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Trump and the hydroxychloroquine panic: sorting the facts from the spin

Donald Trump has several times referred to the possibility of using the anti-malarial drug hydroxychloroquine as a preventative against coronavirus. Despite not being the only person to do so, and despite the fact that the use of the drug is being subject to many clinical trials, Trump’s statement, and his May 18 reference to taking the drug personally, are cited by those who hate him as more evidence of his being either mad or stupid.

Others have claimed that there is strong scientific evidence against the use of hydroxychloroquine, and that it is unsafe and dangerous with fatal side effects. This is untrue. As with any other drug being tested for a possible new function, there is as yet “insufficient evidence” regarding its efficacy or otherwise as a possible preventative against this particular virus, but hydroxychloroquine, when administered under the direction of a medical professional, has been used safely for decades in the treatment of malaria, lupus and other conditions.

The search for a vaccine has been given top priority but there is not a great deal of optimism regarding the possibility of discovering one before the end of 2020. In that context there are obviously going to be many proposals, some of them more plausible than others, regarding the possible use of already existing drugs.

Hydroxychloroquine is actually one of the suggestions with possibilities, taken seriously enough to be now subject to global testing, but it is still a long shot. All Trump did was to refer to that possibility and that he had put his money where his mouth was by taking it himself.

So far, there seems to be mixed results as to its efficacy. One retrospective analysis (not a controlled study) published this week in The Lancet looked at patient’s medical records and found that there seemed to be an increased risk of death for those given hydroxychloroquine and an antibiotic. However, the preliminary results of a study from the Grossman School of Medicine has found that patients given a combination of hydroxychloroquine, azithromycin and zinc sulfate were 1.5 times more likely to recover and be discharged, and 44% less likely to die. The addition of Zinc sulfate, it is suggested, may be key to the improved outcomes for the treatment.

In Britain, a major trial of hydroxychloroquine is about to begin. It is part of a world wide project initiated by the Mahidol Oxford Tropical Medicine Research Unit (MORU) which is based in Bangkok and is supported by a range of prestigious academic medical institutions and the medical research charity, The Wellcome Trust.

The drug is already being tested in trials conducted across a wide range of countries and has even been approved for limited use in the treatment of some people who have been infected with the virus.

The British trials will involve volunteers, mainly NHS professionals, who have been in direct contact with people infected with the virus. Trials will be conducted at 25 sites and results are expected by the end of the year. Professor Mark Llewelyn who is one of the key people involved has stated that the discovery of a safe vaccine is potentially a “long way off,” but that proof that chloroquine and hydroxychloroquine might prove to be such a preventative would be “incredibly valuable.”

Interestingly, the British public sector union Unison which represents many NHS employees has not objected to the tests and would be in a position to instruct its members not to take part if it were opposed. Unison would be considered to be a left wing union and certainly not one that takes its lead from President Trump.

With regard to side effects, hydroxychloroquine is considered after over 60 years of use as an effective weapon against malaria to be “very safe.” That flies in the face of hysterical and politically motivated claims that it can cause life threatening heart and other problems in the general population.

It begs the obvious question: if that was the case then why would its use among the general population as a potential preventative against covid 19 produce any different side effects than its use among the general population in countries where malaria is still a current threat?

The fact is that the documented side effects of hydroxychloroquine are mild; and consist among a small number of users of headaches, upset stomach, and very rarely non life threatening heart conditions. There should then be no serious threat to those being tested as part of the trials.

Then again, as with the canard that Trump had encouraged people to inject themselves with disinfectant, the distortion of the facts is part of the increasingly desperate attempts to replace him with Joe ‘you ain’t black if you don’t vote for me’ Biden, and its echoes among the rather dim left outside of America, is the priority for many above any pretence of concerns in tackling coronavirus.

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