Everybody Loves Their Own Cows
Since at least March of this year, probably earlier in China, researchers in the medical community have suspected that the widely used malaria drug hydroxychloroquine might be an effective treatment for Covid19.
On March 13th, I posted this link to study out of Stanford on Facebook:
My only point (so far) is that the recent attempt to portray the therapeutic use of this drug for Covid19 as quackery is entirely unwarranted.
One of the problems with the way this is discussed in the media is with the failure to distinguish between medical research and the practice of medicine. And I observe some of my very smart friends on Facebook neglecting to make this distinction as well.
The recently censored video of medical practitioners advocating for the use of hydroxychloroquine (there are other similar videos advocating for the use of budesonide) are examples of medical practitioners advocating for treatments that their front-line experience suggests are beneficial.
But others, including those self-appointed "medical experts" who run social media sites, loudly object to this on the basis that these do not represent scientifically sanctioned double-blind studies with all the imprimatur of medical officialdom.
To which I say, "so what?"
Were these doctors advocating for the use of therapeutics that had no rational basis underlying their application, it would be one thing. But they're not advocating for, say, stuffing the patient's ear canals with bat guano. They're suggesting only things that are both known to be generally safe and have a rationale informed by scientific reasoning.
Now, we should all want and support medical research with all of the appropriate scientific methodologies and bureaucratic endorsements.
But what do the harumphing elite expect sick people and frontline doctors to do in the meantime?
By all means, let's do the disciplined research. But let's also be willing to do all we can, even in the absence of sufficient medical research. Please let's not deny potentially beneficial treatments to people who could die, especially when those treatments are known to be safe, merely because we haven't tied all of our research up with a nice neat bow. I'm not saying just willy-nilly experiment on people. No one that I've seen has been proposing that. They've only been proposing that we use treatments we already use for other reasons and apply them to Covid19. Everyone needs to take a chill pill and let doctors do what they can for their own patients, and share their learning.
When the sanctioned studies are finished we can apply their learning to our practice of medicine and maybe things will even improve, although that's not a given.
I once had a controller at an internet startup I founded inform me, with a superior attitude, that whatever the rest of us thought, she knew that we were actually in the accounting business. I mentioned this comment to one of our investors during a board meeting and he said something I've never forgotten: "Keith, you've gotta remember. Everybody loves their own cows."
A lot of the technology leadership at social media companies come out of the research world. They love and value research, publishing, and the rigor that can be a part of that effort (although there's a much discussed reproducibility crisis in a lot of current research).
They object to anecdotal evidence because it doesn't meet their high standard for research. And that's a fair objection as far as it goes. Research is the cow they love and, for them, the only legitimate basis on which to make decisions. But a social media poobah doesn't have to watch his patients get sick and die like frontline doctors do.
Let's get as much knowledge from research as soon as we can. And let's also allow doctors to practice medicine and share information in the meantime, even in the face of limited knowledge. As long as they're not recommending something manifestly harmful, we should be humble in light of our limited understanding, and remain open to ideas.