Hydroxychloroquine (HCQ) has been widely recognized since its discovery in the 1940s, when its anti-malarial properties had an important role in the Pacific Theater in World War II. This medication is still used to treat and prevent malaria, as well as a treatment for lupus and rheumatoid arthritis. It is currently gaining traction in the media as one of the three most commonly prescribed treatments – the other two being analgesics and azithromycin – for COVID-19.
HCQ and azithromycin “taken together, have a real chance to be one of the biggest game changers in the history of medicine,” President Trump said on Twitter.
Sermo, an American healthcare polling company, polled 6,200 physicians in 30 countries over the span of 3 days in March. According to results, physicians chose HCQ as the most effective therapy for COVID-19 out of 15 different medications. A study conducted in early March at The Méditerranée Infection University Hospital Institute in Marseille, France, showed that HCQ is very effective in treating COVID-19 patients. Thirty-six patients with symptoms were treated, and twenty were given the drug while sixteen others served as the control. By the end of the study, results illustrated that azithromycin (a bacterial antibiotic) added to HCQ was considerably more efficient in virus elimination. Scientists stated that patients administered HCQ and azithromycin were cleared of the virus within three to six days, and that after the six days, 70% of patients given the medication were clear. By that time, only 12.5% of control patients who were not given HCQ had recovered. “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,” the French team concluded.
At first, the world sprang into action based on these results. On March 28th, the Federal Drug Administration (FDA) put an emergency use authorization for HCQ into place in order to treat patients hospitalized with the coronavirus. HCQ started to be prescribed by doctors in the United States, France, and Bahrain, while South Korea, India, and Belgium recommended its use. Specifically, health officials in South Korea, based on their own study, recommended that HCQ and azithromycin be used early on in the course of the illness. American doctors mostly prescribed the medication to high-risk patients, which may explain why, according to NBC News’ report, HCQ “does not have much of an effect on the sickest of patients”. This suggests that smaller studies, conducted outside of the United States, may have seen more cleared cases because the medication was administered equally to patients with severe and light symptoms.
So, with all of these results, full of promise and potential, why is the legitimacy of HCQ as a medication for coronavirus still under debate?
Dr. Anthony Fauci, a lead member on the White House Coronavirus Task Force and one of the United States’ top experts on infectious disease, claimed that information on the effectiveness of HCQ “was not [gathered] in a controlled clinical trial. So, you really can’t make any definitive statement about it.” Despite results with potential to cure as well as to promote optimism, health officials have warned the public to avoid HCQ until well-known organizations can conduct studies and produce evidence that validates smaller, existing studies. In turn, hospitals across the world are not using HCQ, claiming they are not authorized to administer medicine that lacks “scientific evidence” proving its benefits.
In late March, Nevada governor Steve Sisolak (D) issued an executive order that limited the use of HCQ and other anti-malarial drugs for COVID-19 patients, to guarantee their accessibility when “legitimate medical purposes” require them. New York governor Andrew Cuomo (D) has ordered that doctors cannot prescribe HCQ against COVID-19 via pharmacies – patients can only receive it in the hospital. Just yesterday, April 8th, the United States’ Centers for Disease Control and Prevention (CDC) removed information on early studies of HQC previously published on its website. Additionally, it is no longer offering dosage recommendations for HCQ usage for COVID-19.
Differences in opinion between President Trump, who displayed eagerness to start administering HCQ on a broader scale, and Dr. Fauci are becoming increasingly more apparent, leading to the formation of various conspiracy theories. One such theory, being pushed by the news media (MSNBC, New York Times, Washington Post), argues that President Trump is pushing the use of HCQ in order to benefit financially, as he holds shares within pharmaceutical companies that sell the drug.
Other theories, mostly shared on social media platforms, claim that Dr. Fauci is the pawn of the World Health Organization and some major nongovernmental organizations, shown in his dismissal and “downplaying” of HCQ.
As President Kennedy once said, “every accomplishment starts with the decision to try.” Why should the United States delay prescribing a promising treatment? Would it not be better to make a “decision to try” and possibly emerge as an international frontrunner in treating coronavirus?
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