a market for models, you would just use
| whatever research delivers from whoever has the most
| accurate data & hardware.
| walterbell wrote:
| Media & select journals helped justify trillions of societal
| costs when many could be saved from death by _early_ treatment
| with zinc + zinc ionophore (HCQ /quercetin) therapeutic that
| costs less than one dollar. Some poorly designed HCQ studies have
| used late treatment or omitted zinc, which is known not to work.
| Specific cohorts are also excluded, including cardiac patients
| with long QT interval and some malaria-prone populations with
| G6PD gene.
|
| Some US states have blocked pharmacies from filling doctor
| prescriptions for HCQ, instead of advocating for increased
| manufacturing capacity within US factories that make
| HCQ/ingredients. Meanwhile, we boosted ventilator production,
| where hospitals received $30K for each late-stage patient placed
| on ventilation, with only 20% chance of survival. We blocked
| early treatment that worked and we funded expensive late-stage
| equipment that did not work.
|
| All this with more global information sharing than ever before in
| the history of humanity. Since we were collectively unable to
| filter/parse data generated by wildly different economic
| incentives, where the consequences were DEATH, how can we design
| new systemic incentives to avoid repeating such mistakes?
|
| https://www.telegraph.co.uk/news/2020/06/02/prof-lockdown-ne...
|
| _> Neil Ferguson, who became known as "professor lockdown" after
| convincing Boris Johnson to radically curtail everyday freedoms,
| acknowledged that, despite relying on "quite similar science",
| the Swedish authorities had "got a long way to the same effect"
| without a full lockdown._
| ceejayoz wrote:
| > Some US states have blocked pharmacies from filling doctor
| prescriptions for HCQ...
|
| Good. Patients with lupus and other diseases were experiencing
| shortages of what for them is demonstrably life-saving
| medication. There's not an infinite supply, and there are folks
| who need it for more than speculation and self-administered
| home prophylaxis.
|
| https://jamanetwork.com/channels/health-forum/fullarticle/27...
| rootusrootus wrote:
| And yet, if you look at the actual mortality rate of
| hospitalized patients, the US has actually done relatively well
| compared to many other countries.
| andreilys wrote:
| _" how can we design new systemic incentives to avoid repeating
| such mistakes?"_
|
| I don't think you'll like the answer here.
|
| Financial incentives have been known to cause perverse outcomes
| where moral hazards occur more often than not. I think
| financial incentives work well in a lot of cases, but
| healthcare and media have been so perverted by financial
| interests it's become untenable.
| chasd00 wrote:
| I never understood the hate for what Sweden did during the
| pandemic both here and in media. It's like there was a whole
| misinformation campaign to frame Sweden's approach as
| irresponsible and deadly. Article after article in the news,
| all the comments here back in April, the list goes on. Yet the
| data shows Sweden pretty much as stable as any other country.
|
| http://91-divoc.com/pages/covid-visualization/
| ceejayoz wrote:
| https://www.theguardian.com/world/2020/jun/03/architect-
| of-s...
|
| > Sweden's chief epidemiologist and the architect of its
| light-touch approach to the coronavirus has acknowledged that
| the country has had too many deaths from Covid-19 and should
| have done more to curb the spread of the virus.
|
| > Sweden's death rate per capita was the highest in the world
| over the seven days to 2 June, figures suggest. This week the
| government bowed to mounting opposition pressure and promised
| to set up a commission to look into its Covid-19 strategy.
|
| > Sweden's 4,468 fatalities from Covid-19 represent a death
| toll of 449 per million inhabitants, compared with 45 in
| Norway, 100 in Denmark and 58 in Finland. Its per-million
| tally remains lower than the corresponding figures of 555,
| 581 and 593 in Italy, Spain and the UK respectively.
| chasd00 wrote:
| ok but lockdowns don't make sick people get better so
| deaths aren't the best measure. The lockdowns are aimed at
| slowing the infection rate and reducing total number of
| infections.
|
| I don't recall ever reading how Sweden's hospitals were
| overwhelmed so the injection rate never increased beyond
| what they could handle.
|
| As for total infections, If you look at the graph of cases
| by country normalized by population, highlight Sweden, and
| then select show all, Sweden is about in the middle.
|
| They're right there in the mix, it's not like the Swedish
| model was perfect but Sweden certainly didn't devolve into
| rivers choked with the dead either. They're having about
| the same problems as everyone else but didn't add to their
| misery by completely destroying their economy.
| drtillberg wrote:
| That's a _seven_ _day_ death rate.
|
| The specific shortcoming its government is looking into,
| according to the article, was inability to "protect care
| homes where half of all Sweden's Covid-19 deaths have
| occurred."
|
| Sorry, don't need a society-wide lockdown to protect
| nursing and group homes, which are highly regulated and
| often government-operated.
|
| Lies, bad lies, and statistics.
| ceejayoz wrote:
| 10x the total per-capita deaths of Norway (third
| paragraph I quoted is not seven-day; seven-day rate has
| held consistently higher than their neighbors; it's not a
| short-term aberration, and it remains that high _after_
| locking down care homes etc.) is an issue you can 't just
| handwave away.
| jeltz wrote:
| But much lower per capita rate than Belgium which had
| full lockdown. So obviously a lockdown is not a magic
| fix. we do not even know how effective they are since
| there are many more differences than lockdown/no lockdown
| between Norway and Sweden.
| ceejayoz wrote:
| https://www.npr.org/sections/coronavirus-live-
| updates/2020/0...
|
| > Belgium has surged to the top of the grim leaderboard
| because authorities decided to be radically transparent,
| if perhaps a bit speculative, about the toll from the
| novel coronavirus. They include not only deaths that are
| confirmed to be virus-related, but even those suspected
| of being linked, whether the victim was tested or not.
|
| > As of Wednesday, Belgium, with a population of over
| 11.4 million, has counted a total 6,262 deaths from
| COVID-19 -- roughly 540 per million citizens -- and more
| than half of those deaths were in nursing homes. Of those
| 52%, just 4.5% were confirmed as having been infected,
| yet all are counted in the national tally.
