Promising COVID-19 Treatment Faces Political Hurdles
Hydroxychloroquine (HCQ) is part of recommended treatment for COVID-19 in modern healthcare systems around the world, and every day brings new evidence that appears to support this judgment call by overseas public health authorities. Sadly the U.S. is the only country on earth where the drug has become a toxic political football — due entirely to President Trump’s endorsement.
With over 150 trials underway in the U.S. and worldwide to see if HCQ does indeed help COVID-19 patients, we must remove our partisan glasses so we can clearly interpret the results — and maybe even gain valuable insights into the functioning of the virus itself.
In the last few days, new studies have shown improvement in patient outcomes associated with HCQ. A peer-reviewed analysis of 1,061 COVID-19 cases treated with a combination of HCQ and azithromycin in France concluded that early treatment was safe and associated with very low fatality rate. Two more studies, while not yet peer-reviewed, reported that treatment with HCQ was significantly associated with fewer deaths among critically ill COVID-19 patients in China, and that early treatment may have increased survival of COVID-19 patients in Spain.
But you likely won’t hear about any of this. Instead, you’ll probably hear that HCQ doesn’t work, according to a new study in the New England Journal of Medicine. The media’s eagerness to exaggerate limited studies like this one — which looked mainly at very sick patients given HCQ and concluded that proper trials are needed — is blinding us to the developing story of the worldwide search for an effective treatment.
From the early days of the pandemic, various countries in Asia and Europe began adopting HCQ as the recommended treatment for COVID-19. We published a review of the international timeline showing President Trump was in step with the global medical mainstream when he recommended these medicines on March 19.
Advanced national health systems were already using HCQ to treat COVID-19 in South Korea, Italy, Spain, and Turkey. (Notably, in Turkey, recovered patients now outnumber active COVID-19 cases.) And the World Health Organization included HCQ in its global study of the most promising drugs to treat COVID-19 on March 11. Today, almost every country impacted by the virus either actively recommends HCQ, allows doctors to prescribe it, or is studying the medicine in clinical trials.
The U.S. discussion simply does not track this global reality. Following mainstream media coverage here, you’d never know that HCQ has long been recognized as a relatively safe medicine, used to treat millions of patients for multiple diseases going back decades.
It is also recognized as having wide potential: even before the COVID-19 pandemic, HCQ was being studied as a potential treatment for all sorts of conditions. The National Clinical Trials database contains hundreds of recent studies of HCQ as a treatment for HIV, hepatitis C, breast cancer, melanoma, soft tissue sarcoma, metastatic prostate cancer, Crohn’s Disease, Hashimoto’s thyroiditis, cystic fibrosis, alopecia, and chronic graft-versus-host disease, as well as thrombosis prevention and post-surgical wound recovery.
Of course, this does not mean HCQ is guaranteed to work against these diseases, or against COVID-19. But it does mean that many doctors and scientists see potential in the drug, which is already widely and safely used both for recognized treatment purposes and in cutting-edge research. It would be irrational to let politics blind us to the potential.
Yet reporters brush aside these facts aside to seize on any news that can fit their preferred narrative, in which Trump touted a potentially harmful medicine and endangered Americans. Not much more seriously, pundits hold up flawed studies — for example, of treating COVID-19 in elderly patients with significant comorbidities — as definitive evidence that HCQ kills.
These media pathologies hurt us all. According to Dr. David Boulware, the FDA’s public announcement to “reiterate importance of close patient supervision” — amplified by the press — had a chilling effect on participation in a University of Minnesota trial he is overseeing.
Top U.S. medical schools, hospitals systems, and respected institutions from the Gates Foundation to the Pentagon are running clinical trials to test HCQ against COVID-19. We should be supporting this process — not rooting for these efforts to fail.
Some of these studies may advance our knowledge of COVID-19 itself. To cite just one example, Dr. Adam Brufsky, a breast cancer specialist at the University of Pittsburgh School of Medicine who is familiar with HCQ from years of use, theorized in the Journal of Medical Virology that the severity of COVID-19 disease — and potentially even its spread from person to person — might be associated with elevated concentrations of sugar molecules in the bloodstream. If further research confirms that HCQ works by interrupting a link between blood sugar and virality, we’ll be one step closer to defeating COVID-19.
When the Germans surrounded Allied soldiers at Dunkirk, a flotilla of private boats — the “Little Ships” — answered the call to help lift them out. Only afterwards could the longer-term process of planning and building the D-Day invasion begin. An undoubted improvisation, HCQ could be one of today’s “Little Ships,” as it is among the few drugs we have now showing promise. We must continue to test it, study the results as they come in and — where doctors judge it appropriate — use it more broadly as treatment. Many around the world, and also here at home, are doing just that. Our national conversation needs to reflect this.
Erik Sass is Editor-in-Chief of The Economic Standard and author of popular history books.