I do my best not to censor comments left on my blog posts, which must be approved by me before they're published. But I'm going to change that rule for comments relating to the coronavirus pandemic.
Facts, truth, and science are our best weapons against COVID-19. So I have zero tolerance for people who spread untruths about it. I apologize for not acting sooner to prevent some false comments from being published. But better late than never.
Specifically, ignore anyone who says that hydroxychloroquine should be taken without a doctor's order to either prevent or treat a coronavirus infection.
This should never be done. It can be extremely harmful, even deadly. There are clinical trials of hydroxychloroquine underway. Doctors have the authority, in the United States at least, to prescribe it for COVID-19 patients.
So do not, repeat, do not, take it on your own, and do not, repeat, do not, give it to anyone else, like a family member or friend.
I'm ashamed that the president of the United States, the hugely incompetent Donald J. Trump, has been promoting hydroxychloroquine in his rambling, incoherent, mostly fact-free White House coronavirus briefings. The fact that Trump favors the drug is a strong argument against using it, since almost always Trump is on the wrong side of the truth/lies divide.
Understand: it may turn out that hydroxychloroquine is a worthwhile drug to use in the treatment of COVID-19. However, medical experts are warning against its use outside of a well-informed decision by a doctor to use it for this purpose, or in a clinical trial.
The Atlantic has a good story on this subject, "Why Does the President Keep Pushing a Malaria Drug?" It's written by James Hamblin, a physician who teaches public health at Yale University. Excerpts:
Based on the limited evidence so far, giving hydroxychloroquine to people could very well be—as with most drugs that modulate the immune system—of some benefit in some circumstances. Some people will be made sicker by it, depending on underlying physiology, other medications they’re taking, timing, and dosing. Identifying who stands to benefit and why requires data, and several randomized controlled studies of hydroxychloroquine are under way.
But Trump has plunged ahead. On March 28, amid his constant enthusiasm, the FDA issued an emergency authorization allowing the use of hydroxychloroquine for treatment of COVID-19. Even still, the agency urged that the drug should be given only to patients “for whom a clinical trial is not available, or participation is not feasible.”
Some hospitals in the U.S., including Massachusetts General Hospital, have begun incorporating hydroxychloroquine into treatment protocols, at the discretion of an infectious-disease specialist. Other institutions are more guarded. At the University of Washington, doctors are advised in official treatment policy that although the drug has been shown to inhibit replication of the virus in cultures of monkey kidney cells, “it has not been shown to be an effective antiviral” in living organisms. The University of Michigan Medical School advises its doctors that “the current body of literature and local experience does not support the routine use of any specific treatment regimen, including hydroxychloroquine, for patients with confirmed COVID-19 infection.”
...On Saturday, Trump suggested research exists that shows people with lupus don’t get the coronavirus, implying that their use of hydroxychloroquine protects them. “There’s a rumor out there that because it takes care of lupus very effectively, as I understand it, and it’s a, you know, a drug that’s used for lupus,” he said, “so there’s a study out there that says people that have lupus haven’t been catching this virus. Maybe it’s true; maybe it’s not.”
There is no such study.
In fact, it appears that people with lupus who have been taking hydroxychloroquine for that condition have been infected with the coronavirus. So says a doctor.
Given the surge in eBay sales of chloroquine phosphate, and the anecdotal reports in Arizona and Nigeria of patients poisoning themselves by self-administering chloroquine formulations, there’s concern throughout the public health community that Trump’s exhortations to try the drug could do more harm than good. Of course, Trump isn’t encouraging self-medication, telling Americans instead to “go through your medical people.”
So what do the medical people say? Jeremy Faust, an emergency physician at Harvard Medical School and Brigham and Women’s Hospital in Boston, has attempted to caution against the idea of hydroxychloroquine as a preventive medication. He tweeted Sunday: “Patients with lupus, arthritis, other conditions are *already* on hydroxychloroquine. And we are diagnosing them with Covid-19 LEFT AND RIGHT.”
To repeat, don't believe false rumors on the internet about hydroxychloroquine. Don't accept anecdotal reports that it is OK to self-treat yourself with this drug. Do take hydroxychloroquine if you have COVID-19 and your doctor has prescribed it.
A story in The Guardian also is worth reading. Here's an excerpt from "Trump touts hydroxychloroquine as a cure for Covid-19. Don't believe the hype."
Why is Trump touting it?
Trump was influenced by a widely publicized study in France where 40 coronavirus patients were given hydroxychloroquine, with more than half experiencing the clearing of their airways within three to six days. This apparent improvement is important as it would curtail the timeframe in which infected people could spread Covid-19 to others.
However, experts have warned that the study is small and lacks sufficient rigor to be classed as evidence of a potential treatment. The French health ministry has warned against the use of hydroxychloroquine for Covid-19, with Olivier Véran, France’s health minister, saying that it shouldn’t be used by anyone with the exception of “serious forms of hospitalization and on the collegial decision of doctors and under strict medical supervision”.
What does the evidence show?
The French study followed work by Chinese researchers which suggested that hydroxychloroquine can slow infections from Sars-CoV-2, the virus behind Covid-19, by blocking it from entering cells in the body. But more recent, albeit small-scale, research from China has shown that patients who were treated with the drugs fought off coronavirus no more quickly than those who didn’t get it. Indeed, one patient given hydroxychloroquine severely worsened in condition while four patients on the medicine developed signs of liver damage and experienced diarrhea.
Regardless of these findings, any drug being used for a certain purpose before full clinical trials are completed is, by definition, untested and unproven. It’s too early to say if hydroxychloroquine can have a major benefit or not.
The European Medicines Agency, an agency of the EU, has said hydroxychloroquine should not be taken by coronavirus patients except for clinical trials or emergency use programs.
As always, follow the science. Lives depend on it.
And don't bother leaving a comment on this post about hydroxychloroquine that isn't backed up by a reputable source. You'll just be wasting your time, because it won't be published. On the other hand, include a link to a good source of scientific information, and likely I'll approve your comment.