| SomeoneFromCA wrote:
| No it is not stable. A week ago, death per 1M was below
| Ireland. Now it is above France (!). Ireland's rate barely
| changed.
| arkades wrote:
| You jumped real hard from "we prematurely cancelled studies
| (meant to show if it works)" to "WE STOPPED A TREATMENT THAT
| SAVES PEOPLE FROM DYING!"
| bluGill wrote:
| Jump for sure, but if it works we stopped a treatment that
| saves people. Even if it doesn't work we wasted a month to
| find that out.
| javagram wrote:
| > Some US states have blocked pharmacies from filling doctor
| prescriptions for HCQ, instead of advocating for increased
| manufacturing capacity within US factories that make
| HCQ/ingredients.
|
| This was done because of a run on HCQ by people who had no
| business prescribing it such as dentists and others who were
| abusing their prescribing authority. Meanwhile patients who
| have depended on HCQ for decades were facing withdrawal because
| the drug supply had suddenly choked up.
|
| > Meanwhile, we boosted ventilator production, where hospitals
| received $30K for each late-stage patient placed on
| ventilation, with only 20% chance of survival.
|
| The 20% chance of survival on a ventilator was a clickbait and
| has been proven false. https://www.npr.org/sections/health-
| shots/2020/05/15/8567680...
|
| > The mortality rate among 165 COVID-19 patients placed on a
| ventilator at Emory was just under 30%. And unlike the New York
| study, only a few patients were still on a ventilator when the
| data were collected.
|
| It's almost the exact opposite - 70-80% of vented patients are
| surviving.
|
| Meanwhile HCQ/zinc therapy has not shown any benefit despite a
| rush across the world to try and use it.
| tamaharbor wrote:
| How many more must die by Democrat hands and their hatred of
| Trump?
| InTheArena wrote:
| The lancet has really fscked up a number of elements in Covid19.
| Not only this, they also published a letter on March 11th saying
| that NSAIDS make COVID worst.
|
| This is a consistent problem with them recently. I'm more then
| willing to say that it's more due to error in judgement then
| malice, but the political ramifications are obvious.
| chrisbrandow wrote:
| Despite the helpfulness of quick exchange of laboratory results
| via preprint, peer review is clearly going to remain central to
| the scientific process.
| rootusrootus wrote:
| I completely agree. It seems great now, because the situation
| is dire, to get preprints instantly as they become available.
| But people don't seem to realize just how much crap gets into
| preprints and ultimately fails during peer review. There's so
| much garbage out there now, and it can and will (and probably
| already is) be used as just more political fodder.
|
| I like reading preprints as much as the next geek, but I think
| we might ultimately be better served if the papers weren't
| released until after peer review.
| James_Henry wrote:
| Do you think that people will start to read preprints for
| what they really are? If that's the case then I think they'll
| never go away. Open review by peers before publication is
| incredibly useful compared to peer review. Imagine if these 3
| papers could have been scrutinized before getting that Lancet
| peer review stamp that has led to bad policy decisions and
| research decisions by so many. People would have started
| questioning Surgisphere's data sooner and wouldn't have taken
| their results so seriously.
| James_Henry wrote:
| I'm not sure I understand where this comment is coming from.
| The 3 Surgisphere papers were peer reviewed.
| AlleyTrotter wrote:
| TDS at it's finest
| ddrt wrote:
| Can anyone explain why there's a new trend I. Saying a negative,
| then saying "but" and stating another negative. Like...
|
| "He was a dishonest man. But, he cheated on his wife"
|
| "He had a nut allergy. But, he had a dairy allergy."
|
| It's like they're saying: "he's a good father. However, he had a
| dark side." But they're really not.
|
| Also, at the beginning they say "it may be unraveling" and begin
| to show how it never had any legs to stand on. Just confusing
| communication for an article.
| dec0dedab0de wrote:
| _Antimalarial drugs touted by the White House as possible
| COVID-19 treatments looked to be not just ineffective, but
| downright deadly._
|
| I think the quote above is what you're referring to. If so, the
| structure "Not only {small_point}, but {large_point}" is
| extremely common and used both with negatives and positives.
| wyldfire wrote:
| Titles are the copy that are the most critical to driving
| eyeballs to your content. I suppose "mysterious company ... may
| be unraveling" sounds like an engaging mystery for the reader
| to enjoy.
| salimmadjd wrote:
| OT - lets face it. Half of the country wants to see Trump fail
| and another half want him to succeed. For covid we should hope
| 100% of country want to see him succeed.
|
| The problem is, part of that half is entire media enterprise
| (BTW, next adminstration will face the wrath of the other half of
| that enterprise) who have invested so much of their own
| credibility on Trump failing.
|
| As a result I have little confidence (just knowing how the CYA-
| mindset works inside any type of corporations) that we will ever
| hear a correction with (or nearly with) the same magnitude that
| will inform the public of the updates. It's unclear what data
| ultimately comes out of the Hydroxychloroquine research, maybe no
| update is needed. But I just don't have the confidence we'll get
| any mea culpa broadcasted across the airways. Nor will I expect
| much, if any, of my social media contacts who posted some of the
| articles to post the correction.
|
| Trump is a polarizing figure, but I don't understand (outside of
| increase ratings) why the media falls for his traps day after
| day.
|
| It's possible Trump might accidentally be right once (or not
| completely wrong), if the media can not remain objective, the
| entire nation will lose faith in the institution of journalism as
| a whole. Opening the doors for all types of conspiracies and
| people searching for alternative news sources. This will
| eventually lead to a showdown between Facebook and these media
| entities that Facebook should ban anything outside of the few
| established news outlets to prevent the spread of disinformation.
| Which is another bad policy, because people ultimately leave
| Facebook to other places to find these disinformation or
| alternate sources.
