COVID-19: Will Hydroxychloroquine Work?
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Hydroxychloroquine was not a household name when the year started. Outside of the world of virology, few Americans had heard of the malaria drug, let alone considered taking it. That is, until President Donald Trump suggested it as a potential treatment for COVID-19 during a March 20th press conference. With more than a dozen clinical trials underway — and little (if any) evidence in his favor — Trump remarked, “I sure as hell think we ought to give [hydroxychloroquine] a try.” The next day, he tweeted that the drug had the potential to be “one of the biggest game changers in the history of medicine,” particularly in combination with azithromycin.
His comments created a firestorm. Concerned Americans began scrambling to get their hands on the drug, further burdening the already strained medical supply chain. Global health experts, for their part, went on the offensive to discourage reckless self-medication.
A Potential Cure?
President Trump was not the first to stoke speculation that hydroxychloroquine might help treat COVID-19. His now-infamous press conference came just a few days after a promising, if highly-flawed, French study. In the early weeks of March, French researchers found that the drug was “effective” in quickly alleviating upper respiratory systems. “Such results,” they wrote, “open the possibility of an international strategy to decisionmakers to fight this emerging viral infection in real-time.” They even went to far as to conclude, “We therefore recommend that COVID-19 patients be treated with hydroxychloroquine and azithromycin to cure their infection and to limit the transmission of the virus to other people in order to curb the spread of COVID-19 in the world.”
The study’s scientific merit, however, is dubious. In addition to examining a tiny sample of just 36 patients, the study was neither randomized nor blind. Dr. Anthony Fauci, perhaps America’s preeminent expert on infectious diseases, addressed the study and his misgivings during the same press conference. Responding directly to the president, he noted, “The information that you are referring to specifically is anecdotal . . . so you really can’t make any definitive statement about it.”
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While the President has avoided discussing the drug’s potential side effects, doctors are well aware of hydroxychloroquine’s drawbacks. These can include retinal damage, cardiac arrhythmia, and hallucinations, in addition to reactions with other medication. Patients who are already prescribed hydroxychloroquine are now experiencing an unexpected side effect of COVID-19: dwindling supplies of necessary medication. At least one major healthcare network, Kaiser Permanente, stopped filling out routine hydroxychloroquine prescriptions for diseases like Lupus. In an email, the company informed members that they were “conserving the critical supply for those who are critically ill with COVID-19” before thanking them for making such a “sacrifice.”
A new U.S. study casts even more doubt on hydroxychroloquine’s efficacy. On April 21st, a team of scientists based in Virginia and South Carolina published the findings of a retrospective study on COVID-19 treatment at veteran’s hospitals. They not only found no evidence that hydroxychloroquine will cure COVID-19, but actually saw more fatalities among patients who received the drug.
With around 360 subjects, the trial is still much too small to draw definite conclusions and has not been peer reviewed. It is, however, the largest study of its kind to date. While the authors concluded that more research is necessary, their report was sufficient to quiet some of the calls for hydroxychloroquine treatments. As Vox reports, Dr. Mehmet Oz appeared to distance himself from the drug during a Fox News interview on the 23rd. “We are better off waiting for the randomized trials Dr. Fauci has called for,” he said. This is a far cry from the Op-Ed he published in the Washington Examiner earlier this month. That piece encouraged doctors and healthcare providers to “march into battle with the army we have” and begin administering hydroxychloroquine more widely.
Last week, researchers at the University of Chicago shared some more promising findings. They have seen a number of COVID-19 patients recover after receiving another antiviral drug, Gilead Science’s remdesivir. Earlier this month, the New England Journal of Medicine published similar findings from trials around the globe. These, too, are both promising and insufficient to draw definitive conclusions.
As more studies are published and more potential cures are proffered, seniors are advised to stay calm and identify trustworthy news sources.