Many different drugs found to kill the SARS-CoV-2 virus in the lab are now being tested to see if they are effective in humans. One, however, has attracted far more attention than all the rest, leading some people to act in dangerous ways.
Hydroxychloroquine and the closely related chloroquine are drugs known to be effective against malaria and lupus, but they also carry serious risks. Its potential against a number of other diseases is under investigation, including as a promising candidate for Covid-19. After one small, flawed study created a buzz and reached President Trump, things started to go wrong.
Trump praised a combination of hydroxychloroquine and the antibiotic azithromycin in tweets and at press conferences. Initially, this led to some people buying all the hydroxychloroquine they could obtain to take themselves, leading to a shortage for those with lupus.
Not only that but NPR reports that Dr Robin Armstrong in Texas has started giving patients hydroxychloroquine in an unregistered trial. Worse still, there is considerable doubt about whether the patients involved gave informed consent. Dr Armstrong admitted to not telling families he was giving the drug to their relatives when patients couldn't consent. Having played down the drug's risks in an interview with the Houston Chronicle, it seems unlikely those given the drug were alerted to the full list of side-effects. NIH-registered trials require extensive paperwork precisely so everyone can see what patients are being told. By using his political contacts to create an “observational study”, Armstrong appears to have avoided these.
Meanwhile, several trials of hydroxychloroquine/chloroquine have been abandoned because of the serious side effects, including potentially fatal irregular heart rates. Other trials failed to find any benefits from the drug. Many medical experts remain cautious about the drug.
"There may be a role for it for some people,” Dr Megan L. Ranney of Brown University told The New York Times, “but to tell Americans ‘you don’t have anything to lose,’ that’s not true. People certainly have something to lose by taking it indiscriminately.”
Meanwhile, anti-vaxxers are spreading the claim hydroxychloroquine is such a miracle cure that we don't need vaccines at all. Ridiculous as the idea is, it may sound credible to those immersed in the hydroxychloroquine hype. It is indeed possible hydroxychloroquine, perhaps in combination with other drugs, will prove helpful for some people, which is why several proper trials continue. However, its supporters, including Brazilian President Jair Bolsonaro and Trump lawyer Rudy Giuliani, have gone beyond claiming it works to describing it as a silver-bullet, capable of saving everyone infected with the virus. We already know this is not true.
Hydroxychloroquine is reportedly being widely used in Italy and Spain, and it has not stopped the death toll there, leading experts to conclude that if it works at all the benefits are modest. In March, Dr Anthony Fauci, director of the National Institute for Allergy and Infectious Diseases, and the president's leading advisor on Covid-19 described the reported benefits of hyroxychloroquine as "anecdotal" and there are no signs his position has changed.
