Thread by @ClaireBerlinski

I'd recommend everyone chill out about Trump promoting chloroquine. Strictly speaking, he shouldn't, I agree. It hasn't been clearly proven beneficial in randomized, placebo-controlled, double-blind studies;

it causes nitwits to hoard it and then injure or kill themselves by taking it w/out proper medical supervision; it causes long QT syndrome and psychosis; it makes people psychotic (and suicidal); and gives people massive hives on their sexual organs.

If people hoard it, those who need it for other, equally serious diseases won't have it--all true.

But there's also non-gold-standard evidence that it works, and the results of the gold standard trials will be out soon. If it turns out that it *is* effective:

1) You'll look stupid for insisting it isn't, even though you're absolutely right that *at this point* we don't know--but this subtlety will be lost on those who want to believe Trump has magical powers;

2) You'll have succeeded in scaring off people who might benefit from the therapy. That, too, would be an unfortunate medical outcome caused by people yapping their heads off about medical therapies on the Internet despite not knowing what they're talking about.

Here's what we actually know:
1) Chloroquine does seem to inhibit SARS-type viruses in test tubes. But a test tube is not a human. Bleach would inhibit it in a test tube, too. You shouldn't drink bleach.

2) Chloroquine does seem to inhibit SARS-CoV in primate cells. "Primate cells" are not "your grandma." (But if I were Trump, maybe I'd say, "What do I have to lose?)

3) A lethal HCoV-OC43 infection in newborn C57BL/6 mice can be treated quite well with chloroquine acquired transplacentally or via maternal milk. NB: Not the same coronavirus; you're not a mouse, and neither's your mom.

4) Because of this, it *does make sense* to investigate the effects of chloroquine/hydroxychloroquine against SARS-CoV-2. That's why trials are going on around the world.

5) Preliminary trials, in China, *have been encouraging.* They're not high-quality trials, but they're encouraging enough that the idea, "What do you have to lose" *may* be appropriate for patients with no known contraindications.

6) This is a deadly disease. It can kill you. If you have it, and if you don't mind the idea of massive hives on your sexual organs, have no contraindications, take it under medical supervision, and in a safe dose, you probably don't have much to lose--

--unless you're one of the unfortunate people who dies from it, which happens (especially to diabetics). But if you're in a hospital and being supervised closely, it's more likely they'll figure out that you're about to die from the chloroquine and get you off of it in time.

But be aware: chloroquine won't keep you from getting it, or keep you from dying. It *may* reduce the length of time from which you suffer from Covid19 associated pneumonia. (And my guess, based on the literature, is that the trials will show that yes, it does.)

But the reason we do rigorous trials is because they tend to show a lot of people that things they thought worked *don't* actually work.

So: If you're dying of Covid19, today, and you want to take the risk, I think you should be allowed to do it. I would.

I would much rather wait until the results of the gold-standard trials came back, but if you're dying today, you can't.

On the other hand, if you're dying today, you're not reading this.

So basically, I'm just advising people on Twitter who've decided they hate chloroquine because Trump keeps yammering on about it that they may well be in for a spot of embarrassment if the trials show that it's efficacious, or mildly efficacious.

You can believe almost everything that comes out of Trump's mouth is a lie (I do) without believing that therefore, chloroquine has no potential to be therapeutically valuable. The correct answer to the question is, "We don't know yet, but there are some reasons to be hopeful,"

And for God's sake, don't sit there *hoping* it doesn't work just to prove that Trump's an idiot. It's a lot more important to save people's lives than it is to find yet another example of Trump's stupidity. We have millions of examples of that--but few therapies for Covid19.