Please Don't Try A Coronavirus "Cure" Based On A Tweet

The anti-malaria drug hydroxychloroquine, in combination with other existing anti-viral drugs has been touted as a treatment for COVID-19. However, the evidence is so far inadequate and the drugs are dangerous if taken inappropriately. David Shao/Shutterstock.com

Several drugs already approved for other diseases are being tested against COVID-19. Everyone hopes some will work, saving millions of lives and potentially allowing us to ease restrictions long before we get a vaccine. Unfortunately, a rush appears to be starting of people taking these drugs without suitable medical supervision. Obviously this is a terrible idea, particularly when inspired by statements from those without medical training.

It probably won't surprise anyone to learn one of the major drivers of this irresponsible behavior.

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President Trump called for hydroxychloroquine and azithromycin to be “put in place IMMEDIATELY” and some people apparently interpreted this as instructions to individuals, not researchers or clinicians. This came two days after a press conference where Trump announced hydroxychloroquine and the similar drug chloroquine have been approved by the FDA for this use, forcing FDA Commissioner Stephen Hahn to clarify that is not actually the case

When asked if these drugs were known COVID-19 treatments by reporters at a press briefing the day before the tweet, Trump advisor Dr Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, responded: "The answer is no, and the evidence that you're talking about ... is anecdotal evidence.

There are several reasons why self-medicating with unproven drugs is incredibly dangerous, both for the individual and society as a whole.

1) These drugs really are unproven. What evidence we have comes from small samples. Many of the trials that have been done have not been peer-reviewed and reports may contain serious errors. Moreover, under the extreme pressures of such a fast-moving pandemic research hasn't always met the careful standards scientists usually aspire to. The study that inspired Trump had a small sample size, some of whom dropped out. There were noticeable differences between the patients given the drugs and the control group even before the trial started, rendering the results questionable.

Hydroxychloroquine, primarily used to treat malaria, but also with demonstrated benefits for some other conditions, has previously been proposed for use against several viral diseases. However, trials for both HIV and influenza proved disappointing.

2) Even if the drugs currently under trial turn out to work, dosage is important. Most drugs cause side effects if taken inappropriately. Without medical supervision you could do yourself a lot of harm. If you end up in a hospital because you experimented with drug combinations, you are also putting a strain on already strained resources.

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The repercussions of the US President's tweet – a megaphone heard around the world – appeared a day later in Nigeria after demand for chloroquine surged in Lagos and two people were hospitalized for chloroquine poisoning, Bloomberg reports

The same warnings apply to over-the-counter medications. One (not yet peer-reviewed) paper reports COVID-19 depletes potassium levels and finds preliminary evidence supplements may contribute to recovery. We don't yet know if this is true, but we definitely do know even quite modest doses of potassium can be poisonous. There is also no evidence potassium is any use in protecting people from catching the virus, even if it does turn out to be useful for those who have been infected.

3) These drugs are available because they are important, sometimes life-saving, for people with specific conditions. We've seen what happens when people panic-buy toilet paper or face masks. There are unconfirmed reports the same thing is already happening with drugs promoted as COVID-19 cures. If that keeps happening, people with pre-existing conditions won't need to contract SARS-CoV-2 to fall victim to this pandemic.

To steal a phrase from a former First Lady, to unproven drugs, Just Say No.

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