|
| Doing some basic fact checking on this company, before taking
| their research at face value, especially given there was so much
| red flags, is what should separate established media from someone
| writing a blog post in Romania. This is really a massive failure,
| given the vitality of information around COIVD.
| raverbashing wrote:
| It's amazing how big of a mess this is:
|
| - NEJM and the Lancet published (and "peer reviewed") this
| article, or apparently just rubber stamped it.
|
| - The company doesn't have any semblance of having the capability
| of doing the work it purports to do.
|
| - The article has severe inconsistencies, for example, do you
| really have data on 98k hospitalized patients?
| http://freerangestats.info/blog/2020/05/30/implausible-healt...
|
| - The company apparently was founded in 2008 but no data from
| them was used in any peer-reviewed journal until this year.
| https://www.theguardian.com/world/2020/jun/03/covid-19-surgi...
|
| And governments and the WHO bought this, hook line and sinker?
| James_Henry wrote:
| My favorite part of the whole fiasco is the low quality medical
| books that Surgisphere was publishing on Amazon around
| 2008/2009 with reviews that impersonated big names in medicine.
| The company was founded in 2008, but it appears that data
| falsification is just their latest scam.
| javagram wrote:
| Look at how easily the original flawed pro-HCQ paper was bought
| into (edit: removed my false statement it was retracted - I
| think it was criticized by the publishing society of the
| journal, but not retracted.). Many people were treated with HCQ
| across the world and so far there is no evidence it did
| anything to help them.
|
| An important lesson here about the limits of peer review and
| science. A lot depends on the original authors not being frauds
| or simply making mistakes as we've seen time and again with
| scandals.
| raverbashing wrote:
| Yeah the 1st study was deficient in several ways (low n,
| questionable criteria), which at one point, as a work in
| progress in an emergency situation was understandable, and
| was caught early by the community.
|
| Another very different thing is to misrepresent the source of
| the data, or worse.
| lenkite wrote:
| There is a truckload of evidence unless you have closed your
| eyes to it. Anyways many national medical boards of south-
| asia have adopted HCQ formally.
|
| https://www.newindianexpress.com/nation/2020/may/29/icmr-
| wri...
|
| https://timesofindia.indiatimes.com/india/hcq-and-ppe-
| used-t...
| javagram wrote:
| Looked at both your links
|
| 1. Seems to be saying there isn't currently a health risk
| posed by the continuing of their trial.
|
| 2. Says they tried using HCQ and PPE together and found
| health providers were catching the virus less. Nothing in
| the article attempts to break out whether HCQ or PPE was
| responsible for it - obviously it's common sense that using
| PPE would reduce the risk of catching the virus.
|
| This is hardly a truckload of evidence at all. Also the
| original study from France was about using HCQ for patients
| who had already caught the virus, not prophylactic use. HCQ
| proponents shift around between possible uses of the drug
| as it becomes clearer that there is a lack of evidence for
| one way to use it.
|
| Could evidence be found in the future that the drug has
| some small beneficial effect? It's possible - but what's
| clear is that claims that it was a miracle cure are
| completely unfounded.
| lenkite wrote:
| Yes, I guess I should have posted the other links apart
| from the French study. Apologies. There is also a massive
| ongoing study in India which is expected to post findings
| by July end.
|
| Statement from American Journal of Epidemiology,
| https://academic.oup.com/aje/advance-
| article/doi/10.1093/aje...
|
| Statement from Yale https://medicine.yale.edu/yigh/news-
| article/25085/
|
| HCQ Studies https://www.medrxiv.org/content/10.1101/2020.
| 03.22.20040758v... https://www.medrxiv.org/content/10.110
| 1/2020.04.27.20073379v...
|
| The older study on SARS
| https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1232869/
| javagram wrote:
| Ongoing studies should continue and we can see if there
| is an provable effect, now that the claim of health
| danger has been discredited.
|
| My guess right now is that at best it will be as
| effective as remdesivir, but really until an actual RCT
| is conducted there is no proof either way.
|
| The only thing I'm sure of it isn't a "100%" cure as was
| touted by some politicians since if so, that would be
| obvious by now as the drug has been tried since
| January/February and yet patients treated with it are
| still dying.
| lbeltrame wrote:
| > My guess right now is that at best it will be as
| effective as remdesivir, but really until an actual RCT
| is conducted there is no proof either way.
|
| By now, it also matters _when_ you give it. Lopinavir
| /ritonavir were called ineffective in NEJM, but a recent
| publication (in Lancet, ironically) says that perhaps (no
| placebo, blech) that given within 7 days of symptom onset
| they may be beneficial.
|
| Remedisivir looks best in patients with moderate
| (requiring oxygen) but not critical disease.
|
| And as for RCTs on HCQ, one of those (for post-exposure
| prophylaxis) from UMN should be apparently be published
| soon (no idea when or how: their PI is being, IMO rightly
| so, tight-lipped), and another is under review. A third
| one is ongoing.
| knzhou wrote:
| Whenever this kind of thing happens, you get a lot of people
| advocating for the abolition of peer review and its replacement
| with Twitter or something. I simply don't understand that.
|
| Normal peer review means "we showed our work to about 2 people
| who know what they're talking about and they thought it was
| okay."
|
| Preprints mean "nobody who knows what they're talking about has
| looked at this carefully yet, but we think it's okay."
|
| Viral Twitter threads mean "here's my opinion, which hasn't been
| shown to anybody who actually knows what they're talking about,
| but which has been selected for maximum public response."
|
| Of course, in all cases, real credibility only comes once a paper
| has been looked over by _hundreds_ of people who know what they
| 're talking about. Yes, showing something to only 2 experts (who
| themselves are very busy, and are powerless to directly verify
| many of the paper's claims) is not a perfect initial quality cut
| -- but no cut at all is worse.
|
| If you really believe in the power of Twitter, take a long, hard
| look at the sensational, outrageous tweets you've liked. Go look
| at a sample of 100 old threads and see how many actually held up.
| The accuracy rate will not even be comparable to the Lancet's.
