Hmm, Wikipedia tells me that Choloquine mildly suppresses the immune system, and also that it has a low theraputic index—that is, the ratio between an effective dose and an overdose is relatively small—and that it is “very dangerous in overdose”. This does not sound like a drug that is necessarily very safe to self-administer, or recommend to people to do that, without substantial research.
EDIT: Additionally, the article you link has very little information in it. It lists a bunch of clinical trials but I can’t figure out whether it’s possible for me to see the results. It’s not an academic paper in any real sense, just some kind of summary of other results. The only citation for the “multicenter clinical trials” given is to a press briefing by the Chinese government. There is one relevant citation to an article in Nature, but it is short and contains limited information, and is listed as a “Letter to the Editor” presumably meaning it’s a preliminary result not subject to peer review.
None of this inherently means the science isn’t good, but I think the risks of suggesting that people consider self-medicating with an apparently-dangerous drug are not justified by the flimsy evidence so far available.
Sorry, I wrote that in a hurry and didn’t have time to report all of my reasoning. According to Wikipedia:
Hydroxychloroquine was approved for medical use in the United States in 1955.[1] It is on the World Health Organization’s List of Essential Medicines, the safest and most effective medicines needed in a health system.
Yes the therapeutic index is low and I’m not a doctor but I don’t think that mean it’s easy to overdose if you follow direction. Otherwise it wouldn’t be a very widely prescribed drug (in parts of the world where malaria is common). I haven’t seen any reports or warnings of people overdosing after following recommended dosages (ETA: except after taking it for years). I only found accidents or suicides.
And you’re right the paper is not a normal academic paper, but that is understandable given the fast moving circumstances. I do think it’s pretty strong Bayesian evidence that Chloroquine and Hydroxychloroquine do more good than harm. Suppressing the immune system may be part of how it works (i.e., the immune system can do a lot of damage to one’s lungs in the course of fighting infection).
Thanks for the additional info. (I think this could well be a good idea, but I think it’s also good for people to know they need to be a big careful about it. E.g., to what extent do people self-prescribing chloroquine have access to good directions to follow, on how to dose it?)
The idea is that if the virus infects 40-70% of all people, the health care system will run out of resources to treat everyone, so one may be forced to stay home and self-medicate. You can also take it when you first start to get mild COVID-19 symptoms to help prevent it from getting worse, potentially saving you from a trip to the hospital even if beds are still available. As the first link says, China has been doing clinical trials with Chloroquine and the preliminary results seem promising.
note: I think it’s good to update the OP answers with a summary of reasoning and whatnot so that the abridged version of the Answer section is easier to skim (and easier to evaluate how well the karma system is floating good ideas to the top)
This advice may be individually rational but seems generally quite bad from a social point of view. Don’t stockpile a medicine because you think the public health system will run out of it. Same goes for stockpiling a large number of surgical masks. I’ve heard that hospitals and institutions in Italy already fear running out of them, and masks are crucial in these places.
The case might be different for people with high age or a preexisting condition that puts them in danger.
I used the first pharmacy, which didn’t require a prescription. The FAQ on the second one says they can write most prescriptions themselves, so try contacting them and asking them to do that. If that doesn’t work, try ask your health provider to write a prescription? Or sign up at the first pharmacy to be notified when Hydroxychloroquine comes back into stock. I waited about a week for it myself. After receiving the notification, stock went out again in 2 hours so look out for it.
[This should have been posted under answers. Mods, please move this if you can.]
Buy Chloroquine or Hydroxychloroquine: https://www.jstage.jst.go.jp/article/bst/advpub/0/advpub_2020.01047/_article
Reputable online pharmacies:
https://www.inhousepharmacy.vu/p-1106-plaquenil-tablets-200mg.aspx (recommended by 2 seemingly trustworthy people)
https://www.reliablerxpharmacy.com/catalogsearch/result/?q=Chloroquine (most upvoted at https://www.reddit.com/r/tretinoin/comments/asf8tq/where_can_i_order_tret_online_as_an_american/)
(I used the first one but the order hasn’t arrived yet.)
ETA: See https://www.chinalawtranslate.com/en/coronavirus-treatment-plan-7/ for dosing directions.
Hmm, Wikipedia tells me that Choloquine mildly suppresses the immune system, and also that it has a low theraputic index—that is, the ratio between an effective dose and an overdose is relatively small—and that it is “very dangerous in overdose”. This does not sound like a drug that is necessarily very safe to self-administer, or recommend to people to do that, without substantial research.
EDIT: Additionally, the article you link has very little information in it. It lists a bunch of clinical trials but I can’t figure out whether it’s possible for me to see the results. It’s not an academic paper in any real sense, just some kind of summary of other results. The only citation for the “multicenter clinical trials” given is to a press briefing by the Chinese government. There is one relevant citation to an article in Nature, but it is short and contains limited information, and is listed as a “Letter to the Editor” presumably meaning it’s a preliminary result not subject to peer review.
None of this inherently means the science isn’t good, but I think the risks of suggesting that people consider self-medicating with an apparently-dangerous drug are not justified by the flimsy evidence so far available.
Sorry, I wrote that in a hurry and didn’t have time to report all of my reasoning. According to Wikipedia:
Yes the therapeutic index is low and I’m not a doctor but I don’t think that mean it’s easy to overdose if you follow direction. Otherwise it wouldn’t be a very widely prescribed drug (in parts of the world where malaria is common). I haven’t seen any reports or warnings of people overdosing after following recommended dosages (ETA: except after taking it for years). I only found accidents or suicides.
And you’re right the paper is not a normal academic paper, but that is understandable given the fast moving circumstances. I do think it’s pretty strong Bayesian evidence that Chloroquine and Hydroxychloroquine do more good than harm. Suppressing the immune system may be part of how it works (i.e., the immune system can do a lot of damage to one’s lungs in the course of fighting infection).
Thanks for the additional info. (I think this could well be a good idea, but I think it’s also good for people to know they need to be a big careful about it. E.g., to what extent do people self-prescribing chloroquine have access to good directions to follow, on how to dose it?)
Why is this a useful thing to do?
The idea is that if the virus infects 40-70% of all people, the health care system will run out of resources to treat everyone, so one may be forced to stay home and self-medicate. You can also take it when you first start to get mild COVID-19 symptoms to help prevent it from getting worse, potentially saving you from a trip to the hospital even if beds are still available. As the first link says, China has been doing clinical trials with Chloroquine and the preliminary results seem promising.
note: I think it’s good to update the OP answers with a summary of reasoning and whatnot so that the abridged version of the Answer section is easier to skim (and easier to evaluate how well the karma system is floating good ideas to the top)
(note: I’ve moved this to the comments section for now, but would move it back if the OP was edited to have a good summary of the reasoning)
This advice may be individually rational but seems generally quite bad from a social point of view. Don’t stockpile a medicine because you think the public health system will run out of it. Same goes for stockpiling a large number of surgical masks. I’ve heard that hospitals and institutions in Italy already fear running out of them, and masks are crucial in these places.
The case might be different for people with high age or a preexisting condition that puts them in danger.
How did you order this without a prescription? When I went to order from the second link it asked for a prescription which I don’t have.
I used the first pharmacy, which didn’t require a prescription. The FAQ on the second one says they can write most prescriptions themselves, so try contacting them and asking them to do that. If that doesn’t work, try ask your health provider to write a prescription? Or sign up at the first pharmacy to be notified when Hydroxychloroquine comes back into stock. I waited about a week for it myself. After receiving the notification, stock went out again in 2 hours so look out for it.