“Hydroxychloroquine doesn’t have an RCT and remdesivir does!” Yes, true, and ALSO notice that hydroxychloroquine is a cheap generic so there’s nobody to *pay* for a big RCT.
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And the public only knows about hydroxychloroquine because there’s this one doc with a bee in his bonnet about it (and he’s probably biased and sloppy and goes to the media too early and exaggerates.)
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If it’s a cheap generic that *doesn’t* have a crazed fanboy, it’ll have even less apparent “success.” When was the last time you heard Discourse about indomethacin or niclosamide?
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If you don’t like that the “standard of care” is biased towards the interests of a handful of pharma companies...maybe the problem is that you need to be a hundred-billion-dollar company to run a clinical trial that satisfies today’s FDA?
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Replying to @s_r_constantin
Is there any account of folks in positions of influence soberly realizing that the FDA can do more harm than good as a result of the pandemic?
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Replying to @maxefremov
The FDA has loosened many of its usual restrictions because of the pandemic. The concept of risk-benefit tradeoffs is, I expect, very familiar to them. “Deregulation can ever be good” is clearly a notion the Trump administration has heard of.
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Replying to @s_r_constantin @maxefremov
Actually deregulating to the extent I support would require what is commonly called “fanaticism” — willingness to keep pushing against resistance to the point of becoming a boor — which I think is selected against in all leadership positions, public or private.
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Replying to @s_r_constantin @maxefremov
“I don’t care how nice, smart, or “reasonable” you are, I’m not gonna accept your excuses until the cost (or death rate, or w/e) goes down” is the attitude you need here.
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Replying to @s_r_constantin @maxefremov
Because bureaucrats *are* nice, sincere, and extremely well educated. They will always have plausible reasons, which they actually believe, why some source of delay or cost is necessary. And, typically, you will get your explanation and feel sheepish and not push.
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Replying to @s_r_constantin @maxefremov
(Trump is a boor but not a fanatic; he is willing to “disrespect” experts by pushing them on timelines and asking “stupid” but often essential questions, but he’s *not* monomaniacally focused on a single desired outcome, no matter the social cost.)
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Jeff Bezos is, by all accounts, a fanatic in this sense about cost-cutting within Amazon. I am not sure we have ever had a fanatic US President.
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Replying to @s_r_constantin @maxefremov
A fanatic asks “ok but does it help with the Outcome?” every. single. time. to the point where if upending his own organization will help, he’ll do that. Larry Kramer was a fanatic. That’s why he got kicked out of the org he founded.
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Replying to @s_r_constantin @maxefremov
When you meet a fanatic, you realize how many of your preconceptions about “necessity” are fake. “But you Need to pay a salary this high!” Do you? Or could you relocate to somewhere unfashionable? hire people who didn’t go to fancy schools but can still do the work?
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