| stephc_int13 wrote:
| The credibility problem has been partially solved with a
| PageRank type algorithm. (Sergei and Larry were actually
| inspired by the weighting system of research papers)
|
| Highly regarded scientific journals like the Lancet are used to
| accelerate this weighting process.
|
| The problem is that nowadays they seem kind of outdated, opaque
| and corrupt on many levels.
|
| Nobody wants to suppress peer-review, simply replace the
| journals mafia with something less corrupt.
| knzhou wrote:
| But this isn't a case of a journal acting like a "mafia".
| This is a case where something bad slipped past peer review,
| because of the inherent limitations of peer review. The
| reason is that expert time and attention is intrinsically
| scarce (if you double the number of experts, you double the
| number of papers produced, and hence double the amount of
| time that must be spent on peer review), and really properly
| vetting a paper takes a massive amount of time. This wouldn't
| be changed by system reform.
|
| In my opinion, the best option for everybody who's serious
| about this is to read a lot of papers, until you become
| "well-calibrated", i.e. when you have a good handle on the
| overall chances a preprint is true, vs. a Twitter thread, vs.
| a paper in a top-tier journal. This has to be learned from
| experience. Reform doesn't change the fact that you need to
| do this -- it just adds yet another venue, either more or
| less reliable than the previous ones, that you also need to
| become calibrated on.
| stephc_int13 wrote:
| There is also the problem with cost and access. (Remember
| Aaron Swartz)
|
| https://en.wikipedia.org/wiki/Open_access
| https://en.wikipedia.org/wiki/Aaron_Swartz
| fragmede wrote:
| > read a lot of papers
|
| In order to do this, those that are serious need to be able
| to access papers, but paying hundreds or thousands of
| dollars for Elsevier can put them out of reach.
| knzhou wrote:
| Indeed, but that _is_ the problem that preprints can
| solve. (As in, they don 't solve the problem of telling
| what is correct, because that's just inherently hard, but
| they solve the problem of giving access so people can
| learn to tell.)
| gator-io wrote:
| The corruption of science should be aggressively confronted.
|
| If you dig into Surgisphere, you will see they have significant
| consulting engagements with Johnson and Johnson. Not saying
| that's necessarily bad, but so much bad science about Covid and
| HCQ seems geared towards promoting high-priced treatments like
| Remdesivir, and not low-cost preventative measures like making
| sure you're not D deficient. All these studies need to be
| evaluated based on who's funding them or the political agenda
| behind them.
|
| HCQ seems like it's been targeted for destruction. Every study
| I've read on it shows you shouldn't use it in late stages of
| disease. Fair enough, but the theory of its effectiveness (as a
| Zinc ionophore) hasn't been fully studied, although there is a
| good amount of anecdotal and country-level evidence it works well
| if taken early (with Zinc).
|
| These garbage studies are dangerous and should be called out
| loudly.
| inasio wrote:
| This is a pretty simplistic view, the article talks about a
| different Surgisphere study where the conclusion is that a
| cheap and widely available drug is effective against covid-19
| (the study also has its problems though):
|
| "A third COVID-19 study using Surgisphere data has also drawn
| fire. In a preprint first posted in early April, Surgisphere
| founder and CEO Sapan Desai and co-authors conclude that
| ivermectin, an antiparasitic drug, dramatically reduced
| mortality in COVID-19 patients. In Latin America, where
| ivermectin is widely available, that study has led government
| officials to authorize the drug--although with precautions--
| creating a surge in demand in several countries."
| gator-io wrote:
| I pointed out the Johnson and Johnson relationship only to
| say motives should be examined.
|
| Surgisphere is producing studies based on data they don't
| actually have, according to researchers, Australian
| hospitals, etc. It could be for self-aggrandizement, or pay-
| for-publish or something else. I don't know, but it should
| not be tolerated for any reason.
| jbritton wrote:
| I have been wondering why so many HCQ studies do not include
| Zinc. A couple months ago I watched a video that detailed how
| Zinc once inside a cell could block replication of
| coronaviruses. And that HCQ being a Zinc ionophore gets the
| Zinc into the cell. The relevant study was published
| approximately 10 years ago.
| javagram wrote:
| Zinc has been pushed as a cure/treatment for common cold for
| decades.
|
| The actual track record of whether the OTC zinc tablets you
| can buy in a store work is quite uncertain though. Lots of
| studies coming down one way or another, and uncertain levels
| of statistical rigor. https://www.mayoclinic.org/diseases-
| conditions/common-cold/e...
|
| It is easy enough to make a video with what seems convincing
| but many of these neat explanations don't actually work once
| you get into the human body.
| eric_b wrote:
| Chloroquine and its derivatives were given to thousands, if not
| millions, of people for years. We know and understand the safety
| profile of this drug well. To think that all of a sudden it
| became more dangerous was silly and unreasonable.
|
| This study always smelled bad. The media was _so_ quick to
| champion it everywhere though. Why might that be I wonder? Where
| are the retractions now? The whole thing is disgusting.
|
| The media in the US is doing everyone a disservice. Because of
| this less people are going to believe "science" and more people
| are going to just retreat to their echo chambers and believe
| whatever they want. I know I'm not going to trust the Lancet or
| the NEJM ever again. It's all political now.
|
| What a mess.
| v77 wrote:
| A lot of people on this forum have been aware with the issues
| in social science and medical research for a long time, it's
| only under real stress that it's become an issue that will get
| wide coverage.
|
| The next fiasco-in-the-making to watch is the 'evidence-based'
| criminal justice reform sure to come to a lot more American
| cities soon.
| takeda wrote:
| Every medication has a side effects and you balance if the
| benefits are better than the side effects it causes.
| Chloroquine has tons of side effects[1] though (including
| things like causing trouble with breathing). It might still be
| worth it if you have Lupus.
|
| When an existing drug is intended to treat some new disease it
| needs to be reevaluated for that disease again, because even if
| it can save lives for one disease it can be deadly for another.
|
| So the fact that it is given to thousands or millions does not
| mean much in this context.
