One of the stranger little Coronavirus culture wars that’s been ongoing in recent months has been the great struggle between those who are convinced that Hydroxychloroquine, a medicine usually used to treat Malaria, is an effective treatment for Covid 19, and those that aren’t.
Much like all the great culture war fights of our time, this one started with President Trump:
This weekend, Donald Trump used his daily White House coronavirus briefings to again urge Americans to take hydroxychloroquine, an anti-malaria drug that has not been shown to be safe or effective against Covid-19.
“What do you have to lose? Take it,” the president said on Saturday as he boasted that the US had amassed 29m doses of the drug. On Sunday, facing questions from the press about his aggressive promotion of an unproven treatment, he argued against waiting for the completion of clinical trials. “In France, they had a very good test,” he said. “But we don’t have time to go and say, ‘Gee, let’s take a couple of years and test it out, and let’s go and test with the test tubes and the laboratories.’”
Love him or loathe him, there is no politician on earth with quite the same level of influence over people as President Trump, because there are almost no other circumstances imaginable where a politician saying something might lead to things like this happening. But happen, it did:
An Arizona man has died and his wife is in a critical condition after both ingested chloroquine phosphate in an apparent effort to stave off Covid-19.
President Donald Trump has touted the medication form of chloroquine as a possible treatment for the virus.
But the toxic ingredient taken by the Phoenix couple was a chemical commonly used to clean fish tanks.
Shortly after ingestion, the couple fell ill, said Arizona-based hospital system Banner Health.
The couple were both in their 60s.
But, that horrendous episode aside, it did seem for a while as if Trump might be onto something. The initial results for Hydroxychloroquine (the drug, not the fish tank cleaner) did, in fact, seem promising:
In February, a research group led by virologist Manli Wang of the Chinese Academy of Sciences put the idea to the test and found that chloroquine successfully stopped the spread of SARS-CoV-2 in cultured human cells. Preliminary reports from China, South Korea and France suggest that the treatment is at least somewhat effective in treating human patients, and some hospitals in the U.S. have begun administering the drug, according to The New York Times. In addition, the FDA is organizing a large clinical trial to formally assess the drug’s effects, the Times reported.
There was even some speculation that Chloroquine was a treatment used by doctors in the case of UK Prime Minister Boris Johnson, on the advice of the Trump administration:
Donald Trump last night asked two drug giants working with the US government on experimental drugs to ‘contact London’ and offer the PM support. Number 10 today thanked the President and said officials are in ‘constant contact’ with US officials.
Mr Johnson is being cared for at St Thomas’ Hospital, a central London hospital involved with major trials of experimental drugs on COVID-19 patients.
The medicines – including the promising antimalarial drug hydroxychloroquine – have been approved by drug regulators for clinical trial purposes only.
Whether Johnson did receive Chloroquine, we do not know. What we do know, unfortunately, is that having mentioned the drug almost every day for about six weeks, President Trump has suddenly stopped mentioning it altogether:
Although Trump had repeatedly promoted the decades-old malaria drug since the early days of the disease’s outbreak in the United States, his public statements regarding hydroxychloroquine have diminished significantly over the past week for reasons that remain unclear.
His most recent mention of the drug at the White House’s daily coronavirus news conferences came last Tuesday, when the president announced his administration had deployed roughly 28 million doses of hydroxychloroquine from the federal government’s Strategic National Stockpile.
Earlier at that same briefing, though, the president also trumpeted remdesivir, another experimental treatment developed by the biopharmaceutical company Gilead, and spoke positively of its “promising results.”
Why is that? Well, unfortunately, the mounting clinical evidence is not good:
Researchers analyzed medical records of 368 male veterans hospitalized with confirmed coronavirus infection at Veterans Health Administration medical centers who died or were discharged by April 11.
About 28% who were given hydroxychloroquine plus usual care died, versus 11% of those getting routine care alone. About 22% of those getting the drug plus azithromycin died too, but the difference between that group and usual care was not considered large enough to rule out other factors that could have affected survival.
Hydroxychloroquine made no difference in the need for a breathing machine, either.
Researchers did not track side effects, but noted a hint that hydroxychloroquine might have damaged other organs. The drug has long been known to have potentially serious side effects, including altering the heartbeat in a way that could lead to sudden death.
People who were given it were actually more than twice as likely to die as those who did not receive it.
Of course, the odd thing about medicine is that this isn’t evidence, per se, that the drug doesn’t work. It’s quite possible that it’s a good treatment for some people, and a terrible treatment for others. As the AP notes there, it has very serious side effects. Give it to somebody with a dodgy heart, and well, goodnight.
One of the studies actually notes that Chloroquine might work, but only in doses so high as to be dangerous for humans, rendering it interesting but useless, and meaning that Trump wasn’t wrong in principle, only in practice.
But this is much more encouraging:
A young COVID-19 patient at the Children’s Hospital of Philadelphia is recovering after receiving donated plasma, marking a possible breakthrough in the fight against the coronavirus pandemic.
Experts say those who have fully recovered from COVID-19 have antibodies in their plasma that can attack the virus. Now there’s a nationwide effort to collect blood plasma from recovered COVID-19 patients to assist in treating those currently ill with the disease or perhaps prevent others, like front-line medical workers, from getting the virus at all.
CHOP announced they successfully treated their first pediatric COVID-19 treatment with donated plasma.
The idea behind plasma treatment is very simple. Basically, if I have the virus, and recover, I should still have antibodies for it in my blood plasma. If my plasma is then given to you, you should get those antibodies too, boosting your immune response to the virus. It’s complicated stuff, but the concept is relatively simple.
Of course, this will also require clinical trials, and extensive testing, so don’t go drinking the next thing you see with “Plasma” written on it, like those two poor people in Arizona.