hydroxychloroquine, azithromycin, and the skies above

Will you simply assure life if you take hydroxychloroquine and azithromycin? This is a critical question, and unfortunately the answer depends on a few personal factors we do not have complete visibility into.  This idea is now being promoted by President Trump in an attempt now to resolve the unravelling coronavirus debacle from getting so much worse.  With deaths officially multiplying at a weekly rate of 10x, despite the futile curve-flattening attempt the government now has us on. 


The drug data is very small.  36 foreign patients within a short period of time. 16 of whom were controls, and of those 5 had missing data. Also 14 received hydroxychloroquine only, and of those 1 had missing data. 6 received azithromycin in conjunction.  16+14+6=36 patients.


Now we have all seen the popular time series lines charting the portion of positive patients over time, in the three cohorts above.  (C) control, (HC) hydroxychloroquine, and (HCZ) hydroxychloroquine and azithromycin together.  But what does the chart mean?  Does it give you any guidance at a personal level?  And while clever, what wasn’t shown is how this fares between the younger half of the patients (10-45 years).  Which I was the first to identify to millions (prior to the White House admission a few days later) were at increased risk, versus older half of patients (45-87 years).  Does the drug simply work as our only solution, despite virus mutations?  Can we self-administer?  These are all the questions that are fair for people to want to know, as in a long time ago. 

I am personally near the boundary between these two age buckets.  In any event, the younger cohort showed that they started in just as unhealthy a position as the older cohorts and also had no improvement at all (on essence) by taking the HC medicine.  That’s not great news for people such as myself who now still have to worry just as much as I did before (perhaps more if people are getting too excited that our problems are no solved and therefore continue to relax).  And while HCZ for this group does sometimes show an improvement, this too is a very weak conclusion since it was the result of just a single sample (from the 6 total who received HCZ).  The world is being expected to execute a hasty hail-mary policy now, on a noisy situation, given a sample of one.


Now for older patients, generally starting from an unhealthier position before medication (and generally worse than upper-respiratory tract infection), there was seen some improvement.  This is of course welcome news.  With hope it can be raced to market (something America has not been best-in-class at, as seen in recent weeks) and will endure in the years ahead.  We must however also remind people that improvement does not necessarily imply survival, nor does it imply a steady and homogenous result across all genetic profiles and seasons and preconditions, etc.