For months sharemarkets around the world have been running on a strange cocktail of COVID-19 research announcements, politics and liquidity. This week, Wall Street was boosted by data published by the New England Journal of Medicine which showed that Moderna’s coronavirus vaccine produced a “robust” immune response in 45 early trial patients.
But the strangest story in this saga is hydroxychloroquine. In March, US President Donald Trump called hydroxychloroquine, which is used to treat malaria and other conditions, a COVID-19 game changer.
Wall Street responded and had its biggest rise since 1933. Later Trump took the drug himself to ward off COVID-19.
Suddenly attitudes to the 60-year-old malaria drug became linked to the US political battle. The research started well, with the World Health Organisation testing hydroxychloroquine on 3500 COVID-19 patients at 400 hospitals, across 35 countries. But the drug was too closely tied to Trump and so the anti-hydroxychloroquine movement became vicious.
The infectious-disease specialist who briefed the President on the benefits was told to stop prescribing the drug to patients at a New York City hospital unless it was done via a clinical trial. It was an unprecedented action.
Suddenly studies emerged claiming hydroxychloroquine not only didn’t work but was dangerous.
The Lancet is among the world’s oldest and most respected general medical journals but got sucked in by this anti-hydroxychloroquine medical hysteria. And so Lancet in late May published data from Surgisphere to conclude that coronavirus patients taking hydroxychloroquine or chloroquine were more likely to die in the hospital.
The anti-hydroxychloroquine movement went into overdrove.
Within days of study’s publication, trials of hydroxychloroquine came to a stop, including part of the World Health Organisation’s trial of potential COVID-19 treatments. Hydroxychloroquine seemed dead in the water.
Then suddenly The Lancet released “an expression of concern” about the study, stating that “important scientific questions have been raised about data reported in the paper” and “an independent audit of the provenance and validity of the data has been commissioned by the authors not affiliated with Surgisphere and is ongoing”.
Later The Lancet withdrew the study, finding it was flawed.
Why was this false campaign launched? Some say it was anti-Trump and others say that big drug companies could see a fortune ahead in making high-priced cures and vaccines for coronavirus. There are no big profits from using hydroxychloroquine.
I am no expert in this area and I have no evidence in favour of the conspiracy theory but I can’t emphasise strongly enough that the drug is clearly not a comprehensive cure and must be administered early. It does not always work but the success rate has been notable.
In the US, the Henry Ford Health System looked at 2541 patients at six hospitals between March 10 and May 2. While 26.4 per cent of those who did not receive hydroxychloroquine died, only 13 per cent of those who did get the drug died.
The study concluded that treatment with hydroxychloroquine cut the death rate significantly in COVID-19 patients. Doctors associated with Ford declared: “Our analysis shows that using hydroxychloroquine helped saves lives.
“As doctors and scientists, we look to the data for insight. And the data here is clear that there was benefit to using the drug as a treatment for sick, hospitalised patients.”
The Ford study showed most of the patients were given hydroxychloroquine within 48 hours of admission, and scientists think the quick dosages may be a key to success.
In Vadodara, India, a major study involving more than 300,000 people including health workers and other frontline staff showed positive results with few side-effects.
That and other global studies led the Association of American Physicians and Surgeons to state that the anti-malaria drug hydroxychloroquine is being used safely and effectively to prevent COVID-19 in exposed workers.
Yet around the same time, Arizona’s governor issued an executive order specifically prohibiting its use. In the US, politics wins over medicine.
After reviewing new data on hydroxychloroquine, the WHO announced it would resume its study into the drug.
Some of the early evidence indicates that the drug works best when combined with zinc tablets because they enable zinc to enter infected cells on a scale not possible with normal zinc doses. But zinc is not always used.
Remember hydroxychloroquine has been around for almost 70 years as a treatment for malaria, lupus and rheumatoid arthritis.
The World Health Organisation has designated it as a safe and effective medication akin to taking an aspirin. A global survey of 6000 doctors affirmed it as their treatment of choice for COVID-19.
The Australian Health Department’s Health Protection Principal Committee (AHPPC) says there is “very limited evidence” to support the use of antimalarial drugs such as chloroquine and hydroxychloroquine for the treatment of COVID-19.
“Due to safety concerns, and the unknown effects of prescribing these medications for off-label usage, such as for COVID-19 infection, there are no current recommendations to treat patients with mild to moderate COVID-19 illness,” the AHPPC says.
Australia’s Walter and Hall Institute of Medical Research is studying using hydroxychloroquine as a preventive drug. This is how President Trump used it. Hopefully in Australia we can keep politics out of medicine.
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