I had a brief chat with someone who had not been vaccinated. He cited concerns for the side reactions and that covid kill only negligible percent.
Well. ... Personally I think vaccine refusal is unwise, under the light of available vaccine and covid data by July 2021. But I'll let him live his way. No arguments. He does not work in medicine, so he has no professional obligation or requirement.
For me, vaccine refusal is categorized in the same place as blood transfusion refusal on religious ground. There may be some angels other than me or vaccine to rescue him (or not).
He also mentioned that hydroxychloroquine is still a drug for covid, only shot down by political reasons.
I thought hydroxychloroquine for covid is a long dead approach. But to be sure, I checked recent publications.
To refresh the memory, hydroxychloroquine is mainly an anti-malaria drug and inhibit growth of malaria parasite. Additionally, hydroxychloroquine can modulate immune response, and occasionally used for autoimmune diseases (lupus, Rheumatoid Arthritis), which may have been a reason to be purported as effective for covid management.
Downside of hydroxychloroquine use is its narrow range of optimal dosing. Because of that, clinicians are careful with dosing. Cardiac arrhythmia (erratic heartbeat) is commonly reported in clinical use. It is a prescription-only and is not a drug for self-medication.
In early phase of pandemic (early 2020), use of hydroxychloroquine with or without azithromycin, an antibiotic presumably for secondary bacterial pneumonia, was purported to be effective against covid19.
1.5 years later, scientific evidence has piled up.
In the field of medical science, not all evidence and reports are equal. Some evidence are more respected or taken more seriously than others. There is a hierarchy in evidence.
Lower tier evidence is preclinical studies with model systems, like cultured cells, lab animals, and computer modeling. They can provide proof of principle toward clinical trials, but the reports are taken with a grain of salt when questioned for human use.
Case reports and observations in small number of patients are also considered low-tier evidence. Numbers count in science.
Middle tier evidence is individual clinical trials. Clinical trials come in three phases. Phase I is basically toxicity test on small number of volunteers. Phase II is an expanded version of phase I. In phase III, the drug or treatment of interest may be applied on actual patients. Yet, various designs can be employed, and only a "randomized and controlled phase III clinical trial with large number of patients" provides scientifically sound data that can be interpreted and concluded.
But single "randomized and controlled phase III clinical trial" may still not be enough to conclude everything.
The highest tier evidence is meta analysis. In a meta analysis, researchers apply inclusion/exclusion criteria on many published clinical trials, and results from multiple clinical trials are evaluated. Meta analysis follows statistics and specific data handling. Basically, meta analysis can answer whether these clinical trials are indicating the same results, or not.
Someone once sent me a bunch of "covid19 and hydroxychloroquine" reports to comment. They were collated by some radio personality. It was a poor attempt to evaluate bunch of reports by a layman and was a mockery of meta-analysis. I did not want to touch it or deal with it. So I refused to see it. ....I digress.
To make matters a little more complicated, journals for each tier publications come with high or low impact factor (IF), which is an averaged score indicating how many times papers appeared in the journal is cited by colleagues/peers. IF of a journal is a metric suggesting whether the paper is well-recognized among experts in the field.
IF 30-40 is the highest, attained by a few commercial and prestigious scientific journals. IF 8+ is quite decent, basically top ranked journals for the specific research field (like cancer research or immunology or aging). IF3-5 would make regular respectable research papers. I would read the papers with an assumption that they are not doing horrible job in the peer review process and the results can be taken seriously.
If the paper concerns my own research, I will add extra caution. Even if it is not scientific misconduct, unintentional mistakes and misinterpretations can happen. And just trusting others' single report can mislead us, if their report contains errors.
In addition to peer-reviewed publications, there are "preprints without peer review". They are more like press release of sorts, or preliminary results that may or may not be solid. As an evidence, they are not as strong or trustworthy as peer-reviewed papers.
Above is somewhat oversimplified way to view medical research evidence and papers.
That said, when I accessed Pubmed databese (https://pubmed.ncbi.nlm.nih.gov/) and typed in "covid hydroxychloroquine meta analysis", there were 103 hits (7/17/2021).
I checked out several recent papers. ("Recent" is important, with relentless updating in science). They pointed toward the same conclusions. (No wonder. They are mostly based on the same clinical trials.)
In short, "Meta-analysis of included studies revealed no significant reduction in mortality with HCQ use, .....There was a higher risk of ECG abnormalities/arrhythmia ....The quality of evidence was graded as very low for these outcomes."
Hydroxychloroquine did not work against covid. It even increased risk for heart malfunctions.
I wouldn't take Hydroxychloroquine for covid. For malaria, I would, though.
[Hydroxychloroquine]
There may be a question, "what about combination of hydroxychloroquine with zinc, folate, etc?"
In terms of publications, with limited evidence, efficacy of hydroxychloroquine and zinc combination remains hypothetical. Combination is difficult to properly compare. It remains to be seen if zinc by itself has better effects than hydroxychloroquine, for example.
Whataboutism do not mix well with clinical trials requiring solid rationales. May I remind you, clinical trials are experimentation on humans. If combination with X,Y and Z have theoretical support and show efficacy in preclinical models, combination may be considered. But when the main component X indicates little promise, it is dead end, at least in western clinical trial methodology. As of July 2021, FDA is recommending against use of hydroxychloroquine for covid.
