I'm so grateful for the lifesaving work done by the RECOVERY platform trialists: because of them we know that dexamethasone and tocilizumab save lives in severe COVID (and so use them), and that various other therapeutics don't work (and so are not tempted to use them) ...
... The important lesson is that we NEED A NATIONAL, PUBLICLY-FUNDED CLINICAL TRIAL SYSTEM IN THE US. We achieved nothing close to RECOVERY, despite our far greater size. So many more lives were lost as a result of our failure to aggressively, rapidly perform the needed trials.
The lives lost because of our failure to socialize such clinical research endeavors are largely invisible — but are no less real than those lost because of more direct forms of policy stupidity.
Doctors and patients, for the most part, CANNOT know the usefulness of particular treatments based on their own observations of apparent efficacy — this has nothing to do with shortfalls in individual perspicacity and everything to do with the ...
... inherent impossibility in perceiving real but slight improvements in probabilities of survival from the impenetrable haystack of observations that constitutes everyday life (and doctoring).
For that reason, there is not, and never will be, a substitute for trials. Only trials can tell us the efficacy of the vast majority of therapeutics. And only public funding can deliver the trials we need.
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