|
| [1] https://www.drugs.com/sfx/chloroquine-side-effects.html
| snowwrestler wrote:
| > Chloroquine and its derivatives were given to thousands, if
| not millions, of people for years. We know and understand the
| safety profile of this drug well. To think that all of a sudden
| it became more dangerous was silly and unreasonable.
|
| Aspirin is one of the most widely used drugs and generally
| considered safe. But you should never give it to a kid with
| chickenpox, because doing so is a risk factor for developing
| Reye's Syndrome, a serious and potentially fatal disease.
|
| It's not that aspirin "becomes more dangerous" in general, but
| it is more dangerous for those particular patients. And we
| don't really know why, either; but the data is clear on the
| correlation.
|
| We don't yet know all the ways that the novel coronavirus makes
| people sick. Heck we don't even have a reliable inventory of
| possible symptoms yet.
|
| So it's really not fair to pretend that it would be silly or
| unreasonable to suspect the possibility of some sort of
| negative correlation with a particular drug or class of drugs.
| This sort of thing happens all the time in medicine.
| throwaway_pdp09 wrote:
| > was silly and unreasonable / This study always smelled bad /
| The whole thing is disgusting / "science"[0] / I know I'm not
| going to trust the Lancet or the NEJM ever again / What a mess
|
| You're throwing around an awful lot of poo. Nothing concrete at
| all but all in very emotive terms. Not constructive - but was
| that the point?
|
| [0] (note scare quotes)
| gameswithgo wrote:
| >Why might that be I wonder?
|
| Because our president was idiotically and irresponsibly
| championing a drug for which there was no good evidence of
| efficacy at all.
| zpeti wrote:
| What makes it even worse is that social media companies are now
| so paranoid about being labelled spreaders of misinformation,
| they are relying on sources who could easily be wrong about
| something as well (like in this case).
|
| I guess this way at least they can point the responsibility
| somewhere else, and say it's not their fault.
| ed25519FUUU wrote:
| > _Why might that be I wonder? Where are the retractions now?
| The whole thing is disgusting._
|
| It's going to take a _long_ time to recover from what the media
| has done here. HCQ isn't even allowed as a treatment in a lot
| of places, or require hospitalization (funny for a drug on the
| market for 60 years and over the counter in some places).
|
| Other countries are ramping up production and we're still
| dealing with the yet another casualty of culture war.
| throwaway5752 wrote:
| We don't know as much about the safety profile of the drug in
| patients with COVID-19.
|
| Aspirin has a long track record and well understood safety
| profile, but it can still cause life threatening complications
| like Reye syndrome in certain viral infections.
| everdrive wrote:
| > I know I'm not going to trust the Lancet or the NEJM ever
| again. It's all political now.
|
| Who can you trust these days?
| scottlocklin wrote:
| Named editors. Peer review is recent, and has mostly proved
| itself a bad idea. Editors who have a personal reputation to
| maintain will do a better job, just as they did back in the
| day when, you know, guys like Einstein walked the earth.
| snowwrestler wrote:
| Personally I do not think of trust as binary. If I ruled out
| every journal, publisher, or news property that published
| something that turned out to be wrong, I would read nothing
| at all and wallow in blissful ignorance. Actually that sounds
| kind of nice right now...
| raphlinus wrote:
| This may have been asked rhetorically, but I will answer it
| seriously.
|
| First, there are some really good science reporters out
| there, doing excellent work. I recommend Ed Yong at the
| Atlantic, Helen Branswell of STAT News, Jon Cohen at Science,
| Amy Maxmen at Nature. There are others (it's a team effort
| and those are all great publications), but if you just read
| all of the articles under their bylines, you will get a good
| overview of what's going on. They will not let you down.
|
| If you have a little bit more time and energy for this stuff
| (as I do), then there are many experts on Twitter who freely
| share their analysis, and among them are some excellent
| communicators. When controversial stuff comes out, you can
| get a good sense very quickly what the flaws are and what
| seems to be the consensus. If you want to dip your toes into
| these waters, I recommend Angela Rasmussen, Trevor Bedford,
| and Marc Lipsitch. For critical analysis of bullshit
| published by seemingly reputable academics, I highly
| recommend Carl Bergstrom (his takedowns are highly
| entertaining as well as informative).
|
| It's frustrating for me to see such pearls of knowledge and
| expertise so freely available, yet the vast majority of
| people snarfing down huge quantities of information swill.
| sonicggg wrote:
| Some media conglomerates, like CNN, were clearly using this
| study as a political attack. Not uncommon these days to cherry
| pick your favourite paper.
|
| On top of that, there is no patent money to be made by big
| pharmaceuticals on this drug. It makes me wonder where the
| funding really came from in this Lancet study.
| nathan_compton wrote:
| "I know I'm not going to trust the Lancet or the NEJM ever
| again. It's all political now."
|
| This is an absurd reaction and I suspect you know it. There
| isn't a single scientific journal in the world not subject to
| some bias, trend, or failure of one form or another. To dismiss
| an entire platform because of an imperfect record amounts to an
| abdication of your own responsibility to form your own opinions
| about scientific matters. This is a responsibility for which
| journal reviewers can only ever take partial responsibility for
| both practical and intrinsic reasons.
|
| Peer review is not a rubber stamp which blesses anything which
| passes through it as "TRUTH." It is a minimal standard and
| subject, at any rate, to all the uncertainties and biases
| implicit in any human endeavor. It is entirely possible this
| paper represents a political bias. Almost everything does. It
| still falls to us to make reasonable judgments about science.
| What doesn't make sense is to reject the entire process because
| it fails to meet some unreachable expectation of perfection.
| Alex3917 wrote:
| > This is an absurd reaction and I suspect you know it.
|
| Why? They knew the data was fake when they published it, but
| they published it anyway to boost sales of Remdesivir.
|
| They're literally trying to make money by killing people. If
| you wouldn't trust someone if you saw them run over someone
| else with their car, why would you trust Lancet?
