Issue link: https://www.ascpskindeepdigital.com/i/1235208
for the latest info, visit https://www.ascpskincare.com/updates/blog-posts/coronavirus-and-your-practice 23 with wildly different approaches taken to disease staging (deciding when is the right time to apply certain types of treatment) and treatment approaches (choice of drugs, use of ventilators, etc.). 24 Some limited success has been seen in small trials and desperate cases. It is those small trials that have led to the current focus on chloroquine or its safer derivative, hydroxychloroquine, an anti-malarial drug, following reports of French trials based on Chinese in vitro (laboratory) studies. 25 The most recent commentary also notes that optimal safe dosage has not yet been established, that the drug can be highly toxic if misused, and makes it clear that more research is needed before we know for certain whether these, and other drugs have a replicable effect, and what the safe timing and dosage is. An early French nonrandomized trial on the use of chloroquine and hydroxychloroquine to treat COVID-19 featured a very small number of subjects (n=20) with mild to moderate symptoms. While cautiously positive, this study will need to be repeated with a much higher number of subjects, including severe cases (and this raises ethical concerns). 26 These are just some of the hindrances to finding appropriate treatments. Other drugs tested in more robustly designed clinical trials do not yet seem to have generated positive results. A recent Chinese trial of the HIV protease inhibitors lopinavir/ritonavir combination yielded no sign of benefits. 27 Two randomized controlled trials on Remdesivir—originally produced to treat Ebola—are available only in Chinese. Strong claims are being made in news reports stating there is clear evidence in favor of a Japanese antiviral drug called Favipiravir. 28 However, digging deeper, the current "evidence" consists of claims made by the pharmaceutical company producing the drug, a pre-print that has not yet been peer-reviewed; a small-scale, nonrandomized study published in an engineering journal based at the Chinese Academy of Engineering; That civil liberties have currently been curtailed wherever full lockdown has been instituted is true, but in all locations these rules have also been given expiry dates, with legislative and governing bodies obliged to review and reconsider them every few weeks as the situation evolves. It is also true that if this crisis lasts for more than a few weeks, the economic, social, and labor situations may be permanently changed, but that does not equate with a permanent restriction of freedoms. On the contrary, history has demonstrated that our temporary loss of civil liberties is likely to provide opportunities for growth, innovation, and perhaps, a unique chance to correct some of the most problematic systems in developed countries, including those that have impacted the environment. This is an area worth exploring, particularly if your business has been impacted by the current lockdown, and the links below provide commentaries and food for thought for those interested in exploring the question further. 22 An excellent source exploring related issues is the "SNF Agora Conversations," available through the Johns Hopkins hub, where experts from a variety of fields discuss and debate the political and policy implications of the handling of the COVID-19 crisis. 23 TRUE OR FALSE? We have the cure! Chloroquine has made international headlines, spurred on by recent US presidential statements. Numerous other drugs have been mentioned in international news sources as potential "cures" for COVID-19, with various governments ordering them by the truckload in the hope of lowering the mortality rate. Both the research and WHO guidelines reveal a rather different picture than the news reports. At the time of this writing, there is no proven effective intervention for COVID-19. The medication cocktails being used are off-label and highly experimental, this way. Secondly, global communication is not just freely available. It is enhanced at present, and at least in the Western world, there is no censoring of information. True conspiracies can only work under total secrecy; yet it is quite easy to confirm the veracity of the anguished reports coming from Italy, Spain, and elsewhere, and it is impossible to fabricate the amount of medical data being checked and double- checked before being undersigned by the WHO, CDC, and other major institutions. The rules of probability alone make it impossible to put all the moving parts of this unfolding crisis down to a global conspiracy. History teaches us that this kind of pressure in fact reveals hidden fault lines and social dramas within society; that is a far more interesting—and sobering—line of inquiry, since human judgment error in crisis management right now is a far more realistic and dangerous scenario than any secret elites plotting global domination. 21