A new model needs to be developed for studies like this. The old model was ok for a different world, without AI and other advances. The current model could be likened to still trying to connect to the internet with dial-up and modem.
The “new model” you’re looking for has been with us a long time in the cancer field.
That’s why cancer treatment is advancing so rapidly today. Doctors are often dealing with patients that have exhausted all treatments and are still dying, so they try something else off label. Most of the time, it probably doesn’t work and the patient eventually dies of cancer.
But once in a while it DOES work, maybe if it’s even just a fluke. But the doctor remembers it and will try it again in a similar situation. Maybe it works again. Now he’s excited so he tells a colleague who also tries it. And it works for his patient too. Now the first doctor is really excited, and the second one is curious.
This process extends itself until enough patients have responded favorably that the doctors are sharing it, informally at first, and then formally, at conferences. More and more patients are surviving.
Only after all that, does a clinical trial get proposed and what has been happening all along finally gets gold standard confirmation. Or that trial might never be done at all, since it’s extremely expensive and of little value at that point anyway.
For example, has a gold standard trial every been done confirming that hydroxychloroquine works for lupus patients, or for rheumatoid arthritis patients? I don’t know the answer to that, but I’d bet that the discovery of it’s effectiveness was made off label more or less as I described above. The value of the original malaria trial(s) was that it confirmed not only efficacy, but SAFETY. Once declared safe, off label drug use is common when known treatments fail.
Disclaimer: I am not a doctor nor am I in the medical field. But this is how I’ve perceived cancer treatment to progress over the past few decades. I could be wrong.
The work on chloroquine was abandoned after sars was believed eradicated. Perhaps now we know that next time such work should be continued. The RdRP interference mechanism has important implications for HIV too.
Fauci and Birx will want a three stage clinical trial spread out over three years. That’s not the way the west was won.