| ppod wrote:
| Do you think this study would have been published if Trump
| had loudly proclaimed that Hydroxychlorine was dangerous and
| should be avoided?
| BFatts wrote:
| I still believe it would have. The information regarding
| COVID-19 has been evolving since the beginning, 24/7 which
| has lead to the "truth" changing repeatedly. Also, Trump
| has huge support from his business buddies, including Big
| Pharma so I would have to assume they would have either
| protected him or they would have warned him.
|
| If your implication is that the media and the science
| community conspired to make the president look stupid, I
| think you've got a big hill to climb to prove that.
| koheripbal wrote:
| No conspiracy is necessary. There is a mass emotional
| desire to contradict anything Trump says. Agreeing with
| something Trump says has become very taboo, particularly
| in academic social circles.
|
| ...and I think it's possible that's what we see here. An
| emotional decision to publish, and then no one wanted to
| contradict because no one wanted to be viewed as a Trump
| sympathizer.
| potta_coffee wrote:
| No, but the folks here will just downvote rather than
| engage with you.
| [deleted]
| eric_b wrote:
| > This is a responsibility for which journal reviewers can
| only ever take partial responsibility for both practical and
| intrinsic reasons.
|
| So what you're saying is we should never fully trust these
| journals? We should always be skeptical?
|
| That's what I'm saying too...
| DiogenesKynikos wrote:
| No one in science places 100% blind trust in any paper,
| even if it is published in a prestigious journal.
|
| In fact, scientists often say, somewhat tongue-in-cheek,
| "It's published in Nature, so it's probably wrong" (the
| more revolutionary a result, the more likely it is to be
| wrong, but also the more likely it is to get into one of
| the top journals).
| natechols wrote:
| Repeating what I've said in the past, anyone that has
| worked in scientific research for at least five years
| probably has a list of high-profile papers in their field
| that never should have made it past peer review. There's
| definitely at least one _Nature_ paper in my personal
| hall of fame, and I 'm still pissed off about it after
| six years.
| ardy42 wrote:
| > So what you're saying is we should never fully trust
| these journals? We should always be skeptical?
|
| I think that exactly how good scientists proceed. This
| isn't my field, but my understanding is that research
| groups don't "fully trust" peer reviewed research, so they
| usually attempt to replicate the key results they plan to
| cite in their new research.
| macinjosh wrote:
| I agree, but if you do this you are usually labeled a
| 'denier' of some sort in regards to the topic at hand.
| macintux wrote:
| No, you said you wouldn't trust it at all and that it was
| 100% political.
|
| HN isn't the ideal venue for hyperbole.
| JoeAltmaier wrote:
| Journals are, after all, a filter for high-correlation
| results using small data sets. By definition that includes
| every coincidental result out there. You can probably
| create a distribution of accuracy with enough historical
| data.
| lbeltrame wrote:
| Andrew Gelman put it very well:
|
| "No, the real scandal is that the respected medical journal
| Lancet aids and abets in poor research practices by serving
| as a kind of shield for the authors of a questionable
| paper, by acting as if secret pre-publication review has
| more validity than open post-publication review." [1]
|
| [1] https://statmodeling.stat.columbia.edu/2020/06/01/this-
| ones-...
| PiggySpeed wrote:
| If you're healthcare, you're taught not to trust results
| because it was published under a brand-name journal.
|
| YES, you should be skeptical, but mostly not at the
| journal-level. You need to be skeptical at the article-
| level. That is why it's so important to be actually TRAINED
| to interpret the studies.
|
| The abstract of a trial is like an "advertisement" for the
| study. You quickly scan it to see if the study is worth
| reading. If it is, you make multiple passes of the article,
| identifying biases, understanding the study context,
| calculating ratios and numbers, reading through the lens of
| your own practice, and a bunch of other things.
| rscho wrote:
| Healthcare pros are minimally trained in research paper
| interpretation and are almost all unable to perform the
| most basic statistical or critical review work.
|
| So yes, I'd argue that brand names are a big problem. You
| just have to see how proud people are when they are
| accepted in one of the major publication venues, and the
| prestige that results.
|
| I think you are not being objective.
| panabee wrote:
| i am in the process of compiling a list of ways to
| quickly spot flawed studies. do you mind sharing your
| best tips?
| raphlinus wrote:
| There is a course on this (taught Autumn 2019 at U Wash)
| that will also soon be published as a book:
|
| https://callingbullshit.org/
| cm2187 wrote:
| Except that it on the sole basis of this publication that
| the WHO and many other health organisations suspended
| ongoing trials of this molecule. So let's not pretend
| they would have done the same based on some random
| obscure journal.
| seesawtron wrote:
| But you argued as if you were always trustworthy of these
| Journals before but from now on, you plan to be skeptical.
| Your future intentions are similar but for the wrong
| reasons.
|
| One should always be skeptical of research and have
| dicsussions on the reported data and to what extent and in
| what context it makes sense. The media outlets summarizing
| the research papers very often fail to do that so as to
| skip the details and keep the readers happy because they
| assume "readers just want to know the superficial abstract
| knowledge, they can't possibly be interested in the
| critical analysis of the figures and the numbers so let's
| exclude that".
| eric_b wrote:
| But in this case the media is acting very dishonestly. I
| remember every major outlet posting articles about how
| now HCQ was debunked by this study. I have yet to see a
| single retraction of those articles or any new articles
| mentioning this. Only the science publications are
| covering this part of it so far.
| cma wrote:
| https://www.bloomberg.com/news/articles/2020-06-03/france
| -se...
|
| https://www.reuters.com/article/brief-the-lancet-editors-
| iss...
|
| https://www.theguardian.com/science/2020/may/28/questions
| -ra...
|
| https://www.wsj.com/articles/the-lancets-politicized-
| science...
| JadeNB wrote:
| But why should the actions of the media change your
| perspective on the trustworthiness of the journals?
| mhh__ wrote:
| It's much easier to throw your arms up and say "Conspiracy"
| than actually assess things on a case by case basis.
