THE question of the effectiveness of the anti-malarial drug hydroxychloroquine (HCQ) in treating Covid-19 remains contested.
There is a great deal of anecdotal evidence (and a number of studies) suggesting that, when used early, the treatment can help save lives and ease symptoms. I’ve previously reported on the debate surrounding the drug here and here.
However, a torrent of negative findings and media reports in the United States over the past few weeks makes the prospect of the treatment receiving any kind of official endorsement decidedly bleak.
For example, a study in New York found no statistical difference in the likelihood of death or intubation in the group that used the treatment compared with patients who were not treated.
However, this study has been criticised on a number of grounds, including the fact that patients were treated late. It has been suggested that numbers of patients treated early continue to have very high success rates. See this Twitter thread:
It seems that those trying to discredit this treatment are winning the war of the airwaves. However, the controversy is not stopping countries, and some states, using it widely. Here in the UK, it was reported last week that a pharmaceutical manufacturer will start making hydroxychloroquine amid fears that supplies will run out during the pandemic. Accord Healthcare announced it was importing 50 tonnes of raw chemical materials to its factory in Durham.
In other developments:
• Texas and Florida have secured their own supply of hydroxychloroquine and made it available for doctors to prescribe, while New York and New Jersey have restricted access.
Anecdotal reports, and other clinical research, suggest that hydroxychloroquine works best when used early on an outpatient basis – exactly where New York and New Jersey did not allow it.
The number of deaths per million in Texas and Florida is far below those in New York and New Jersey. Indeed, the ratio of active cases to recovered cases is shockingly high in New York, where outpatient use of hydroxychloroquine was banned, compared with Texas, where it wasn’t.
A peer-reviewed study of 1,061 patients published on May 5 found that, when administered early, the cheap drug combo hydroxychloroquine and azithromycin keeps Covid-19 from progressing into critical illness.
• Thousands have been given the treatment in southern France.
• A study carried out by the ANSM (National Agency for the Safety of Medicines and Health Products) found that the treatment was being used in Paris even more than in Marseille.
• Turkey’s Ministry of Health has also said that a relatively low death toll is thanks to treatment protocols in the country, which involve two existing drugs – hydroxychloroquine and the Japanese antiviral favipiravir.
• Algeria’s Health Minister says of hydroxychloroquine: ‘The indicators of use of this therapeutic protocol are encouraging and very satisfactory. I think the number of deaths has decreased thanks to this treatment.’
• A retrospective study from Spain showed treatment with hydroxychloroquine significantly improves survival in Covid-19 patients with mild symptoms and trends towards significance in moderate and severe patients.
Though clinical trials continue in many countries – including the UK and Australia – the jury is still out on the treatment’s efficacy. However, due to the politicisation of the issue, especially in the US, it is very difficult to sort fact from fiction.
What is clear is that there is a huge gap between the varying findings of different studies and the deluge of partisan-fuelled media hostility that has been launched at hydroxychloroquine.
It is shameful that politics appears to have interfered in the process of trying to understand the effectiveness of a potentially helpful drug in the midst of a pandemic.
If so, it is a monumental failure of government, the pharmaceutical industry and the so-called ‘experts’. It is an aspect of the response to Covid-19 that reveals the worst of human nature which we are likely to be discussing for years to come.