Originally published at: https://boingboing.net/2020/08/23/trump-and-fda-to-hype-convales.html
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The FDA literally revoked the previous emergency authorization a few days ago. Did they seriously do this just for press purposes? (Rhetorical question: of course they did.)
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I can very easily see various State boards announcing that prescribing highly speculative, not to say experimental, treatments based on Donald Trump’s authority is a good way to retire from the practice of medicine.
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All this infantile Deep State conspiracy theory bullshit should be enough to get any president laughed out of office. I still cannot believe that so many Americans are so blisteringly stupid and gullible that they take any of it seriously, but apparently they’re at such a critical mass that their alternate, dumber reality is the one on which all policy decisions are now based.
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The likely problem with convelescent plasma treatment – why isnt likely to be a useful treatment in most cases is that it likely needs to be given very early to have any effect (if it works at all). So essentially you need to be able to treat everyone both from a cost / capacity point of view and the side effects need to be mild enough to treat people before you know if they are going to have a bad case. Also that is contingent on finding the patient and getting a positive test result early enough. By the time someone shows up in the hospital it is often too late.
It still might turn out to be useful at least in some circumstances and is worth studying in case it can help, but it isn’t going to be the silver bullet some people seem to hope it is. And so far the evidence isn’t really there that it helps at all.
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The tell will be how many times he uses the word “cure” in his announcement.
This a possibly beneficial treatment and…that’s about it.
If he throws around the “c” word then he leaves no doubt about his motivations and it just looking redirect the fear of his ignorant followers. (I know, I know, there’s no doubt already…)
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Underpowered study, but hopeful. As expected, more effective early in disease, but showed effect in more severe cases as well. As always, needs more study, but not nearly as hare-brained as Il Douche usually goes.
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It’s definitely no hydrochloroquinine or lung bleach.
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Holy Kubrick! It’s really happening! The deep state commie FDA! Sapping and impurifiying our precious bodily fluids!
Seriously though. This is going to be blown dangerously out of proportion.
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Trump’s going to jump on anything waved at him until he’s the stopped clock that’s right once, all while hoping we forget the bleach, hydroxychloroquine, and oleandrin, then parade that mutha like the new messiah. The nuts will eat it up.
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Apparently, now it’s the “Deep State or Whoever” conspiracy theory.
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Why is it so hard to believe?
Big Business has been covertly working hand in hand with Big Gov ever since the end of WW2 to make the American populace as mentally dull, lazy, complacent and easily manipulated as possible… and after 60 years or so, we now see just how very successful the Dumbening has been.
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Trump probably started transfusions from nubile virgins weeks ago …
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Well, this is a train wreck. What a surprise!
What is convalescent plasma? The idea is that it will be chock full of anti-COVID antibodies from people on the mend, which will help the immune system attack active COVID in not-yet-convalescent patients, who–upon convalescence–will pay forward their plasma in a virtuous cycle of healing! Praise be!
What are the issues?
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Your antibodies are not like my antibodies and won’t necessarily work the same.
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Not all antibodies are created equal–some will help, some will be neutral, some could even make the disease’s symptoms worse.
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Antibody concentration, specificity, potency, stability, post-translational modifications, etc, will vary from donor-to-donor.
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We can theoretically get around that variability by pooling plasma from multiple donors, but that risks diluting effective antibodies or introducing other issues.
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Collecting plasma is pretty labor-intensive, especially if you want it from patients who are still on the mend, and it has a pretty short half-life. Very, very difficult to scale. Cutting corners with blood-derived products is very, very bad.
The broader problem here is that there’s every appearance that Hahn folded to political pressure to re-issue this particular EUA. That’s politicization of a public health agency that degrades its perceived objectivity when we really need it to stay objective for upcoming vaccine reviews. Maybe this can be walked back or mollified with other context, but if it isn’t, I’ma be wanting to see direct data for vaccine trials before I get in line for one.
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Basically, a small group of seriously ill COVID patients who got the plasma treatment saw a slight improvement BUT there was no control group - and the same rate of improvement appeared across the nation at the same time, hinting that now that doctors are very familiar with COVID, consistent treatment with less guesswork might have been responsible. Trump now has a new hydroxychloroquine scam - a possible treatment without solid evidence.
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The UK have been stocking up on plasma too https://www.theguardian.com/world/2020/aug/03/nhs-appeals-for-urgent-plasma-donations-from-covid-19-coronavirus-survivors and there are also signs that breast milk is an alternative https://www.thetimes.co.uk/article/coronavirus-breast-milk-ice-cubes-could-deliver-protective-antibodies-v69wcpf0w (paywall, but the alternative is a daily mail article and I never visit them)
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FWIW, Wired did a good story on this a few days ago.
The upshot is that it probably does no harm (unlike the 'roxy, the bleach injections, the oleandrin, etc.) It’s just that it may also do very little good. At least one group has done a pseudorandomization test and found a positive correlation between higher Ab titers and recovery. The real dangers here are that 1) it sets another bad precedent for a bad president – twisting the FDA’s arm to get his way and 2) Now NObody will sign up for a proper randomized clinical trial. Why would you accept a 50-50 chance of getting the treatment as opposed to a placebo when you can now get it 100%?
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Thread:
And now we can no longer trust the FDA. Thanks, Trump.
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As others have noted, the benefits are very modest at best. Worth studying but nowhere near the 35% mortality reduction that the administration is claiming.
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"I need to use the words “Deep State” at least eleventeen times per day for the next six months until the election? Thoughts? Ideas?
What? 71 days? Is that even a number? What are you, an accountant?
Alright, I need to say it twentyteen times a day.
What? Alright Vladdy, Dvadtsat times a day.
Thoughts? Ideas?"
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