|
| Peer Review gone wrong ->
| https://www.youtube.com/watch?v=wLlA1w4OZWQ
| koheripbal wrote:
| On the other hand, we've seen so many cases of people more
| interested in contradicting Trump than being logical about
| their positions, that I don't think such theories qualify
| for "conspiracy" territory. ...just emotionally charged bad
| decisions.
| throwaway_pdp09 wrote:
| > ...of people more interested in contradicting Trump
| than being logical...
|
| Precisely the way trump himself behaves, but you don't
| point that out.
| koheripbal wrote:
| ...because his stupidity isn't relevant to the point I'm
| making.
|
| You illustrate my point by assuming that I'm supporting
| him, just because I'm not criticizing him.
| throwaway_pdp09 wrote:
| Valid point. Upvoted.
| mhh__ wrote:
| > On the other hand, we've seen so many cases of people
| more interested in contradicting Trump than being logical
| about their positions,
|
| Examples? His list of gaffes - that would be considered
| career ending for anyone - else boggles the mind e.g.
| Making fun of a disabled person, McCain, the Khans,
| accusing Joe Scarborough of murder, go back to your
| country, not knowing a verse from the bible, david duke
| etc. etc. (My point being there's enough to go on that
| being anti-trump on a case to case basis is almost
| indistinguishable from what you say for many topics in
| the news)
| pacala wrote:
| It is an abdication of responsibility from Lancet / NEJM
| editors. Everyone not living under a rock is well aware
| hydroxychloroquine has, unfortunately, become a political hot
| potato. In this context, a paper purporting results counter
| to decades of clinical practice should warrant a modicum of
| additional scrutiny.
|
| This incident comes in the middle of the replication crisis,
| with 50%-70% of studies failing replication, including in the
| medical sciences field. Furthermore, many suspect that
| BigPharma pushes inconclusive garbage as peer reviewed
| science to promote commercial interests. Then there is the
| response to covid19, which, justified or not, some regard as
| catastrophic overreaction. The BigScience enterprise is in
| peril of losing public trust. Which is a terrible loss.
|
| Lancet / NEJM editors failed. There are no excuses. The right
| course of action is to apologize, not to further antagonize
| the public. Try humility for a while.
| rayiner wrote:
| And the Lancet and the NEJM have also been willing to publish
| lots of studies that don't necessarily go with their
| politics. It's one of the few places you can read about the
| facts of the healthcare system, not just the political
| narratives. So it seems unfair to take the anger at the media
| out on these journals specifically.
| koheripbal wrote:
| > lots of studies that don't necessarily go with their
| politics.
|
| Can you provide examples? I'm sure it'll be hard, if not
| impossible, to provide an example that's as emotionally
| satisfying as directly contradicting Trump, but I'd love to
| see which studies you're thinking of.
| rayiner wrote:
| Random example: hospital mergers don't have a negative
| impact on patient outcomes:
| https://www.nejm.org/doi/full/10.1056/NEJMsa1901383
| majormajor wrote:
| Somehow people are able to turn Trump's sheer
| ridiculousness and lack of credibility into a positive -
| they can say "you're just irrationally attacking Trump"
| and try to drop things there, instead of having to make
| the argument that Trump is right.
| joshuakelly wrote:
| Lancet is different than other scientific journals - it is
| the pinnacle. Publishing something so bad is reputationally
| harmful in ways that might not be so severe in other cases.
| Of course, this isn't the first incident Lancet has had
| (recalling the Wakefield incident in particular), but it
| should not be excused - just as Wakefield shouldn't - and
| should be judged rather harshly.
| salmon30salmon wrote:
| Edit: As OP mentioned, this is the "wakefield incident"
|
| Don't forget, The Lancet is also the journal which
| published the paper that kicked off the anti-vax movement:
| https://en.wikipedia.org/wiki/Lancet_MMR_autism_fraud
| andrepd wrote:
| This is what GP means by "Wakefield".
| gamblor956 wrote:
| That is the Wakefield incident he was referring to.
| yaj54 wrote:
| TIL about the Wakefield incident. TY.
| OJFord wrote:
| It also published [0] which seemed to be the ultimate
| source for the 'ibuprofen kills COVID-19 patients' scare,
| every article I found on ibuprofen+coronavirus led back
| there, which matter-of-factly states:
|
| > ACE2 can also be increased by thiazolidinediones and
| ibuprofen.
|
| The closest thing I could find [2] to a source for that was
| [1]:
|
| > NSAIDs [Non-Steroidal Anti-inflammatory Drugs, which
| includes ibuprofen] might affect how Covid-19 binds to
| human cells, according to Dr. Yogen Kanthi, assistant
| professor of cardiology at the University of Michigan, who
| studies inflammation.
|
| > "There is data from basic science studies that have shown
| that Covid-19 itself binds to a protein at the surface of
| cells called ACE2," he said. "There is a hypothetical risk
| that giving NSAIDs like ibuprofen could increase levels of
| ACE2 shown in animal models, but not in patients."
|
| [0] - https://www.thelancet.com/pdfs/journals/lanres/PIIS22
| 13-2600...
|
| [1] - https://kvia.com/health/2020/03/17/france-says-
| ibuprofen-may...
|
| [2] - https://news.ycombinator.com/item?id=22611363
| truebeliefs wrote:
| It was interesting to see Facui so quickly endorse remdesivir
| but perhaps he did so because it's safer than choloroquine. It
| is convienent that remdesivir costs $1000 to 4000 per patient,
| whereas choloroquine is basically free compared to that.
|
| And this: "Before the Covid outbreak, remdesivir was a drug for
| which Gilead had failed to find a use." (Barrons 6/2/2020)
| garraeth wrote:
| fyi: https://www.barrons.com/articles/coronavirus-news-
| updates-51...
| haltingproblem wrote:
| HCQ and its derivatives were given not to thousands or millions
| but tens of millions sometimes for years on end. In tropical
| countries like Nigeria it is customary for visitors and
| residents alike to be on long term HCQ dosages.
