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GidMK's profile
Health Nerd
Health Nerd
Health Nerd
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@GidMK

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Health NerdVerified account

@GidMK

Epidemiologist. Writer (Guardian, Observer etc). "Well known research trouble-maker". PhDing at @UoW Host of @senscipod Email gidmk.healthnerd@gmail.com he/him

Sydney, New South Wales
theguardian.com/profile/gideon…
Joined November 2015

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    1. Health Nerd‏Verified account @GidMK 30 Sep 2020

      Health Nerd Retweeted Miguel Hernán

      Leaving aside any commentary on this preprint, I thought it worthwhile running the numbers that a 20% reduction in relative risk would confer if HCQ really does prevent this many infectionshttps://twitter.com/_MiguelHernan/status/1311304453484679174 …

      Health Nerd added,

      Miguel HernánVerified account @_MiguelHernan
      1/ We don't have a vaccine yet, but we have a treatment that may reduce the risk of #COVID19 by 20% without serious side effects. That treatment is #hydroxychloroquine. Risk ratio of COVID-19 in our meta-analysis of 3 prophylaxis randomized trials: 0.78 https://www.medrxiv.org/content/10.1101/2020.09.29.20203869v1 … pic.twitter.com/hCVq6h6UlB
      Show this thread
      3 replies 12 retweets 33 likes
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    2. Health Nerd‏Verified account @GidMK 30 Sep 2020

      So, firstly, how many people get COVID-19 in a given area over a period of time - let's say a year Very crudely, if we look at different places in the world with quite large outbreaks, it's around 15-20% at a population level in most places

      1 reply 0 retweets 2 likes
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    3. Health Nerd‏Verified account @GidMK 30 Sep 2020

      Using the population IFR estimated from our meta-analysis, this gives an overall death rate in a population of (say) 10,000 people of: 0.15*0.0068*10,000 = 10 deaths

      1 reply 0 retweets 2 likes
      Show this thread
    4. Health Nerd‏Verified account @GidMK 30 Sep 2020

      What if they were all taking HCQ? Well, the relative risk reduction is 20%, so plugging that into our equation: 0.15*0.0068*0.8*10,000= 8 deaths You'd prevent about 2 COVID-19 deaths in this population

      1 reply 0 retweets 3 likes
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    5. Health Nerd‏Verified account @GidMK 30 Sep 2020

      Now, what's the harm? Well, HCQ has a very good side-effect profile, and mostly causes transient issues that resolve. But, for long-term use, there's evidence that it increases the risk of heart issues i.e.https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(20)30276-9/fulltext#tbl2 …

      1 reply 0 retweets 2 likes
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    6. Health Nerd‏Verified account @GidMK 30 Sep 2020

      Now, the population in that study isn't exactly comparable to our general, healthy population, because it's a selected group. But leaving that aside, the absolute risk increase for cardiovascular death (dying from heart issues) is about 2 more events per 1,000 long-term userspic.twitter.com/r5DTP7Nq7l

      1 reply 0 retweets 3 likes
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    7. Health Nerd‏Verified account @GidMK 30 Sep 2020

      In other words, for every 1,000 people who use HCQ long-term, 2 would die of heart disease that would not have otherwise (again, based on a selected population, this risk may be lower in the general pop)

      1 reply 0 retweets 2 likes
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    8. Health Nerd‏Verified account @GidMK 30 Sep 2020

      Plugging those numbers in, we find that: 10,000*0.002 = 20 people will die because they are using HCQ long-term That's...actually not very good

      1 reply 0 retweets 6 likes
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    9. Health Nerd‏Verified account @GidMK 30 Sep 2020

      We've saved 2 lives from COVID-19 but sacrificed 20 lives due to the medication side-effects This is the problem with population interventions - even pretty rare things happen often when EVERYONE is at risk

      1 reply 2 retweets 17 likes
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      Health Nerd‏Verified account @GidMK 30 Sep 2020

      And the thing is that absolutely, the number I'm using - 2 extra heart deaths per 1,000 - is inflated. But even if it is 10 times lower, in a very large outbreak of COVID-19 (think NYC) HCQ would have no benefit to overall mortality

      3:52 PM - 30 Sep 2020
      • 4 Likes
      • Theo Matthieu H Arnoult 🏠☀️ Kelly Christopher R. Perle, PhD (Biologist, from birth)
      1 reply 0 retweets 4 likes
        1. Health Nerd‏Verified account @GidMK 30 Sep 2020

          This calculus doesn't necessarily invalidate or validate HCQ - if nothing else, it's very rough - but it's something worth considering I think

          0 replies 0 retweets 7 likes
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