|
| I was quite surprised at the newfound fatality. Given that it
| was the Lancet, I took it at face value. Their political biases
| made them overlook the sheer flimsiness of the study.
|
| Rather than a mess, it is showing us the messy humans behind
| the veil of "science". There is no platonic scientist - just
| humans doing imperfect science.
| PiggySpeed wrote:
| > To think that all of a sudden it became more dangerous was
| silly and unreasonable.
|
| This is a dangerous view and not a fair take. Drugs CAN become
| more dangerous when used in a different context. The sheer
| permutation of prior/current medical conditions, interacting
| drugs, demographics, genetics, medical procedures, and a bunch
| of other factors all play into the equation that determines a
| drug's safety and efficacy profile. This is why we continue to
| do research. This is why guidelines are constantly shifting.
| This is why medicine requires years of study.
|
| > The media was so quick to champion it everywhere though.
|
| I definitely agree with this point. The media has caused harm
| to the population by taking the results of a single
| observational study, and parading it around like it was some
| new concrete medical certainty. This is not how professionals
| operate. We don't flip our practice on the whims of a single
| OBSERVATIONAL study.
|
| And I emphasize OBSERVATIONAL because most people here don't
| understand what that entails. Most people here who comment on
| clinical trials are not even trained to interpret them. Is it
| randomized/non-randomized? Double-blinded? What did data
| collection look like? How were results analyzed? What was the
| patient population? Timelines? Control arm? Placebos? Previous
| findings? Primary/secondary endpoint? Do you know the
| difference between a meta-analysis and a systematic review?
| NNT? Hazards ratios? Odds ratios?
|
| Too many people outside of medicine think they know how to
| interpret a study, when in reality they have no idea what
| they're looking at and cherry-pick the interesting sentences
| that they're looking for.
|
| > I know I'm not going to trust the Lancet or the NEJM ever
| again.
|
| This is not a fair take. The journals are responsible for
| reviewing and publishing the most influential clinical research
| in the world. Occasionally a bad study makes its way in due to
| falsified data or other illegitimate factors. Health care
| professionals are well-aware of this, which is why we are
| trained to interpret studies, and be conservative in the face
| of radical findings like this.
|
| If anyone has a problem with the Lancet or NEJM, they should
| see some of the mess found in lower-impact journals.
| pacala wrote:
| Sadly, some of us are aware of the mess found in lower impact
| journals. It doesn't help with the trust issue. At all.
| lbeltrame wrote:
| I did not agree with the conclusions of the paper, but I fell
| prey of the same bias that many others had: it was "published
| in Lancet" and "those journals have strict peer review".
|
| The lesson I learned is that I will _always_ scrutinize
| papers I read with a more critical eye, regardless of where
| they were published in.
| caseysoftware wrote:
| I think we need to understand exactly what "peer review" is
| required for publication or publication certain places. Is
| it:
|
| a) a grammar/spelling check
|
| b) a gut check to make sure it "makes sense"
|
| c) validation of the math/analysis
|
| d) validation of the underlying experimental procedure used
| to collect the data
|
| e) validation of the underlying selection criteria for
| inputs/candidates in the experiment
|
| f) reproducibility of the experiment and results
|
| g) something else?
|
| h) all of the above
|
| My impression is that "peer review" generally includes a &
| b and sometimes c & d.
| ufo wrote:
| > We know and understand the safety profile of this drug well.
| To think that all of a sudden it became more dangerous was
| silly and unreasonable.
|
| COVID patients are different from the patients that normally
| receive chloroquine and the chloroquine doses used for COVID
| are also higher. There is also the issue of how chloroquine
| interacts with other drugs such as azythromycin.
|
| This particular study has its problems but other studies on
| chloroquine were also starting to suggest that chloroquine
| could have dangerous side effects.
|
| https://blogs.sciencemag.org/pipeline/archives/2020/05/04/hy...
| emmelaich wrote:
| Philip Greenspun had some good articles on this. See below.
|
| He also quotes the CDC website saying it is quite safe.
|
| > "CDC has no limits on the use of hydroxychloroquine for the
| prevention of malaria. When hydroxychloroquine is used at
| higher doses for many years, a rare eye condition called
| retinopathy has occurred. People who take hydroxychloroquine
| for more than five years should get regular eye exams."
|
| https://philip.greenspun.com/blog/2020/04/23/the-disappointi...
|
| https://philip.greenspun.com/blog/2020/05/21/hydroxychloroqu...
| sparrc wrote:
| > I know I'm not going to trust the Lancet or the NEJM ever
| again.
|
| Wait, what??
|
| The fact that the lancet was able to determine that there were
| validity concerns with the data and issue an expression of
| concern in less than 2 weeks is proof that the system works.
|
| Science is never 100% certain. The media has never been a good
| source of scientific information and probably never will be.
|
| edit: also, if you "don't trust the Lancet or NEJM" then you
| don't trust a huge number of the treatments available to you at
| the hospital. These are two of the most important and eminent
| medical journals in the world and many life-saving treatments
| began as articles in these journals.
| cm2187 wrote:
| It is proof that the peer review failed, on a topic that the
| Lancet couldn't ignore was high profile. I have no idea what
| the motivation of the reviewers were, but given how political
| this molecule has become, I can't help having a terrible
| doubt.
| mc32 wrote:
| The really odd thing is the media were highlighting risks...
| but not giving them context. Aspirin is risky, but millions
| take it too, over the counter.
|
| I'm all for being skeptical, but I think they went overboard,
| especially given the alternative of having no medicine.
| phkahler wrote:
| >> Because of this less people are going to believe "science"
| and more people are going to just retreat to their echo
| chambers and believe whatever they want.
|
| That's true. There are people who want to discredit science as
| a whole. Reality tends to get in the way of most hidden agendas
| - that's why they're hidden.
| jakeogh wrote:
| More: https://news.ycombinator.com/item?id=23272222
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